Female college athletes struggle with mental health issues at rates similar to their nonathlete peers. Relationships with coaches and teammates can significantly impact mental health. An integrative therapeutic approach that combines cognitive behavioral therapy with relational–cultural theory can provide clinicians with a framework for addressing underlying relational and systemic issues to better meet the needs of female college athletes. A case illustration featuring a Division I female soccer player struggling with negative mental self-talk will demonstrate how to effectively integrate relational–cultural theory and cognitive behavioral therapy when working with female student athletes. This article will discuss the implications for coaches, athletes, parents, mental health providers, and sport psychology practitioners about the integration of relational–cultural theory and cognitive behavioral therapy to enhance relationships with female college athletes to improve their mental health.