This chapter begins with the discussion of clinical features of depressive disorders that have implications for the design and implementation of therapeutic interventions with youths. It summarizes peer-reviewed articles of randomized controlled trials with clinically depressed youths as well as studies with youths classified as depressed based on symptom rating scales. The chapter raises several issues that have not received sufficient consideration in treatment outcome studies of depressed youths and remain to be addressed in current treatment development efforts. Finally, it discusses current issues in the psychotherapeutic management of depressed youngsters and identifies topics that require further attention. The course and outcome of childhood-onset depressive disorders are complicated by family psychopathology and strife. In the treatment of depressed youths, the systematic involvement of the parents or primary care-takers is important. Parents should be engaged, whenever possible, as agents of change in the treatment of their own children.