This book provides a model for adapting best practices in cognitive-behavioral therapy to consumers whose language and cognitive deficits make it difficult for them to benefit from traditional talk oriented psychotherapy. The book focuses primarily upon the mental health care of those deaf clients, sometimes referred to as "low functioning" or "traditionally underserved," who are particularly difficult to engage in meaningful treatment. Drawing most heavily upon the work of Donald Meichenbaum, Marsha Linehan, and Ross Greene, this book presents adaptations and simplifications of psychotherapy which make it accessible and meaningful for persons often viewed as "poor candidates." The heart of the book is a greatly simplified approach to psychosocial skill training, especially in the domains of coping, conflict resolution and relapse prevention skills, as well as an extensive discussion of "pre-treatment" strategies for engaging clients in mental health care. Also included is research demonstrating how deaf mental health clients are different than hearing clients, guidelines for doing mental status examinations with deaf clients whose language dysfluency gives them the false appearance of having thought disorders, and a chapter on developing staff and creating culturally and clinically appropriate treatment programs. Included with the book is a CD-ROM containing over 1500 beautifully drawn illustrations of a wide range of mental health and substance abuse related concepts. These pictures or "skill cards" are used in psychoeducation and therapy with persons who can not read English.