Counseling happens at school during the day so students can access care without added barriers. After consent and a focused intake, we set concrete goals tied to school outcomes (attendance, work completion, behavior, peer/teacher relationships). Treatment blends CBT/DBT skills, behavioral activation, exposure for anxiety/OCD, and emotion coaching; for trauma, stabilization and pacing come first. We coordinate with school counselors/teachers (and 504/IEP teams) to align supports, create simple classroom plans, and design re-entry after hospitalizations or crises. Progress is tracked with brief measures and functional data (tardies, nurse visits, referrals, missing work), and caregivers receive regular, practical updates. Services fit within MTSS (Tier 1 consults, Tier 2 skills groups if requested, Tier 3 individual care). Confidentiality and its limits (safety, mandated reporting, FERPA/HIPAA boundaries) are clear. When risk escalates, we follow school protocols and coordinate higher levels of care. Culturally responsive, neurodiversity-affirming, and available by telehealth on closure days so momentum isn’t lost.