Justin was socially isolated and would bang his head on school walls and leave the classroom anytime he made a mistake. Collaboration with his teachers helped set up interventions to avoid his maladaptive reactions to frustration. His grandmother brought him to her home daily after school to get his homework done. His family was initially fearful about using medications, but fine-tuned medication plus psychotherapy with Justin, his father and grandmother helped him improve his emotional disruptions, his schoolwork and interacting with peers. Psychotherapy also helped him to address his concerns about growth and sexuality.