Evidence-Based Interventions for Adolescents with Disruptive Behaviors in School-Based Settings Tarah M. Kuhn, PhD a, *, Jon S. Ebert, PsyD a , Kathy A. Gracey, MEd a , Gabrielle L. Chapman, PhD b , Richard A. Epstein, PhD, MPH a INTRODUCTION Approximately 70 million children and adolescents are enrolled in elementary and sec- ondary schools in the United States each year. 1 Elementary and secondary education play a significant role in child and adolescent development. A significant educational task is to create and maintain learning environments that promote optimal learning by providing developmentally appropriate challenges and tasks. 2 The authors have nothing to disclose. a Department of Psychiatry, Vanderbilt University School of Medicine, 1500 21st Avenue South, Village at Vanderbilt, Suite 2200, Nashville, TN 37211, USA; b Peabody Research Institute, Vanderbilt University, 230 Appleton Place, PMB 181, Nashville, TN 37203, USA * Corresponding author. Department of Psychiatry, Vanderbilt University School of Medicine, 1500 21st Avenue South, Village at Vanderbilt, Suite 2200, Nashville, TN 37211. E-mail address: tarah.kuhn@vanderbilt.edu KEYWORDS  Disruptive behavior disorder  School health  Evidence-based practice KEY POINTS  Disruptive behaviors in the classroom are a threat to an optimal learning environment. Educators commonly request assistance managing challenging classroom behaviors and these behaviors are a common reason for referral to mental health services.  Disruptive behavior disorders (DBDs) commonly co-occur with other conditions, thus making defining a course of treatment more challenging. Not all behavior stems from the same emotional/psychosocial source. Interventions need to be individualized and need to consider the underlying and environmental factors contributing to them.  The primary factor related to effectiveness of interventions for DBDs in adolescents is quality of implementation. Programs with support and established infrastructure, proper training, and ongoing supervision are more effective at reducing disruptive behavior problems. Child Adolesc Psychiatric Clin N Am 24 (2015) 305–317 http://dx.doi.org/10.1016/j.chc.2014.11.005 childpsych.theclinics.com 1056-4993/15/$ – see front matter Ó 2015 Elsevier Inc. All rights reserved.