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Active school social workers are tasked with teaching social-emotional learning to students, including high need youth placed in alternative education settings. Multitiered systems of support provide a framework utilized by school systems to identify and address all student needs. However, a gap in research exists for evidenced-based social-emotional learning practices for students falling within Tier 3 of the multitiered systems of support framework, particularly those separated from the mainstream population and educated in alternative programs. This study explored how school social workers address the social-emotional learning needs of students in alternative education settings within the state of Illinois. The qualitative case-study design used a purposive sample of school social workers. Data sources included individual semistructured and focus group interviews of school social workers, and program curricula materials. Data analysis followed the constructivist perspective that multiple explanations of reality exist and, therefore, knowledge is constructed and emerges through the social practices and interpretations of people. Results indicated that school social workers in Illinois struggle to find existing evidence-based interventions to meet the social-emotional learning needs of high-school students in alternative education due to limited resources. Social work services maintain a student-driven focus and are strengthened by school-wide systemic structures for social-emotional learning that include cohesive efforts among staff and time for individual student processing of behaviors. This research has potential for social change through expanding knowledge available for school social work practitioners to meet the social-emotional learning needs of students in alternative education.