This chapter explains how psychosis manifests within mood disorders and outlines principles for integrating symptom-based CBT within these presentations. It distinguishes psychotic symptoms emerging from depressive, manic, or mixed states, emphasizing their fluctuating intensity and state dependence. Treatment planning requires coordination with pharmacotherapy, careful monitoring of mood episodes, and prioritization of foundational interventions such as sleep normalization, anxiety reduction, and behavioral activation. CBT techniques targeting hallucinations or delusions are applied only after mood stabilization, ensuring that interventions align with the patient’s functional stage and emotional capacity. The chapter highlights the importance of dynamic treatment steering, adjusting module selection as mood states shift.