This report is intended as a resource for use by educators, trainers, and program managers in developing more effective courses and professional development resources for professionals working with women and girls with mental health and substance abuse problems. The report was developed as a result of research showing that both sex and gender play a role in how men and women experience the same diseases at different rates or with different symptoms. The framework put forth in this guide aims to address these differences. The report begins with a discussion on the need for core competencies when working with women and girls. This is followed by a discussion of the competency framework as well as a set of guidance statements that form the basis for the development of the core competencies. The next two sections of the report discuss the KSAAs (Knowledge, Skills, Attitudes/Attributes) that form the core competencies for working with women and girls. The Knowledge and Skill competencies are described under the following subject headings: sex and gender differences, relational approaches in working with women and girls; understanding trauma in women and girls; family-centered needs of women and girls; special considerations during pregnancy; women's health and health care; and collaboration and interdisciplinary effectiveness. The Attitude and Attribute competencies are described under the following subject headings: respect and empathy; recovery orientation; service-specific attitudes and attributes; and self-awareness and professional development. The final section of the report discusses application of the core competencies. Appendix and endnotes