ASL interpreters are an essential communication accommodation for individuals with hearing losses.  In situations involving psychological health care, however, it is important that communication be done in the individual’s primary language.  Additionally, it is important that the provider have the cultural training of working with the deaf, hard of hearing, and deaf-blind population. When an interpreter is used, the language and cultural competencies are likely missing from the provider, which often results in misdiagnoses and ineffective treatment outcomes.  It should also be recognized that when using interpreters, even the highest levels of preparation, quality, and professionalism will not resolve all of the concern related to the complex process of diagnosis and treatment.  As such, the decision to use an interpreter should not be a casual one.