Nearly 137,500 students in K-12 schools in Pennsylvania identified with Emotional Disturbance (ED) who receive special education services for externalizing behaviors experience bleak outcomes related to school connectedness and academic success. Teachers report feeling ill-equipped to work with students with EDEB. This instrumental case study identified critical skills necessary to promote supportive relationships for students with EDEB, to inform the development of improved teacher education programs expressly focusing on the current social phenomenon of teacher-student relationships within the school setting. This study was conducted in a rural K-12 district in Pennsylvania with twelve secondary teacher participants. Semi-structured interviews captured the knowledge and perspectives of teachers of students with EDEB. Data sources also included observations and documents and artifacts. The theoretical pillars of the research were attachment theory, social-motivational theories, and developmental systems theory. The findings were organized into three themes and subthemes, skills used by teachers to build relationships with these students. They were empathy and understanding with acceptance, conversing and attending with spend focused time on student interests, and encourage and motivate with consistent strategies based on student needs. The data showed that the majority of teachers learned to build the relationships by talking with other teachers. Only one participant noted a college course and two noted two in-service trainings that provided insight. The results indicate the following list of skills that should be taught to pre-service and in-service teachers: empathy and understanding, acceptance, conversing and attending, dedicating time to student interests, encouragement and motivation strategies, and consistent use of strategies based on student needs. Implications of these findings are discussed relative to improving teacher knowledge and skills. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]