Written specifically for the office-based psychotherapist, this practical guide describes how to detect, assess, diagnose, and treat clients presenting with a range of alcohol and drug problems. Detailed is an integrated, flexible psychotherapeutic approach that emphasizes building a strong therapeutic relationship, engaging clients where they are, and addressing substance use within the larger context of their lives. The authors describe in very pragmatic terms how to use a combination of motivational, cognitive-behavioral, 12-step, and psychodynamic techniques with clients in different stages of change. Techniques are brought to life with numerous case vignettes, and appendices include reproducible client forms and handouts.