Irritability, an increased proneness to anger relative to same-aged peers, is a significant public health issue. Along with the burden experienced by youth and parents across development, severe and impairing irritability is associated with an increased likelihood of depression, anxiety disorders, and suicidality in adulthood. Although there have been several treatments for disruptive behavior disorders that have been proven to be effective, limited interventions specifically target severe irritability. This chapter is focused on a treatment that has been developed to specifically treat severe and impairing irritability. The treatment consists of 12 sessions, including both child and parent components. The child component involves both psychoeducation about irritability and in vivo exposures to anger-inducing stimuli. The parent component covers topics often taught in parent behavior management training with the goal of teaching concrete skills for managing youth’s irritability. Efficacy data suggests that this novel treatment may decrease severe irritability and positively impact overall level of functioning. Clinical trials of this treatment are ongoing with active recruitment of participants. Overall, this treatment demonstrates promise as an effective treatment for severe irritability in youth.