This chapter will introduce the reader to the first creative intervention featured in this book, ‘Working with Images’. This chapter will begin by discussing the use of published images in therapy. For example, therapists can obtain images by collecting greeting cards and computer-based pictures. This chapter will then consider therapeutic photography, including examples from practice, and offer pragmatic guidance for professionals. The following discussion will focus on how a client’s internal image symbolising their experience can contribute to the therapeutic process. Finally, there will be a consideration of the intrusion of images and how these cause psychological distress for some clients who have experienced trauma, with strategies provided to aid therapists to help clients manage this distressing issue.