Complicated Grief after Murder of Deaf Young Man

Deaf Counseling Center’s Dr. Candace McCullough and Sharon Duchesneau share some thoughts on the complicated nature of grief after murder of Grant Whitaker by Mavrick Martin Fisher and offer support to the national Deaf community in the form of pro bono counseling sessions to those who may be directly impacted by the situation, yet lack insurance to access therapy.

Candace: Sharon and I would like to share some thoughts after this past week’s news about Grant Whitaker’s alleged murder by Mavrick Martin Fisher.

Different Grief Process

Sharon: The grief process following a death by murder is very different and more complicated than that of a death by natural causes such as a heart attack or illness.

Anger as Normal Reaction

Candace: This is because the death is caused by another person, and not simply a natural cause. Anger is a normal reaction and it is okay to feel angry. To add to the complexity, many people in the Deaf community may know one or both of the people involved. For example, we know Grant, with whom we traveled to China on a Deaf school trip with our daughter, and we all have memories of a wonderful time with him. We also know Mav, whom we met with his dad at a national Deaf Academic Bowl reception back when he was young. I’m sure that many people are impacted by this situation, including teachers, friends, and family members. The fact that Mav was well-known on a national basis for his vlogs in which he shared his dreams with the community makes this hit even closer to home for many people.

Danger of Assumptions

Sharon: The public nature of this situation adds to the complexity of grief in the community. People have been sharing their opinions, perspectives, stories, and assumptions online – and these can be difficult for family members and friends of the men to see. None of us have all the information about exactly what happened and the history behind this. Some people have shared concerns that the Deaf community should have been able to prevent this from happening somehow. Again, we can’t assume anything. It’s possible that help was offered or that Mav sought help in the past. We just don’t know, so it’s important that we be mindful of what we say in public, especially online.

Duty of Confidentiality of Professionals

Candace: It’s also interesting that if Mav did get help, those professionals are not able to say so, due to confidentiality reasons.

Sharon: I think when discussing this – of course, it’s important for us as a Deaf community to discuss how we can support people who may be dealing with difficult situations. When we say that no one helped him, however, we may be indirectly placing blame on people close to him, such as family, friends, teachers and others who were close to him and knew him well. We can’t assume they did nothing. Maybe they didn’t or maybe they did.

Deaf Mental Health Stigma

Candace: Also, it’s important to address stigma related to mental health, which is likely to be a factor here, but again, we don’t know the full story. In general, only a very, very small percentage of people dealing with mental illnesses commit crimes like murder. The majority of these people are fine and harmless – we don’t want to see the stigma about people with mental illness being blown out of proportion and spreading unnecessary fear. Let’s be careful about this.

National Legal System and Deaf People

Sharon: Yes, that’s right. Another issue that is coming up here relates to the national legal system. Now we have an alleged murder, which means we are looking at issues related to the court process, a trial, lawyers, interpreting access, fairness, individual rights – all of which are triggers for our Deaf community.

Candace: I think that Deaf people as a whole already have a difficult experience with trying navigate the legal system.

Sharon: Yes, that’s something to keep in mind with the many layers of complexity in this situation, in particular, while we are waiting for answers and things are still unknown. This makes people feel sensitive. It’s a difficult thing.

Pro Bono Deaf Counseling and Therapy Services

Candace: We’d like to offer free counseling/therapy to anyone who is directly impacted by this situation, but who may not have insurance to access counseling/therapy. Please feel free to contact us and we can discuss how we can provide support through the grief process.

Sharon: Thank you.

Candace: Good bye.

(video description: Sharon and Candace, Deaf therapists, (l-r) are seated on a sofa, signing their comments.) Deaf Counseling Center offers national Deaf therapy services.

References:

https://www.facebook.com/TheDailyMoth/videos/2205459446424784/

https://www.facebook.com/TheDailyMoth/videos/492864761281393/?v=492864761281393

https://www.facebook.com/TheDailyMoth/videos/live-mavrick-fisher-in-custody-in-mexico-for-suspected-murder-of-grant-whitakerl/293300168202592/

https://www.mercurynews.com/2019/08/27/missing-mendocino-camper-body-found-companion-arrested-in-mexico/

https://www.justice.gov/sites/default/files/usao-dc/legacy/2013/08/07/coping_after_homicide.pdf

https://victimconnect.org/learn/types-of-crime/homicide-and-grief/

https://deafcounseling.com/recommended-films/ Films on Grief/Loss

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Videophone and Internet-based Counseling: Who Benefits? One more video from our archives, this one from 2007, featuring Sharon introducing the concept of online/virtual/videophone counseling. It’s hard to believe 16 years have flown by since we brought online counseling sessions to the Deaf community for the first time in 2003. Thanks to Sorenson for distributing the first videophones to the Deaf community, which made this possible.

Transcript: For some time now, people have been asking if it’s possible to use the videophone (VP) or virtual for psychological services. We’ve been using this new modality of counseling for a while here at ASC. When most people think of counseling, they envision the counselor and client sitting down together in the same room. Videophone or internet-based counseling is different. It’s actually not a new idea though. Starting in the 1950’s, the military used telehealth technology to provide counseling services to remote bases where there were no counselors available. So, the idea of telehealth counseling is not new, but it is somewhat new in the Deaf community. We’re seeing it slowly being made more available. My experience with videophone counseling has been very positive. It’s a nice option for many people.

One example is people who live far away, or in another state where there are no good Deaf services available, can benefit from videophone counseling. Second, other people may live far away, but prefer not to see their local Deaf counselor because they already know the counselor or don’t feel comfortable with that counselor or they just prefer to work with someone outside their community. Virtual counseling is a nice option. A third example is people who can’t drive or who don’t have a car, who may be sick or too weak to travel, or who can’t afford to buy gas. They can also benefit from videophone access to counseling. Fourth, people who may feel anxious or uncomfortable about going into a counselor’s office, but who do want to start counseling, can do online sessions to start with, then perhaps go to the office for sessions. Finally, many people are very busy these days and find it hard to fit an appointment into their schedules, due to time conflicts or wanting to spend evenings with their families. They can set up videophone counseling sessions during their lunch or break times at work.

There are some differences between in-office counseling sessions and VP or online sessions. In the former, the counselor can see the client’s full body, how they walk, if they are limping, if they have vision issues or a limited range of vision. Body language is obvious. With VP counseling, it’s possible for the counselor to overlook or not realize some things. A client might have Usher Syndrome, for instance, but see well enough to communciate easily via VP, and never share this with the counselor. Someone might have difficulty walking, but it’s not apparent to the counselor through the VP. That’s why it’s especially important to share information with the counselor.

Overall, I’ve found VP counseling to be such a nice option. It’s perfect for people who have no local options for in-office counseling sessions. Thank you.

(video description: Sharon is sitting in an armchair and signing.)

Resources:

https://www.verywellhealth.com/mental-health-services-deaf-1046719

https://deafcounseling.com/understanding-deaf-people-in-counseling-contexts/

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Dr. Candace A. McCullough Deaf Counseling Center Receives 2018 Best of North Bethesda Award
North Bethesda Award Program Honors the Achievement

NORTH BETHESDA November 1, 2018 — Dr. Candace A. McCullough Deaf Counseling Center has been selected for the 2018 Best of North Bethesda Award in the Mental Health and Addiction Services category by the North Bethesda Award Program. Deaf Counseling Center provides both in-person and videophone therapy to Deaf clients on a national basis. Each year, the North Bethesda Award Program identifies companies that we believe have achieved exceptional marketing success in their local community and business category. These are local companies that enhance the positive image of small business through service to their customers and our community. These exceptional companies help make the North Bethesda area a great place to live, work and play.
Various sources of information were gathered and analyzed to choose the winners in each category. The 2018 North Bethesda Award Program focuses on quality, not quantity. Winners are determined based on the information gathered both internally by the North Bethesda Award Program and data provided by third parties.
About North Bethesda Award Program
The North Bethesda Award Program is an annual awards program honoring the achievements and accomplishments of local businesses throughout the North Bethesda area. Recognition is given to those companies that have shown the ability to use their best practices and implemented programs to generate competitive advantages and long-term value.
The North Bethesda Award Program was established to recognize the best of local businesses in our community. Our organization works exclusively with local business owners, trade groups, professional associations and other business advertising and marketing groups. Our mission is to recognize the small business community’s contributions to the U.S. economy.
SOURCE: North Bethesda Award Program

CONTACT:
North Bethesda Award Program
Email: PublicRelations@inrecognition.org
URL: http://www.inrecognition.org
###

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National Deaf Therapy, Hit with Abuse Allegations, Is Closing. A treatment center for Deaf people that was investigated and sued over abuse allegations

Insurance Journal
Negligence or Medical Negligence? Florida Supreme Court Offers Clarity
By Janice L. Merrill
June 6, 2018

Whether a claim arises out of medical negligence and is subject to the presuit screening requirements of Chapter 766 of the Florida Statutes is a question legal practitioners and courts alike have struggled with for years.

In April 2018, the Florida Supreme Court issued an opinion which provides clarity and guidance in making this determination.

Historically, to bring a medical negligence claim in Florida, potential plaintiffs have had to incur the expense of securing an affidavit from a qualified medical professional attesting to a deviation from the standard of care, under a two-year statute of limitations. Healthcare providers largely viewed this presuit screening requirement as an important safeguard in preventing non-meritorious claims.

However, because this process requires a significant expenditure, which can far exceed that of an ordinary negligence claim, many attorneys representing plaintiffs have been reluctant to classify a claim as a medical negligence claim. This allows them to avoid compliance with the presuit screening requirements and affords a four-year statute of limitations. Moreover, conflicting appellate court decisions as to when a claim arises out of the rendering or failure to render medical care and services has only muddied the waters.

The Florida Supreme Court was called on to determine when a negligence claim arises out of the “rendering of, or the failure to render, medical care or services” in the case of National Deaf Therapy, LLC v. Townes.

National Deaf Academy Resident Injured

In this case, a resident was injured during a restraint. The court said while the restraint was included as an intervention in the resident’s care plan, the restraint could be performed by any member of the staff. Although the resident was injured when a registered nurse performed the restraint, any member of the staff, including unlicensed staff such as a sign language interpreter trained on the restraint process, could have performed the restraint.

The court held that simply because a registered nurse performed the restraint, it did not turn the claim from an ordinary negligence claim into a medical negligence claim. The court contrasted these claims with one where an injury arose out of the application of excessive pressure while using mammographic equipment, which caused one of the claimant’s breast implants to rupture, and where a patient was injured while connected to physical therapy equipment. In each of those instances, the injury was sustained as a direct result of medical care, which required the use of professional judgment or skill.

The court held that for a claim to sound in medical malpractice, the act from which the claim arises must be directly related to medical care or services, which require the use of professional judgment or skill. The key is whether the act is one which will require expert testimony as to the standard of care as opposed to the jurors determining through common experience whether the actor breached relevant standard of care.The inquiry for determining whether a claim sounds in medical negligence is two-fold and requires the court to determine (1) whether the action arose out of “medical…diagnosis, treatment, or care,” and (2) whether such diagnosis, treatment, or care was rendered by a healthcare provider (Silva v Southwest Florida Blood Bank, Inc.).

The injury must be a direct result of receiving medical care or treatment by a healthcare provider. As the Florida Supreme Court appropriately noted, merely because a wrongful act occurs in a medical setting does not mean that it involves medical malpractice.

Examples of National Deaf Therapy Negligence

Examples of acts which constitute ordinary negligence as opposed to medical negligence include:

A nurse practitioner spilling scalding hot tea on a patient who arrived at the hospital complaining of a cough, shortness of breath, bronchitis and nasal congestion. This is an ordinary negligence claim, as the act of serving hot tea did not amount to a medical service. There was no medical standard for the serving of hot tea, and thus the claimant was not required to comply with the presuit screening requirements.
A claim arising out of an injury sustained by a dialysis patient when a hospital employee inadvertently kicked the patient’s foot in an attempt to return the foot rest of the patient’s chair to the upright position. This is also an example of an ordinary negligence claim. The testimony of a medical expert as to how to return a chair to an upright position would not be required.
A further example of this is a psychiatric hospital employee’s decision not to separate patients resulting in a patient being punched in the face.
As a result of the Florida Supreme Court’s opinion in National Deaf Therapy, LLC v. Townes, claims that do not arise out of the act of providing medical services and do not involve the use of professional judgment and skill will be treated as ordinary negligence claims. These claims are subject to a four-year statute of limitations and do not require the claimant to incur the expense of obtaining an affidavit from a qualified medical expert attesting to a deviation from the standard of care and causation.

Malpractice

We can expect to see more plaintiff attorneys attempting to characterize claims which arise in a healthcare setting as ordinary negligence opposed to medical malpractice. This will require the defense team to scrutinize the claim carefully to determine whether the act giving rise to the claim truly sounds in ordinary negligence or whether it arises out of the rendering of, or the failure to render, medical care and services and involved the use of professional judgment or skill.

Reference:
https://www.insurancejournal.com/news/southeast/2018/06/06/491206.htm

https://www.nbcnews.com/news/investigations/mom-please-help-fbi-probing-alleged-abuse-deaf-autistic-kids-n193846

http://uhsbehindcloseddoors.org/item/national-deaf-academy/

https://law.justia.com/cases/florida/supreme-court/2018/sc16-1587.html

https://deafcounseling.com/purchase-of-national-deaf-academy/

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In 2016, an inmate in Corcoran, California, faced a dilemma. The parole board wanted to know whether he’d completed any self-help programs during his incarceration, a sign that he’d rehabilitated and could be trusted to go home. The inmate, whose name has been withheld for privacy reasons, said yes: At the Substance Abuse Treatment Facility (SATF), a state-run correctional center, he’d signed up for a group for people serving life sentences. The problem, he admitted, was that he was deaf, and his hearing impairment prevented him from understanding what went on during meetings. “I guess they’re waiting to get an interpreter for that group,” he explained to the board, referring to a sign language interpreter. “But I’ve been going,” he added. “I’m showing up.”

It wasn’t enough for the parole board, which denied him release. “I understand you have limitations,” one of the commissioners said, according to court documents. The commissioner scolded him for not participating in more programs. He would have to wait five years before applying for another hearing.

“With limited access to programs, deaf class members run the risk of serving longer prison sentences,” wrote attorneys at the Prison Law Office.
Under federal law, all prisons are required to provide qualified interpreters for deaf inmates to help them participate in education and self-help classes and communicate with guards. But at SATF, where most of California’s deaf inmates are housed, hard-of-hearing prisoners are regularly denied access to interpreters, according to recent court filings in a long-running disability rights case known as Armstrong v. Brown. “With limited access to programs, deaf class members run the risk of serving longer prison sentences,” wrote attorneys at the Prison Law Office in a statement filed with the court in May. Inmates say the facility has failed to offer interpreters for some Alcoholics and Narcotics Anonymous meetings, lifer groups, religious services, and educational and vocational programming.

In California, deaf inmates’ fight for equal rights stretches back decades. In the 1990s, the state corrections department admitted that deaf prisoners were generally expected to communicate through a combination of written notes, lip-reading, gesturing, and sometimes an informal staff or inmate interpreter. But as the corrections department acknowledged, even the best lip-readers can only understand a fraction of spoken words, and many people who rely on American Sign Language never learn to read or write English. “They are wholly different languages,” says Talila Lewis, director of the nonprofit group HEARD, which notes that ASL uses its own syntax and grammar, and that the average deaf prisoner’s reading comprehension is at about a second-grade level.

In a series of orders from 1996 to 2002, the US District Court for the Northern District of California ruled in Armstrong that the state’s treatment of prisoners with disabilities, including deaf inmates, violated the Americans with Disabilities Act. In 2013 the court found that while the situation had improved, SATF was still failing to provide interpreters at about a quarter of classes for which interpreters were needed—a level, Judge Claudia Wilken noted, that “simply does not constitute making a reasonable effort to comply with the court’s prior orders.” She told the facility to provide a qualified interpreter for any educational or vocational class that enrolled an inmate who communicated through sign language.

One inmate at SATF complained he was removed from an Alcohol Anonymous class without explanation after requesting an interpreter in 2016.
Five years later, that still hasn’t happened, the Prison Law Office told the court in its May filing. When deaf inmates try to enroll in programs, some believe they are rejected because of their special needs. One inmate at SATF complained he was removed from an Alcoholics Anonymous and Narcotics Anonymous class without explanation after requesting an interpreter in 2016. Another inmate in the building maintenance vocational program said he struggled to understand the instructor during conversations about safety and proper equipment. “Most of the time, no sign language interpreter is provided for the safety meetings, and he relies on an incarcerated person to attempt to finger spell the instructions,” the attorneys noted. They argue that the need for interpreters increased after California voters passed a ballot initiative in 2016 that allocated more funding for rehabilitation programs in prisons and gave inmates more opportunities to earn time off their sentences by participating in them.

The California Department of Corrections and Rehabilitation, which hired more full-time interpreters for SATF after the 2013 order, told the court in May that its use of staff interpreters, contract in-person interpreters, and video remote interpretation provided inmates with reasonable access to programs and complied with the Americans with Disabilities Act. “We are committed to ensuring hearing impaired inmates are provided equal access to program assignments and will continue to work to provide services to hearing impaired parolees,” a spokeswoman for the department told Mother Jones. The warden at SATF last month directed his staff to draft a new policy memo for sign language interpreters and to implement training, according to Prison Law Office attorney Rita Lomio. “I am cautiously optimistic,” she says, adding that if the situation does not improve soon, her office will consider whether to seek court intervention.

California, because of its size, has more deaf inmates requiring sign language interpreters than most other states—about 75 at SATF alone, according to the corrections department. And the fact that so many are clustered at one institution creates problems, according to prisoners rights advocates, because SATF is located in a remote part of California’s Central Valley, far from the biggest pools of interpreters in metropolitan areas like San Francisco and Los Angeles. “Not all of them want to drive two hours to go to a prison to translate when they could go to a school or hospital down the street from their home,” says Corene Kendrick, another attorney at the Prison Law Office.

Over the past few years, deaf inmates across the country have sued for better treatment and access to programs. In 2016, a deaf man in Washington, DC, was awarded $70,000 in damages after he was jailed for two months without an interpreter. Maryland, Kentucky, and South Carolina have also reached legal settlements to improve access to interpreter services in prisons. “Nearly all state prisons and the entire federal prison system are in violation of federal law with respect to providing [for] deaf and hard-of-hearing inmates and parolees,” writes Howard Rosenblum, CEO and director of legal services for the National Association of the Deaf.

“It’s the utmost violation of due process I can think of,” says attorney Gay Crosthwait Grunfield.
When deaf inmates leave the prison, some also struggle to access interpreters for parole meetings, especially if they live in remote areas. Between August and December 2017, for example, one deaf parolee in California allegedly did not have access to an interpreter for four out of five parole-mandated mental health appointments. He was soon rearrested, according to Gay Crosthwait Grunfeld, a partner at the law firm Rosen Bien Galvan & Grunfeld who argues the lack of interpretation services prevented him from fully taking advantage of his treatment program and may have contributed to his recidivism. “It’s the utmost violation of due process I can think of,” she says.

In the May filing, the California Department of Corrections and Rehabilitation argued interpretation services are not required for every parole encounter. The department’s attorneys wrote that the use of in-person interpreters could also present safety and security issues, though they did not elaborate. They noted that the parole division was exploring ways of providing interpretation services over cellphones or tablets, and that the corrections department was recently authorized to hire another interpreter at its headquarters to help parole officers in the field.

“We are not discounting how challenging it is,” says Grunfeld. “We are just saying we need to try harder.”

Reference:

https://www.motherjones.com/crime-justice/2018/06/without-interpreters-californias-deaf-prisoners-are-getting-stuck-behind-bars/

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The purpose of this position statement is to acknowledge and emphasize the importance and need for specialized sign language interpreting services in the delivery of mental health services to deaf individuals. While direct mental health services are optimal and always preferred, such services are not always available. When there are no direct mental health services, it is critical to ensure effective communication through specialized sign language interpreting services, which must be complete with sensitivity to cultural affiliation and awareness of the dynamics involved, in the delivery of mental health services to people who are deaf.[1] The National Association of the Deaf (NAD) wishes to use this platform to increase meaningful access to mental health services by elevating the knowledge, awareness, and sophistication with respect to use of sign language interpreting by mental health professionals, healthcare delivery systems, and deaf consumers. The sections below highlight critical information for mental health providers, interpreters and the deaf community to gain a comprehensive understanding of how to better serve and support deaf individuals.

Direct vs. Interpreted Mental Health Services

The NAD recommends that individuals who are deaf be referred to specially trained providers for direct mental health services (see NAD Position Statements on Mental Health Services) whenever possible and that appropriate support services, guided by consumer choice, be made available, if necessary. In situations where it is not possible to find a service provider who is able to provide direct mental health services, or because of consumer preference, the NAD strongly recommends that service providers work collaboratively with qualified sign language interpreters who have specialized mental health interpreting expertise.

The NAD urges mental health professionals, interpreters and the Deaf Community to recognize the unique challenges faced by mental health providers and interpreters working with deaf consumers in mental health settings and to be aware that there is a need for specialized training in order to meet those challenges. The mental health care field is broad and includes both deaf and hearing service providers in the areas of psychotherapy, psychiatry, counseling and social work, psychological testing, substance abuse treatment, forensic therapy, and more. Settings may range from a client’s home, private offices, hospitals and prison facilities.

According to the Registry of Interpreters for the Deaf’s (RID) Standard Practice Paper on Interpreting in Mental Health Settings, “Mental health professionals depend heavily on language form and content for diagnosis and treatment. Nuances in communication, including affective tone and subtleties of language structure, may be significant for diagnosis and treatment effectiveness.” (RID, 2007). While there is great variability in ability to recognition of mental health terms in English by hearing people, a reliable study exploring cultural and linguistic barriers to mental health service access found that deaf participants’ ability varied even more widely (Steinberg, Sullivan, & Lowe, 1998). In addition to understanding terminology specific to mental health settings, interpreters face complex interpersonal dynamics stemming from the symptoms of psychological disorders, diagnostic and treatment goals specific to various mental health settings, as well as the unique communication and therapeutic objectives of each member of the mental health treatment team.

Interpreters are encouraged to adhere to high standards of ethical practice (RID, 2007), which includes ensuring that they have appropriate training in mental health interpreting prior to accepting work in such settings. Interpreters need to be prepared for a variety of group dynamics including but not limited to: hearing clinicians working directly with deaf consumers; hearing clinicians working with deaf consumers and their hearing family members or partners; and deaf mental health professionals with various interpreting needs. These scenarios present their own challenges and complications (Hauser, Finch, & Hauser, 2008) and interpreters would benefit from training and preparation in order to be qualified for such jobs.

Credentials in Mental Health Interpreting

Though the RID lists standards of practice in mental health interpreting, as of early 2012, RID does not have any specialist certification for mental health interpreting.[2] There are several independent programs focusing on mental health interpreting, but there is no uniformity in those programs. The only known certification program that provides intensive training in mental health interpreting is offered through the Alabama Mental Health Interpreter Training. (Alabama Department of Mental Health Administrative Code, 2003; Crump, 2012).

Requirements of Mental Health Interpreters:

Intrapersonal Awareness
While mental health professionals are trained to deal with patients and situations that are emotionally charged, most interpreters are not. As such, interpreters working in the mental health setting must have keen intrapersonal skills in terms of strong awareness of biases and values, triggers, limitations, and potential for countertransference. The ability of the interpreter to self-manage and remain calm during a mental health interpreting assignment is paramount to a successful mental health session for the deaf consumer. Intrapersonal skills can be developed with training, supervision, and peer support, and such skills can guide decisions on accepting jobs in this field. A few aspects of the assignment to consider prior to accepting the job would be: culture, race, gender, religious affiliation, and sexual orientation.

Expertise in Language and Culture
In order to avoid misdiagnosis in deaf consumers, it is critical that interpreters not only have receptive and expressive fluency in American Sign Language, but are extensively trained in mental health techniques. Mental health interpreters must be familiar with and able to utilize different interpreting modalities. Furthermore, the interpreter must be prepared to educate providers on the possible need for longer sessions, the need for appropriate pausing during sessions, or changes in how questions are posed. Providers may rely on interpreters for cultural information. For optimal results, the interpreter’s communication with the service provider and the consumer prior to the first session is critical (Hamerdinger & Karlin, 2003).

Some deaf consumers, especially those with a lifetime experience of mental illness, may also have limited language or information deficits. This can make it much more difficult for a provider working through an interpreter to appropriately differentiate between such deficits and symptoms of mental illness. It is important to ensure that the interpreting process does not mask the language deficits of consumers as clinicians rely on accurate interpretation to make inferences about mental processes (Crump & Glickman, 2011).

Confidentiality & Professional Boundaries
Throughout the United States, limited resources often restrict options for interpreter services. Deaf consumers may encounter the same interpreters at general life events or appointments that were present for their mental health appointments. These encounters could create some conflicts or discomfort for both the individual and the interpreter. Maintaining confidentiality becomes even more crucial.

Confidentiality in mental health interpreting requires a level of discernment and critical thinking unique to this setting. The NAD-RID Code of Professional Conduct encourages interpreters to “share assignment-related information only on a confidential and ‘as-needed’ basis (e.g., supervisors, interpreter team members, members of the educational team, hiring entities)” (RID, 2005). While it is important for the interpreter to receive some information on what has been happening with a deaf consumer’s treatment, there must be strict protocols to maintain confidentiality. When communicating in writing, it is imperative that interpreters learn standards of such communication, be aware that such communication may become a part of the client’s official file and understand relevant confidentiality laws such as HIPAA and Federal Regulation 42 CFR, Part 2.

Ethics, Supervision & Peer Consultation
Mental health providers are expected to adhere to high standards of ethical practice.[3] In mental health work, there is higher risk for abuse of power, vicarious trauma, boundary crossings, and burnout. As such, providers are encouraged to engage in regular supervision and peer consultation. Interpreters working in such settings need to be held to the same standards and benefit from the opportunity to work with supervisors and/or consult with peers (Atwood, 1986; Fritsch-Rudser, 1986; Dean & Pollard, 2009, 2011; Keller, 2008; Hetherington, 2011; Anderson, 2011). In order to achieve higher standards of supervision in mental health interpreting, the NAD recommends building a pool of experienced interpreters who are qualified to perform supervision and are available to work with new mental health interpreters on a national level.

Qualified Mental Health Interpreters
The NAD recommends the following qualifications for interpreters working in mental health settings:

1. Fluency in American Sign Language;

2. Fluency in English and register choices;

3. Culturally competent;

4. Attending a comprehensive training curriculum for mental health interpreting

5. Mentoring with experienced mental health interpreters (at least 50 hours);

6. Individual or group supervision and peer consultation;

7. High standards of ethical practice; and

8. Knowledge of relevant ethical literature or decision-making models in interpreting.

The NAD recommends that a certification process for specialization in mental health interpreting be set up through nationally recognized means. Alternatively, a standardized portfolio system can be used to emphasize the individual’s specialization in mental health interpreting. It is also recommended that interpreters maintain their skills with continuing education in the area of mental health with every certification cycle (15 hours annually or 60 hours per four year RID certification maintenance program cycle). To achieve this, developing more options for seminars to meet the required 60 hours of continuing education in a four year period in the area of mental health is critical. In order to recruit more interpreters specializing in mental health interpreting, the interpreter training programs are encouraged to provide students at least one class focusing solely on mental health interpreting for a full quarter or semester to capture their interest in this specialization.

In summary, mental health interpreters are an important component in the mental health delivery system for deaf individuals with mental health needs, as they provide auxiliary services when a service provider is unable to deliver direct mental health services or when a deaf consumer requests it. While the field of mental health interpreting has aimed to set higher standards over the past decade, this position paper hopes to raise the standards by defining qualifications, expanding the credentials and requirements for mental health interpreters, as well as addressing the professional boundaries, ethics, supervision, and peer consultation in this profession.

References

Alabama Department of Mental Health. (2003). Chapter 580-3-24, Mental health interpreter standards. Retrieved from http://www.alabamaadministrativecode.state.al.us/docs/mhlth/3mhlth24.htm
Anderson, A. A. (2011). Peer Support and Consultation Project for Interpreters: A Model for Supporting the Well-Being of Interpreters who Practice in Mental Health Settings. Journal of Interpretation, 21(1), pp. 9-20.

Atwood, A. (1986). Clinical supervision as a method of providing behavioral feedback to sign language interpreters and students of interpreting. In M. L. McIntire (Ed.). New dimensions in interpreter education: Curriculum and instruction (pp. 87-93). Proceedings of the 6th national Convention of the Conference of Interpreter Trainers. Chevy Chase MD.

Crump. C. (2012). Mental Health Interpreting Training, Standards, and Certification. In K. Malcolm and L. A. Swabey (Eds.). In Our Hands: Educating Healthcare Interpreters. (pp. 54-76). Gallaudet University Press. Washington, D.C.

Crump, C. & Glickman, N. (2011). Mental Health Interpreting with Language Dysfluent Deaf Clients. Journal of Interpretation, 21(1), pp. 21-36.

Dean, R. K. & Pollard, R. Q. (2011). The importance, challenges, and outcomes of teaching context-based ethics in interpreting: A demand control schema perspective. Interpreter and Translator Trainer, 5(1), pp. 155-182.

Dean, R. K. & Pollard, R. Q. (2009, Fall). “I don’t think we’re supposed to be talking about this:” Case conferencing and supervision for interpreters. VIEWS, 26, pp. 28-30.

Fritsch-Rudser, S. (1986). The RID code of ethics, confidentiality and supervision. Journal of Interpretation, 3, pp. 47-51.

Hamerdinger, S., & Karlin, B. (2003). Therapy using interpreters: Questions on the use of interpreters in therapeutic settings for monolingual therapists. Journal of American Deafness and Rehabilitation Association, 36(3), pp. 12-30.

Hauser, P. C., Finch, K. L., and Hauser, A. B. (2008). Deaf Professionals and Designated Interpreters: A New Paradigm. Gallaudet University Press. Washington, D.C.

Hetherington, A. (2011). A Magical Profession? Causes and management of occupational stress in sign language interpreting profession. In L. Leeson, S. Wurm, M. Vermeerbergen (Eds.). Signed Language interpreting: Preparation, practice and performance (pp. 138-159). St. Jerome Publishing. Manchester, UK.

Keller, K. (2008). Demand-control schema: Applications for deaf interpreters. In L. Roberson & S. Shaw (Eds.).Proceedings of the 17th National Convention of the Conference of Interpreter Trainers: Putting the pieces together: A collaborative approach to excellence in education. (pp. 3-16). Conference of Interpreter Trainers. San Juan, PR.

Steinberg, A. G., Sullivan, V. J., and Loew, R. C. (1998). Cultural and Linguistic Barriers to Mental Health Service Access: The Deaf Consumer’s Perspective. American Journal of Psychiatry, 155(7), pp. 982-984.

Registry of Interpreters for the Deaf (RID). (2005). NAD-RID Code of Professional Conduct. Retrieved from http://rid.org/ethics/code-of-professional-conduct/

Registry of Interpreters for the Deaf (RID). (2007). Standard Practice Paper on Interpreting in Mental Health Settings. Retrieved from https://drive.google.com/file/d/0B3DKvZMflFLdWmFVV2tydVRFTHM/view

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Deaf Counseling Center (DCC), a counseling, life coaching and consulting practice based in Maryland, is celebrating 17 years of service to the Deaf community. DCC is the first Deaf-owned therapy business to incorporate a Deaf-centered philosophy and framework. It is also the first to offer videophone access to counseling, in addition to in-person sessions.

Headed by Clinical Psychology alum Dr. Candace A. McCullough, ’87, G-’91 & G-’03 and Mental Health Counseling alum Sharon M. Duchesneau, G-’93, DCC provides individual, couples and family counseling, life coaching and assessments to the Deaf community and its allies on a national basis. The 11-member (and growing) team of Deaf counselors includes Gallaudet alums Sheli Barber, ’92 & G-’95, Madeline Davis-Shelton, ‘76 and Scott Staubach, ’92.

To mark May Mental Health Awareness Month 2018, DCC is spotlighting the need to improve Deaf people’s access to mental health care. Through a nationwide campaign targeting health insurance companies, government agencies and health care providers, DCC aims to bring attention to the challenges and inequities Deaf people face when seeking mental health services.

To read more about DCC’s May campaign, go to www.deafcounseling.com or follow DCC on social media at Facebook (www.facebook.com/deafcounseling), Instagram (www.instagram.com/deafcounseling), Twitter (www.twitter.com/deafcounseling) and LinkedIn (http://www.linkedin.com/company/deafcounseling).

Reference:

https://my.gallaudet.edu/intranet/announcements-archive/dcc-celebrates-17-years-of-service-by-kicking-off-may-mental-health-awareness-month-campaign?fbclid=IwAR1wzSCRSvN0r9bIIhmEw9WjvJasvFxFyc0-cDUfubWitmlKvweYmNBM6-Y

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Published Oct. 1, 2013 in Counseling Today – A pUblication of the American Counseling Association

Aimee K. Whyte, Alison L. Aubrecht, Candace A. McCullough, Jeffrey W. Lewis & Danielle Thompson-Ocha

We, five Deaf counselors, have come together to write this article to educate our fellow counselors about Deaf culture, the Deaf community and working with Deaf clients. This article is written from the Deaf experience — a “Deaf center” — which reflects “a different normality” (as Irene Leigh explains in her book A Lens on Deaf Identities). This means the perspectives shared here are not from an audiological center or phonological constructs that include the views and terms of “deafness,” “hearing loss,” “hearing impaired” and “cannot hear.” We discuss Deaf people from a social-cultural minority standpoint.

This article is only a starting point to understanding Deaf people in counseling contexts. It is not comprehensive. When meeting with a Deaf client, several important issues need to be considered, including cultural competence, assessing and working through personal biases, counselor advocacy and client empowerment, communication, confidentiality, service delivery, referral, consulting and connecting with professional Deaf counselors, and working with sign language interpreters.

Deaf culture, Deaf community and Deaf identity

Deaf people are part of an ethnic group — a cultural, linguistic minority. It is living in a nonsigning world that can be disabling, not the experience of being Deaf. Deaf people share a collective name, language, culture, history, values, customs and behavior norms, feelings of community and kinship, arts and literature, and social/organizational structures. Being Deaf is a biological characteristic — just like being Black or White, female or male — and is not a condition; it is a way of being.

We use “Deaf” with a capital D in this article as any author would when referring to other cultural or religious groups (Hispanic, Japanese, Jewish and so on). Our use of a capital D indicates, as Joanne Cripps explains in Quiet Journey: Understanding the Rights of Deaf Children, that Deaf culture “is the birthright of every Deaf individual by virtue of their having been born Deaf or having become Deaf in childhood, whether or not they have been exposed to Deaf culture.” 

Like members of other ethnic groups, Deaf people come with a wide range of identities. It is common practice to use a capital D when identifying as culturally Deaf and a member of the Deaf community. Deaf people who have different experiences with vision may identify as Deafblind. Some use a lowercase d for “deaf,” which stems from the medical model and focuses on audiological status, communication style and/or level of exposure to and experience in the Deaf community. Other examples include hard of hearing, late-deafened or Deaf learning ASL later in life. The term hearing impaired may seem politically correct, but for most Deaf people, it is insulting. Additionally, Deaf people have a range of intersections — racial/ethnic, sexuality, gender and so on (for example, African American Deaf or Black Deaf, Native Deaf, Latina Deaf lesbian, Deaf immigrant, Deaf with cerebral palsy). There are also hearing children of Deaf adults who identify with Deaf culture and as members of the Deaf community.

It is important for counselors to engage in readings about Deaf culture and Deaf identity development. Only 10 percent of Deaf people are born into Deaf families, meaning approximately 90 percent are born into families who are hearing and not aware of Deaf culture or American Sign Language (ASL). Often the latter grow up feeling they may be inferior and learn to accept labels born from the medical model. A great number of Deaf people share a common experience called the “dinner table syndrome,” a term informally coined by counselors working with Deaf college students. It describes how, at the dinner table, hearing family members converse freely through speech about their day at work or school and other issues and, all the while, the Deaf person is missing out on these exchanges. (Susan Dupor’s painting, Family Dog, phenomenally portrays these experiences.) Counselors working with Deaf clients would want to educate themselves — as well as their Deaf clients and, when appropriate, the clients’ families — about “Deafhood.” Deafhood, as described by Paddy Ladd, is “to begin the process of defining an existential state of Deaf ‘being-in-the-world.’”

ASL is the language of Deaf people in North America. ASL is not universal. There are different sign languages around the world just as there are different spoken languages. The multicultural aspect of the Deaf community may influence a Deaf person’s signing style. Different signs are used in different regions for the same term. Deaf ethnic/racial minority groups may have their own unique signs and dialects (such as in Black ASL). Education and class may influence a person’s signing as well. For example, the signing of Gallaudet University graduates is often a combination of ASL and English, while a purer from of ASL is retained by those less affected by the higher value academia has long placed on English.

In ASL, the use of nodding is important, as it is in the Japanese language. When a Deaf person is nodding, it means she or he is listening and sees what you are saying. It does not necessarily mean that person is in agreement with what you are saying. Like the Hebrew language, ASL is effective without use of the words “was,” “are,” “to,” “be,” “were,” etc. ASL does not follow the grammatical or syntax structures of English.

Cultural competence and working through biases

In Deaf-centered counseling, the counselor provides culturally and linguistically affirmative services to Deaf clients. The counselor is conscious of how Deaf clients’ lives are shaped by their identity and experiences and by being members of a cultural/linguistic minority group. The counselor uses ASL and communication that matches clients’ preferences and is mindful of issues related to managing life in a small community (for example, dual roles/relationships and the possibility of backstabbing/grapevine talk being misunderstood as Deaf culture).

If a hearing counselor has minimal awareness of Deaf culture and the Deaf community and does not know ASL, this counselor can refer the Deaf client to a Deaf or signing counselor. Another option is for the hearing counselor to work with the Deaf client and a sign language interpreter. It is important to discuss this issue with the Deaf client to find out which option the client prefers. Usually, Deaf clients prefer to work with Deaf counselors. However, there are some Deaf clients who prefer to work with hearing counselors. There are a variety of reasons for either preference (for more on this, see the chapter “Deaf College Students” by Aimee K. Whyte and Kendra Smith in the second edition of Psychotherapy With Deaf Clients From Diverse Groups, edited by Irene Leigh).

As is the case when working with any client, working with Deaf clients requires cultural competence. Cultural competence is developmental, educational, community focused, family oriented, systemic and culturally relevant. Being culturally competent means understanding one’s own worldviews as well as those of the client, and paying attention to the needs of individuals and groups. It involves the integration of cultural attitudes, beliefs and practices into the building of rapport, diagnosis and treatment, education and training, and the counseling office or agency itself.

Ongoing counselor advocacy, client empowerment and use of reframing with Deaf clients — meaning paying particular attention to how we frame things and how our own views of “Deaf” come through in sometimes harmful ways (biases) — fall under cultural competency. Ongoing self-assessment is a must, and this article can be used as a guide.

It is important to focus on how to advocate for Deaf clients and to teach self-advocacy with Deaf clients, both on an individual basis and with families and within systems. It is also important to learn to be anti-audist. Although the word appeared in the Deaf community in 1975, it was not until 2012 that the American Heritage Dictionary first published an official definition of audism: the belief that people with hearing are superior to those who are Deaf and/or that the English language is superior to ASL. Audism is essentially discrimination or prejudice against people who are Deaf. Acts of audism — much like racism, sexism, ageism and other isms — may be intentional or unintentional on the part of a hearing person toward a Deaf person.

Beliefs that Deaf people are helpless, inferior, vulnerable, unintelligent or unable to “speak” for themselves have long dominated our social consciousness. Those same beliefs are perpetuated in many areas of our society, including the professional literature, and negatively influence how we frame the discourse about Deaf people. Deaf people have yet to be identified as a distinct cultural group in counseling and psychology textbooks. They are often included — if at all — in sections discussing people with disabilities (one possible exception is the second edition of Addressing Cultural Competencies in Practice by Pamela Hays, which contains some limited mentions about counseling Deaf people).

In examining the prevalence of the pathological framework in the literature, we are better able to understand the basis of many of our beliefs about Deaf clients. One of the first steps is to accept that much of what you have read thus far in the literature is misleading, incorrect or incomplete. It is our responsibility as professionals working with minority groups to commit ourselves to unlearning what we already “know” and then relearning from the very communities with which we are working. Should a Deaf individual show up at your office, do not assume that because you have read a book or even several articles (including this one) that you are automatically qualified to work with the person. One of the best ways you can advocate for and with Deaf clients is to seek consultation with Deaf mental health professionals.

As a counselor who has studied multiculturalism, you may be aware of the need to unpack your privileges prior to working with clients. One such privilege is “hearing privilege.” Encouraging a Deaf client to become more “hearing” (for instance, by suggesting that the client should speak or speak more often, work to accommodate others, get a cochlear implant or simply accept that the world is not fair) may result in the client feeling less than human.

It is crucial to create a space for Deaf people, to empower them to take a journey into exploring exactly what Deafhood is for them and to support them in discovering and utilizing tools for countering an oppressive society in ways that are both compassionate and liberating. Encouraging clients to develop skills and tools for managing oppression, prejudice and negative attitudes is empowering. On the other hand, teaching a Deaf client to “cope” with oppression as opposed to exploring advocacy — thus placing the burden on the individual rather than on society — is an explicit example of a counselor who has yet to unpack her or his hearing privilege.

Referral

If a Deaf client prefers to work with a Deaf or hearing-signing counselor and one of these counselors is in close proximity, be prepared to make a referral. Discuss this with the client. The client may or may not already know the Deaf/signing counselor. When contacting the Deaf/signing counselor, do not use the client’s name until the client gives her or his full consent. If referring to a hearing-signing counselor, find out the counselor’s knowledge of sign language and Deaf culture. Advise the client that you are not qualified to evaluate a person’s sign language proficiency and knowledge but that you were informed or are aware that the counselor knows sign language.

Another option is to refer the client to an agency that provides videophone counseling. Videophone counseling is also referred to as distance counseling, telecounseling or teletherapy. With just a videophone or webcam and a broadband Internet connection, Deaf clients can now have unprecedented access to Deaf counselors. Technology enables real-time, face-to-face communication between Deaf counselors and clients who communicate in ASL, a visual language perfectly suited to this particular therapeutic modality. Advanced equipment ensures picture quality that is far superior to the typical Skype picture with which most people are familiar. Videophone counseling facilitates therapeutic dialogue by enabling continuous eye contact and observation of facial expressions and upper body language. With the click of a remote, clients can go outside of their geographic regions, as well as their social and professional circles, to obtain support from a larger, more diverse pool of licensed Deaf counselors.

Alternative Solutions Center (ASC), for example, has offered videophone sessions through a national network of licensed Deaf clinicians since its establishment as the first Deaf-centered counseling practice in 2001. By an overwhelming majority, ASC’s clients report a strong preference for videophone sessions with Deaf counselors who understand and “get” the Deaf experience in life over meeting in person with hearing counselors and interpreters, or even with hearing counselors who signs.

When the counselor-client relationship is the best predictor of success, it is not surprising that Deaf clients choose videophone sessions with Deaf counselors. This dyad lets clients relax and focus on the issues that brought them to counseling in the first place rather than dealing with the additional strain so often present when Deaf clients find it necessary to alter or slow down their signing so a hearing counselor can understand them. With videophone sessions, Deaf clients do not feel the need to take care of a hearing counselor’s feelings by throwing in a disclaimer such as “but I don’t mean you” when venting their frustrations about hearing people. Nor do they need to deal with subtle undercurrents of Deaf-hearing inequity that is so prevalent in our society and unavoidable in the therapeutic dyad of a Deaf client and hearing counselor or a therapeutic triad when an interpreter is present. According to ASC, clients tend to keep videophone appointments more regularly than appointments that require traveling to the counselor’s office.

Consulting and connecting with Deaf counselors

The Department of Counseling at Gallaudet University, located in Washington, D.C., is the world’s only training program that prepares mental health and school counseling graduates to work with a wide range of Deaf people. These programs are accredited by the Council for Accreditation of Counseling and Related Educational Programs. Graduates are highly trained in their CACREP specialty areas and possess in-depth knowledge about the Deaf community, including its various subgroups, and are required to have sign language fluency. Interns and graduates from these counseling programs have had a dramatic impact on service delivery systems for Deaf individuals as well as the Deaf community throughout the United States and internationally, increasing full communication and service accessibility for this population. For example, several state mental health directors for Deaf services are Gallaudet counseling graduates.

Although sign language interpreters continue to be an option for making counseling services accessible to the Deaf community, in combination with nonsigning hearing professionals who may or may not be knowledgeable about this population, this is not comparable to direct communication with clients. Gallaudet’s counselor training program is unique because all communication in classrooms is in ASL. Practicum and internship placements are at agencies that serve Deaf people. Graduates of the counseling programs are not limited to working with Deaf clientele; they are trained to serve hearing clients as well.

There are a variety of ways to connect with Deaf counselors. Gallaudet’s counseling training program and its mental health center are good starting points. We have also listed some other agencies and organizations below.

If you do not know of any Deaf agencies in your area, contact one from the list (or from your own Internet search) and ask these organizations to help connect you to the closest Deaf counselor or service agency in your area. Many Deaf counselors are also available to consult through videophones using video relay service (see fcc.gov/guides/video-relay-services). There is no cost to consumers using video relay service.

If you see Deaf counselors at a workshop or conference, talk with them. Invite Deaf counselors to provide education and training to you and your colleagues about working with Deaf clients. When training new counselors about multicultural issues and ethnic groups, include Deaf populations in your discussions and invite Deaf professionals to serve as guest speakers in classes. Finally, attend events and conferences hosted by Deaf counselors.

Working with interpreters

In some instances, the Deaf client may decide to work with a hearing counselor and an interpreter, or for some reason, it may be the only option. Remember that the interpreter is in the session for boththe counselor and the client. It is recommended that the interpreter be nationally certified by the National Association of the Deaf and the Registry of Interpreters for the Deaf (see nad.org/issues/health-care/mental-health-services and rid.org) as well as trained and experienced in interpreting counseling and mental health situations. Trust Deaf clients if they share that they are not getting their needs met via the interpreter or if they explain that the interpreter’s signing skill level does not match their own.

Counselors can also use an interpreting referral agency both to find interpreters and to become familiar with the code of conduct and ethics of interpreters. It is helpful if the counselor asks about the Deaf client’s communication preference and whether the client has a preferred interpreter prior to the counseling session. Confidentiality is a critical issue for Deaf clients, particularly because the Deaf community is small and close-knit. Deaf people work with interpreters often, so there may be specific interpreters the Deaf client would prefer to work with or avoid in counseling sessions for various reasons. Deafblind clients may ask specifically for a close vision interpreter or a tactile interpreter. On some occasions, depending on the language skills of the client, there may be a need for a certified Deaf interpreter in the session in addition to the hearing sign language interpreter.

When in the counseling session, discuss seating arrangements with the Deaf client and ask where the client prefers the interpreter to sit. Most likely, the client will prefer for the interpreter to sit next to the counselor. Avoid talking with the interpreter before and after sessions without the presence of the Deaf client. Otherwise, the client may think you are talking about her or him, and this may have an impact on rapport building and trust. Typically, it is helpful for interpreters to know the goals and important terms that may be used in communications prior to interpreting assignments. In counseling sessions, however, this is not always possible. Instead, this communication can take place with the Deaf client present. Best practice includes the client in any communication with the interpreter.

If any communication is unclear, ask for clarification as the counselor. It is possible either that the client was unclear or that the interpreter was unclear or misinterpreted information. It is also helpful at times to repeat back what the client has said through the interpreter to ensure understanding between all parties. Remember that sign language interpreters are not only interpreting what is said between the Deaf and hearing persons, they are also mediating between cultures. As Claude Namy once said, “Interpreting … is not merely transposing from one language to another. It is, rather, throwing a semantic bridge between two different cultures, two different thought worlds.”

Be mindful of communication flow and turn taking with the client when talking. What is said in ASL often takes longer to interpret or say in English. Eye contact is also important. Be sure to look at the client rather than the interpreter. In addition, avoid using phrases such as “Tell her that …” Always talk to the client directly.

Key counseling approaches

• First and foremost, be ready to refer Deaf clients to Deaf counselors or hire contractual Deaf counselors as needed. If neither option is available, develop a budget for interpreters.
• Remember that Deaf people are diverse. No Deaf person is the same.
• Deaf people are visual beings. Visual, expressive and tactile approaches may be beneficial, including the use of art and play therapy, particularly in school counseling settings. Be mindful that assignments or handouts in English language may not be culturally compatible with Deaf clients.
• Encourage families of Deaf children to learn ASL. In addition, encourage these families to seek opportunities for the child to attend Deaf community events and connect with Deaf role models to foster self-efficacy, communication and social skills.
• n Hearing counselors who are fluent in sign language should never assume the role of interpreter, even in family counseling sessions or if their school is facing financial constraints. Accepting this dual role is unethical and also creates role confusion.
• Become attuned to the power dynamics present when you have an interpreter in your session.
• Be open to and invite challenge from your Deaf clients to neutralize the power dynamics in session. Adopt the vocabulary your client uses (except when it may interfere with treatment goals or identity development issues, or contribute to faulty thinking).
• Be aware that ASL is a specific language. When asking a Deaf client if she or he is “mad,” “angry,” “furious,” “livid” or “enraged,” be cognizant that the sign for each word may be the same. However, the intensity of the sign may change, as may facial expressions. When a client signs that she or he is “mad” with an “enraged” facial expression, there is no telling what terminology the interpreter will choose to describe the client’s anger. For this reason, asking scale questions may be helpful. For example, “Describe your anger on a scale of 1-10.” When assessing for suicide, access to weapons or experience of abuse, use straightforward, simple questions. For example, “Do you want to kill yourself?” The word “suicide” in English actually has several specific signs in ASL, such as “slash wrists,” “take pills” or “hang self.”
• Avoid making decisions for the client or giving advice. Deaf clients may have had decisions made for them for much of their life by family members or hearing service providers. For example, parents may have decided to get them a cochlear implant, vocational rehabilitation counselors may have told them what they could and could not major in in college, schools may have assigned them interpreters with whom they did not feel comfortable, school individualized education programs may have required them to take speech classes while hearing students were in an enjoyable art class and so on.
• Avoid making assumptions about what Deaf people should be feeling. For instance, many counselors assume that Deaf people are grieving a loss of hearing when, in reality, many embrace their Deafhood. Focus on Deaf Gain (see the work of Dirksen Bauman, Joseph J. Murray and Peter Hauser).
• Do not require proof of audist injury and/or minimize experiences that a Deaf person has as a result of familial or systematic oppression. Statements such as, “I would imagine your father wanted to communicate with you, even though …” are not helpful. Validate the client from the client’s experience.
• Beware of challenging Deaf clients to explore patterns of dependency and statements of helplessness. This may trigger transference.
• Avoid asking Deaf clients to teach you about Deaf people or ASL. It is not their responsibility, and counseling sessions certainly aren’t the time for this. Do that research on your own time.
• Do not devalue ASL. Learning the basics of ASL does not make you fluent enough to work with Deaf clients. However, learning some basic sign language and fingerspelling may aid in building rapport and demonstrate that you are interested in your client’s language.
• Be attuned to ways that self-pity elicits your own pity as a counselor, particularly as it pertains to internal biases about the experiences of Deaf people.
• Acknowledge, apologize for and learn from mistakes.
• Pay attention to the framework you discuss in sessions by monitoring your word choices and the ways you may be placing responsibility on the individual for social issues. Consider adopting feminist, systemic, social constructivist approaches to counseling with Deaf clients.
• Use caution when diagnosing. When Deaf people say they believe their family members are talking about them, they may be right (for example, hearing members discussing the Deaf person through speech in the Deaf person’s presence, but the Deaf person not understanding what is said). Or if they think the Deaf community knows something about them, they may be right (the community is very small and close-knit). Because of these issues, some Deaf people have been misdiagnosed as anxious or paranoid. Others have been misdiagnosed with schizophrenia because they were “hearing voices or sounds.” In reality, they were experiencing tinnitus or ringing in the ears, or they were simply misunderstood. Misdiagnoses of attention-deficit/hyperactivity disorder are common for Deaf children with “attention challenges.” This is particularly prevalent in mainstream settings where Deaf children may not have the right kind of interpreter or are feeling that they do not belong, or in Deaf school settings where they have finally discovered peers with whom they can sign.
• Some Deaf clients may have misconceptions about Deaf people and being Deaf. This is known as internalized or “dysconscious audism” (see the work of Genie Gertz). These Deaf people may not have had much exposure to other Deaf people and may possess an identity that was imposed on them (medical perspective). This may be consciously or unconsciously interfering with the client’s life, relationships, self-concept/well-being and perspectives of Deaf people, and would thus be an important issue in treatment. Some treatment goals and activities may include unpacking perspectives (realistic and unrealistic) of Deaf people, meeting other Deaf people, joining Deaf organizations, finding Deaf role models and so on. It may be helpful for the counselor to review development models such as Anita Small, Joanne Cripps and James Cote’s Minority Deaf Identity Development framework, as well as Jean Phinney’s Model of Ethnic Identity Development or Anthony D’Augelli’s Model of Lesbian, Gay and Bisexual Identity Development because there are some parallels in these models to Deaf people’s experiences.
• Ensure that your agency or private practice is Deaf-friendly. For example, list “Deaf” under ethnicity in your forms and checklists. Include a question about communication preference or if an interpreter is needed in sessions. Print intake forms and other paperwork in a larger font size for Deafblind clients (14-point Verdana on yellow paper, unless the client specifies a different need or preference). Become familiar with the relay phone services that Deaf people use, including video relay service and text relay.
• When possible, high school counselors could connect Deaf students with a Deaf unit in a department of vocational rehabilitation to support the students’ vocational and career goals after graduation.

Resources

• Deaf Counseling/Mental Health Organizations & Agencies:
  • Abused Deaf Women’s Advocacy Services (ADWAS): adwas.org
  • ADARA (Professionals Networking for Excellence in Service Delivery with Individuals who are Deaf or HOH): adara.org
  • Advocacy Services for Abused Deaf Victims (ASADV): asadv.org
  • Alternative Solutions Center (ASC): ascdeaf.com
  • Deaf Counseling, Advocacy and Referral Agency (DCARA)
  • Deaf Wellness Center (DWC): urmc.rochester.edu/deaf-wellness-center
  • Gallaudet Mental Health Center
  • National Counselors of the Deaf Association
  • Minnesota Chemical Dependency Program for Deaf/HOH
  • National Deaf Academy Behavioral Health System: nda.com
  • Substance and Alcohol Intervention Services for the Deaf (SAISD): rit.edu/ntid/saisd
  • Deafblind International: deafblindinternational.org
  • Facundo Element: facundoelement.com

  Deaf Organizations:

  • American Association of the Deaf-Blind
  • American Society for Deaf Children: deafchildren.org
  • Children of Deaf Adults, Inc.: coda-international.org/blog
  • Deafhood Foundation: deafhoodfoundation.org
  • Deaf Women of Color: deafwomenofcolor.com
  • Deaf Women United, Inc.: dwu.org
  • Audism Free America (AFA): audismfreeamerica.blogspot.com
  • Intertribal Deaf Council (IDC): deafnative.com
  • Jewish Deaf Congress (JDC): jdc.org
  • Journal of Deaf Studies and Deaf Education: jdsde.oxfordjournals.org
  • Latino Deaf & Hard of Hearing Association of the Metro DC Area, Inc.: ldhhamdc.org
  • National Asian Deaf Congress (NADC): icdri.org/dhhi/nadc.htm
  • National Association of the Deaf: nad.org and nad.org/affiliates
  • National Black Deaf Advocates (NBDA): nbda.org
  • National Council of Hispano Deaf and Hard of Hearing: nchdhh.org
  • Rainbow Alliance of the Deaf: rad.org

  Books/Videos for Counselors:

  • “A Lens on Deaf Identities” by Irene W. Leigh.
  • “Cognitive-Behavioral Therapy for Deaf and hearing persons with language and Learning Challenges” by Neil Glickman.
  • “Cultural Space and Self/Identity Development Among Deaf Youth” by Anita Small, Joanne Cripps and James Cote (Available Online).
  • “Deaf and Sober: Journeys Through Recovery” by Betty Miller.
  •  “Deaf in America: Voices from a Culture” by Carol Padden and Tom Humphries.
  • “Deafhood Discussions” (various videos): deafhood.us/wp.
  • “Ethics in Mental Health and Deafness” by Virginia Gutman.
  • “History Through Deaf Eyes” (PBS movie).
  • “Mental Health Care of Deaf People: A Culturally Affirmative Approach” by Neil Glickman and S. Gulati.
  • “Psychotherapy with Deaf Clients from Diverse Groups” (first and second editions), edited by Irene W. Leigh.
  • “Quiet Journey: Understanding the Rights of Deaf Children” by Joanne Cripps.
  • “The Mask of Benevolence” by Harlan Lane.
  • “Understanding Deaf Culture: In Search of Deafhood” by Paddy Ladd.

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Aimee K. Whyte is a licensed mental health counselor, approved clinical supervisor and Canadian certified counselors. She is a doctoral candidate at the University of Rochester Warner School of Counseling and Counselor Education. She is also the director of community education and counseling for Advocacy Services for Abused Deaf Victims in Rochester, N.Y.

Alison L. Aubrecht is a distance credentialed counselor and licensed professional clinical counselor who works as an independent consultant in Minnesota.

Candace A. McCullough is a licensed clinical professional counselor, approved clinical supervisor and distance credentialed counselor. She holds a doctorate in clinical psychology and is the CEO of Deaf Counseling Center in Maryland.

Jeffrey W. Lewis holds a doctorate in counseling psychology and is a professor of counseling at Gallaudet University. He is also a licensed psychologist and maintains a small private practice.

Danielle Thompson-Ochoa has a teacher’s license for school counselors K-12 and holds a doctorate in behavioral health. She is a school counselor at the Hawaii School for the Deaf and Blind in Honolulu.

Deaf Counseling Center provide therapy to Deaf clients on a national basis.

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Iowa Deaf Community Comes Together in Support of Sexual Assault Survivors
APRIL 8, 2018, BY YESSENIA CHAVEZ

The Iowa Deaf community came together on Sunday afternoon to kick off National Crime Victims Rights Week.

The Deaf Iowan’s Against Abuse organization hosted “Heels for Hope” at the Elks Lodge in Rock Island.

Heels for HOPE is a nationwide program where people walk in heels to show solidarity for women and men who have been victims of sexual assault.

Sheli Barber, deaf psychotherapist and CJ Jones a Comedian who played a role in the 2017 summer movie “Baby Driver” were the keynote speakers at the event.

Barber focused her presentation on the #MeToo movement and where it started.

“It’s to raise awareness and accountability because we want perpetrators of sexual assault and violence to be held accountable for their actions,” said Barber.

Jones spoke out about his own hardship experiences of growing up deaf, and gave a speech of never giving up hope.

“It’s our responsibility to work together be there for each other we’re one people one world,” said Jones.

Members and allies strutted in high heels to raise awareness on sexual assault. The goal of the event is to shed light on survivors in the wake of the Me Too movement.

Executive Director of the DIAA, JenniferUpah-Kyes, said members of the deaf community have a higher chance of being a victim of violence than the general population due to communication barriers. According to the Bureau of Justice, a National Survey said those with disabilities are at least 2 and a half times more likely to be victims of violence between the years 2009-2015.

The goal of the event is to spread a message of hope and inclusiveness. Organizers say it’s also a chance to show that there is help and resources for those going through trauma.

“That’s the point of this Heels for Hope event…(to show) we walk together and no one is alone,” said Upah Kyes.

Reference:

http://wqad.com/2018/04/08/iowa-deaf-community-comes-together-in-support-of-sexual-assault-survivors/

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There have been a lot of shootings recently – in schools, Las Vegas and other places. People blame mental illness as the cause of this, but that is wrong. It perpetuates the stigma against mental illness.

In reality, most people who are mentally ill are not dangerous. Only a very, very small percentage are. Blaming mentally ill people for gun violence needs to stop. If you can envision two circles, one representing people with mental illness and the other representing people who are violent, the little part where they overlap is the very small percentage of people who are mentally ill and dangerous. This is less than 4% of people who are violent and dangerous.

If you believe that mental illness causes gun violence, strangely, you should see equal numbers of men and women using gun violence, but men far outnumber women when it comes to gun violence. This does not make sense, because both men and women can have mental illness, but both do not engage in gun violence.

When people who are mentally ill get ahold of a gun, they are more likely to use it for suicide purposes. They do not tend to shoot other people. If they do shoot other people, it is more often family members, friends or coworkers with whom they may have a grievance. The do not usually use guns for mass shootings.

Also, if you believe than mental illness causes gun violence, look at the rest of the world. The US has far higher numbers of gun violence than other countries such as Japan have far lower numbers. Mental illness is a universal phenomenon so the statistics do not make sense.

Even if psychologists and counselors diagnose people with mental illness, they cannot predict who will become violent and shoot people. There is more chance of recognizing risk of gun violence by looking at factors such as history of violence, including domestic violence and hurting others. History of two or more DUI convictions in five years also increases risk. Additionally, two or more convictions of drug-related crimes in five years are associated with increased risk of gun violence. Gun violence is typically correlated with rage, impulsivity, reaction to job loss or divorce and alcohol use.

People who suffer from mental illness often have no voice to defend themselves. They are more likely to be victims of crime themselves, than to conduct crimes against others.

Blaming mental illness as the cause of gun violence diverts our attention from the real causes. These are the need for gun control laws and for dealing with social and economic problems in society. These are the issues that we need to look at.

We need to stop targeting mental illness and look at the real causes so we can make improvements. If you see people blaming mental illness for gun violence, it is important that you correct them so they can disseminate the right information about gun violence This will help show support for people with people illnesses.

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