ABSTRACT
This chapter discusses pre-therapy from the point of view of a clinician sitting with a person who is linguistically, cognitively, and developmentally unprepared to use therapy. Pre-therapy considerations guide the therapist or therapeutic team in thinking about the therapy readiness of the persons they serve, including what clinical and communication skills they need to do this work. The chapter also discusses pre-therapy considerations as they played out in a Deaf-centered, mental health treatment agency, PAHrtners Deaf services, in Glenside, Pennsylvania. In the Deaf Community, there are many sophisticated, sign-fluent Deaf people who can easily make use of language-intensive experience like psychotherapy provided that therapists use their language well, or use interpreters, and make other adaptations to fit their learning styles and worldviews. The majority fall in the mid-ranges with language dysfluencies, cognitive delays, poor psychosocial skills, and significant behavioral health challenges.
