All high school students aged 14-17 in our country have an important event ahead: the Unified State Exam. For a teenager, the school exam is a priority, because it is also the entrance exam to universities. The first experiment on introducing the Unified State Exam was introduced in 2001, it was carried out in republics: Yakutia, Chuvashia, Mari El, also in the Samara and Rostov regions. The idea to introduce the Unified State Exam in our schools belongs to the Soviet and Russian mathematician statesman, Doctor of Mathematical Sciences Vladimir Mikhailovich Fillipov, who at one time received a silver medal. The Unified State Exam has its advantages and their shortcomings. This article will discuss how high school students have been coming to psychotherapy with a clinical psychologist in recent years with medication support from a psychotherapist. All names in this article have been changed and the cases described have a collective image. However, I leave the essence of the situations open. L.V., the 10th grade class teacher in the city of N., an average school in our vast country, noticed traces of cuts on 15-year-old S.’s hand. L.V. is 51 years old, she has sufficient experience working at school, communicating with and their parents. She has been working at school since her youth, immediately after graduating from college. This 10th grade will be her second graduation.L. V. is a fairly strict teacher, but she knows how to find a common language with children. She knows very well how to communicate with children from disadvantaged families, with children who have various deviant behavior and with children who have a low level of motivation in educational activities. But she had not personally encountered self-cutting in her experience, and this moment alerted her. Having sounded the alarm, L.V. decides to turn to an educational psychologist and social teacher of the school service. The teacher-psychologist has experience and an excellent higher education, but when she sees the cuts, the woman thinks: “What if the girl tries to commit suicide?” It was customary to call S.'s parents to school. S.’s mother is an educated woman, an accountant, disciplined, strict and unemotional. Dad is an engineer working in a small private factory. In addition to S., the family has a youngest child, 8 years old, who is in second grade. According to his parents, S. has a small social circle, increasingly uses social networks and instant messengers, and communicates with loved ones at home only on business. There are no common interests in the family. Loves to draw. Mom insists that S. finish school without C grades. S. plans to become a designer. The girl does not use drugs or alcohol. Not seen in bad companies, dating a guy. In a conversation between parents, a social worker and a school psychologist, it turned out that the girl has a positive psychological portrait, there are no problems in school education, and she does not participate in conflicts between peers. In the conclusion of the educational psychologist, based on the results of psychodiagnostics, there is a high level of personal and situational anxiety in S. The parents decided to visit a psychotherapist. A conversation with a psychotherapist It turned out that the girl did not have suicidal thoughts, however, there was a depressive state, SSRI drugs and anxiolytics were prescribed, cognitive behavioral therapy was recommended (In this case, the diagnosis was made by a psychotherapist and is known to him. Often a clinical psychologist works with the patient from the doctor, based on recommendations). So, S. came to my office. During the conversation, the girl spoke reluctantly and responded negatively. Since childhood, she was told that she needed to behave appropriately in society, she should not cry, scream, or generally show her emotions openly. Mom demanded that any conflict situations be resolved with a “cool head.” The reason for self-harm in this case is the prohibition of showing emotions. Over time, the girl began to note that she was experiencing very strong emotional pain, which she could not drown out with anything other than physical pain in the form of dangerous self-cuts with a blade on hand. Because it's easier this way.