CALIFORNIA STATE UNIVERSITY, NORlliRIDGE
C0UNSELING THE DEAF
l(
AND
PARENTS 0F DEAF CHJLDR.EN
in
A graduate
project submitted
partial
satisfacti.on of the requirements for
the degree of Masters of Arts in
Education, Educational Psychology
Counseling and Guidance
by
-
Dana Rozner
August, 1979
The Graduate Project of Dana Rozner is approved:
Larry Fleischer
California State University, Northridge
ii
PREFACE
The intent of this project is to provide a concise
compilation of pertinent data relevant to deafness that can
be utilized as a tool for counselors.
It is geared for the
counselor confronted with either deaf clients or parents of
deaf children.
Frequently, there exist isolated deaf
communities with either inadequate or non-existent mental
health services for the deaf and their families.
This
project may be used as a resource when no other is available
as well as serving as a supplementary guide.
iii
DEDICATION
To Jeffrey for his unending
patience and encouragement.
iv
.
ACKNOWLEDGEMENTS
I would like to extend my deep appreciation to the
following people:
To Stan Charnofsky, my committee chairman, for
his guidance and support.
To Larry Fleischer, for his valuable input and
personal insight into the content of this
project.
To Barbara Reinhart for her willingness to take
the time to meet and for her special concern
and interest.
To my parents for their continual love and
support.
And to all the deaf people who have meant so
much to me and who have made the completion of
this project possible.
v
Table of Contents
Approval • • • .
Preface. . . • .
Dedication . • . . • • • .
Acknowledgements . • • • .
Table of Contents.
Abstract • • • • . . • •
.ii
iii
. . . iv
• v
. . vi
. . viii
• • .
• . •
Chapter I
BACKGROUND DATA • •
. . . • • . . . • 1
Statement of the Problem. •
• • • • . • . . • 1
Definition of Tenns . • . • •
• • •
. 5
Aspects of Deafness • . • • • • .
. • •
. 7
Communication and Language • • • . . . • . . 7
Education and Intelligence
. • . . . . . 10
Personality and Social Development • ~
.12
Psychological and Emotional Problems. •
• • . 14
Considerations for the Counselor. .
. • . 17
Surnrnary
•
•
•
•
•
•
•
•
•
•
•
•
•
Chapter II
METHODS OF COUNSELING THE
Individual Therapeutic Approaches
Group Counseling with the Deaf. •
An Overview. . • • • • • • •
Psychodrama. • . . • . • • •
Art and Dance Therapy.
•
Dreamwork. . . . . . . . . .
•
•
•
•
•
• 25
DEAF.
.
.
.
• . •
. • .
·
.26
. • • • .26
• • . • • 28
• • • • . 28
.33
• • • 36
.41
· ·
.44
Surnrnary • • • • • • • • • • • • • • • •
Chapter III
COUNSELING THE PARENTS OF
DEAF CHILDREN • • . • . . •
Importance of the Family. • • • . .
Mental Health Needs of the Parents.
Attitudes Helpful to the Parents. .
Attitudes Helpful to the Deaf Child
Considerations for the Counselor. •
•
•
•
•
• • • 46
. 46
. . • • 47
• • •
.51
.
.53
•
.56
Surnrnary •
•
•
.
•
•
•
•
•
•
•
vi
•
•
•
•
•
.
.
•
•
• 60
Table of Contents
Chapter IV
References •
RECOMMENDATIONS FOR THE FUTURE • •
.......... ...
.62
.69
.72
Appendix • •
vii
ABSTRACT
COUNSELING THE DEAF
AND
PARENTS OF DEAF CHILDREN
by
Dana Rozner
Master of Arts in Educational Psychology
There are presently very few diversified counseling
services for deaf people of all ages.
Several mental
health programs servicing the deaf are now starting to
emerge.
I hope to generate enough interest to spark action-
oriented strategies toward making services for the deaf as
comprehensive as services for the hearing.
This project presents an overview of aspects of
deafness pertinent to the counselor working with deaf individuals.
The counselor needs to be aware of and knowledge-
able about the communication; language; intelligence;
educational, social and emotional difficulties encountered
by a prospective deaf client.
When dealing with the
psychological aspects inherent to deafness the special
learning and adjustment needs of the deaf person must be
taken into consideration.
In general, the objective of any
counseling situation with the deaf is to help them to
viii
develop emotionally and socially so that they may achieve
satisfactory adjustment to various life situations in spite
of their hearing impairment.
Even though very little research has been conducted
with regard to the kinds of therapeutic approaches that
benefit the deaf in a counseling relationship, available
information suggests the hypothesis that the less verbal
and less abs_tract approaches are more appropriate for the
deaf.
For this reason I have included a recommendation for
the use of group psychotherapy with the deaf.
I have
incorporated the use of Psychodrama, Art and Dance Therapy
and Dreamwork as primarily nonverbal, visual and actionoriented therapeutic approaches.
A critical factor in the development of the deaf
child is the family.
Whether or not he can adequately
adjust is a function of the acceptance he receives at home.
Since the lack of proper communication in the family seems
to be of such importance then perhaps the mental health
needs of the deaf can be dealt with more successfully with
the parents in mind.
Based on this premise I have included
a section for either the parent of deaf children or the
counselor of parents of deaf children.
Comprehensive counseling services for deaf people
should have goals of human growth, fulfillment and happiness by assisting all ages to achieve psychological and
social integrity and health.
Hopefully, the present
ix
scientific research of the deaf will lead to the establishment of mental health programs services by professionals
who are knowledgeable about deafness.
If this occurs, then
the deaf population will begin to receive the services that
they deserve.
X
CHAPTER 1
BACKGROUND DATA
Statement of the Problem
Man is highly dependent on his senses since it is
through these means that he receives the sensations which
constitute his experience.
Based upon the information
which he receives in this manner he builds his world of
perception, of conception, and forms his attitudes, opinions
and interests.
By this means he learns to unders.:j:.and and
come to terms with his environment through the process
called adjustment.
A sensory deprivation limits the world of experience.
It deprives the individual of a portion of the
natural resources from which the mind and personality develop.
For the individual who has had hearing and then
loses it, the equilibrium of all psychological processes is
disturbed.
When this hearing is lacking it alters the
integration and functioning of the other sensory processes.
Experience is perceived differently.
The counselor of the deaf must be cognizant of the
fact that research
~ndicates
that it is more difficult for
abstract intelligence to develop normally when a communication deprivation is present from early life.
This more
often occurs when the deaf child is raised in a hearing
1
2
family.
The stress derived from impaired hearing causes
emotional adjustment to be more difficult to achieve.
Deafness is a handicap which causes greater dependence on
others and, by societal design, the limited communication
greatly increases the difficulties of understanding and
relating to other people (Myklebust, 1962) •
Due to the nature of deafness unique problems are
created that may require some degree of adjustment or compensation.
It is apparent that the primary limitation of
deafness is the auditory input and that the resulting
consequences then derive in some
limitation.
w~y
from this initial
Discovering one's role and making an adjust-
ment in society is a more difficult and complex process
when deafness is present.
The handicap requires that the
deaf individual make maximum use of his potentials and
abilities; determination of these potentials is even
crucial in the case of the hearing individual (Handy, 1974).
Although the deaf population of the world may be
estimated at three million, organized psychiatric information dealing with mental health needs of the deaf is
meager.
att~ntion
seling.
Counseling with deaf people has received little
in either literature or in the field of counPrior to 1.970 there had been no research of the
relationship, the process, or the outcome of individual or
group counseling with the deaf (Bolton, 1976).
Until
recently, very few psychotherapists were trained in the
3
diagnosis and treatment of emotional problems of the deaf.
No attempt was made to synthesize basic information
regarding the specific adjustment problems of this group.
As a result, the provision of these services for the deaf
has been either unavailable or inadequate.
This lack has
been felt by mental hospitals, clinic personnel, workers in
rehabilitation centers and social agencies.
To date,
counselors have had little guidance on how to implement
general principles of counseling with their deaf clients.
To begin with, a definition of the deaf population
is necessary.
The deaf are commonly classified together
and are, in reality, a conglomeration of both deaf and hard
of hearing individuals.
The hearing loss of the deaf is so
severe that they receive communication almost entirely
through their eyes.
versible.
Their hearing loss is usually irre-
The hard of hearing are those who have losses
ranging from very slight to very severe.
The hard of
hearing person depends mainly upon his ears, with or without
amplification.
As a result, the hard of hearing population
differs psychologically and socially from the normally
hearing society in varying degrees, from not at all to a
great deal of difference.
The deaf and their hearing
counterparts differ. to a much greater extent (Sussman,
1971).
As a whole; the deaf population displays some very
admirable traits.
They are generally law-abiding citizens,
4
group conscious, seek means of defense of their rights as
a class, are prompt and diligent workers and are tolerant
to different races and creeds (Fusfeld, 1954).
They have
not abandoned the responsibility of their welfare to others
but have formed strong organizations to meet their social
and legislative needs (Vernon, 1969).
The communication problem of the deaf person is the
most all encompassing manifestation of his disability.
affects every aspect of his life.
It
His degree of adjustment
and achievement in all of his activities is primarily
dependent on aspects of his communication skills.
This
emphasis on the importance of communication is one of the
reasons that the deaf need special consideration in the
area of mental health services and why there are so few
services available for the deaf at the present time.
In this paper some of the essential principles of
counseling deaf clients will be examined as well as how
these affect the counseling process and how to cope with
the problems involved.
The concern here is with the
resulting difficulties encountered by hearing loss and the
psychological, social and emotional problems that stem from
that loss.
There will be an attempt to alleviate some of
the misconstrued conceptions of deafness and its consequences as well as provision of means for counselors to
deal with either deaf clients or parents of deaf children.
In addition, a recommendation for the use of group
5
counseling and its value for the deaf client will be ineluded.
This section will incorporate the use of Psycho-
drama, Art and
~ance
Therapy and Dreamwork in conjunction
with how these particular techniques can be utilized with
the deaf population.
Included will be a section providing
an overview of the various counseling or mental health services presently available to the deaf.
There will also be
an examination of several prospects for the future of mental
health services for the deaf.
Deaf individuals present a
great challenge to therapy--the challenge to acquire and
apply special communication skills, special understanding
of deaf culture and psycho-social knowledge of audiocommunicative disabilities.
Success in this area promises
to lead to new insights into the entire field of mental
illness and mental health.
Definition of Terms
Adventiously Deaf. Those who were born with normal hearing
but in whom the sense of hearing became nonfunctional later through illness or accident.
Art Therapy. The use of art as a means of encouraging
expression and communication.
Congenitally Deaf.
Those who were born deaf.
Dance Therapy. A forrn.of psychotherapy in which the
therapist utilizes movement interaction as the
primary means for accomplishing therapeutic goals.
Dreamwork. The use of ·dreams as a tool to bring about
1nsight in a therapeutic situation.
Expressive Skills. The ability to use fingerspelling and
sign language.
6
Fingerspelling. The use of the manual alphabet with the
deaf to communicate.
Interpreting. The transmission of a speaker's words and
thoughts into sign language, informal gestures or
pantomime.
Manual Communication. Communication in both language and
.f1.ngerspell1.ng.
Postlingual Deafness. A hearing loss which occurs after
spoken language patterns have been established and
which is severe enough to make impossible the
understanding of conversational speech in most
normal situations.
Prelingual Deafness. A hearing loss which occurs before
the child has acquired language patterns (2 or 3
years) and which is severe enough to render impossible the understanding of conversational speech
in most normal situations.
Psychodrama. A method by which a person can be helped to
explore the psychological dimensions of his problems through the enactment of his conflict
situations rather than by talking about them.
Receptive Skills. The ability to understand what is
expressed in both fingerspelling and sign language.
Speechreading. The ability to understand expressively and
receptively the oral language or speech of a person
through observation of his lips and facial movement.
Total Communication. The right of every deaf child to learn
to use all forms of communication so that he may
have the full opportunity·to develop language competence at the earliest possible age. This includes
the full spectrum of language modes: child-devised
gestures, sign language, speech, speechreading,
fingerspelling, reading and writing. It also
implies that the deaf child have the opportunity to
develop any residual hearing through the use of
·amplification systems.
7
Aspects of Deafness
Communication and Language
Although the deaf population has the same range of
variability of education, personality and vocational
interests that are present among the hearing population,
deafness has so many ramifications in certain areas of
functiorting that the average deaf person is different from
the majority of hearing persons.
A counselor must be aware
of the characteristics which comprise these differences as
well as those which constitute the similarities.
Most young people today who are deaf were born with
their hearing loss or else acquired it early in life before
they were old enough to have learned to talk and use language {Vernon, 1966). ·Under these circumstances, normal
speech cannot be developed.
Sometimes intelligible speech
can be acquired, but in many cases the prelingually
deafened client will not be able to talk in a way that is
understandable to the average person.
Speechreading is another aspect of the communication
problem faced by deaf clients.
Only rarely do professional
specialists in deafness understand the limitations of
speechreading.
Few recognize that 40 to 60 percent of
sounds of the English language are homophenous, meaning
they look just like some other sounds on the lips.
Adding
to this ambiguity inherent in the phonetics of the language
8
are factors such as poor
lighti~g;
protruding teeth; cig-
arettes in the mouth; mustaches; bad speech habits; small,
immobile mouths; head movements; and countless other interferences.
These reduce the percentage of most speech that
can be lipread to about 20 or 30 percent at the most, provided the person is a good lipreader (Vernon, 1965).
Another aspect of the communication problem is the
fact that the prelingually deafened person does not have
the chance to learn the vocabulary and syntax of spoken
language by hearing it.
Because of this difficulty, the
average deaf person does not develop a large vocabulary or
a skill in the use of English syntax.
His written language
is generally poor and in many cases he is unable to clearly
communicate complex ideas through writing (Furth, 1973).
In view of the communication problems deaf people
have with speech, lipreading and writing, many find that
they achieve greatest communication skill by utilizing sign
language and fingerspelling.
Often those who lack any
appreciable ability at oral and written communication can
express and receive complex ideas in sign language (Vernon,
1965) •
Since deaf people mainly receive information through
their eyes, the use of sign language and fingerspelling
permits them to draw on common words in the spoken language.
Basic to any meaningful counseling of deaf clients
is an understanding of the general communication problems
of deafness.
Once this knowledge is made apparent the
9
counselor must then indicate a respect for the client's
right to choose the means of communication with which he is
most comfortable (Gowan, 1972) •
One of the primary pre-
requisites of good counseling is good communication.
This
statement implies much more than an exchange of words between two individuals.
Counseling, to be effective and
beneficial to the client, must involve a true sharing of
thoughts, idea? and feelings.
If deaf persons prefer speech and lipreading as a
means of communication in counseling and if they can function adequately, expressively and receptively, the counselor
should respect their desires and counsel orally.
The same
is true of the modalities of writing and manual communication.
In the case of the counselor who cannot fingerspell
or use sign language, an interpreter should be available to
assist the clients in need of this service.
Interpreters
can be readily located by writing to the National Registry
of Interpreters.
It must be recognized that although the use of sign
language can greatly facilitate communication, it is limited
by the basic linguistic competence of the deaf client and
the manual skills of the counselor or interpreter.
Simply
making a lot of sig.ns does not insure communication nor does
it overcome the basic vocabulary problem of a semi-literate
deaf person (Gowan, 1972) •
A knowledge of manual methods of communication has
10
a great deal of advantage when counseling a. deaf client.
It informs the deaf client that there is an interest indicated by an attempt to learn to communicate in the method
most comfortable to a majority of deaf individuals.
The
counselor is then often able to gain his client's confidence
and cooperation on a far deeper level than he ordinarily
would.
Education and Intelligence
The counselor of the deaf needs to be aware of the
fact that deaf people have the same range and variability
of intelligence as hearing people do except in certain cases
where the disease which caused the deafness also caused
brain damage (Vernon, 1967).
Despite the fact that deaf
persons as a group are equally as intelligent as hearing
persons and despite the fact that some of them attain great
academic achievement, the average deaf client is educationally behind his hearing counterparts.
In a recent study of 93 percent of deaf students
16 years or older in the United States, it was found that
only 5 percent achieved at a lOth grade level or better
(most of these being hard of hearing or adventiously
deafened); 60 percent were at grade level 5.3 or below; and
30 percent were functionally illiterate (Boatner, 1965;
McClure, 1966).
There is a paradox to the educational picture
presented by the deaf client of which the counselor must be
11
aware.
Although the deaf person is often at a low level
academically, he has the same intellectual, conceptual and
cognitive abilities as others (Vernon, 1967).
However,
there is some evidence of functional lags that exist in the
areas of conceptual thinking and abstract reasoning for the
deaf person.
According to studies made by Dr. Syech Abdullah,
there exist certain areas of vague development as well as
areas where responses have become a little distorted for
the deaf individual.
There are also other areas of develop-
ment where there is not enough reinforcement of these
responses.
The challenge for the counselor is to understand in
which areas these gaps occur, in which areas there are distortions in responses, and in which areas responses are intact and adaptive.
The best way to determine this is to sit
down and talk with the client.
With prolonged periods of
discussion these gaps and fulfillments, and the client's
spectrum of assets and shortcomings, become clearly delineated (Altshuler, 1967).
Additional studies indicate that deaf people are
similar to people from an impoverished social and intellectual environment.
If the culture and the surrounding life
habits do not foster habits of abstract thinking, they are
less likely to emerge.
The thinking then emerges with much
less frequency than in an environment that provides
oppor~
12
tunities for thinking (Furth, 1973).
Personality and Social Development
The counselor of the deaf may find it useful to consider the personality and social development in general.
Personality is a vague term that covers such diverse aspects
of human life as a person's emotions and the way they are
handled; moral values as expressed in personal choices; the
capacity for relating to other human beings including interrelationships with friends, family·and loved ones.
In the sense that many deaf people share a number of
early life experiences, they may also share some common problems and some common ways of coping with the environment.
Recent psychological research with a selected group of deaf
adults suggests that the personality of these individuals is
restricted in breadth of experience, is rigid and confused
in thought processes and characterized by an inability to
integrate experiences meaningfully (Bolton, 1976).
Many of these problems result in an emphasis on
early education for the deaf.
With the communication
barrier present, educators are faced with a vast and demanding task, of getting the information internalized.
As
a result, a dependency is fostered in the children who become accustomed to having things done for them.
There is
very little encouragement for independent, creative thinking
because of the emphasis placed upon speech and English by
educators of the deaf.
13
Regardless of the degree to which an individual has
developed emotional security, he will only develop patterns
for independent behavior if he is given opportunities to
engage in such behavior.
Such opportunities should require
that the deaf person be faced with a problem and go through
a process involving:
1) consideration of the problem and
possible alternatives for action; 2) reaching an independent
decision; 3) carrying out actions which reflect the decision; and 4) facing the consequences of an action.
These
steps are necessary in order to promote independent behavior.
Because of the tendency towards immaturity in
thinking and reasoning by the deaf, the counselor has the
task of being aware of such dependency needs and then of
helping the deaf person understand and manage them (Gowan,
1972).
According to Silver (1964), so much is done for deaf
persons that they have little opportunity to experience
their own capacities to help themselves.
A deaf person of
this kind is apt to expect the counselor to tell him what he
should do rather than discuss and think through his problems
independently.
The long years of living in residential schools may
also tend to foster. a dependence, leading to self-concern
and apathy toward the needs of others.
There is some evi-
dence of a lessened awareness of the impact of behavior on
other people and its consequences.
In addition, the compli-
14
cated nuances of social and sexual rules, roles in dating
behavior, mutual responsibilities and even a clear understanding of the reproductive system tend to be vaguely defined for the deaf person
(Alshul~r,
1967).
Psychological and Emotional Problems
The psychological implications of early total deafness deserve careful examination.
Hampered by his or her
handicap, the deaf child remains relatively fixed and isolated so that an imbalanced development occurs.
While the
physical maturation may proceed normally, the emotional
aspects of growth may lag behind, causing limitations in
certain areas (Alshuler, 1969).
The deaf child seems to
exemplify Bender's idea of uneven development in sectors of
personality or an imbalance between development and maturation.
Many psychological studies of the deaf have indicated limitations in abstract conceptual ability that may
never be corrected.
There seems to be a lack of conceptual
tools for the child to use for codifying and synthesizing
his experiences.
He does not seem to process the concep-
tual or symbolic ability to integrate his experiences.
What is interesting is that a number of these abilities to
manipulate symbols may be important for evolving a sense of
feeling for other people and perhaps even for exercising
self-control (Altshuler, 1964).
Because of the wide impact on emotional development
15
some individual differences may be eliminated in deaf people.
The very universality of the stress on all areas of
development would lead to some similarity in people affected.
The similarities detected include the tendency towards
impulsive behavior and an egocentricity which is possibly
caused by a lack of communication.
This indication of egocentricity must take into
account that the child is able to understand the wishes of
others and what it is about his behavior that affects others
in either a positive or negative manner.
An explanation of
emotions experienced by others is difficult without fairly
complex language.
The language of emotions is an area
where deaf children of hearing parents are particularly deficient.
Because the deaf child is often unaware of the
effect of his behavior on others, he can be viewed as one
who is unwilling or unable to consider the needs, opinions
or desires of others (Bolton, 1976}.
The impulsive behavior does not necessarily imply
that the conscious is impaired but that something about the
control of impulse seems to be limited.
This impulsiveness
develops in deaf children because parents normally tell
their children when they can expect to receive something or
why a delay is necessary.
cult or impossible.
Without language this is diffi-
Thus the deaf child does not learn to
control his demands for immediate gratification by learning
that sometimes he can expect to be given something later
16
(Bolton, 1976).
In early total deafness, the absence of audition
affects all systems of adaptation.
The deaf baby comes in-
to the world with the same psychological needs as the one
who hears.
Sound is an important part of the child's bond
with his mother.
Sound maintains contact both out of sight
and at a distance.
Experiences conveyed through hearing
play a major role in initiating mental, social and emotional development.
The auditory perception of an indivi-
dual stimulates the development of increasingly advanced
relationships between a child and his environment.
Through
hearing, an individual exchanges views with others, compares
opinions, learns to interpret behavior and to understand
motives.
He gains insights and forms value judgments.
This auditory contact is lost to the deaf child.
The
exception is deaf children of deaf parents, for whom at
least manual language is available (Bolton, 1976) . ' ·
This disordered communication and disruption of the
early child-parent relationship exemplify the conditions
under which the young deaf person develops.
Parents are
rarely encouraged to learn manual (sign) language.
Instead,
vocalization is practiced to induce the child to speak.
Very often deaf
chi~dren
behave with a negative attitude
towards spoken language because of the frequency and intensity with which they receive the message:
"You are
good only if you communicate the way I wish you to."
When
p
'
17
in contact with individuals who are fully accepting of them,
with or without speech, the negativism may no longer be
necessary, and the learning of both speech and language can
proceed with greater ease.
The most frequently stated generalization about the
psychological development of deaf individuals is that they
seem to exhibit a high degree of emotional immaturity.
Studies indicate that although most handicapped children
have been found to be deficient in self-help skills, there
is a discrepancy between the tasks that deaf children are
capable of performing and those they actually do for themselves (Vernon, 1971) •
In this case, as in the ones pre-
viously stated, the communication problem stands out as
the all-encompassing barrier for normal psychological
development for the deaf individual.
Considerations for the Counselor
In order to experience the therapeutic conditions
basic for successful counseling and to communicate these
conditions of the deaf client, the counselor must:
1)
understand certain facts about deaf people; 2) be aware of
the special problems experienced by the deaf; 3) know the
impact of these problems so as to minimize interference
with the counseling· relationship;_ 4) be able to communicate
in the system of choice by the deaf client; and 5) be aware
of ways that deaf clients can be helped to express themselves better (Sussman, 1971) •
18
There is a tendency for most people unfamiliar with
the deaf to see them as totally different from others.
This
is an erroneous perception for, in most respects, deaf
people are more like those with hearing than they are like
one another (Sussman, 1971).
When speaking about a psycho-
logy of deafness, this refers to the special learning and
adjustment needs inherent to deafness.
Deaf people do have
the same psychological needs as other people.
The deaf
person also needs love, esteem, acceptance, productivity
and independence.
In general, the objective of any counseling situation with a deaf individual is to help him to develop
emotionally and socially so that he may achieve satisfactory
adjustment to various life situations in spite of his hearing impairment.
Deaf people have within themselves the potential
for resolving their difficulties and growing towards responsible independence.
Counseling can represent a unique
opportunity for the deaf individual to talk about and explore his inner thoughts, feelings and attitudes.
Counselors should attempt to develop within deaf
people a better understanding of deafness and improved
attitudes toward the hearing population.
Deaf individuals
also require an essential comprehension of how they appear
to others and of the attitudes of others toward them as
deaf people (Thompson, 1964).
An essential need of many
19
deaf people requiring counseling is to be able to view
their problems in proper perspective.
One possible
approach toward handling of problems is to develop an
ability to cope with these problems.
Very little in the
field of deafness to date has dealt with the teaching of
coping strategies in deaf people which may help them
realize their potentials for psychological and social
adjustment in a hearing world (Bolton, 1976).
In addition to viewing problems in proper perspective, there is the need for the deaf person to develop
more adequate logical thinking with consideration of causes
of his own psychological and social problems.
There is a
definite need for a better differentiation of problems in
terms of whether they are directly related to deafness or
to the individual,himself.
Individuals who have been deaf since birth or early
childhood often have limited ability to deal with concepts
that have no immediate or specific referrents (Sussman,
1971).
This problem may result from language limitations,
isolation, and lack of adequate stimulation during the
developmental years.
A client's conceptual limitations may
affect the counseling process in several ways.
client may present
~nly
First, the
a very gross picture of his prob-
lems or may fail to discuss his feelings since these are
not clear and observable to him.
He may mention specific
things that bother him but may fail to recognize the
20
affective nature of his difficulties.
The counselor may
have only a very brief sentence or two to aid him in understanding the client's thoughts and feelings at the moment.
In turn he may ask a question or make a statement that has
no meaning to the client; thus, a lack of communication·
occurs.
Counseling requires almost continuous visual contact between the counselor and the deaf client.
Some
adjustments may be needed by the counselor who is not
accustomed to working with deaf clients.
Generally, the
counselor should pay close attention to what the client is
saying, but he should avoid giving the impression of
staring when there are lapses in communication (Sussman,
1971).
This can be accomplished by looking away slightly
when the client appears to be uncomfortable, and then
looking back either when he wishes to say something or when
the client begins to sign or speak again.
The following
are several possible methods of improving communication
between the counselor and the deaf client:
- Keep one's face in view at all times.
- Do not cover the mouth when talking.
-Place oneself so the light_shines on one's face and
not in the deaf person's eyes.
- When repeating something not initially understood,
use different wording.
- Avoid slang phrases, idioms and odd sentence
constructions.
21
- Bring an interpreter to facilitate communication if
necessary.
- Do not be embarrassed to use pencil and paper if
necessary.
- Encourage the deaf person to write when his speech
is difficult to understand or his signs are not
clearly comprehended.
(Schein, 1974)
The need for the counselor to be aware of the
various possibilities for misunderstanding and confusion
and how these can be prevented cannot be emphasized enough.
Concentration on these aspects of the total counseling
process may appear as an over concern with mechanics to the
exclusion of the interpersonal relationship.
Genuine
awareness of and concern for effective communication, however, must include such considerations.
As a result, the
client may become more aware that the counselor really does
want to understand him.
When dealing with the deaf client information-giving
is basic to effective counseling since many clients lack
information that makes successful counseling possible.
For
example, with the client who feels that hearing people talk
about him behind his back, it is not enough to deal only
with his feelings about the situation.
An explanation to
the effect that deafness is rather unusual and that others
sometimes react negatively towards someone they do not
understand is as useful and important as trying to help a
client to deal with his hostile feelings (Knee, 1976).
Overcoming dependency and unrealistic expectations
22
requires that the counselor help the client to understand
the purpose of counseling, the responsibilities of the
counselor and the client, and how the two can work together
to achieve their goals.
This dependency is created by the
fact that a deaf individual has a more restricted range of
experience to guide him, has had fewer opportunities to make
decisions, and has generally had others help him most of his
life.
The counselor, by recognizing this, can provide in-
formation the client needs to become more independent and
can encourage him to participate in activities that will
provide him with a broader range of experiences and behavior
patterns.
The limited experience and under-developed skills
indicate the need for the counselor to assist the client to
become involved in activities that will increase his knowledge and skills in relating to people.
Thi~
implies that
the counselor should find out some of the things the client
is doing in his work life, in his personal life, and in his
social life, and help to direct him into activities that
will provide rewarding experiences and knowledge.
Deaf people generally encounter relatively greater
difficulties in their world than do hearing people.
difficulties begin
hood.
in
These
childhood and continue through adult-
If the deaf client complains that he is discrimina-
ted against in his job, chances are there is some truth in
it.
If he feels his co-workers sometimes
l~ugh
at him and
23
talk about him, the fact is that this is a common occurrence.
If he states that he feels uncomfortable and anxious
when meeting new hearing people, he is not alone, for most
people with a serious communication handicap have a difficult time meeting new people who do not know how to talk
with a deaf person (Sussman, 1971}.
There is a wide variety of situational barriers
faced by the deaf that are decidedly not common for those
who hear.
The counselor must understand these barriers and
their impact on the client before he can hope to understand
the client's thoughts and feelings about them.
The
counselor must have some insight into how other deaf
people have successfully overcome these barriers.
If he
has this knowledge, he will be in a better position to help
the deaf client understand how he can deal with special
situations as well as his feelings about them.
The counse-
lor must also be aware of those situations that are almost
impossible to change and must help the deaf client to change
as well as help the deaf client to understand and accept
his limitations (Sussman, 1971}.
One common situational barrier is the deaf client
who has been raised with the idea that if he tries very
hard he will speak normally and speechread with total comprehension.
The counselor who is aware of the fact that
this is not the case can help the client to achieve a more
realistic understanding of his own capabilities as well as
24
a better self-acceptance and positive self image.
Attitudes of family members toward deafness may
represent another very real situational barrier for the
deaf person.
Parents who have misconceptions about their
deaf child may foster emotional difficulties by their unrealistic expectations.
The concept that the deaf child is
punishment for acts committed is not uncommon among parents.
Many parents may experience guilt feelings because of this,
which may lead to either rejection or overprotection of the
deaf child.
The need for privacy and confidentiality for the
deaf client is as great or greater than this need with other
clients.
The impact of deafness is such that deaf people
seek out others like themselves for social and recreational
purposes.
One consequence of this closeness is that they
know what others like themselves are doing and have done in
the past.
While this may be advantageous in some respects,
it is disadvantageous in the sense that the individual may
have little, if any, privacy and may often conceal many of
his thoughts and feelings for fear of exposure to and rejection by peers.
The counselor's ability to maintain con-
fidentiality will eventually become known among deaf people,
and this knowledge will establish his reputation as a trustworthy counselor (Myklebust, 1962) •
In conclusion, a counselor of the deaf should make
sure the information given to the client is factual, con-
25
cise and clear.
He should be certain that the client's
perception of his disability is correct and that the cause
is completely understood.
This understanding greatly en-
hances the adjustment of the client to his deafness.
The
deaf person should be assisted in exploring his feelings
regarding the manner in which he is currently being treated
by family and friends.
The most important role anyone can
play towards assisting a client in adjustment to deafness
is to be a warm, empathetic, accepting individual who is
positive in his regard toward the client.
Summary
This chapter is intended to sharpen the focus of
counseling the deaf for those who have little or no experience with the deaf population as a whole.
Deaf people of
all ages generally have been denied access to proper
counseling services primarily due to the problems of
communication between the counselor and the deaf client.
General counseling programs have therefore been unable to ·
serve deaf people properly.
Comparatively little attention
has been given to the many theoretical and applied considerations that are basic to the growth and development of
the profession of counseling deaf people.
This chapter con-
tains information that can be utilized to upgrade the
quality of counseling services for deaf people.
an end in itself, but a beginning.
It is not
CHAPTER II
METHODS OF COUNSELING THE DEAF
Individual Therapeutic Approaches
Very little research has been conducted with regard
to the kinds of therapeutic approaches that benefit the
deaf in the counseling relationship.
Despite this lack of
research in counseling the deaf, available information
suggests the hypothesis that the less verbal in English and
less abstract the counseling approaches, the more appropriate it will be for the majority of deaf clients.
The more
verbal and abstract approaches can be utilized only with
those who possess normal or exceptional verbal skills
(Gowan, 1972) •
With most deaf clients counseling must be concrete.
Efforts to use techniques such as classical psychoanalysis
have failed even when highly skilled therapists have made
the attempt (Rainer, 1963)".
Goetzinger,
(1967) suggest that an edlectic approach
(1967) and Vernon
~sing
basically
directive techniques is most effective with deaf clients.
Several others appear to share this view, stressing that the
development of insight in deaf clients is very difficult because of their language and conceptual limitations.
(Altshuler & Rainer, 1966 & Drinker, 1969.)
Successful counseling with most deaf persons and
26
27
perhaps with people in general must be related in direct
ways to the here and now.
lvhat the person is experiencing
in the moment can be dealt with concretely, allowing the
deaf person to interact with understanding.
Rogerians who
attempt to reflect affective overtones or responding with
"hrnrnrn's" which cannot be lipread and for which there is no
sign discover that their technique can be inappropriate with
the average deaf client.
When counseling either low verbal deaf adults or
young deaf children some communication may be achieved
through the use of psychodrama, art therapy or pantomime.
These particular techniques will enable these individuals to
achieve some degree of emotional expression as well as
realize more of their potentials.
The limited research
available indicates that visual, nonverbal therapies have
proven more successful than the "talk" therapies with the
deaf person.
This emphasis and focus on the,action and
visualization, rather than the verbal and intellectual,
allows the deaf individual to experience greater ease in
communicating his thoughts and feelings with clarity.
These
particular techniques that I have mentioned can be utilized
either individually or within the context of a group.
Individual
~herapy
purpose for deaf clients.
has proven to serve a twofold
On the one hand, it is usually
supportive, didactic and directive.
Equally as important,
it provides a meaningful relationship, perhaps the first in
28
a client's life.
This relationship can serve to bridge the
gap to other cooperative friendships.
Very often it offers
an opportunity to replace an important relationship that may
be missing with one that is firmly oriented to reality
(Rainer & Altshuler, 1967).
Group Counseling With The Deaf
An Overview
The emotional aspects of communication lacking in
the early years for the deaf individual may be responsible
for something which might be called a difficulty in empathy.
This may be described as a difficulty in putting oneself in
the other person's place or seeing the consequences of one's
reactions upon someone else.
It could also incorporate the
modification of one's behavior in a social situation.
All
of this can stem from the lack of opportunity and the lack
of necessity for the deaf infant to interact with his mother
in such a way as to learn what he can and can't do and how
his actions appear to the other person and then are reflected back to himself.
If this is the case then group work
would be the ideal area in which to try to remedy this
particular kind of developmental gap (Schein, 1971) .
Group work can aid in bringing understanding of the
motivations of people's actions.
Why these motivations
sometimes misfire and how behavior reflects on other people
can also be dealt:
with.
Again, this is the kind of be-
havior that arises developmentally in the context of early
-
---~--...,...,.---~~
-------
----~----------·-~
---~·-------~~-~-
-------~-
29
childhood-parent relationships that the deaf so often do
not experience.
Group therapy is particularly effective in
fostering deaf clients' insight into their own behavior.
The problem of isolation and withdrawal is a common
one for the deaf.
Due to under-developed verbal, motor and
game skills, deaf children may not participate freely with
their peers.
Adults will develop their own groupings and
have minimal contact with the larger hearing_ society.
Due
to the nature of deafness there is a definite subculture
seen among the deaf population (O'rourke, 1972).
The de-
velopment of this subculture stems from the isolation experienced by the deaf.
Because of this separation, the
deaf have been resourceful enough to unite and provide
their own culture, entertainment, religious and athletic
activities as well as a unique language.
Quite often, the concept of universality within the
structure of group therapy is a very important issue.
the deaf it can be even more crucial.
With
The deaf person's
sense of uniqueness is often heightened by his social
isolation as I previously mentioned.
1-vithin the group, the
deaf individual has the opportunity to relate to others who
share his feelings of loneliness.
I agree with Carl Rogers
that individuals nowadays are probably more aware of their
inner loneliness than ever before.
This loneliness is
partly due to the expanding awareness of interpersonal relationships found today.
30
Rogers sees two aspects of loneliness as crucial
issues: the first is the aloneness, the separateness which
is a basic part of human existence.
it is to be another person.
uniqueness separates us.
One can never know what
It is still true that our very
How a person comes to terms with
that - whether he accepts his separateness and uses his
aloneness as a base from which creative expression can occur
- or whether one fears and tries to escape from this condition is the important issue (Rogers, 1973).
This present
day awareness of man and his environment may tend to magnify any loneliness experienced by the deaf.
This loneliness
is often experienced by children raised in hearing families
where the prevailing problem is the communication deprivation of the deaf child.
Hopefully, based on their experience within a group,
deaf individuals will eventually move toward a realization
that they are unique and productive, with a very exciting
means of expression and communication through sign language.
Only the fact of their deafness has allowed them to develop
such a beautiful means of self-expression, and they need to
be very proud of who and what they are!
Group cohesiveness is another important issue in
establishing a group.
By definition, cohesiveness refers to
the attraction that members have for their group and for the
other members.
Members of cohesive groups are more accept-
ing of one another, more supportive, and more inclined to
31
form meaningful relationships in the group (Yalom, 1975) •
Cohesiveness seems to be one of the most significant factors
in successful group therapy outcome.
This cohesiveness is
often established rather early with a group of deaf people
due to the basic similarities they bring to the therapy
group.
Deafness appears to create a bond, one that may
allow group participants to be more apt to express and explore themselves and relate to others more deeply.
Most groups will eventually develop into what is
described by Yalom as a social microcosm of the participant
members.
This means that each individual will begin to
interact with the group members as he interacts with others
in his social sphere.
A deaf child growing up is very often
surrounded only by hearing models with very little exposure
to deaf models.
As a result the deaf person receives an un-
realistic and incomplete picture of the kinds of opportunities available to him.
Very likely, if a deaf person is
able to participate in a group with other deaf people, he
will be given a broader spectrum of possibilities from which
to draw upon.
Perhaps because deaf clients often feel pent-up from
lack of adequate communication over the years, they have
evidenced a great
n~ed
for emotional catharsis.
This in-
sight was the result of experimental group therapy with deaf
adults at New York State Psychiatric Institute (Altshuler,
1966) •
Catharsis or ventilation plays a very important role
32
in the therapeutic process.
Learning to express feelings
openly among the members of a group is essential.
For the
deaf individual, the English language is a second language,
not his native one.
American sign language has a very
different structure, in both syntax and semantics, and must
be taken into consideration.
Because of the language
barrier, deaf people will have much greater ease expressing
themselves with clarity among a group of individuals proficient in the use of sign language (Altshuler, 1969).
The
deaf person will be able to ventilate his feelings with
assurance that others are receiving the messages with
accuracy.
In summary, group therapy for deaf clients has been
demonstrated to be both feasible and valuable.
To make it
work requires firm but flexible leadership, an alertness to
trends of feeling of the individual and the group, and a
respect for the conceptual and emotional limitations imposed
by the deafness (Altshuler, 1966).
When used properly,
group therapy has been found to enrich concurrent individual
treatment and can serve as a method for broadening general
experience.
This could lead to learning in microcosm to
function in society.
A sense of group identity was developed and with it
came the first emp:a.th:i.c: interest in others of the deaf
clients involved in experimental group therapy.
Most of the
clients soon began to relax and make tentative efforts to
33
communicate with others • . Deaf clients carne to group
sessions with questions and doubts which may have been waiting for years for answers.
Often the sessions were used for
fact-finding purposes and information giving.
The therapist
working with a group of deaf individuals needs to be patient
and resourceful.
This person must strive to create concrete
situations which extend to the entire group the scope of an
individual's feeling and concern.
Although this approach
requires time, effort and dedication, its rewards are undeniable (Altshuler, 1966).
Psychodrama
Due to the non-verbal and participatory nature of
psychodrama, the technique can be an excellent tool to
utilize with the deaf.
Psychodrama is particularly rele-
vant to deaf clients because it is an action method of
therapy through which deaf people can express themselves
totally and spontaneously.
Because of its versatility,
psychodrama can be used with both the low and high verbal
deaf.
The psychodrarnatic method integrates the modes of
cognitive analysis with the dimensions of experiential and
participatory involvement (Blatner, 1973).
This is especi-
ally important not only for those who tend to overintellectualize their experiences but also for those who have
little capacity for intellectual and verbal explanations.
Dr. I. L. Moreno, the founder of psychodrama, de-
34
scribes the elements in a psychodrama session as follows:
The chief participants are the protagonist, or subject; the
director; the auxiliary egos; and the group.
The protago-
nist presents either a private or group problem; the
auxiliary egos help him to bring the personal and collective
drama to life and to deal with it.
Meaningful psychological
experiences of the protagonist are given shape more thoroughly and completely than life would permit under normal
circumstances.
Through psychodramatic enactment, the impulses and
their associated fantasies, memories and projections are
made consciously explicit, which serves to express these
feelings while simultaneously developing the person's
awareness (Blatner, 1973).
"The common denominator of all
human activity is, in fact, movement.
Even in stillness,
heartbeat and breathing continue, and the qualities of movement can be recognized in facial expression and body movement." (Wethered, 1973.)
This statement supports my hypo-
thesis of the use of movement and drama as the provision of
an excellent means of expression and release.
The Mental Health Program for the Deaf at St.
Elizabeth's Hospital has enacted a psychodrama group for
deaf people to determine positive or negative results.
In
carrying out this technique, the therapist uses multiple
communication methods: vocal, lip reading, sign language,
fingerspelling and acting.
This method enables the deaf
35
persons involved to incorporate their whole self in an interactive process.
It can be used to bring into sharper
focus an issue or problem that has been outside of awareness
and to produce a change in perceptions which may lead to
changes in behavior (Robinson, 1971).
When utilized with deaf people a variety of roles
are developed.
The deaf person naturally acts the nonver-
bal components of roles and is more attentive to them.
The
use of pantomime and concrete illustrations which are
necessary with low verbal deaf people when language development has been limited are a part of acting in psychodrama.
The verbal components of roles are just as important.
Sometimes with the low verbal deaf the communication
process itself has become a problem area.
Psychodrama can
help deaf people to verbalize more, to be understood and
therefore to communicate more.
This may assist in develop-
ing the bridge between his language and normal spoken
language (Robinson, 1971).
Another example of psychodrama's focus on the verbal
aspects of role is where communication itself has become a
conflictual issue.
This can happen at horne, for instance,
where there is disagreement between parents about communication.
Psychodrama helps this issue to become identified
and provides a medium through which intervention and change
can take place.
Psychodrama also deals with interactive roles
36
(Robinson, 1971).
dual identities.
Other people can help to find indiviIf the people that are needed are not
found in real life, then a fantasy is created to satisfy
those needs.
In psychodrama, all interactive aspects of
role, both real and fantasy, are explored.
The problem be-
tween the real and fantasy is not that of abandoning the
one in favor of the other, but rather to establish means
by which the individual can gain mastery over the situation.
One should be able to live in both worlds as well as to
shift from one to another.
For the deaf, psychodrama attempts to develop
communication awareness on a nonverbal level through total
body involvement and a combination of communication media.
This therapeutic tool permits exploration of the client's
social situation through the use of role playing with a
systematic orientation.
Thus, it attempts to clarify per-
ceptions of the problems and find new ways of relating in
conflict situations inherent to deafness.
Art and Dance Therapy
"Art Therapy" is currently used to designate widely
varying practices in education, rehabilitation and psychotherapy.
Possibly the only common thing to all of the
current art therapy.activities is that the materials of the
visual arts are used in some attempt to assist integration
of personality.
What occurs in art therapy may be thought
of in terms of behavior processes such as catharsis, in-
37
crease in effective communication, self disclosure and
changes in behavior.
Self disclosure may occur in art
therapy not only through words, but also through artistic
expression.
Self disclosure refers to an individual's ex-
plicitly communicating to one or more others some personal
information that he believes would be unknown unless he
shares it (Ulman, 1977).
Since artistic expression is both visual and nonverbal for the deaf person, it is an ideal means of conveying and transmitting a part of himself.
In my experience
working with the deaf during the last six years, I have discovered many deaf people who excel in artistic expression.
They often utilize art as a means of release that very
likely can only be released with this particular technique.
The language of art offers the deaf person a means
of communicating ideas which cannot be expressed in other
ways.
Their picture stories have an important place in the
development of their spoken vocabulary (Chapman, 1977) .
It
is frequently stated that a deaf person lacks imagination
and the ability to do abstract thinking.
Perhaps it would
be more accurate ko say that he lacks opportunities to use
his imagination.
The child who is deficient in language is
restricted in the ability to enjoy imaginary play such that
a child with hearing may employ.
If a child who cannot
verbalize about an imaginary experience were to depict it
visually, he would be engaging in imaginary play and might
38
also be enabled to share, sustain and extend it (Silver,
1970) •
It is conceivable that art symbols and procedures
can serve deaf people, as a means of "pinning down" perceptions and organizing experiences.
It is also conceivable
that they have the capacity for abstract thinking with high
intelligence.
Art experiences can serve as a means to de-
velop this capacity for abstract thought.
Art therapy sessions are frequently divided into a
period of involvement in the particular medium being utilized which is then followed by a period of discussion.
There
are a variety of methods used to initiate group rapport.
The following are several examples that I have found useful
while working with the deaf in Art Therapy.
Group members can work \..rith chosen partners sitting
across from one another to communicate with shapes, lines
and colors.
For a brief period each pair shares a mutual
world (the piece of paper) and is asked not to use words.
vlhen the drawn "dialogue" is completed, the partners discuss what they have produced.
Conversational drawing pro-
vides a relatively easy opportunity for group members to
become well acquainted in early sessions.
Another method is to direct each group member to
name an object, event, or feeling and then depict it in
whatever medium is desired.
additions.
One or more group members make
Individual members are encouraged to express
39
their feelings about changes made in the artistic expression.
Possibly such experiences can make one aware of his
or her feelings and what occurs when one lets others add
anything they want upon your creation.
Art Therapy can be utilized to deal with either recent or recurring problems.
The feeling or event can be
portrayed and then discussed with the therapist and the
group.
Dreams can also be dealt with in conjunction with
Art Therapy.
Those who have difficulty relating their
dreams may find it less difficult to depict them in some
art form.
Daydreams and fantasies also provide a rich
source for art expression.
An activity that I have found to be very revealing
is the creation of \vhat I call "Ego Bubbles".
An Ego
Bubble is a transparent container (a transparent plastic
sphere) for one's ego or imagination.
The group members can
either compile a number of objects and/or materials in the
creation of an assemblage depicting the entire group or
devise individual
bubbles~
The word assemblage applies
generally to works put together from a variety of elements;
it includes both the two-dimensional medium of collage and
three-dimensional constructions.
Periodic drawings or depictions of the therapy group
provide valuable information about the group process.
They
may take the form of individual portraits or of abstract expression about the group experience.
Clients may indicate
40
that they are freed or that they are frustrated by what
occurs in the group.
They may also illustrate feelings
about support or rejection for either group members or the
therapist.
Dance therapy is another form of psychotherapy in
which the therapist utilizes movement interaction and
emotional expression as the primary means for accomplishing
therapeutic goals.
Movement is the medium of dance therapy
just as words are the medium of verbal therapy.
Literature
in the area of dance therapy for the deaf is almost nonexistent.
Only recently has the realization of the value
of dance therapy for the deaf been observed.
Deafness is considered a cause of isolation from
the hearing and also isolation among the deaf themselves.
Inasmuch as dance becomes a social experience it tends to
lessen this feeling of isolation.
It also provides an en-
vironment which may promote consideration of others, acceptable behavior and unselfishness.
Through dance the participant has a means of reducing tensions resulting from frustrations caused by deafness.
Emotions, ideas and imagination can be externalized through
appropriate movements.
Dance incorporates body language
which is indispensable for the deaf.
According to Pete
Wisher, a dance therapist for 18 years, many deaf students
have stated that dance experience has given them a confidence which they never had before.
They acquired feelings
41
of personal wortn which applied to their relationships not
only with other deaf people but with the hearing as well
(Mason, 1974).
Since the deaf are often limited in their avenues
for expressing themselves, the place of dance and art as
learning tools and as social and therapeutic experiences
becomes vital.
Dance and art therapy for the deaf are slow-
ly making advances, but currently need a great impetus so
that more deaf people can benefit from them.
Dreamwork
Group psychotherapy with deaf clients is relatively
new.
This treatment modality employs principles of group
dynamics in a therapeutic setting, using communication
methods most suited to the particular group of deaf people.
I recommend the use of dream\ITOrk as extremely beneficial in
group work with the deaf.
What one does, thinks and feels
are closely interv1oven in every moment of living.
Our com-
plex personalities allow some release through reflectio'n
on our dreams.
Although science is still a long way from having any
comprehensive understanding of dreams, several findings have
emerged from modern research.
of dreams seem to
r~flect
These are that the majority
things that preoccupy our minds
during the course of daily life and that dreams express
themselves in a special kind of picture language.
Thinking
by means of pictures and pictorial idea association is
42
probably the most primitive of all modes of thought.
Ever
since words became an essential part of human life, dreams
have used them, but their role is usually subordinate to the
expression of feeling contained in the picture story.
Ac-
tion pictures in dreams are far·more expressive and less
restrictive than words (Faraday, 1976).
Due to the nature of deafness, the deaf individual
structures his language in visual, pictorial terms.
Be-
cause the action in a situation is of utmost importance, it
always appears first in a deaf person's language and conversation (O'rourke, 1976).
the research on dreams.
This principle coincides with
The distinguishing quality of
dream symbols is their individuality arising out of the
core of the dreamer's personal history and the offering of
cognitive as well as emotional definitions of his experience.
Dreams convey a vividness that would be impossible
to achieve in verbal terms (Hall, 1972).
Since dreams re-
flect not only actual happenings but also a whole host of
thoughts and feelings that occur during the course of
every~
day existence, dreams prove to be extremely helpful as a
release of those feelings.
Probably the most significant expression of any
individual's
person~lity
lies in his feelings.
The effort
to discover and to understand feelings is central throughout the therapeutic process.
The detection of implicit or
explicit emotion is also central in the consideration of a
43
dream.
Insight into the health of a client is profoundly
enhanced through the use of his dreams.
Feelings, when de-
tected and fully comprehended, are perhaps the most subtle,
accurate and comprehensive indicators of the total personality.
Dream feeling helps to reveal values and conceptual-
izations associated with activities in the waking life of a
dreamer (Bonime, 1962).
For deaf people, even more so than the hearing population, expressions of feelings are minimal.
In many cases
there are very few people with whom a deaf person can really
share his feelings.
For example, many deaf people live in
areas that have very small or non-existent deaf communities
as well as limited functions and activities for the deaf.
The area where I am presently working with the deaf is one
such area.
The deaf people I deal with have only each other
and me with whom they can converse.
Their respective famil-
ies do not use sign language in the home.
Since dreams are
such an excellent means of releasing feelings and emotions,
I quite often work with the dreams of students while in the
context of a group setting.
Because their native language,
sign language, is both conceptually and pictorially based,
the deaf are able to make connections between the visualaction occurring in.their dreams and the visual structure of
the
langu~ge
with which they are most familiar.
The use of dreams in group therapy has been found to
be a valuable technique according to studies with deaf pee-
44
ple at the New York School for the Deaf (Altshuler, 1967).
Clients with early total deafness indicated a great deal of
insight from the interpretation of dream material.
In this
particular setting the dream heightened the insight of the
therapist into the nature of the individual dynamics and
was helpful in focusing the group's attention on emotions.
In addition there was a heightened awareness that these .
emotions exist and guide one's actions though they are not
often consciously visible.
Problems encountered during the
course of this group experiment included the need for the
therapist to be alert to specific motivational lags and
experiential naivete.
There was also a need to make ab-
stract concepts more concrete so that interpretation of
behavior and fantasy could be made more meaningful.
The use of dreamwork in conjunction with the
therapeutic process can provide additional clarity and insight into an awareness of self for the deaf person.
In
the context of dreams, the dream symbols instead of being
figures of speech, are the nonverbal, graphic representation of qualities or concepts.
Expression of emotions is
critical for all living organisms ahd since feelings are
reflected in dreams, the deaf person can utilize his dreams
as a means of
relea~e
and as an expression of these feel-
ings.
Summary
Throughout the duration of a deaf person's up-
45
bringing, he is faced exclusively with tasks based on proficiency in the use of English or spoken language.
Because
of this emphasis, deaf people experience failure in almost
every area.
Due to the absence of verbal skills in the
deaf, non-verbal, visual modes of communication are a
better measurement of their abilities and a more accurate
measurement of their feelings.
Words are often not adequate for imaginative,
creative thought.
A quote by Louis S. Sullivan provides a
concise statement in regard to the benefits of visual
skills.
"Real thinking and feeling are better done
without words than with them, and creative thinking
must be done without words. When the mind is actively and vitally at work, for its own creative uses,
it has no time for word building: words are too
clumsy: you have no time to select and group them.
Hence you must think in terms of images, pictures,
states of feeling and rhythm."
It has been observed in recent studies that clients
who could never benefit from individual counseling and who
were unwilling or unable to express themselves to a counselor have sometimes been able to express themselves only
within the group counseling setting (Schein, 1971) .
For
the above and previously stated reasons, I have proposed
the recommendation for the use of group psychotherapy with
the deaf.
Research indicates the current psychotherapy of
the traditional model is unsuitable for those individuals
with limited communication.
These therapies have proven
unsuccessful and are currently being replaced by the more
action-oriented models (U.S. Department of Health, Education and Welfare, 1969) I have already discussed.
CHAPTER III
COUNSELING THE PARENTS OF DEAF CHILDREN
Importance of the Family
A crucial factor in the development of the deaf
child is the family.
Whether or not he can adequately ad-
just is a function of the acceptance he receives at home.
Approximately 90% of deaf children are born to hearing
parents (Rawlings, 1973).
Most programs for deaf children
do not adequately provide for t:he emotional needs of these
parents thus limiting the success of the child and his
total education.
This situation has led to confusion in
services provided for the deaf child and his family.
In this chapter, I am attempting to give parents
and professionals
a
full and accurate perspective of the
total social and psychological system in which they participate.
child.
Mental health should begin at home for the deaf
Early contact with parents may help these parents
to overcome their guilt and shame, avoid the extremes of
overprotection and rejection, and encourage them to communicate with the
chil~ren
by all means available.
The traumatic response of parents to the diagnosis
of deafness is noted as contributing to a distorted and impaired parent-child relationship (Schlesinger, 1968).
46
From
47
the onset, the deaf child is introduced to a socialization
process that often is characterized by continued parental
preoccupation with his deafness.
The child is forced into
a "sick" role with few limitations placed on his behavior
and little responsibility given to him.
The controversy
over oral as opposed to manual modes of communication also
contributes to the alienation of child from parent and frequently delays the
dev~lopment
of effective communications
between hearing parent and deaf child (Kane, 1970").
Since the lack of proper communication in the family seems to be such a crucial issue in the development of
personality for the deaf, perhaps the mental health needs
of the deaf can be dealt with more successfully with the
parents in mind.
The parents must initially work out their
feelings about having a child who is deaf.
Then the parents
must be informed in regard to the available opportunities,
educational issues, hearing aides and language development
tools.
This
infor~ation
will provide constructive ways of
coping with deafness and should include sign language instruction so as to alleviate the most predominant problem that of successful communication in the home (Vernon, 1974).
Mental Health Needs of the Parents
The discovery of a child's deafness is not an event
that happens instantly.
It feels as if it happens all at
once because the emotional reaction becomes so intense when
the parent is finally confronted with reality.
The dis-
48
covery, however, is a 'gradual unfolding of knowledge about
the child.
This unfolding depends on a variety of factors.
These include the nature of the parent's personalities, the
degree of acceptance of the child and the relationship of
the child to his family.
The parent's individual personality influences significantly the initial perception of the child's deafness.
If the discovery is prolonged by denial and rationalization
beyond the time when obvious behavioral patterns in the infant reveal the deafness, then the future parental decisions
will occur slowly and thus beyond the optimum time.
When
the growing child passes through and beyond ideal periods
without having had the opportunity for learning, the delay
often results in an irreversible loss.
This is especially
true in language learning and all that is dependent upon it
(Vernon,. 1971) •
Very important in the development of the deaf child
is the reaction of his parents.
As stated earlier, about
90% of. the deaf come from hearing parents who are thoroughly surprised by the handicap.
Carrying a child is an
emotionally laden experience.
The child is often thought of
as an extension of the parents.
In these very early stages.
the family is likely to need a great deal of emotional and
moral support together with practical advice on what they
can do immediately to help their child.
Shontz (1965)
presents a five stage scheme that can be valuable as a
49
reference model.
He suggests that these five stages in-
corporate the most prevalent reactions of parents to their
handicapped children.
The stages he describes are: 1)
shock; 2) recognition; 3) defense; 4) retreat; and 5) acknowledgement and constructive action (McCormick, 1975).
Parents of deaf children must be offered guidance throughout these crucial stages.
Having a deaf child is traumatic to a family.
It
arouses responses such as g~ief, denial, guilt, anger and
frustration which are of an intense and deep nature.
Unless
these feelings are worked through in what is called a
mourning or grief process, they are tremendously destructive
to the entire family in general and to the mental health of
the deaf child in particular.
It is not until a person has
started to feel more positively - to cry, to feel sad and
work out these feelings - that he begins to cope with the
problem (Vernon, 1971).
Lutterman (1973) thought that in
order for parents to deal positively with their child's
needs, they must first work through their own feelings of
guilt, fear and confusion.
When parents accept their
feelings and their behavior is not controlled by negative
feelings, then they can move to constructive action
(McCormick, 1975) . .
The deaf child, because he must depend more often
on communication of a nonverbal nature, remains more dependent on the mother than does the hearing child.
His is
50
a forced dependence born of an inability to develop conventional communication.
This inability forces him to de-
pend on the actions, not the words, of the few people with
whom he is familiar.
He must approach strangers cautiously.
Often they provide little or no new learning opportunity
for him.
This occurs because few people can handle with
ease the difficulties inherent in activities and communication with a deaf child (Vernon, 1971).
This forced de-
pendence upon the mother imposes additional frustrations for
her that must be dealt with.
Once the parents are faced with the reality of
deafness in their family they must have the confidence to
continue to treat their child in the manner that came
naturally to them before they discovered the deafness.
Green (1965) discusses the marked feelings of inadequacy
which parents may feel when they are informed of something
they do not fully understand.
Dybwal (1973) makes the point
that, "The greatest source of emotional disturbance of
parents is uncertainty -
just not knowing what has happened,
but not knowing what can be done."
Parents do need help and
the consolation and comfort of talking with someone who
knows something about deafness.
The following are some of the most important needs
of parents of deaf children.
Within the context of the
counseling relationship: 1) the need to be dealt with as an
individual rather than as a case, a type or a category; 2)
51
the need to express feelings, both negative and positive;
3) the need to be accepted as a person of worth, a person
with innate dignity regardless of dependence, weakness·,
faults or failures; 4) the need for empathic understanding
of and response to feelings expressed; 5) the need to be
neither judged nor condemned and 6) the need to make one's
own decisions and choices given a series of alternatives
and pertinent information.
Attitudes Helpful to the Parents
There are certain attitudes that may foster favorable results when exercised by·a parent of deaf children.
These particular attitudes may aid the children in achieving
a realistic emotional adjustment to deafness.
The deaf
child is confronted with both obstructions and frustrations
while he is growing up and he needs as much help as possible
from his parents in learning how to deal with these problems
effectively.
Basic to all other constructive feelings about the
handicap· of deafness is acceptance_ - the recognition of
the nature of deafness and the problems it creates without
either belittling or exaggerating its significance.
First,
parents should not blame themselves for the child's hearing
problem.
Few children; if any, are deaf because of some-
thing their parents did, or did not, do {Gowan, 1972) •
•
Responsibility must be taken for the child's welfare but not
for his deafness.
One cannot accept deafness if it is view-
52
ed as a living reminder of negligence on the part of the
parent.
Hearing impairment should not be viewed as a
punishment.
Another attitude that interferes with the acceptance
of a deaf child is the denial that deafness is a handicap.
It is not the same handicap for every child but no matter
how favorable the circumstances may be, nothing will change
the hearing loss from
a
liability to an asset.
Denying
that hearing loss is a handicap is one extreme reaction to
deafness; the opposite extreme is the exaggeration of the
degree of handicap which deafness involves.
Objectivity must be developed by the parents of
deaf children.
The first step towards objectivity is to de-
fine the goals for the child in terms of his abilities and
interests.
A basic requirement in this respect is to reco-
gnize the limitations of educational achievement which are
imposed by the language deficiencies resulting from deafness.
A second step tmvard obj ecti vi ty is to avoid overemphasizing the importance of speech (Gowan, 1972).
Many
parents of"deaf children are so determined to teach their
children to talk that i t distorts their sense of educational perspective.
There is no doubt that the deaf person who
can talk intelligibly and who can read lips has some advantage in dealing with hearing people.
However, learning to
talk is not the equivalent of getting an education.
In
53
terms of his ultimate school achievement, it is probably
more important that a deaf child learn to read than that he
learn to speak; and this also tends to be true for the child
with normal hearing (McCormick, 1975).
Speech is desirable
for all deaf people, and the schools should make every
effort to teach it; but it should not be the ultimate
ambition for the deaf child to the extent that his other
educational needs are ignored.
Parents should not consider
their child only to be an educational success if he can talk
and an educational failure if he cannot.
Parents of deaf children should keep in mind that
each child is an individual with his own unique set of
skills, desires, motivations and limitations.
Because this
is the case, it is impossible for him to do things exactly
the way that other children do them.
Sharing the handicap
of deafness does not imply sharing all other characteristics or behavior.
when evaluating a child's progress,
emphasis must be placed on what he has learned and can do
rather than on his failures.
Attitudes Helpful to the Deaf Child
Just as there are particular attitudes helpful to
parents of deaf children there are also attitudes which are
desirable for the child to instill into his personality.
Simply an awareness of these attitudes on the part of the
parent can assist in their formation and development.
The first is an attitude of independence.
Achieving
54
this depends to a great extent upon the desire to be independent.
This desire must be fostered and encouraged
from the earliest years of a child's life.
Ordinarily it
is well developed by the time the child enters school (Kane,
1970).
Assisting the child in learning the advantages of
independence can be achieved in the-following manner: parents can give their child freedom to investigate the world.
Children need to explore the world at first hand, and the
exploration seems to be more meaningful if done as a result
of the child's initiative. (Myklebust, 1962).
Due to the
communication handicap, the deaf child is more dependent on
physical exploration and manipulation than the hearing
child (O'rourke, 1972).
Too severe a restriction upon a
child's actions as a searching, investigating child will
have the effect of teaching him that the attitude of independence is undesirable.
Another way to promote the attitude of independence
is by giving a child responsibility.
Each new task that
the child assumes responsibility for means less dependence
on others and as a result is a step toward social maturity.
Giving responsibility to children often involves some inconvenience to parents.
These trials are transient, and
when they have passed, the parents will find new pride and
satisfaction in the fact that their child is becoming a more
responsible individual.
Failure to give the child respon-
sibility produces dependency and passivity which are un-
55
desirable characteristics.
These are the characteristics
that lead to the perception that deaf people tend to be
socially and emotionally immature.
This immaturity is un-
necessary and can be prevented and corrected in the home.
An attitude that needs to be encouraged in all
children, and even more so in deaf children, is confidence.
I am referring to the establishment of a secure, stable and
emotional environment in the home and particularly in the
relationships between parents and child.
Confidence for
the child is pretty much a matter of emotional security and
the maintenance of this security is a primary responsibility
of parents.
A child needs to feel that the world is a safe,
orderly place to live.
Some means of providing limitations must be established for the child.
The absence of rules deprives the
child of a standard by which to anticipate the results of
his own conduct and increases the probability that a given
experience will be painful.
Thus, a child who lives in a
world which is inconsistent will tend to behave with confusion and uncertainty (Gowan, 1972) •
It is important there-
fore, that parents be consistent from one day to the next if
they are to establish that emotional environment which develops the attitude.of confidence.
Another aspect which needs emphasis is that of establishing boundaries of permitted and forbidden behavior.
This is a corollary of the first, for consistency of manage-
56
ment is based on consistency of standards.
The point is
that standards need to be adequately defined for the child.
The parent is the model by which the child imitates appropriate behavior patterns.
Children trust their parents'
judgment, wisdom and fairness.
The hearing child may ask
his parents why certain things are done, and in a relatively short time he learns to distinguish subtler nuances of
motivation and modifies his own behavior accordingly.
deaf child, however, can judge only by what he sees.
The
One
of the jobs as a parent of a deaf child is to ensure that he
sees behavior which is desirable for him to imitate.
Considerations for the Counselor
If parents of deaf children are fortunate enough to
find good counseling, they may be able to obtain some relief.
They can be helped to realize that deafness is, after
all, only deafness; that their child simply does not hear.
His experience will be limited in one respect but full in
others.
The deaf child is educable and otherwise healthy.
He can learn to develop normally given the opportunity.
Unfortunately parents of most deaf children seen by
counselors to date have not been so guided (Bolton, 1976).
Counseling
for parents of deaf children should involve the
entire family complex. · The goal of this family participation and education is the attainment of attitudes, insights,
understandings and skills.
These are the tools required to
develop confidence and competence in assuming responsibility
57
for a stimulating family life which promotes the development of communication skills in the child.
Again the primary issue is the necessity of the development of communication skills in the deaf child.
If the
avenues of communica.tion are different in the family, then
the usual mutual relaxation.between family members and child
is disturbed (Altshuler, "1967) •
Parents may desperately
want the child to be like themselves, and frequently they
achieve the exact opposite of their desires.
The deaf child
is simply not like his hearing family and often requires a
different system in which to communicate effectively.
It
is important that the deaf child feel positively about the
manner in which he communicates.
This can only be accom-
plished if the parents play a part in fostering this attitude.
Even when a manual form of communication is utilized,
children may still learn that it is not quite as acceptable
as spoken
langu~ge.
This concept could result in interfer-
ence with the healthy development of self concept for the
deaf child.
The counselor for parents of deaf children must be
aware of a variety of foreseeable reactions.
When confront-
ed with·their child's deafness, the parents begin a process,
which if successful will allow them to abandon .the hope of
having a ·"perfect" and normal child.
The original concept.
of the infant's future must be replaced with more realistic
notions of the limits imposed by the disability.
Only with
58
a realistic appraisal of the deaf child's capacities is it
possible for the parents to help him achieve the maximum
within his limitations (Vernon, 1971).
In addition [~the counselor needs a broad source of
background information regarding deafness and its limital'
tions (real and imagined) as well as an ~nderstanding of
normal child growth and development:)
For his own effec-
tiveness it is important that the counselor develop the
skill in putting professional knowledge into language understandable to parents when i t relates to current needs concerning the deaf child (Hardy, 1974).
Perhaps one of the most difficult psychological
burdens for the parent to handle is the anger that the
frustrations of deafness cre~t~ in everyday liv~ng (Vernon,
1971).
Because of this difficulty, the counselor needs to
/provide alternatives for parents in forms that are practical
enough to be applied to their daily activities.
Essential
in fulfilling this need is recognition of the difficulties
parents face as individuals as well as the complexities of
the family roles.
To instill confidence and courage, a
counselor must be able to put himself in the parent's position.
He may then be able to develop the insight necessary
to enable him to establish a relationship in which his guidance will be accepted.
During the various stages of a child's development,
there will be highs and lows.
Concerned parents' feelings
59
may be expected to fluctuate accordingly.
needs to anticipate such occurrences.
the parents for such eventualities.
The counselor
He can then prepare
Studies indicate that
many young deaf children are prone to either withdrawal or
aggressiveness.
While anxiety and shyness define with-
drawal; temper tantrums, outbursts and stubborness signify
aggression (Myklebust, 1962).
As the deaf child grows older, his awareness of
himself as "different" may precipitate feelings of depression which, in turn, may lead to withdrawal from social contacts, particularly in the hearing world.
In addition, ·
there is ·often a rising sense of inferiority and suspiciousness (Myklebust, 1962).
In 1972, Schlesinger and Meadow
identified the following disturbances at selected age
levels: for young children there existed behavioral and
learning problems; for older children, conflict revolved
around their self-identification and emancipation; for
adults, the primary problems dealt with jobs and marriage.
This information may clarify some of the major difficulties
encountered so that the counselor may be able to impart this
information to the parents.
Another study that should be considered is one that
indicates that anxiety may be contagiou~}(McCormick, 1975).
If young children are in the presence of anxious parents,
they may take on the anxiety themselves.
This can severely
impair the normal close loving relationship and the normal
60
parent-child interaction.
Bolby's investigations on the
effects of deprivation of normal contact in the earliest
months points to the adverse affects on the child's ability
to make deep and lasting friendships and to the dulling of
the sense o£ drive and exploration.
The counselor there-
fore has a valuable role to play in trying to reduce some
of the above anxieties and tensions which may challenge the
stability of the home.
In conclusion, the major mental health need of a deaf
child is parents who: 1) worked through their feelings about
having a child who is deaf; 2) are knowledgeable about
available opportunities, educational issues, hearing aids
and language development; 3) can and do communicate with
their deaf child; and 4) who can use the social system to
their child's advantage.
To provide a deaf child with a
parent having these qualities requires the delivery of
counseling services almost immediately upon the diagnosis of
the child's deafness.
These services are necessary for the
proper development of a positive self image for the deaf
child.
Summary
There is a close correlation between the parents'
early reactions to the discovery of the deafness and their
future handling of the child (Vernon, 1971).
Those
reac~
tions which result in bitterness and resentment can be prevented by early enlightened professional intervention.
61
Successful family adaptations to childhood deafness are
rare today because of narrow habilitation efforts.
As a
consequence, deaf children become progressively more isolated from their families and from the hearing community as
well.
This occurs despite the common and misleading dictum:
"The deaf child must learn to get along in the hearing
world."
(Vernon, 1971)
It is difficult for hearing parents to understand
the complexities of deafness since their exposure to deaf
people before the birth of. their deaf child was probably
minimal or non-existent.
They must develop an acceptance
of their deaf child and realize that his behavior pattern
may differ from that of his hearing siblings.
It must be
stated that complete and unqualified acceptance of the
deaf child is a remarkable achievement (Knee, 1970).
Hearing parents must also realize that the communication gap which exists between themselves and their deaf
children is reciprocal.
In other words, the failure to
communicate is attributable to parents as well as children.
Instead of stressing to their children the importance of
oral language, parents should make themselves understood
through the system of total communication.
In this way, the
communication deficit would be mitigated or largely alleviated.
Counseling for hearing parents and their deaf children
has been shown to be advantageous (Kane, 1970).
Parents
could develop a realistic approach toward their children as
well as a better understanding of them.
Deaf children
could learn to comprehend and adjust to their hearing environments but at the same time maintain their identity and
self-respect.
A form of counseling which deals with various
facets of life would
therefore be beneficial to deaf people
of all ages.
CHAPTER IV
RECO~~ENDATIONS
FOR THE FUTURE
As an educator of the deaf and a future counselor
for the deaf, I consider it necessary to encourage the provision of special mental health services for the deaf.
Studies have indicated that successful deaf adults {successful in terms of psychological health, adaptation and
self-actualization) use more coping mechanisms than defense
mechanisms and also had meaningful and enjoyable parentchild linguistic interactions.
Successful deaf adults have
tended to have a greater degree of residual hearing, or to
have deaf parents with whom they could communicate {U.S.
Department of HEW, 1977).
I postulate that under certain circumstances, deaf
people can become more successful even with greater hearing
loss, an earlier onset of deafness, and with hearing parents.
This can occur by an attempt to diminish some of the
commonly encountered problems of the deaf that I have already stated, or by increasing enhancing life experiences.
The lack of counseling personnel with the kind of training
62
63
and experience that provides understanding of deafness and
the necessary communication skills contributes to the problems associated with deafness.
The accessibility of family
mental health services to the deaf can be instrumental in
changing the present trend.
Effective counseling for the deaf should include
the following guidelines: 1} it must begin when the child
is young and must be a consistent inclusion in the dea£
school education (Fusfeld, 1954},
(Rainer & Altshuler,
1971} ; 2} it must include tests sensitive to the needs and
limitations of the deaf and these should be employed to obtain an accurate diagnosis (Altshuler, 1971}
(Levine, 1969};
3} it must incorporate an interdisciplinary approach, offering the services of teachers, parent, psychiatrist,
psychologist and social worker (Thompson, 1964},
(Rainer,
1967}; and 4} i t must employ counselors who are fluent in
sign language and train parents in the use of total communication (Levine, 1969} •
For most deaf persons, the important recommendations
1n the field of mental health planning lie in the preventive
area.
Conditions leading to frustration, poor adjustment,
sexual and other forms of delinquency arise within the
matrix of the family and the early residential setting of
the school (Rainer, 1969}.
Deaf adolescents grow up and go
on to parenthood, often without adequate knowledge and
guidance.
The most beneficial approach to prevention of
64
maladjustment is to center attention on preparation for
family living, since it is in this context that most unhappiness and behavior disorder manifest themselves.
A number of recommendations can be made for a preventive psychiatric program which would help young deaf
people and their families before emotional distress leads
to severe disturbance.
A mental health program for the
deaf should include facilities for early diagnosis, group
therapy techniques for adolescents of both sexes, methods
of group and individual family guidance for the parents and
families of the deaf, and training for teachers and parents
enabling them to cope with those problems encountered.
A variety of treatment programs could increase the
opportunity for deaf people to lead more successful lives.
Planning for children's programs should involve personnel
from schools for the deaf, mental health centers, rehabilitation and community leaders of the deaf.
It cannot be
assumed that children in schools for the deaf do not have
emotional and mental disturbances, so that a program geared
specifically to the needs of deaf children could also have
a preventive role.
Some deaf children have the feeling that living in
an institution is equivalent to rejection by their parents.
Others, in public schools, may be rejected and ridiculed by
hearing fellow students.
Deaf children face different
problems from the hearing child, and they may also have
65
similar problems but to a different degree.
Preventive
mental health should top the list of achievement goals for
the program and the counselor (Altshuler, 1969).
Although facilities for psychatric treatment are
badly needed for the deaf, even more urgent are mental
hygiene programs such as sex education and preparation for
marriage for young deaf persons in high school or college
(Rainer, 1969).
These will benefit not only those deaf
persons but their future families.
No group is more en-
titled to counseling in marriage, parenthood and genetics
than the deaf.
In addition treatment programs for deaf
adolescents should incorporate means of fitting deaf young
people into the competitive labor market, into the hearing
community and into the deaf community of adults.
Through
planning with other agencies the counselor can often develop an effective rehabilitative and preventive program for
deaf adolescents.
Adult treatment programs should deal with the broad
spectrum of problems encountered by this age group of the
deaf population.
Possibly a class in mental health and
mental hygiene could assist deaf adults by giving them insignt into mental health programs.
As a result, deaf per-
sons would be made more aware of what mental illness and
health services consist, and the preventive potential of
such programs will be enhanced.
There is also a definite need for followup once
66
mental health services have been utilized.
In order to
carry deaf clients effectively through a rehabilitation
period, the psychiatric personnel should be supplemented by
social workers and rehabilitation counselors specialized in
the care of the deaf.
This kind of a program should explore
the following: 1) the role and feasibility of a special
halfway house and day care program; 2) a means of achieving
an effective integration between the total psychiatric program and state vocational rehabilitation agencies and; 3)
methods for close follow-up and supervision of family,
vocational and community adjustment (Bolton, 1976) .
For a truly comprehensive mental health service program, the following services are considered vital: inpatient
services, outpatient services, partial hospitalization,
community services, diagnostic services, rehabilitation
services, complete care and after-care services, training,
research and evaluation.
A comprehensive mental health
service program for the deaf should comprise the same types
of services but should narrow the focus to the needs of the
deaf.
Such a program should also have special provisions
to train professionals and psychiatric interpreters to
treat the deaf.
There is a real necessity for the organization of a
group of interpreters to specialize in an interpreting
service program within mental health centers.
Such inter-
preters should receive training with psychiatric content.
67
They should also receive training to interpretively assist
the counselor in his testing and therapeutic work.
Such
interpreting skills should range from a high literate use
of sign language to graphic pantomime, according to the
communicative skill of the clients to be served (Altshuler,
1969) •
An interpreter should also have an intimate knowledge of the deaf community.
If the interpreter does not
know the community then he quite often cannot interpret the
full meaning intended by a deaf client.
This knowledge can
help the therapist bring the client to a more relevant
analysis of an existing problem.
As has been shown, there is a wide range of possible
mental health services.
Presently there exist far too few
of these programs to service the deaf individual.
This
situation exists in the face of research findings that indicate a higher incidence of emotional disturbance in the
deaf population than in the general population (Hardy,
1974).
Part of the problem has again been the scarcity of
mental health personnel to work with the deaf.
While it is
customary for hospitalized hearing persons to be restored
early to their homes, deaf patients are apt to wait for
months and years in hospitals where their needs remain unmet (Altshuler and Rainer, 1970).
A large scale training program on mental health
services to the deaf and severely hearing impaired for
68
personnel in psychiatry is a high priority need to increase sharply the availability and effectiveness of ongoing programs.
It should include university courses in
orientation to deafness, in-service training arrangements,
practicum under supervision of the known experts in extending mental health services to deaf persons, intensive
training in manual communication and recruitment of more
individuals interested in this field (Rainer and Altshuler,
1970).
Summary
My hopes are that the present scientific studies of
deaf people will lead to the establishment of mental health
programs serviced by professionals who are knowledgeable
about deafness and who are skilled in sign language.
Communication, the vital tool of counseling and therapy, is
not really taking place unless an easy exchange of thinking
exists.
For
dea~
clients, such counseling comes alive as a
healing force in direct ratio to the counselor's ability to
communicate with them.
The times are more auspicious for a
major effort toward the improvement and expansion of the
mental health services for deaf people.
The times are right, the needs are known and generally agreed upon.
awaits us.
Only the challenge of implementation
69
References
1)
Altshuler, K.Z. & Rainer, J.D. Comprehensive Mental
Health Services for the Deaf. New York: Columbia
University; 1966.
2)
Altshuler, K.Z. & Rainer, J.D. & Kallman, F.J. Family
and Mental Health Problems in a Deaf Population.
Illinois: Charles C. Thomas; 1964.
3)
Altshuler, K.Z. & Rainer, J~D. Personality Traits and
Depressive Symptoms in the Deaf: Recent Advances In
Biological Psychology, Vol. 6; 1964.
4)
Altshuler, K.Z. & Rainer, J.D. Psychiatry and The Deaf.
New York: University Center for Research & Training in
Deaf Rehabilitation: 1967.
5)
Blatner, Howard A. Acting-In: Practical Applications
of Psychodramatic Methods. New York: Springer Publishing Co., Inc.; 1973.
~
6}
Bolton, Brian. Psychology of Deafness for Rehabilitation Counselors. London: University Park Press; 1976.
7)
Bonime, Walter. The Clinical Use of Dreams. New York:
Basic Books; 1962.
8)
Chapman, Gay. Learning In a Friendly Environment: Art
As An Instructor. Microfilm; April, 1977.
9)
Faraday, Ann. The Dream Game. New York: Harper & Row
Publishers; 1976.
10)
Faraday, Ann. Dream Power. New York: Harper & Row
Publishers; 1976.
11)
Fusfeld, J.S. Counseling the Deafened: Developing
Psychological Acceptance of the Disability. Washington
D.C.: Gallaudet College; 1954.
12)
Gowan, J.C. The Guidance of Exceptional Children. New
York: David McKay Co., Inc.; 1972.
13)
Hall, Calvin S. & Nordby, V.J. Th~ Individual and His
Dreams. New York: New American Library, Inc.; 1972.
14}
Kane, Joseph & Shafer, Carl M. Personal and Family
Counseling Services of Los Angeles, California. Microfilm, 1970.
70
15)
Knee, Sonya Siegel. Emotional Problems of the Deaf
Child. The Teacher of the Deaf. Vol. 74: 413-425.
1970.
16)
Levine, E.S. The Psychology of Deafness: Techniques
of Appraisal for Rehabilitation. New York: Columbia
University Press; 1960.
17)
Mason, Kathleen. Dance Therapy In Perspective. American
Association for Health, Physical Education and Recreation. Washington D.C.; 1974.
18)
McCormick, B. Parent Guidance: The Needs of Families
and of the Professional Worker. Teacher of the Deaf;
Vol. 73: 315-330, Nov. 1975.
19)
Moreno, J.L. Psychodrama.
1964.
20)
Myklebust, Neyhaus & Mulholland. Guidance and Counseling for the Deaf. American Annals of the Deaf. Vol.
107: 370-415. 1962.
21)
O'rourke, Terrence J. Psycholinguistics and Total
Communication:
The State of the Art. American Annals
of the Deaf, 1972.
22)
Rainer, J.D. & Altshuler, K.Z. Expanded Mental Health
Care for the Deaf: Rehabilitation and Prevention.
New York: Research Foundation for Mental Hygiene, Inc.,
1970.
23)
Rawlings, B. Characteristics of Hearing Impaired
Students by Hearing Status. Office of Demographic
Studies, Washington D.C.; 1973.
24)
Robinson, Luther D. & Clayton L. Psychodrama With Deaf
People. American Annals of the Deaf. Vol. 116: 415419. August, 1971.
25)
Rogers, Carl. On Encounter Groups. New York: Harper &
Row Publishers; 1973.
26)
Sch~in, Jerome D. Orientation To Deafness for General
Counselors. Deaf American, Vol. 27: Nov., 1974.
27)
Schein, Jerome D. The Use of Group Techiques with Deaf
Persons. Social & Rehabilitation Service, Dept. of
Health, Education & Welfare, Washington, D.C. 1970.
New York: Beacon House, Inc.;
71
28)
Silver, Rawley A. Art Breaks the Silence. Children's
House. Vol. 14: 10-13 & 477; 1970.
29)
Sussman, Allen E. Counseling With Deaf People: New
York Deafness Research & Training Center, University
School of Education. 1971.
30)
Thompson, R. Counseling & The Deaf Student. Volta
Review. 1966.
31)
Ulman, Elinor. Art Therapy: In Theory & Practice.
New York: Schochen Books; 1977.
32)
U.S. Dept. of Health, Education & Welfare. Mental
Health In Deafness. Washington D.C., 1977.
33)
U.S. Dept. of Health, Education & Welfare. Psychiatric
Diagnosis, Theory & Research of the Psychotic Deaf.
Washington D.C., 1969.
34)
Vernon, M. Interpreting In Counseling and Therapeutic
Situations, Interpreting for Deaf People. U.S. Dept.
of HEW., Washington D.C.; 1965.
35)
Vernon, M. Sociological & Psychological Factors
Associated with Hearing Loss. Speech & Hearing Research. Vol. 12: 541-563.; 1969.
36)
Vernon, M. & Mindell, E.D. They Grow In Silence.
Silverspring, Maryland: National Association of the
Deaf. 1971.
37} . Wethered, Audrey. Drama & Movement In Therapy. London:
MacDonald & Evans Ltd; 1973.
38}
Yalom, Irvin D. The Theory & Practice of Group
Psychotherapy. New York: Basic Books, Inc.; 1975.
72
APPENIHX
Organizations Serving the Deaf
Deaf Community Services
1.
National Association of the Deaf
Lillian Skinner, President
17301 Halsted
Northridge, California 91324
2.
Greater Los Angeles Council on Deafness
a. Glad Administrative Office
616 South Westmoreland
Los Angeles, California 90005
b. Glad-Info
616 South Westmoreland
Los Angeles, California 90005
Downtown Los Angeles
TTY/Voice (213)383-2220
San Fernando Valley Area TTY/Voice (213)780-2200
San Gabriel Valley Area TTY/Voice (213)579-4474
South Bay Cities
TTY/Voice (213)638-7337
3.
Registry of Interpreters for the Deaf, Inc.
P.O. Box 1339, Washington, D.C. 20013
(202)447-0511
4.
Communication Skills Program of NAD
814 Thayer Avenue
Silver Spring, Maryland 20910
5.
Southern California Registry of Interpreters for the
Deaf
P.O. Box 4212
Thousand Oaks, California 91359
TTY/Voice: (213)885-2614
Mental Health Services
A.
In-Patient - Out-Patient
1) Furthermore Foundation
18740 Ventura Blvd., Suite 211
Tarzana, CA 91356
TTY: (213)894-7068, Voice: (213)342-2424
Marriage, family, child counseling. Adjustment through
group, couple or individual interactions. Interpreters
available. Fees on a sliding scale. Ronald Furst, M.A.
M.F.C., Executive Director. Office hours, everyday: 9:00
a.m. to 11:00 p.m. (24 hour emergency service).
73
2)
Saint John's Hospital Mental Health Services for
the Deaf
1328 22nd St.
Santa Monica, CA 90404
Voice: (213)829-8537, TTY/Voice: (213)829-7451
Day treatment/partial hospitalization (allages); outpatient
psychiatric clinic (allages); psychological testing; family
counseling; parent education groups - services available to
all persons either deaf/hard of hearing or associated with
hearing impaired~ Evening and Saturday appointments by
special arrangement. Medicare/Medi-Cal accepted. Gregory
c. Kimberlin, Director.
3)
South Bay Children's Health Center
410 So. Camino Real
Redondo Beach, CA 90277
(213)376-8936
Mental health services, child and teenage guidance clinic.
18 months - 18 years and their families. Medi-Cal accepted.
Frank C. Masi, Executive Director. Office hours: 8:305:00.
B.
Psychatrists, Psychologists, Counselors
1) Associated Behavior and Communication Center
6325 Topanga Canyon Blvd.
Woodland Hills, CA 91367
(213)348-6333
Marriage, child and family counseling, psychotherapy, educational therapy. Sign language used. James Gerth,
Managing Director, Ricardo Brady, Counselor. Office hours
by appointment only.
2)
Dan Clere, M.S.
8601 E. Florence Ave.
Downey, CA 90240
(714)893-2545, (213)927-4497
Marriage, family, child counseling. Individuals, couples,
groups, psychological and intelligence testing, vocational
counseling. Services all hearing impaired.
3)
Carlo P. Deantonio
4835 Van Nuys Blvd.
Sherman Oaks, CA 91403
(213)691-0731
Does not know sign language, must have interpreter.
4)
Gail Goodman, M.Ed.
1441 South Robertson Blvd.
Los Angeles, CA 90035
(213)559-6933
Individual,· marriage, family and child counseling. Total
communication used. Call or write for appointment. Sliding
74
scale fees.
5)
William J. Hansen, M.D.
11665 W. Olympic Blvd.
Los Angeles, CA 90064
(213)473-9833
6)
Leland Heffner, M.D.
1100 Glendon Ave., Suite 900
Los Angeles, CA 90024
(213}477-2726
Adult and child psychiatrist, group or individual basis.
Career, health and rehabilitation services. Private practice by appointment. Member of·Dept. of Psychiatry, Los
Angeles County-USC Medical Center.
7)
Hartley K. Koch
1806 W. Flora St.
Santa Ana, CA 92704
Office: TTY/Voice:
(714)834-5242, 558-5706
Home: Voice:
(714)557-1355
8)
Orange County Mental Health Services for the Deaf.
1600 N. Broadway, Suite 310
Santa Ana, CA 92706
TTY/Voice:
(714)834-5242 or 834-5243
Counseling, therapy, family-marriage-child counseling. Consultation with the community, parent education, special
school liaison. Services to deaf and their families. Outpatient services stressed, inpatient services arranged.
Medicare/Medi-Cal accepted . . Dr. Geno M. Veseovi, Program
Manager • . office hours 9:00a.m. to lO:OOp.m. M-F.
9)
Mary Ann Read~ Licensed M.F.C.C.
226 W. Foothill, Suite D
Claremont, CA 91107
Direct line or answering service:
(714)621-6245
Humane Circle: Family counseling, individual counseling,
educational counseling, workshops. Sign language used.
10)
Shari F. Schiff, M.A., M.F.C.
(213)267-2554
Marriage, family, child counselor. Knows sign language •
.Call for an appointment.
11)
Dr. Jack Share, P.h.D.
14140 Ventura Blvd., Suite 14
Sherman Oaks, CA 91423
981-9800
Clinical Psychologist who works with families that have deaf
children. Interpreter on staff. Medi-Cal/Medicare accepted. Office hours:
9:00-7:00 M-F.
8:00-1:00 Sat.
75
12)
Natalie G. Stephenson, M.D.W., A.C.S.W.
17150 Tulsa St.
Granada Hills, CA 91344
TTY/Voice:
(213)360-5800
Psychotherapy consultant; individual and group; marriage,
family and child counseling. Diagnostic testing. Sign
language used. Office hours: On call 24 hours, 7 days.
13)
Valley Women's Center
5651 Parkmor Road
Calabasas, CA 91302
Voice:
(213)880-5248 TTY:
(213)360-8508
Counseling for women and families - interpreter services
available. Norma Ehrcil, Executive Director, Office hours:
9:00 - 5:00.
14)
Betsy Watschke
1302 South Leaf Ave.
West Covina, CA 91791
(213)332-7301
Marriage, family and child counseling for the deaf.
hours: 6:00 - 10:00 M-TH, 8:00 - 12:00 Sat.
Office