Deaf/Hard of Hearing and DeafBlind Services

Overview of Services:  TSA’s Deaf/Hard of Hearing and DeafBlind Mental Health Program provides culturally affirmative mental health services to children (birth to 22 years), who are Deaf/hard of hearing or DeafBlind and their families; and who are experiencing difficulties due to emotional or behavioral disorder(s). These mental health services include: comprehensive diagnostic assessment, individual psychotherapy, family psychotherapy, family psychoeducation, and Children’s Therapeutic Services and Supports (CTSS), a flexible package of mental health services for children who require varying therapeutic and rehabilitative levels of intervention and combine psychotherapy (individual, family, group) with skills training (individual, family, group) and crisis assistance to help strengthen the emotional, behavioral, and social functioning of children and their families.

The therapists in the Deaf/Hard of Hearing and DeafBlind program have a broad range of understanding about the physical and mental health challenges and needs of children who have mild to profound hearing losses.  They understand how these needs influence behavior, school performance, family life, and social relationships.  They are well versed in addressing communication needs and language barriers. Therapists in the Deaf/Hard of Hearing and DeafBlind program are fluent in both American Sign Language (ASL) and English, and have an in depth understanding of Deaf Culture and the Deaf Community. This gives them a unique lens in which to look through to support their clients that other therapists do not have access to in the field of mental health.

The therapists within the DHHDB program also provide consultation and trainings to schools, organizations, other healthcare providers, and at various conferences on topics related to hearing loss and how it intersects and uniquely impacts mental health. This is in addition to TSA's new Health and Wellness Conference that takes place annually on various topics related to Mental Health and the Deaf Community. The consultations and trainings are covered by a grant provided by the Department of Human Services Deaf and Hard of Hearing Services Mental Health Division to educate and support families and other professionals when interacting and working with individuals with hearing loss that are within the state of Minnesota. Consultation and trainings provided to organizations and groups outside of Minnesota can contact the DHHDB program to discuss how they can support you and your specific needs.

TSA’s DHHDB Program now provides a parent education course for Deaf/Hard of Hearing and DeafBlind parents of hearing or Deaf children. It is a class that meets virtually once a week for 1.5 hours. The cost for the class is $80 and there is financial assistance made possible by a grant from Deaf and Hard of Hearing Services Mental Health Division for those that qualify. This class runs three sessions between September and May. For more information, please contact us for a brochure.

Location(s): Northwest, Northeast, East-Central, Southwest and South-Central areas of Minnesota. TSA has offices for the Deaf/Hard of Hearing and DeafBlind (DHHDB) Program in Coon Rapids, Mankato, and Moorhead where clients can come in to meet with our staff and receive supports and services. Therapists in the DHHDB program also are able to meet with children and families in their schools, homes, and communities as needed. Therapists partner with school personnel, who welcome them into their schools to help students with mental health needs.  Staff are working to establish partnerships with various local community facilities.  In some situations, the use of telemedicine may be available. 

Ages: Birth - 22 years old

Typical Frequency of Service: 1-2 sessions per week

Available Services:

  • Diagnostic Assessment
  • Individual Therapy
  • Family Therapy
  • Group Therapy
  • Individual Skills Building
  • Family Skill Building
  • Group Skill Building
  • Consultations and Trainings

Additional Information: 

Fees for services are billed to Medical Assistance, managed care companies, and other third-party payers.  TSA is enrolled as a provider with most insurance plans.  Grant funds awarded to TSA by the Department of Human Services Deaf and Hard of Hearing Services Division may be available for children who do not have insurance or who are under-insured.

For more information or to make a referral: 


 What Others Have Said...

  • "Our son has made a lot of progress!"
  • "I am so grateful for this program! [Therapist} has been amazing and [my child] has really connected with her. It is so nice to have a therapist that knows ASL and the culture and can relate to [my child]. Thank you."
  • "[Therapist] has helped [my child] in so many ways."
  • "[Therapist] has done wonders with my child. He actually said that he was getting help and wants to continue with his therapy sessions. He has never said that prior. I’m very Happy!"


Why choose services that are specific to Deaf/Hard of Hearing and DeafBlind?

Therapeutic Services Agency’s Deaf/Hard of Hearing and DeafBlind Mental Health Program, in accordance with the Board of the National Association of the Deaf (NAD) staff and Mental Health Committee, offers its position on Mental Health Services for individuals who are Deaf/Hard of Hearing and DeafBlind. These individuals are considered a low-incidence and underserved cultural and linguistic population within the nation’s mental health system. Unfortunately, normal adjustment, language deprivation, cultural, and communication issues are often mistaken for developmental delays, mental illness, oppositional behavior, and/or cognitive deficits.

Since the mid-1950s, the National Association of the Deaf (NAD) along with a professional community of skilled and experienced providers in various fields serving this population have addressed and advocated for quality mental health services for individuals who are Deaf/Hard of Hearing and DeafBlind.  As a result, extensive theoretical policy and practice literature has developed. This includes the Americans with Disabilities Act (ADA) and several landmark court cases on mental health and hearing loss. These were efforts that advocated and endorsed appropriate care guidelines for services and the importance of consumer voice.

This has culminated in supporting and informing professionals, that for the estimated 28 million individuals who have hearing loss in the United States, mental health services should be provided using culturally and linguistically affirmative approaches. The base foundation for successful therapeutic interventions is understanding and respecting communication choice and family needs of the Deaf/Hard of Hearing and DeafBlind individual in both their nuclear and extended families. Public and private mental health services in all states need to be set up in a way to effectively serve this population, ensuring therapeutic interventions are equal in quality and effectiveness to those provided to persons who can hear. Services should be provided by culturally and linguistically competent providers who use appropriate, evidenced-based practices, and who understand facilitating the acceptance of hearing loss as an integral and potentially valued part of an individual’s life.

The skills of culturally and linguistically competent providers, whether they be hearing, Deaf/Hard of Hearing or DeafBlind include:

  • The ability to communicate directly with a Deaf/Hard of Hearing or DeafBlind client, which frequently requires fluency in American Sign Language, but may also include other modes of a signed, visual, or ProTactile/Tactile communication systems.
  • Appropriate use of services and/or adaptive technology as is best identified and utilized by the client and their family members, including qualified and certified interpreters, assistive listening devices, and real-time captioning services, etc.
  • Extensive awareness and understanding of the cultural and linguistic differences, and psychosocial impacts associated with hearing loss as well as the quality of the delivery of mental health services to this population.

The purpose of this position statement is to share and help others acknowledge the need for and importance of direct communication, sensitivity to cultural affiliation and identity, and sensitivity to the lifelong, psychosocial impact of hearing loss as it pertains to the delivery of mental health services for people who are Deaf/Hard of Hearing and DeafBlind in Minnesota.

The empirical research and experiences of individuals with hearing loss shows that current best practice is to refer to specially trained culturally and linguistically compatible providers whenever and wherever possible. In situations where that is not possible, clinical consultation with culturally affirmative providers during the diagnostic assessment process and throughout the therapeutic relationship is key along with provision of appropriate support services that are guided by consumer choice be made available such as: sign language interpreters, accurately captioned videotapes/videoclips, telecommunication devices for the Deaf, tele-mental health capability, and closed captioning.

In addition, we encourage mental health agencies, allied service providers, and organizations/programs whose work is directly with, or related to, mental health services to inform their staff and membership about this position paper and to incorporate the language used here wherever possible and appropriate in mental health policy statements that focus on multicultural approaches to care, cross-cultural and cultural care, limited English speaking/signing procedures and guidelines, Olmstead planning, and other kinds of policies, procedures, and standards of care that exist in the mental health field and profession. The population of individuals with hearing loss and vision loss across the lifespan is best served when considered as an ethnic and cultural group and included in efforts to eliminate disparities in mental health care.


Critchfield, A.B. (May 2002). Cultural diversity series: Meeting the mental health needs of persons who are deaf. National Technical Assistance Center for State Mental Health Planning (NTAC).

HHS Office of Minority Health and Resources for Cross Cultural Health Care (1999). Recommended standards for culturally and linguistically appropriate health care services (Resources for Cross Cultural Health Care).

Janet DeVinney, Plaintiff and the United States of America, Plaintiff-Intervenor v. Maine Medical Center, Defendant – Consent Decree – Civil No. 97-276-P-C

Myers, R.R. (Ed.). (1995). Standards of care for the delivery of mental health services to deaf and hard of hearing people. Silver Spring: National Association of the Deaf.

Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581 (1999).

Ries, Peter W. (1994). Prevalence and characteristics of persons with hearing trouble: United States, 1990-91. National Center for Health Statistics. Vital Health Statistics, 10(188).

Tugg v. Towey, U.S. District Court, Southern District of Florida, Miami Division (1993). 21 IDELR 717. Individuals with disabilities education law report. 21(9), 717-723.

Willis, A.G., Ph.D.; Willis, G. B., Ph.D.; Male, A., M.A.; Henderson, M.H., M.P.A; and Manderscheid, R.W., Ph.D. (2001) Mental illness and disability in the U.S. household population. Mental Health 2000, U.S. Department of Health and Human Services, Center for Mental Health Services