This chapter will explore anti-bisexual prejudice and monosexism and consider this in the context of the therapeutic environment. Key theoretical considerations for working with bisexual people will be presented, including the importance of understanding socially created narratives in the context of informing the ways in which bisexual people make sense of their internal worlds. Ways of enhancing therapeutic practice and an illustrative clinical vignette are also presented. This chapter specifically focuses on bisexual clients; while much of the content is likely relevant to clients who use other labels to describe multi-gender attractions (e.g., pansexual, queer, fluid), there may be differences as well (see Galupo).