The widely accepted view of addiction as a disease has contributed an “abstinence-only” treatment system that has failed to be helpful to the large majority of people who struggle with substance use when trauma is a part of the picture. These patients must be welcomed into treatment while they continue to use substances so trauma can be identified and processed as a precondition for addressing the addictive response. This session will introduce an integrative harm reduction psychotherapy that engages people in therapy while they are actively using substances and addresses trauma and addiction simultaneously. A real clinical case of trauma and addiction that was successfully treated by Tatarsky will be presented to illustrate the approach.