Traditional psychotherapy as presented in most psychotherapy training programmes in South Africa do not equip psychotherapists with sufficient skills to deal with people who have special needs. Most of the traditional approaches to psychotherapy rely heavily on a conversation between the therapist and the client. This mode of providing therapy presents challenges when psychotherapy is being conducted with a client who cannot, for example, talk due to a disability. This paper will present the experiences of conducting psychotherapy with a deaf and speechless client. This will include the process, content and challenges encountered. The presentation will be based on a single case study. Analyses of the therapeutic skills which were more adequate / inadequate from both the therapist and the client’s perspective will also be presented. Suggestions for the implications of conducting psychotherapy with clients of this nature will be explored, particularly as it relates to the training of psychotherapists