Working with teens exposed to trauma who are engaging in high-risk behaviors can be challenging for the caring adults in their lives. Understanding that trauma is often underlying and driving these behaviors can help approach teens with more compassion, empathy, and a better understanding of how to help them. This book chapter is written to be practical and meaningful for a range of clinical and non-clinical providers working with teens. This chapter also provides an overview of risky behaviors in the context of trauma, uses case examples to bring concrete strategies and approaches to life, and reviews evidence-based, trauma informed interventions that can be utilized to best support teens.