The Deaf community in Australia comprises a small but diverse group of people with a rich, distinctive culture, unified by a common language and history. In recent times, there has been an increasing awareness among ‘hearing’ counsellors of the importance of understanding deafness and Deaf culture in order to more appropriately meet the needs of this client group. This paper will address political, practice, and research issues relevant to the improvement of counselling services provided by hearing therapists for clients from the Deaf community. Firstly, in regard to politics, the paper will highlight some of the tensions between medical and cultural models of deafness and how these frameworks can impact upon the understanding of deafness. Secondly, it will be proposed that constructionist counselling approaches, and narrative therapy in particular, may provide a more culturally and linguistically relevant approach for practice with both clients and interpreters. Lastly, some of the dilemmas of counselling research specific to this client group will be discussed, together with the author’s own work in these areas. The paper will benefit therapists working in cross-cultural settings, or working with interpreters, and those interested in the dilemmas of counselling research