National Issues Related to Therapy with Deaf Clients

Deaf Counseling Center is sharing this spot-on article about common issues that Deaf people face on a national basis when seeking therapy. Sometimes it is the insurance company that creates barriers. Other times interpreters in therapy sessions make the sessions unproductive or confusing. In still other cases, it is hearing therapists who are not fluent in ASL, but advertise that they are. This is one of the most unethical things a hearing therapist can do – claim to be fluent in ASL but in reality, possess only an elementary (or worse) level of fluency. This is why we established Deaf Counseling Center – to make sure Deaf people have access to therapy anywhere in our nation.

Counseling Deaf Clients, It’s not for everyone by Shannon Ruana

I’ve been counseling deaf and hard of hearing individuals for more than 10 years. The majority of that counseling was done in a state rehabilitation agency and the rest as an individual counselor in private practice. I’ve heard my fair share of horror stories of what deaf clients sometimes face when seeking counseling – some so remarkable I had to shake my head and wonder if the client wasn’t pulling my leg as I do have an exaggerated shock affect. Unfortunately, these are true and ripe for your reading and (hopefully) learning.

A deaf client who communicated exclusively in American Sign Language (ASL) contacted her insurance company and requested to be linked to a counselor who could sign. She was seeking counseling services to handle a very involved familial conflict. The insurance was able to locate a provider claiming to be fluent in ASL, but really was only able to (barely) sign the alphabet in sign language. The client went to her initial intake interview and was expected to finger spell (slowly as the provider was not handy in deciphering the signed alphabet) all of the answers to the intake questions. Just picture it with me for a minute, imagine you’re distraught and finally seek counseling only to arrive at your first appointment and find not only does the provider not communicate in your language, but you have to put all of your time and energy into expressing your feelings letter by letter. Seriously, “M Y N A M E I S.” style of communication. One would ask, even though it’s also a wrong approach, why the provider had not allowed the client to simply write out responses. The answer – wait for it – the provider was excited to ‘practice’ the alphabet as he was learning it from a book!

Another unfortunate occurrence was with a deaf woman who saw her therapist using an ASL interpreter for the sessions. In the very beginning, all parties agreed to make every effort to keep the same interpreter for each session and they would plan their schedules accordingly. This, for all intents and purposes, makes perfect sense as it would allow everyone to become comfortable with one another and also for the interpreter and client to grow accustomed with each other’s unique signing styles. What started out as a good thing quickly backfired. The therapist and interpreter seemingly became a united front and the client would observe them exchanging knowing glances and often making remarks to one another during the session, appearing to be discussing the client – yet leaving her out of the communication. As you can imagine, trust was quickly lost in the counseling relationship. The client stopped attending sessions altogether. This isn’t to say that sign language interpreters habitually do this.

They’re bound by a code of ethics just as we counselors are. I know many spectacular interpreters who always remain in their role and handle situations with both professionalism and integrity. There are; however; some knuckleheads in the bunch – just like with counselors featured here.

Another scenario was of a deaf gentleman receiving services from a deaf counselor. This was going great, until their social lives began to collide as they often mixed within the same social groups within the deaf community. While they attempted to maintain a strict professional boundary, it became evident over time they were unable to work together as they had too many mutual friends. Consequently, gossip leaked within the deaf community about the client was traced back to the counselor. More than likely it wasn’t the deaf counselor who shared information, but the trust had already been damaged and the counseling relationship ended not on the best of terms.

Deaf and hard of hearing individuals have the right to seek and provide counseling just like everyone else. They also have the right to be able to communicate with ease in the therapeutic setting and be able to work with their counselor in developing mutual trust. I have the utmost respect for counselors who are undergoing training to learn ASL and have a desire to work with individuals with hearing loss. The important thing is for people to be honest and conscious of their skill level – if they’re still struggling with finding signs for simple words to engage in basic communication, they are nowhere near ready to begin utilizing the language in a therapeutic setting. Enlisting the assistance of a professionally trained and certified sign language interpreter to facilitate communicate in the sessions is one way to go – and I have seen this work out remarkably well in many circumstances. Similarly there are many great counselors who are deaf and hard of hearing themselves who can readily separate the professional from the social. The key factor is really what the client prefers and is comfortable with – so leave ‘The Joy of Signing ‘at home and help the client link to a more appropriate referral source or explore alternative communication options whenever possible if your skills aren’t exactly up to par. While it’s not always easy to find an abundance of counselors who are fluent in ASL or who are deaf themselves – they’re out there and I’m proud to be one of them.


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