Drama therapy is an emerging mental health practice in North American schools. Yet little research has focused directly on the role of drama therapists in schools or their service navigation practices and challenges. From February to July of 2018, drama therapists affiliated with the North American Drama Therapy Association currently working in North American schools were invited to participate in an online Qualtrics survey. A qualitative thematic analysis was conducted on open-ended response items, the results of which reflect drama therapists' experiences pioneering direct and indirect services and responding to implementation challenges. Findings suggest that while drama therapists provide a number of critical school services, there are identifiable barriers to full integration into the system. Implications for drama therapists include the need for a further specified and structured role, formalized inclusion in student support teams, consistent opportunities to support both students and staff, more secure funding sources, clear implementation logistics, and increased awareness and education about drama therapy among school administrators, faculty, and mental health support staff.