Deaf Clients Research Articles

Ethics in mental health and deafness

Mental health experts describe ethical decisions in working with deaf clients, particularly issues of communication. Addressing those who provide mental health services to deaf people, 10 chapters are presented by Gutman (psychology, Gallaudet U.) that explore a variety of issues of ethics in dealing with varied populations and settings. Discussions include examinations of the law and ethics, working with children and adolescents, working with minorities, training professionals for mental health services, genetic counseling and testing for deafness, and research involving deaf people.

Impact of sign language interpreter and therapist moods on deaf recipient mood.

This study questions how the mood and affective reactions of the interpreter and the therapist affect the therapeutic process. Professional sign language interpreters are trained to be impartial conduits who neither add nor subtract from the primary dyadic relationship. This study revealed that despondent interpreter mood caused significant negative mood changes in the deaf participant even when the therapist mood was neutral/cheerful. Practicing psychologists need to consider the susceptibility of deaf clients to the nonverbal mood presentation of sign language interpreters and its implications on the therapeutic alliance.

Impact of sign language interpreter and therapist moods on deaf recipient mood.

This study questions how the mood and affective reactions of the interpreter and the therapist affect the therapeutic process. Professional sign language interpreters are trained to be impartial conduits who neither add nor subtract from the primary dyadic relationship. This study revealed that despondent interpreter mood caused significant negative mood changes in the deaf participant even when the therapist mood was neutral/cheerful. Practicing psychologists need to consider the susceptibility of deaf clients to the nonverbal mood presentation of sign language interpreters and its implications on the therapeutic alliance.

Interpreting in mental health settings: issues and concerns.

Sign language interpreters in mental health settings face extreme linguistic and cultural difficulties in interpreting basic, everyday language used in these settings. This is particularly true when deaf clients have limited English proficiency, which often requires interpreters to use expansion techniques in order to render messages successfully. To examine how diagnostics may be affected by interpretation, Brauer (1993), Montoya et al. (2001), and Steinberg, Lipton, Eckhardt, Goldstein, and Sullivan (1998) translated two widely used psychological screening instruments into American Sign Language (ASL). The Minnesota Multiphasic Personality Inventory (MMPI) and the Diagnostic Interview Schedule-IV (DIS-IV) were selected for translation, and data from the three studies are presented and discussed. Their implications in terms of the expectations and stresses placed on interpreters are described within a framework of demand and control theory. Finally, sections of the Code of Ethics of the Registry of Interpreters for the Deaf (RID) are examined relative to both the issue of confidentiality and what the interpreter's contribution should be in mental health settings.

Deaf and Hearing-Impaired Lesbians and Gay Males

This nationwide exploratory study describes the social support systems of 43 gay men (n = 19) and lesbians (n = 24) with hearing impairments of varying degrees. It examines the configuration and function of these support systems on both an ongoing basis and in the event of a crisis. Data from this sample of relatively young, healthy, well educated, professional, mostly profoundly deaf lesbian women and gay men indicate that lesbian or gay male friends or fictive family provide the most support in times of crisis. Further, respondents were well integrated into the gay male and lesbian community as well as the heterosexual community where they sought and received social services. Although not particularly religious, respondents were politically liberal and tended to vote for candidates that openly supported lesbian and gay male issues. Open and honest about their sexual orientation, most respondents were in long term relationships with same-sex partners and had few disabilities other than hearing loss. Data further demonstrate that social workers working with deaf or hearing-impaired clients must consider the aspects of community (both the gay and lesbian community and the deaf community), use appropriate communication techniques, and employ an empowerment approach to best meet the needs of this population.

Cultural clinical psychology: assessment of deaf clients

Cultural clinical psychology: assessment of deaf clients

I don't want to hear you, but I'd like to see you

Purpose: To compare attitudes towards clinical genetics between respondents who are Deaf and those who are Deaf-Blind. Previous studies involving Deaf patients have been limited by the barriers inherent in obtaining responses in a clinical setting as well as by a language barrier. This is the first work that elicited non-censored responses from Deaf and Deaf-Blind adults.Methods: Participants in a retreat for Deaf-Blind adults were interviewed concerning their views relating to genetic counseling and treatment of hearing and vision loss. Respondents consisted of Deaf adults (those who identify as part of the Deaf culture in the U.S. and Canada and whose primary language is American Sign Language) and Deaf-Blind adults (those who have both hearing and vision loss). Initial interviews were conducted in-person in the respondent's preferred language and mode of communication. Communication was direct (no interpreter needed) and included American Sign Language (ASL), tactile ASL (the Deaf-Blind respondent read ASL by placing his/her hands on the interviewer's hands while the interviewer signed), and spoken English. Follow-up interviews were obtained within a six-month period.Results: The Deaf adults had negative views towards medical genetics, drawing parallels between treatments to “cure deafness” with eugenics and genocide. However, one respondent would be interested in genetic counseling if the medical personnel had positive attitudes towards the Deaf and would meet the needs of Deaf clients. The Deaf-Blind adults fell into two categories. Those whose communication included both signing and oral methods were interested in preserving both their hearing and vision. Those who identified as culturally Deaf had similar responses as the Deaf adults in terms of resenting the idea of “curing deafness,” while at the same time interested in any avenues that would preserve or restore vision.Conclusions: To provide appropriate services to Deaf and Deaf-Blind adults, it is imperative to establish trust and effective communication. Identifying a contact in the Deaf community who can serve as a cultural mediator is an important tool. In addition, expanding the time frame for clinical appointments and utilizing the preferred mode(s) of communication conveys respect and allows for successful communication. The attitudes of Deaf-Blind adults towards medical interventions differed between those who communicate orally and those who identify as culturally Deaf.

The culture of the deaf.

The population of the United States includes over 1 million deaf people, the majority of whom have chosen to differentiate themselves in terms of a Deaf culture. These Deaf people share unique values and norms and use sign language for communication. The differences that exist between hearing and Deaf individuals necessitate that the nurse understand this population. This article will describe the Deaf culture using Leininger's Sunrise Model and present specific nursing actions in the modes of culture care preservation and/or maintenance, accommodation and/or negotiation, and repatterning or restructuring that enable the nurse to provide culturally congruent care for Deaf clients.

Hallucinations in Deaf People with a Mental Illness: Lessons from the Deaf Clients

The Deaf client is defined as a congenitally or prelingually deaf person whose first language is a sign language and who has schizophrenia.

Enabling service providers to meet the needs of Deaf clients

On November 8 1995 the Disability Discrimination Act was passed by parliament making it '…unlawful to discriminate against disabled persons in connection with…the provision of goods, facilities and services…'. The aim of this article is to look at some of the possible implications of this legislation for health professionals in their dealings with one particular group of disabled people, namely the Deaf community whose first or preferred language is British Sign Language.

Social Work Practice with Deaf Clients

ABSTRACT Persons with severe hearing loss live in a unique cultural context with which social workers may not be familiar. This paper reviews the skills needed for the culturally competent social work assessment with deaf clients, including communication skills, interviewing methods, taking case and family histories and behavioral observation.

Rehabilitation Counseling with the Deaf: Considerations for Counselors with General Caseloads

Due to the lack of adequately trained and experienced rehabilitation counselors for the deaf, the majority of vocational rehabilitation services will be provided by counselors with general caseloads. For those counselors who are assigned deaf clients, information is provided to facilitate greater awareness of the cultural, communication, assessment, and career development needs of this clientele.

Accessibility of mental health services and crisis intervention to the deaf.

The percentage of deaf and hard of hearing people who need mental health services and crisis intervention is similar to that of the general population. Hence, a survey was conducted to evaluate the accessibility of these services to the deaf population in Rhode Island. Staff members at agencies were asked about the number of deaf clients they serve, and asked to judge the accessibility of their basic services (e.g., TDD, interpreters). The results indicated that although more than 70% of respondents indicated they had served deaf people during the past year, only 25% provided certified interpreters and only 39% were accessible to the deaf community via TDD. Other services as well as the needs of the deaf community are also discussed.

Personality Assessment of the Prelingual, Profoundly Deaf Child or Adolescent

Personality assessment of children and adolescents experiencing an early, profound hearing loss is hampered by the lack of instruments standardized and/or developed primarily for use with deaf clients. Further compounding the problem are the relatively few psychologists trained in and/or experienced with deaf personality assessment. This article reviews the rudimentary requirements for personality assessment with the deaf and critiques the available personality tests that are either used or useable in assessing the deaf.

Providing Equal Access for Deaf Clients

Fifteen years after the passage of a law by the Federal Government, many hospitals are still not providing hearing-impaired patients with equal access to their services in a consistent and effective way. Not only does this create frustrating situations for the patients and hospital staff, but it also puts the hospital in the position of noncompliance with the law. The author describes how one hospital addressed this issue at the level of service provision and found some workable solutions.

Social services for deaf and hearing-impaired clients: a review of the literature.

Emphasis on the social service needs of the deaf and hearing impaired has increased in the past decade. The literature that resulted from this attention is fragmented, however, and does not always offer the structure and direction that is needed. This review of the literature identifies issues related to effective service delivery with the objective of enhancing practitioners' understanding and awareness of the social service needs of the deaf community. A second objective is to stimulate interest and action in service delivery, program development, and direct service for the deaf.

Rational-emotive therapy: A discussion of its applicability for deaf clients

This review was conducted to explore the feasibility of Rational-Emotive therapy as an approach to addressing the problems of providing mental health services to persons who have a severe hearing impairment. Informational resources dealing with the topics of Rational-Emotive Therapy and counseling with persons who are hearing impaired were reviewed. References indicated that RET is reasonably well suited to the task of counseling with clients who are hearing impaired, provided that appropriate modifications are incorporated. Specific modifications of RET are recommended and discussed.

Rehabilitation Counseling With Deaf Clients

Hearing impairment is one of the most prevalent disabling conditions in the United States. This article examines the functional limitations imposed by early profound deafness—the most severe form of hearing impairment. The psycho-social, educational and vocational implications of early profound deafness are presented with recommendations for rehabilitaiton practice.

Employability of black deaf persons in Washington, D.C.: national implications.

During the period from July 1978 through May 1981, the Vocational Rehabilitation Services Administration of the District of Columbia served 603 deaf clients, of whom 121 were placed into gainful employment. This paper reports an assessment of employment trends of black deaf clients rehabilitated during that time. The study sought to determine (a) if the minority group status of race affected employment, (b) if gender affected employment, (c) if age affected employment, (d) if jobs obtained were representative of all occupational categories or remained stereotypic, (e) if previous work experience or training was related to the types of jobs obtained, and (f) if certain common social factors may have affected employment status.

Editorial

Editorial POSTSECONDARY EDUCATION FEDERALLY ESTABLISHED REGIONAL PROGRAMS Over the last two decades the federal government has helped develop four regional programs for deaf and hard-of-hearing students. These are the St. Paul Technical Vocational Institute (TVI), California State University at Northridge (CSUN), Delgado Community College, and Seattle Central Community College. Two of these programs have been absolutely outstanding and the other two have been well above average. All have objective follow-up data demonstrating the dividends returned on the educations they provide. In the face of this record of success, including excellent fiscal return on tax dollars invested, it is sad that these four programs now face possible extermination because of withdrawal of federal support. The government seems unable to distinguish between an expense and an investment. The paradox these proposed cutbacks represent is especially pronounced when one considers the huge influx of rubella-deafened youth who will be needing postsecondary education during the next five years. This influx has been fully documented by epidemiological studies and is a clear and indisputable fact. Rehabilitation Centers and Programs Seven rehabilitation programs exist in the U.S. that serve primarily those postsecondary deaf students who cannot or choose not to attend 4year or community colleges. These programs are highly or totally dependent on state rehabilitation funds. As these funds have been cut drastically at a national level, the rehabilitation centers have made gross reductions in the support services necessary for meaningful participation on the part of most deaf clients. The effects of these cutbacks are especially damaging to those deaf youths who are most in need of services. It was these few rehabilitation programs that were trying to meet the needs of the lower third of the deaf population desperate for training. If this third of the deaf population is to survive as economically independent contributing members of society, they must have comprehensive vocational rehabilitation training. Federally Established National Programs Historically, Gallaudet College and the National Technical Institute for the Deaf have been treated generously by the federal government . While they too now face fiscal cutbacks in the face of the increasing needs represented by the "rubella bulge," there are cushions in their budgets which do not exist in the other postsecondary programs. Other Postsecondary Programs There are about 34 other postsecondary programs in the U.S. that have some support services for deaf students. These programs vary tremendously in quality. Most provide training for local clients only. All of these programs depend to some extent on state vocational rehabilitation funds, which in turn depend directly on matching federal money. These federal funds have been drastically cut, crippling the 34 local programs for deaf clients. Overview The network of 48 postsecondary programs with support services for deaf youths and adults is facing near annihilation due to federal fiscal cutbacks. The problem is compounded by federal efforts to take the teeth out of the VR Act of 1973 (and revisions) and P.L. 94-142. This further erodes the financial resources available by eliminating interpreting services and other aspects of equal access. A national plan to meet the postsecondary needs of deaf youth is needed. The current fiscal cutbacks jeopardize all but two of the programs now available. Without adequate postsecondary opportunities, most deaf youth will face unemployment or dead-end routine jobs with low pay and little job satisfaction. McCay Vernon, Ph.D. Editor ANNOUNCEMENT The Annals has changed its subscription policy from a calendar year basis to an annual anniversary basis beginning with the February 1983 issue. February 1983 issues are being sent to unrenewed subscribers to minimize problems as a result of this change of policy. Future subscriptions will terminate 1 or 2 years from receipt of renewal. A.A.O. I February 1983 ...