I have had *huge* successes with my son in implementing The Explosive Child strategies along with behavioral modification. It takes a tremendous amount of effort which I would only be willing to do over the long haul provided I was seeing good results (which we are). Personally as a parent and a former classroom teacher I think applying these both intensively (such as when a child is unstable) for extended periods of time would exhaust a family and is more than regular schools should be expected to do. If it's simply for the purpose of making progress in addressing run of the mill 
difficult child issues than I think it's doable.
The developmental pediatrician offered us a trial of an SSRI medication for my son during our first visit. I turned him down because first I was horrified he would suggest such a thing for *my* child, secondly because we hadn't had any of the speech assessments done and I didn't want skewed results and third, I thought we could manage him. There came a time some months later when all our of our efforts failed in helping him cope with anxiety and we did resort to medications. Those helped almost immediately and even though it went totally against my grain I was glad to be able to give him some relief. We've had problems with side effects so this will always be a last resort for us.
There's a thread about this with a similar question that I asked after first arriving here. You'll see most people's experience didn't lead me to have any hope but I was desperate and went for it anyway and the story had a happy ending.
