In this article we describe the development and implementation of the Substance Abuse and Mental Health Services Administration's (SAMHSA's) multisite Women, Co-Occurring Disorders and Violence Study (WCDVS), highlighting some of the challenges encountered, decisions made, and lessons learned. Four themes are discussed. First, the unique contributions of the consumer/survivor/recovering (C/S/R) women to the research process are described through instances where their knowledge and advocacy were clearly influential. Second, the solutions chosen to address research design challenges are recounted, as are the ways in which these choices played out. Third, the procedures for standardizing recruitment, data collection, and data management across sites are described. Finally, the strategies employed by the nine sites to retain contact with this challenging population are reviewed and successful techniques are highlighted. (Contains 3 figures and 3 tables.)