Despite the ever-increasing clinical needs of “underserved populations,” research, practice guidelines, and clinical training programs have focused primarily on treating middle- and upper-middle-class nonminority clients. This paper high-lights the mental health needs of low-income minority patients, pointing out specific risks, obstacles to service utilization, reasons for treatment failures, and significant opportunities for clinical interventions and innovations. Countertherapeutic patient and therapist beliefs and attributions are discussed. A pilot cognitive-behavioral depression group specifically designed for low-income minority patients is used to demonstrate practical interventions and guidelines for working with this population. Preliminary results suggest that premature attrition and clinical outcomes can be significantly improved. Group structure, content, and special attention to group processes were thought to be responsible for positive findings.