The objective of this Clinical Case Conference is to determine through case reports how we, as child and adolescent psychiatrists, help our patients conduct the politics of their lives in the outside world, meaning schools, neighborhoods, medical offices and hospitals, courts, and cultures foreign to their own. Clinicians learn to help children and youth deal with their problems in the real world, or at the least, to find and follow through with people who help youngsters with these problems. Based on ongoing studies, children's outside problems appear to reside in four main categories, which are loving and liking; competing and hating; finding an identity; and being unusual and/or facing unusual circumstances. We, no matter what our orientation or practice site, must develop pragmatic ideas regarding children's relationships with peers, institutions, and cultures and can develop techniques to aid young people in their encounters in society-at-large.