Dreams represent a powerful, condensed metaphor for irrational beliefs which patients may not otherwise be able to articulate. While contemporary psychodynamic therapists have discarded Freud’s emphasis on dreams as intentional disguise of instinctual wishes, they continue to use dreams as diagnostic and treatment tools. Such work can be integrated with other types of treatments, including cognitivebehavioral, to examine the latent, primitive and non-verbal aspects of cognitions. This article illustrates how dream work can be utilized in symptom-focused psychotherapy with examples drawn from several specific treatment areas: bereavement, depression, trauma, cross-cultural counseling, and behavioral medicine.