I used a program called the Rosetta Stone that gave me a good grasp of spelling, reading, etc. I also used a short version of the Pimsleur CDs, I wish I had used them more.

I also took a phrase book with me and whenever I had to call someone for reservations, buy something in a shop, etc., I would sit down with the phrasebook ahead of time and rehearse and memorize what I expected to say.

In the big tourist areas a lot of people who work in tourist related businesses will recognize you as an American and speak English to you. It's probably a lot easier for them to speak English than to try to understand poorly spoken Italian, and speaking excellent English seems to be a condition of employment in the tourism/hospitality business in Italy. Off the beaten track I found that people were very gracious about trying to understand my attempts at Italian. I also found myself being treated much better in restaurants/cafes than the Americans around me who made no attempt to speak Italian, and who just assumed that the people around them would speak English.