While substance abuse and posttraumatic stress disorder (PTSD) are known to frequently co-occur, there have been few published clinical trials evaluating integrated approaches for this form of dual diagnosis. This article describes Substance Dependence PTSD Therapy (SDPT), the first manualized individual treatment to undergo a controlled clinical trial. SDPT is a 5-month, twice-weekly, two-phase individual cognitive-behavioral treatment utilizing (a) relapse prevention and coping skills training for substance abuse; and (b) psychoeducation, stress inoculation training, and in vivo exposure for PTSD. SDPT is also unique in having been designed for use in mixed-gendered civilians with varied sources of trauma. Design considerations and the format, structure, and content of therapy sessions are discussed. Open trial pilot data indicates efficacy in reducing PTSD severity.