The Invisible Client – Working With Deaf Clients

Imagine living in a world where other people do not see you. You are invisible to the majority population. Your home is broken into, your child is sick, you were laid off, your family goes on a vacation…but no one asks your input. A family member or friend dies, but no one asks you how you are coping with your grief. On the way home from school you are raped, but no one understands when you try to explain what happened. So you are once again acting out and eventually your agitation just disappears into the memory of those you attempted to tell. The agitation may disappear, but you are living with the constant fear, shame, anger, and frustration of not being able to communicate what has occurred. The horror of the experience is still real for you.

You are invisible. However, in Gods sight none is invisible. In Scripture we read that, everyone…is called by my name, whom I created for my glory, whom I formed and made. Lead out those who have eyes but are blind, who have ears but are deaf (Isa. 43:7-8), and The Lord said to him, who gave man his mouth? Who makes him deaf or mute? Is it not I, the Lord? The invisible client is the deaf or hard-of-hearing individual who is unintentionally overlooked by the hearing world. If one is deaf or hard of hearing, the disability is not as noticeable as visible ones, such as blindness or a physical disability. The truth is that 1 out of 15 Americans is affected by deafness.

A deaf person is an individual with a severe to profound hearing loss. The hearing loss does not allow the deaf individual to understand what she or he hears even with amplified assistant devices. A hard-of-hearing person is an individual with moderate to mild hearing loss. The hard-of-hearing person has difficulty understanding what he or she hears but can utilize amplified assistant devices that will help him or her to understand speech. You may be wondering why it is necessary to hire an interpreter. English for the majority of deaf individuals is a second language.

For this population lip-reading is only 26% accurate, the rest is guesswork. Writing notes is time consuming, and, because English is a second language for most of this population, many read between a third- and fifth-grade level. The Americans with Disabilities Act 504, Public Accommodations, requires the counselor to provide an interpreter to ensure accessibility, especially in situations with deaf clients. The counselor should never use a family member as an interpreter, due to boundary and confidentiality problems and the bias of the family member. Professional interpreters are bound by a code of ethics just as clinicians are. In therapeutic settings, the clinician should request interpreters that specialize in mental health interpreting. Find a therapist to get solution of your problems.

Providing therapy to this population is a challenge: The challenge lies not only in the communication problems, but also in finding supporting materials to work with this group. Hearing clients may read books, complete assignments, and even watch videotapes. Most therapeutic materials would have to be adapted to accommodate this population and most videotapes used in therapy are not open or closed caption which means they are usually ineffective with the deaf. Deaf and hard-of-hearing individuals are highly visual and respond better to visual and experiential works. Role-playing, pictorial aids, and collages are useful techniques. Julie came into the office with fleeting glances, barely making eye contact, until my hands said, Hello. I am Dr. Alston. I am happy to meet you. Her eyes started to shine; a look of shock and relief was visible. She had finally found someone who could communicate with her and see her. She was no longer invisible but able to start on her road to healing. You could be a part of the above scenario. You can reach this invisible population by learning about their culture, using interpreters, and being willing to adapt therapeutic materials to fit your clients needs and communication styles.