The problems and needs of rural substance abusers vary from those of abusers in urban areas. Accordingly, the means of treatment must acknowledge and address these differences. Despite this call for specialized care, no theoretically grounded therapy has yet been made available to rural patients. Behavioral Therapy for Rural Substance Abusers, developed and piloted over three years by University of Kentucky faculty and staff and substance abuse counselors in rural eastern Kentucky, provides a model for effective treatment for this segment of the population. A two-phase outpatient treatment, this approach combines group and individual sessions in an environment that is both comfortable and useful for the client. The success of this method lies in its regional approach to therapy. Rather than using role-playing techniques to examine old behaviors, therapy is designed around storytelling activities. Rural patients respond more positively to such time-honored traditions and thus become active participants in their own treatment. This manual offers a clear and well-constructed guide through the strategies of Structured Behavioral Outpatient Rural Therapy (SBORT). Supplemented with illustrations, sample exercises, and case studies, Behavioral Therapy for Rural Substance Abusers is a vital tool in meeting the treatment needs of an otherwise ignored rural population.