Each mental health discipline offers unique contributions to the development and operation of school-based mental health programs. The collaboration of professionals from different disciplines with each other, as well as with health and educational staff, is essential for service delivery in school settings. Conversely, interprofessional conflicts and turf issues can impede the development of effective school-based mental health programs. The authors, who represent counseling, nursing, psychiatry, psychology, and social work, discuss the roles and competencies of each profession in providing school-based mental health services. Training requirements within each discipline that relate to school mental health are described. Barriers to effective interdisciplinary collaboration, and methods of overcoming them, are delineated.

School counselors have an important part to play in helping schools respond to the increasing number of students whose mental health needs place them at risk for school failure. This article identifies the shortcomings of the current developmental guidance and counseling service delivery model as it relates to work with at-risk youth. In addition, a transformed model is proposed, with suggestions for changes in program organization and planning, school counselor role and function, and skills and expertise. Potential barriers to change are also identified.

School and community counselors have important roles in developing and implementing mental health programs for youths and families. Counselors who are working with the more complex issues of at-risk youths can enhance implementation of prevention programs by altering their roles to function within a collaborative consultation model. This model represents a new paradigm in that counselors interdependently and collaboratively partner with people previously considered their "consultees." Such collaboration can result in more comprehensive and integrated programs, and it can prevent fragmentation and duplication of efforts. Collaborative consultation is described and contrasted with more traditional consultation models, and a 5-stage implementation process is presented. Personal and systemic factors that support the collaborative process are examined.

Findings underscore the importance of attending to cultural factors in public health messaging. Messaging that respects the values of gun owners could hold promise in promoting firearm restriction for suicide prevention.

Fifty strategies for establishing and maintaining a therapeutic relationship with defiant, aggressive adolescents are offered. Many of these are taken from the literature, whereas others are unique to this article. A variety of strategies, ranging from reframes to the use of paradox are provided, and take a transtheoretical approach using ideas from cognitive behavioral as well as existential, Gestalt, psychodynamic, and multicultural therapies. Strategies are arranged under 3 categories: reaching, accepting, and relating. The strong desire of defiant adolescents for freedom and autonomy is also discussed, with suggestions for using this in motivating defiant adolescents to work in counseling.