This paper discusses the complex issues faced by clinicians providing counseling to chemically dependent individuals who are deaf or hard of hearing and who are from ethnic, racial, or cultural minority groups. It shares specific examples from the Minnesota Chemical Dependency Program for Deaf and Hard of Hearing Individuals, as well as suggestions for delivering effective clinical services. Recommendations include: (1) openly address issues of ethnic and/or cultural differences and lack of knowledge about the client's background; (2) evaluate the degree of the client's status related to culture, acculturation, or multicultural fluency by using individual cues; (3) allow time for trust to develop before focusing on deeper feelings; (4) be aware that some cultures avoid eye contact and that even if the client does not maintain eye contact, this does not mean disrespect or lack of attention; (5) know the current climate and issues of concern in the deaf community; and (6) be aware of cultural factors that actually are barriers to treatment and recovery and those that are not. An appendix contains a list of American Indian, Anglo, and deaf community characteristics. (Contains 24 references.) (CR)