SMI treatment requires specific approaches. Not only are interventions markedly different, the entire approach, to include counselor's interpersonal style, needs adjustment to meet the unique needs of these diverse and often un-affirmed human beings (Caporoso & Kiselica, 2004; Lysaker, Buck, & Lintner, 2009; Mowbray & Holter, 2002). This program begins with an overview of SMI, then transitions to detail a 2013 cross-sectional survey, predictive research design study from which participant results representing all 5 regions of ACES will be reported and implications discussed.