Step 1: First we have to write polynomials in descending order.
$$ \begin{aligned} P(x) &= 3x+9 \\ Q(x) &= -18x-7 \\ \end{aligned} $$Step 2: Write second polynomial below the first one. Making sure like terms are lined up.
$$ \begin{array}{lrr} & 3x & 9 \\ \color{blue}{ + } & -18x & -7 \\ \hline \end{array} $$Step 3: Combine like terms (add each column):
$$ \begin{array}{lrr} & 3x & 9 \\ \color{blue}{ + } & -18x & -7 \\ \hline & -15x & 2 \end{array} $$