Architectural technical debt in software-intensive systems is a metaphor used to describe the “big” design decisions (e.g., choices regarding structure, frameworks, technologies, languages, etc.) that, while being suitable or even optimal when made, significantly hinder progress in the future. While other types of debt, such as code-level technical debt, can be readily detected by static analyzers, and often be refactored with minimal or only incremental efforts, architectural debt is hard to be identified, of wide-ranging remediation cost, daunting, and often avoided. In this study, we aim at developing a better understanding of how software development organizations conceptualize architectural debt, and how they deal with it. In order to do so, in this investigation we apply a mixed empirical method, constituted by a grounded theory study followed by focus groups. With the grounded theory method we construct a theory on architectural technical debt by eliciting qualitative data from software architects and senior technical staff from a wide range of heterogeneous software development organizations. We applied the focus group method to evaluate the emerging theory and refine it according to the new data collected. The result of the study, i.e., a theory emerging from the gathered data, constitutes an encompassing conceptual model of architectural technical debt, identifying and relating concepts such as its symptoms, causes, consequences, management strategies, and communication problems. From the conducted focus groups, we assessed that the theory adheres to the four evaluation criteria of classic grounded theory, i.e., the theory fits its underlying data, is able to work, has relevance, and is modifiable as new data appears. By grounding the findings in empirical evidence, the theory provides researchers and practitioners with novel knowledge on the crucial factors of architectural technical debt experienced in industrial contexts.