Although published research continues to advocate medication as the first line of treatment for early onset bipolar spectrum disorder (EOBSD; N. Lofthouse & M.A. Fristad, 2004), preliminary research demonstrating the utility of cognitive, cognitive-behavioral, and psychoeducational therapies is promising. It appears as if future treatment of EOBSD will most likely include a combination of psychosocial treatments and medications; however, additional research needs to be conducted to support this assumption. This article provides a brief overview of published research related to EOBSD, the most common medications used to treat EOBSD, and preliminary research on the effectiveness of psychological treatments with children and adolescents classified with EOBSD. Finally, due to the lack of published behavioral and educational management strategies, this article provides practical suggestions for helping children and adolescents with EOBSD within the home and school settings.