Adolescents with ADHD experience serious impairment that taxes our education, mental health, and healthcare systems as well as the children and families. The development and evaluation of effective treatments for these youth have lagged far behind that of many other disorders and age groups. This manuscript describes the treatment development process for a school-based comprehensive care model for treating middle-school aged youth with ADHD. An overview of the development process is described as well as future directions. Specific interventions that comprise the Challenging Horizons Program (CHP) are explained as well as their feasibility in public middle schools.