Working with adult survivors of childhood sexual and physical abuse is broad and complex. Social workers especially play important roles as service providers to many adult survivors who present as clients or patients. The challenge for workers is to effectively implement evidence-based interventions, such as cognitive behavior therapy (CBT), that will enhance the success rate of treatment for these often complex and difficult clients. Case illustrations are included of a 29-yr-old male and a 32-yr-old female. Topics include: literature review, working with difficult clients using CBT (basic treatment strategies, stages of change) and methods of treatment (schema-focused approach). (PsycINFO Database Record (c) 2012 APA, all rights reserved). (chapter)