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Athletes suffer from clinical and subclinical mental health symptoms and disorders that affect their lives and their performance. The objective of this chapter is to describe methods of psychotherapy used in treating elite athletes and the unique challenges that clinicians may face when working with this population. Psychotherapy, either as the sole treatment or combined with other nonpharmacological and pharmacological strategies, is a vital component in the management of clinical and subclinical mental health symptoms and disorders in elite athletes. Effective psychotherapy takes the form of individual, couples/family or group therapy and should address athlete-specific issues while validated as normative by athletes and their core stakeholders. This chapter summarizes research on psychotherapy for elite athletes with clinical and subclinical mental health symptoms and disorders. Though psychotherapeutic interventions are similar to those with non-athletes, working with elite athletes can present unique challenges. These can include diagnostic ambiguity, barriers to help-seeking behaviors, and altered expectations about services. Other personality factors occasionally associated with elite athletes could create difficulties when engaging in psychotherapy. These challenges may prevent athletes from seeking or continuing treatment.