Barbara Held has taken postmodern therapists to task for making “reality claims” when they have presumably committed themselves to an antirealist epistemology. She is concerned that by focusing so exclusively on individual client narratives, they ignore important aspects of the client’s “extralinguistic” world. Held suggests that constructivist therapists adopt a “modest realism” within which they could (a) tailor therapy methods to individual clients, (b) further systemize therapeutic principles, (c) give extralinguistic reality its due, and (d) make truth claims. The authors argue that the problems she identifies derive largely from the distinctions with which she insists on framing the debate. They agree that constructivists are not always crystal clear about the implications of their epistemology, but it would accomplish little if they were to retreat to the realist posture she proposes.