Most school coordinators report that they do not employ a professional school counselor who works specifically with students who are deaf. Instead, those students have access to school counseling with general education counselors who use interpreters (Lomas, Nichter & Robles-Pina, 2011). However, many counselors lack the knowledge and experience to even provide counseling services to people who are deaf (Wright & Reese, 2015). The values and behaviors of clients will differ depending on how the client connects and identifies with Deaf culture (Wright & Reese, 2015), and if the counselor is not aware of that, effective counseling services cannot be implemented. Unfortunately, most counseling programs do not teach about the Deaf culture. It should be a necessary topic in the multicultural curriculum; however, some programs may include it in their disabilities discussion. If it is included here, deafness is viewed as a disability instead of a culture which invalidates the way some individuals identify with their deafness and will impact the way they are counseled. My plan for advocacy is to go to the board of the counseling education program and pitch the idea of including Deaf studies in the multicultural curriculum. I would also bring up the idea of having American Sign Language as a language requirement before joining the program, or to be taken with the other core classes. I would bring up the research that has been discussed in this project and prove the importance. The largest barrier in mental health services for individuals who are deaf is communication with the counselor (Gill & Fox). With these two changes made to the masters’ counseling programs, counselors should be well equipped and feel competent when they work with students who are deaf in mainstream schools.
After looking at the research and conducting interviews, the most important need I found is that counselors need to be able to effectively communicate in the client’s preferred language and understand the Deaf culture. Research shows that language and communication difficulties along with lack of social support are possible reasons for the increase risked of mental health problems in those who are deaf or hard of hearing (Wright & Reese, 2015). In order for a counselor to effectively communicate, the counselor either needs to have sign language skills or provide an interpreter through the organization. Many deaf client’s think the ideal mental health option would be to have a therapist who could use sign language (Gill & Fox, 2012). For my servant leadership activity, I would provide a workshop at the All Ohio’s Counselors Conference. Counselors typically receive less training with regard to physical disabilities and therefore many counselors lack the knowledge and experience to provide counseling services to people who are deaf (Wright & Reese, 2015). This workshop will have a psychoeducational approach and teach about the Deaf culture, values, mannerisms, and why it is important for counselors to have a training such as this. The other half of the workshop will introduce basic American Sign Language (ASL) skills and provide an abundance of resources for learning ASL via internet, classes, and other workshops that will be available. This will hopefully limit the need of interpreters in the counseling sessions which could increase confidentiality and the comfort level of the clients. If the language skills are not learned by many, at least individuals would be able to better understand the needs of this group and what it means for them as counselors.
This image represents the need for counseling within the Deaf community. Many studies have highlighted prevalence rates of mental health problems in adults and children who are deaf, which are often much higher than their hearing peers (Wright & Reese, 2015). Students who are deaf are at higher risk of child abuse, have significant social/emotional and behavioral challenges and difficulties. Studies suggest that language and communication difficulties along with lack of social support are possible reasons for increased risk of mental health problems among individuals who are deaf. (Lomas, Nichter & Robles-Pina, 2011). Individuals who are deaf are strong willed and determined and want to receive help but often do not receive the services they need, to no fault of their own. Counselors typically receive less training with regard to physical disabilities and therefore lack the knowledge and experience to provide effective counseling services to people who are deaf (Wright & Reese, 2015). To provide culturally sensitive services to clients, a counselor must be able to effectively communicate in the client’s preferred language, and this is one of the biggest barriers to providing counseling services because not many counselors are trained in American Sign Language (ASL) (Wright & Reese, 2015). There needs to be more communication access for individuals who are deaf. Having a counselor who is fluent in ASL is preferred, but obtaining services of an interpreter is the second-best option. When interviewing one of my previous ASL professors she explained that Ohio is really screening for people who know sign to go into the counseling profession. She also suggested that counselors take classes in American Sign Language before entering their field because they are highly likely to encounter individuals who are deaf in the mainstream schools. Counselors who would be trained do not necessarily have to be as skilled as an interpreter or translator, but have enough skills to meet the needs of a client who is deaf. If not, counseling sessions can have up to four people in the room, which is not ideal for the client-counselor relationship (T. Shank, personal communication, October 15th, 2018). Also, graduate programs that train mental health professionals need to modify their curriculum and teach Deaf culture in a multicultural context instead of a disabilities context (Wright & Reese, 2015). Until counselors increase their knowledge of the Deaf community and their needs, and recognize that it is a culture and not a disability, individuals who are deaf will not receive the services they need.
This picture is a representation of the battle against Audism. Audism is defined as the notion that one is superior based on the ability to hear or behave in a manner of one who hears (Cooper, Cripps & Reisman, 2013). Deaf Out Loud (Matlin, 2018) is a documentary that also touched on the idea of new born children being congratulated on passing their hearing test- even if the parents are Deaf. This shows the assumption that individuals who are Deaf are suffering from a disability that should be “fixed”. This also introduces the hard decision of hearing aids and cochlear implants that will be mentioned later.
This picture represents breaking down barriers individuals who are Deaf face, especially in regard to healthcare. 70% of Deaf patients do not have access to interpreters during appointments, and 28% of Deaf people avoid going to their general practitioner because of poor communication (BMJ- British Medical Journal, 2008). It also represents the daily discrimination and oppression individuals who are Deaf face. It is difficult and frustrating to always need an interpreter and special services to be able to communicate with others.
This image represents the controversy of cochlear implants in the Deaf community. Some individuals in the Deaf community view the help of hearing aids or cochlear implants as a betrayal to Deafness. Deaf Out Loud (Matlin, 2018) explains that if parents put their child who is Deaf in a mainstream school, the Deaf community sees the family as “deaf”. The little d shuns them from feeling included in the community. This makes it difficult for students and families to feel they belong in either culture they are exposed to.
This photo represents the challenges Deaf individuals face when encountering police officers. Officers often don’t realize that stopped individuals can’t here and it leads to confusion or worse. Miscommunications between law officers and deaf drivers or pedestrians have reports ranging from wrongful arrests to brutal beatings to even homicides (American Civil Liberties Union, 2018). These visuals combined provide an example of the systemic challenges faced by Deaf individuals.
Gill, I. J., & Fox, J. E. (2012). A qualitative meta-synthesis on the experience of psychotherapy for deaf and hard-of-hearing people. Mental Health, Religion & Culture, 15(6), 637-651.
The purpose of this meta-synthesis is to examine qualitative literature to highlight factors that impact the therapeutic relationship between a therapist and a sign language user. This literature review helps identify differences in the therapeutic process, which may be affecting the therapeutic outcome directly. The literature in the first half of the article argues that most significant changes within a client occur due to extra-therapeutic techniques that are not directly controlled by the therapist, such as social support. However, the therapeutic relationship correlates highly with positive outcomes in therapy. These suggestions are based solely on clients who were able to hear and have not yet been applied to populations who are deaf, evenly though research conducted into mental health services with deaf individuals has increased in recent years. The 10 articles that were included in this literature review were all from 1998-2008 which is a little outdated. I would like to see another meta-synthesis conducted with more recent articles. The method of searching for articles followed strict inclusion criteria: published after relevant Disability Act, qualitative empirical studies and information relevant to therapeutic process, participants of any age, race, religion, nationality, culture, or gender, and could include three types of participants: health professional who has served a sign language user, a person who uses sign language as their first language, and sign language interpreters. A cross study display was used for comparative appraisal and the findings were synthesized. The synthesis of the ten reports highlighted seven areas that challenge the formation of a therapeutic relationship between counselor and a client who is deaf: service issues, communication with workers, communication between therapist and client, lack of knowledge, how the client perceives the therapist’s feelings, the use of an interpreter, and the role of family and friends. One implication of this information is the clients’ perspectives, who thought the ideal option would be to have a therapist who could use sign language. Clients often thought their clinicians felt uncomfortable and had unethical and negative views towards people who were deaf. The counselors’ attitude towards deafness may be the most significant factor of building a therapeutic relationship. I thought that this meta-analysis was poorly constructed. At the beginning of the search, there were 1,803 articles that had potential to be reviewed. After many specific exclusions only ten were used in the final study. If I had to do this differently I would have tried to find a more inclusive way in order for my sample size to be larger and easier to generalize. Having said this, it has proven difficult to find information about counseling and the D/deaf culture in the literature myself.
Hardy, J. (2010). The development of a sense of identity in deaf adolescents in mainstream schools. Educational and Child Psychology, 27(2), 58-67.
This study investigated the research question ‘What awareness and ideas do adolescents (age 13 to 16) with severe and profound hearing loss, attending mainstream schools, have about their developing deaf identity?’ (p. 60). Some literature in the first half of the article found that deaf pupils were more likely to be rejected by their hearing peers and to show behavioral problems, low self-esteem and feelings of social isolation. Other studies that focused on inclusive educational environments did not find the same results. Research demonstrated that a social skills training program in improving the social and emotional interactions of deaf students in inclusive settings within mainstream schools was an effective intervention. The research was relevant to the study but most of the sources dated early 2000s. The sample in the current study included 11 deaf students in local authority comprehensive schools with resourced provisions for the hearing impaired. Semi-structured interviews were conducted, videotaped, and fully transcribed. The study took an ideographic approach to explore the individuality of each student. The study found many contradictions in the participants answers during the interview. The emergent variable within this research was group alignment. The participants identified themselves within three groups: deaf aligned, hearing aligned, or the ‘bridge between two worlds’, which effected students interview responses. Implications of this research show dynamic factors within the development will influence changes in group alignment over time. Ease or difficulties with communication, together with students’ previous experiences of friendship, all influence choices regarding group alignment and identification. I was curious how they found these specific participants in the study but liked that it was individualized and more like a case study for each student. The results of this study also aligned with one of the other studies I read, which is comforting that the results are promising.
Kunnen, E. S. (2014). Identity development in deaf adolescents. Journal of Deaf Studies and Deaf Education, 19(4), 496-507.
The purpose of this study is to address the question: how the identity in deaf students in different domains changes over the years, and compare this development with hearing students. Other literature has found that the core variable of identity is group alignment, whether deaf adolescents identify with deaf, hearing, or both groups. The most critical educational experiences turned out to be their social relationships and the language in which they communicated. The most recent research demonstrates that the way in which deaf adolescents identify with different social groups is highly relevant for the formation of their identity. Research studies also base this idea of identity development off of Erikson’s theory. Most of the literature cited in this study is current and relevant to provide background knowledge on the topic. For this study, seven students of a school for deaf or hard of hearing students participated. All participants were skilled in sign language, they were in the same class, and all followed higher general secondary education level. The researchers followed these participants for 5 years, administrating different assessment instruments, followed up by questionnaires. The study found that all students except one showed consistent development as expected on the basis of Erikson’s theory in almost all domains. Most commitments were classified as either moratorium or achieved, indicating that students were exploring their identity. Participants in this study are “realizing their preferred social group identities and are focusing their social energies in those directions where they experience greater depth and ease in their communication and relationships…” (p. 505). A very important implication of this study is that the sample consisted of students at the highest level of education in the schools for the Deaf in the Netherlands and formed a successful and competent group. It is important for future research to see if these findings hold true for lower levels of education. Not all deaf students have support in their schools, which in combination of challenges offered by being deaf, triggers identity development. This research is based on a sample of Dutch participants, which may not be generalizable so I would like to see the differences in results with a new population. Also, there were many methodological issues mentioned, which makes me question the reliability and validity of the study.
Lomas, G. I., Nichter, M., & Robles-Pina, R. (2011). The role of counselors serving deaf or hard of hearing students in public schools. American Annals of the Deaf, 156(3), 305-319.
The purpose of this study was to investigate (a) if there was a difference between how counselors employed by public education programs for d/Deaf and hard of hearing (d/Dhh) students perceived their actual role and how they perceived their ideal role and (b) if there are themes that help to clarify the role and function of those powers. Previous research found that 77% of participants in public school programs for d/Dhh students were receiving individual counseling, but none of the counselors self-reported a proficiency level of communicative ability. There has not been a study on the role of counselors employed by local educational programs for d/Dhh students so it is unknown if traditional models for counseling are effective in meeting the needs of d/Dhh students. Most of the research cited is from more than 10 years prior, so the information needs updated but it is still relevant to the study. The participants in this study consisted of 22 counselors who were working in public schools whose primary job was to counsel students identified as deaf or hard of hearing. A criterion sampling method was used and the counselors had to be serving d/Dhh students and have a working relationship with a program for those students. A questionnaire was sent to 75 programs, but only 22 participants fully completed the survey. Follow up interviews occurred with 6 of the counselors. Respondents perceived their role as exclusive to d/Dhh students. However, these counselors perceive a limited role for themselves as evaluators. Needs assessments for both the students and the counselors are an essential function in school counseling for d/Dhh students. The role and function of the counselor serving this population appear to be more heavily weighted toward direct counseling and guidance. A few important implications of this study are that deafness is a low-incidence disability, and the needs of this population are often overlooked. Of the 75 programs contacted, most coordinators reported that they did not employ a professional school counselor who worked with d/Dhh students. Instead, those students had access to school counseling with general education counselors using interpreters and did not meet the requirements to be in the study. This article suggests that some schools have a separate counselor for d/Deaf students. I love this idea but I think it would be hard to implement that. Some school systems claim they do not have enough money to have just one school counselor for the general population. My question then is, how can we train all counselors to be confident and competent when working with d/Dhh students?
Wright, G. W., & Reese, R. J. (2015). Strengthening cultural sensitivity in mental health counseling for deaf clients. Journal of Multicultural Counseling and Development, 43(4), 275-287.
The purpose of this article is to assist counselors who are either currently or in the future providing mental health counseling services to clients who are deaf. It explains how to deliver culturally sensitive services for those clients. This article is a position paper and is made to provide an overview of the Deaf culture for hearing counselors, and to describe the unique needs of clients who are deaf. The literature in the first half of the article suggest that language and communication difficulties, along with lack of social support, are possible reasons for the increased risk of mental health problems in those who are deaf or hard of hearing. The research also suggests that because deaf individuals are a culture minority and are often viewed as disabled, they experience minority stress as well that contributes to a decrease in mental health. Most of the literature being reviewed was more than ten years old, so the information may have been outdated. The main argument in this article is that other literature categorizes deafness as only a disability, but that categorization is incomplete and for some, an incorrect understanding of the way that many individuals view their deafness. Another argument made is that counselors typically receive less training with regard to physical disabilities and therefore many counselors lack the knowledge and experience to provide counseling services to people who are deaf. The main conclusions in this article is that there are three main categories that need attention when serving clients who are deaf: communication style, sign language interpreters, and values and behaviors. The most meaningful implications given those conclusions are that a counselor must be able to effectively communicate in the client’s preferred language. In order for that to occur, an interpreter is necessary if the counselor is not fluent in sign language and it is the responsibility of the organization to supply those accommodations. Another implication is that values and behaviors of clients will differ depending on how the client connects and identifies with Deaf culture so it is important to provide the opportunity for them to tell their story. I thought the article made great points for counselors who have never worked with a deaf client before and was relevant. I would like to find an article that has interviews or surveys with members of the d/Deaf community.