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In this article, we describe methods for working with dreams and nightmares in individual psychotherapy, provide clinical examples, and review research evidence of immediate and distal outcomes of each method. An original meta-analysis of eight studies using the cognitive-experiential dream model with 514 clients showed moderate effect sizes for session depth and insight gains. In the nightmare treatment literature, a previous meta-analysis of 13 studies with 511 clients showed moderate to large effects in reducing nightmare frequency and small to moderate effects in decreasing sleep disturbance for imagery rehearsal therapy and exposure, relaxation, and rescripting therapy. Limitations of the current meta-analysis of cognitive-experiential dreamwork and of the reviewed research on nightmare methods are described. Training implications and therapeutic practice recommendations are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).