Deaf and hard of hearing (DHH) children are an exceptional needs population with unique mental health concerns requiring specialized intervention. However, psychological interventions aimed at treating these children are limited. Parent-Child Interaction Therapy (PCIT) is an empirically established therapeutic modality for the treatment of children with behavioral and emotional difficulties. This case study describes how PCIT was adapted to effectively intervene in assisting a deaf mother improve parent-child communication, bonding, and her hard-ofhearing son's behavior. Readers will learn how PCIT was adapted and implemented with a DHH family, including the use of sign language interpreters within the model, translating PCIT behavioral coaching to American Sign Language, and an overall broadened understanding of mental health treatment with the DHH population. The effect of treatment on the child and parent who participated is also discussed.