This work illustrates the findings of a participatory research process aimed at identifying responses for sustainable water management in a climate change perspective, in two river basins in Europe and Asia. The chapter describes the methodology implemented through local participatory workshops, aimed at eliciting and evaluating possible responses to flood risk, which were then assessed with respect to the existing governance framework. Socio-economic vulnerability was also investigated developing an indicator, whose future trend was analysed with reference to IPCC scenarios. The main outcome of such activities consists in the identification of Integrated Water Resource Management Strategies (IWRMS) based upon the issues and preferences elicited from local experts. The mDSS decision support tool was used to facilitate transparent and robust management of the information collected and communication of the outputs.