We investigated, in new hearing aid candidates, whether or not the use of coping strategies and the life situation, in terms of activity limitation, participation restriction and psychological well-being, were associated with the outcome of audiological counselling, i.e. the patients’ acceptance or rejection of a hearing aid (HA). The study included 173 consecutive adult patients (104 men and 69 women) with a need for audiological rehabilitation including HA-fitting. Use of communication strategies (Communication Strategies Scale, CSS), experience of activity limitation and participation restriction (Hearing Disability and Handicap Scale, HDHS), and general psychological well-being (Psychological General Well-being scale, PGWB) were assessed by self-report inventories. The hospital records, reviewed 1.5years after the first consultation, showed that 39 patients (25 men and 14 women, 23%) had not accepted a hearing aid. In crude and adjusted logistic regression analyses a low report (high scores) of maladaptive behaviour in communication was associated with a three-times higher odds for rejecting a hearing aid, while a highly perceived activity limitation and participation restriction were related to lower odds for rejection. Patients who felt they had few problems with their hearing or overlooked or repressed their shortcomings, rejected HAs more often.