The emotional climate of the family appears to be a potent predictor of the course of many psychiatric disorders, including bipolar disorder. Studies of expressed emotion suggest that high levels of criticism, hostility, and/or emotional overinvolvement in caregivers are associated with higher rates of recurrence among patients. This chapter examines the assumptions, methods, and research findings of family-focused therapy (FFT), an outpatient conjoint therapy for patients who are stabilizing from an acute episode of hypo/mania or depression. The combination of FFT with standard pharmacotherapy is associated with lower rates of recurrence and greater stabilization of mood symptoms—particularly depression—in adult patients with bipolar disorder. The approach has been successfully applied in studies of adolescents with established bipolar disorder and youth with depression and/or subthreshold manic symptoms who are at familial risk for syndromal bipolar disorder. The recent application of FFT to youth and young adults at high risk for psychosis and elderly couples coping with bipolar disorder is discussed. The treatment components most associated with enhanced clinical outcomes are clarified. Directions for future studies are offered.