Hi, James,

I think another factor that weighs in, is the degree of faith people have in your approach. The more literate/intellectual people tend to believe in reason, and would trust a CT approach to therapy (and trust you). This in itself, introduces an element of hope and a positive attitude. It would be harder to achieve this among people who are not used to a more analytical way of thinking, and simply aren't in the habit of applying reason as a tool and relying on it. Having said that, I agree with your sentiments that some level of CT can be creatively applied to suit a range of IQ's and literacies, but I tend to think it can't be as heavily relied on in the lower ranges, and will need more supplementing, if only because of the hope/trust factor, and the habits/approaches that are already established.
In the higher intellectual and literacy range, CT sessions are enjoyed (the intellectual "challenge"), and new insights appreciated. This generates faith and hope, because it's easier to rely on a tool one is brought up to work with.

Just my two-cents' worth

Janet