This acclaimed clinical guide, now substantially revised and updated, has helped thousands of clinicians put the proven principles of harm reduction into practice with therapy clients who have substance use problems. Written by pioneers in the field, the book shows how to do effective therapeutic work with people still using alcohol or other drugs. It provides clear guidelines for conducting comprehensive assessments, making collaborative treatment decisions, and implementing interventions that combine motivational, cognitive-behavioral, and psychodynamic strategies. The focus is reducing drug-related harm while also addressing co-occurring psychological and emotional difficulties. Detailed clinical illustrations are featured throughout. New to This Edition *Reflects over a decade of research advances and the tremendous growth of harm reduction clinical practice and training. *Section on applications, with chapters on community-based settings, harm reduction groups, and working with families and friends. *Chapters on biological and psychodynamic aspects of treatment. *Expanded discussions of trauma, cultural sensitivity, and ethics. *Supplemental resources and training information at the authors' website: www.harmreductiontherapy.org. See also the authors' related self-help guide, Over the Influence, Second Edition, an ideal client recommendation.