In this chapter, we present therapeutic strategies for managing clinical high risk (CHR) symptoms. These symptoms can lead to severe distress and frequently result in a decline in daily functioning among affected adolescents. That is why it’s so important to talk about how to deal with the symptoms and help patients feel more capable again in therapy. Therapists should adopt the most positive and normalizing attitude possible, emphasizing the possibility of change. To better illustrate the therapeutic approach, sections from therapy dialogues with Lucy and Michael will be presented throughout the following sections. The dialogues are intended as input for dealing with risk symptoms in therapeutic conversations. We have divided risk symptoms into three main categories: alterations in mood, perception, and cognition. In addition to CHR symptoms, we discuss symptom management for the most common comorbid symptoms associated with CHR. The final part of the chapter describes therapeutic work with mood and symptom protocols.