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Dreams have been used in psychotherapy since the early days of psychoanalysis, and the effectiveness of therapeutic work with dreams is now well documented. However, there is still no empirically based model for contemporary therapeutic dream work that integrates the findings of empirical and clinical dream research. Structural Dream Analysis (SDA) developed for this purpose is summarized with its research methodology and the results to date. The central assumption is that the agency of the dream ego (the figure in the dream that the dreamer experiences as the ego) to cope with and solve problems in the dream—as opposed to feeling threatened, being anxious and passive and having no solution—can be equated with ego strength in the psychodynamic sense, and that the improvement in the course of therapy is reflected in an increase in dream ego agency. A typology of six dream patterns has been developed that can be used to identify over 90% of dreams in clinical practice. The dream patterns are related to the patient's specific problems, the themes of psychotherapy and progress in therapy in terms of improvement. The model has been confirmed in a number of empirical studies. The results support Jung's theory of the dream as a self-representation of the psyche and his concept of interpretation at the subjective level.