 This parametric comparative trial will randomly assign 140 inner-city adolescents with ADHD to 1 CASH-AA Only or 2 CASH-AA MIP. Treatment will occur in community behavioral health clinics. All participants will receive behavioral interventions CASH-AA: family psychoeducation in ADHD symptoms, executive functioning, and developmental impacts; family-based motivation and ADHD accommodation interventions; and academic training focused on home environment support and organizational skills. Half of the participants will also receive medication decision-making interventions MIP: ADHD medication psychoeducation, family decision-making interventions, and for those who elect to start medication coordinated medication management. Half of the sample will have comorbid substance use problems. Treatment will occur in three community clinics; therapists will be randomly assigned to study condition. Caregivers and adolescents will complete assessments at baseline, 3, 6, and 12-month follow-up. Multilevel modeling will compare the effectiveness of each condition on key patient and service use outcomes. Patient-centered analyses will explore differential treatment effects based on a Medication decision yesno; b Substance use comorbidity yesno; c RaceEthnicity Hispanic, African American. 