This chapter describes multimodal stress therapy, which integrates multimodal therapy with stress management techniques. It examines the use of multimodal stress therapy in early intervention for substance misuse. The chapter discusses stress as the cause of substance misuse. It presents a case study of multimodal stress therapy in action. Stress reduction methods appear most effective among those who misuse substances specifically to manage stress and anxiety. The first goal of multimodal stress therapy is recovery, which may be achieved through either abstinence or controlled intake, while the second goal is for clients to achieve a better quality of life through the teaching of general stress coping skills and self-control skills. Stress management is first and foremost a psycho-educational approach that helps people to pinpoint, interpret and deal with their personal stressors. The chapter focuses on the therapeutic limitations: thresholds, social learning and missing information, and interpersonal deficits and poor self-acceptance.