Treatment of depression during childhood and early adolescence frequently involves numerous challenges, including co-morbidity, stress and mental health problems within the family. Given the embeddedness of youth within family structures during this developmental period, a family-based model may be particularly advantageous. Family-focused treatment for childhood depression (FFT-CD) is a developmentally-informed intervention that specifically targets family interactions to build strengths and resiliency within the family system to better manage and combat depression. By incorporating an interpersonal model, family members are assisted in identifying both ‘upward’ (helpful and positive) and ‘downward’ (unhelpful and negative) interactional spirals. This model provides a powerful and positive rationale for family inclusion in treatment and specifies the goals of the intervention. In further family sessions, psycho-education, communication enhancement, behavioral activation and problem-solving skills development are then used to build on existing strengths and disrupt negative transactions. In this chapter we describe the conceptual roots and intervention strategies of FFT-CD, illustrate its implementation using case descriptions and discuss core clinician competencies and approaches to common challenges in its implementation (e.g., co-morbidity, sibling inclusion, family stress). FFT-CD provides a flexible and efficacious intervention for depressive symptoms and disorders during a crucial period of development.