This review summarizes findings and reflects on the process and outcome of short-term psychoanalytic psychotherapy (STPP) for adolescents with depression in the context of a UK-based randomized controlled trial. This review reports on what was learned about the effectiveness of STPP, as well as the therapeutic techniques used by STPP therapists, including the therapeutic alliance, alliance ruptures and repairs, and what can be learned from dropout cases. The paper considers the clinical and training implications of this research for those working psychoanalytically with depressed adolescents.