The stigma of mental disorders and psychological treatment afflicts rural clients more than most. This article provides practitioners with guidance in selecting and utilizing effective treatments for self-stigma in rural settings. We review both public stigma and self-stigma. Public stigma explains society's negative impact on individuals, while self-stigma describes an individual's internalization of public stigma. We review treatment principles and empirical research on psychotherapy for self-stigma rural settings. We finish with a case illustration of cognitive therapy with a rural client suffering from self-stigma. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1–13, 2010.