This is a preliminary study of 20 women in an outpatient women's mental health and dual diagnosis treatment program at a community mental health center. The Harborview Mental Health Services Women's Dual Diagnosis Program incorporates empirically based treatments such as cognitive behavioral therapy for dual disorders, Dialectical Behavior Therapy and contingency management into a comprehensive, integrated dual diagnosis program. This article gives a clinical description of the program and a comparison of outcome variables at pre-treatment compared to one year into treatment. As this is a report on a program that underwent clinical development, some individuals with active substance abuse initially received the Substance Abuse Management Model (SAMM; Roberts, Shaner, & Eckman) substance abuse group treatment prior to receiving Seeking Safety. Due to the concern that the SAMM material did not specifically target several concerns relevant to women who are dually diagnosed including preventing substance use in response to emotional dysregulation, the substance abuse group treatment was changed to Najavits' Seeking Safety. This was much better received by the women in our program. In addition to providing Seeking Safety treatment, the women's program also offered Dialectical Behavior Therapy (DBT) skills training groups, didactics on women's issues, and a community support group. Individual skills coaching or individual therapy was provided to help clients integrate DBT skills with those from the Seeking Safety manual. Results indicated that psychiatric hospitalizations significantly dropped from an average of about two hospitalizations in the year prior to entering treatment to less than one in the first year of treatment. The average length of sobriety (which included those who entered the program with sustained sobriety) significantly increased by six months one year later. When examining only those with less than one year of sobriety before entering the program, results remained significant with approximately a 5-month increase in sobriety. Clinician's ratings indicated significant improvement in psychiatric condition by more than one point on a seven-point scale.