A discussion of the models of substance abuse briefly describes 11 models for treating alcoholism, many of which also apply to drug addiction. In psychodynamic approaches to treating substance abuse, the therapy focuses on developmental and structural deficits, such as limited ego control and affective difficulties. Strategies based in classical or operant conditioning include aversion therapies, contingency contracting, token economies, covert sensitization, stimulus control, and community reinforcement. Social learning and cognitive behavioral approaches encompass therapeutic communities, coping and social skills training, and relapse prevention training. The description of family therapy approaches reviews four family therapy models as well as support groups for family members as well as family interventions and confrontations. Pharmacological agents offer a well-known approach to the treatment of opiate addictions. Chief among these are Naltrexone, a narcotic antagonist that blocks the euphoric effects of opiates, and Methadone, which acts as a substitute for opiates. This chapter also considers responsivity considerations (motivation for treatment) in the treatment of the substance abusing offender. An overview of the effectiveness of substance abuse interventions reports that in the most comprehensive meta-analysis of alcohol treatment literature, Miller et al. (1995) report that the most successful programs were behavioral and cognitive-behavioral approaches, such as social skills training, community reinforcement, behavior contracting, relapse prevention, and motivation enhancement. The least successful approaches were education, unspecified general counseling models, psychotherapy, and confrontational approaches. Key concepts and terms as well as discussion questions are provided.