Children classified as emotionally disturbed constitute a most challenging and expensive population in the public schools. This article presents a tri-part model of barriers to program design, implementation, and evaluation for children classified as emotionally disturbed in public school settings. An examination of the available school-based outcome literature with this population offers insights on the efficacy of available programs in schools. In addition, guidelines are outlined for school practitioners to assist in designing and implementing school programs for this population. (Contains 3 notes.)