This chapter offers a framework for understanding and stabilizing risky, unhealthy, and unsafe behaviors. Topics discussed include the importance of approaching this work in a collaborative, trauma-informed way that emphasizes the patient’s autonomy; recognizing risky, unhealthy, and unsafe behaviors as attempts to self-regulate; and providing training and guidance regarding healthy ways to self-regulate as a foundation for changes in these patterns. The chapter also addresses the fears patients experience related to making these kinds of changes, and the importance of looking for the particular functions and the risks and benefits of specific behaviors, especially in relation to the patient’s goals for themselves. This chapter includes roleplays illustrating useful approaches and specific language to address common challenges encountered in working with individuals with trauma-related disorders, such as experiencing ongoing interpersonal violence, potentially risky choices, and ways to improve safety in relationships.