Clinical work with climate-distressed youth using a developmental framework is described, from two theoretical perspectives: acceptance and commitment therapy (ACT) and psychodynamic psychotherapy. General principles of climate-informed therapy are delineated, and case examples illustrate the use of theory in practice. Interventions involving the family, psychoeducation, resilience-building skills, developing a conscious relationship to nature, engaging in environmentally beneficial actions, increasing the tolerance for uncertainty, and developing career goals around the needs of a changing environment and society are described. The authors discuss the need for the clinician to prepare themselves for the challenges of this work, which include one’s own reactions of emotional distress when youth bring this topic up. Ways the clinician can model responses to climate distress are discussed, including staying informed about the multiple unfolding, intersecting crises, and tolerating a multitude of emotional reactions attendant to this urgent situation. The clinician is encouraged to have and use play materials that can be adapted to environmental themes. The importance of providing a secure attachment relationship to use as a base in “weathering the storms” of the climate crisis is emphasized.