Anxiety disorders and related problems affect a large number of children and adolescents, are impairing, and can affect long-term functioning if left untreated. Recent years, beset by the COVID-19 pandemic and reckoning with social injustice, have only amplified the everyday challenges that evoke anxiety in our youth. Youth can be encouraged to actively cope with environmental and societal challenges using cognitive behavioral therapy (CBT), an efficacious set of interventions that teach anxious youth skills to help manage anxiety symptoms, adjust unconstructive thinking and behavioral patterns, and build on strengths. This chapter describes and illustrates CBT principles and strategies that can help children and adolescents address the anxiety they experience in light of trials grounded in real-world challenges where barriers extend beyond their immediate control. Worksheet templates and case illustrations are provided to demonstrate how a clinician turns principles into practice using a flexible, principles-based approach.