Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious trauma. Additionally, we present the results of a study exploring trauma prevalence rates and gender differences among a sample of 121 adults in outpatient substance abuse treatment. Our findings indicated that 85.12% of the sample experienced at least one traumatic event in her or his lifetime. We also found significant gender differences in that more women reported experiencing sexual abuse and more men reported witnessing violence.