You’re Deaf? Breaking through Myths for Effective Therapeutic Practice

ABSTRACT

Most mental health practitioners provide services to hearing clients and might be unprepared when a deaf individual requests services. The purpose of this article is to explore commonly held stereotypes and myths about deaf people and to provide guidance to clinicians who encounter deaf clients in their practices. Myths and stereotypes can affect the way clinicians perceive their clients’ needs. This can lead to miscommunication, misunderstanding, and misinformation, which can harm the therapeutic relationship, thus making effective therapy unattainable. Clinicians should reframe these beliefs and overcome barriers to make way for the therapeutic process to begin.     

Applying an Ecological Framework to Understanding Drug Addiction and Recovery

ABSTRACT

A new conceptual model of drug addiction and recovery, the Acculturation Model, is presented, with “addiction” and “recovery” understood as distinct sociocultural phenomena with their unique prescribed behaviors, rituals, symbols, and language that serve to construct and consolidate a cultural identity. The model suggests that individuals in recovery from drug addiction will need to make a cultural transformation in order to maintain sobriety. Examples of specific rituals that may help facilitate movement from addiction to recovery are detailed.     

Disaster Relief and Crisis Intervention with Deaf Communities: Lessons Learned from the Japanese Deaf Community

ABSTRACT

During natural disasters and crises, the deaf and hard of hearing community might not have full accessibility to all of the information shared with the larger hearing community. This could be due to the lack of awareness among social work professionals about these cultural and linguistic needs of this minority population. The purpose of this article is to explore the challenges faced by the deaf community and to discuss culturally and linguistically appropriate crisis intervention and mobilization to natural disaster situations based on the experiences of the Japanese deaf communities affected by the Kobe and Tohoku earthquakes.     

Psychiatric Symptomatology in a Deaf College Population Affecting Diagnosis and Treatment

Abstract

As the mental health needs of the deaf receive increased recognition, issues of diagnosis and treatment become vital. Several characteristic behavioral patterns are frequently encountered which often confuse diagnosis, particularly in clinicians inexperienced with hearing-impaired individuals. These behavioral characteristics of suspiciousness, the use of odd or idiosyncratic language, difficulties in expression of affects, and acting out behaviors may create a tendency to overdiagnose serious mental illness. In addition, an understanding of the impact of deafness on an individual's personality development is crucial to an intelligent choice of treatment approach. These difficult issues of differential diagnosis and treatment are discussed in the context of the psychotherapeutic experiences of a hearing and nonsigning clinician working with deaf college students.     

Physical Activity as a Helpful Adjunct to Substance Abuse Treatment

ABSTRACT

While limited research exists on the topic of physical activity as an adjunct to substance abuse treatment, a review of relevant multidisciplinary literature indicates a logical rationale for its potential benefits to recovery from addiction. This article provides an overview of common variables that contribute to addictive disease and summarizes the relationship of regular physical activity to improvements on many of these variables. The stages of change from the Transtheoretical Model (TTM, Prochaska & DiClemente, 1982; Prochaska & Velicer, 1997) are described in the context of effectively matching clients in substance abuse therapy to interventions that may include physical activity. Finally, important practical suggestions for implementing physical activity as a useful adjunct to substance abuse treatment are provided.     

Computer addiction. When monitor becomes control center

Computer addiction is a newly recognized problem. While controversy exists about whether computer addiction should be considered a primary psychiatric disorder, clinicians are treating increasing numbers of clients experiencing problems caused by excessive computer use. Case studies are provided that include typical histories and symptoms. Behavioral cognitive therapy is discussed as a treatment approach. The stages of change theory is recommended as a strategy to help clients plan and implement change.     

Self-Care Practices and the Professional Self

ABSTRACT

Consistently and actively engaging in self-care has been shown to improve the performance of mental health practitioners by reducing burnout, vicarious trauma, compassion fatigue, and other stress-related psychological problems. Not only is this important to the individual practitioner’s well-being, but ethical standards also mandate the recognition and remediation of any physical, mental, or emotional self-impairment to maintain high standards of care for clients. Professionals in small communities, like the Deaf community, however, confront unique challenges in attending to their self-care. This article investigates these challenges—as well as the rewards—experienced by Deaf and hearing counselors working in mental health care with deaf clients.     

Exploratory study of the use of community treatment orders with clients of an Ontario ACT team

ABSTRACT

Community Treatment Orders (CTOs) have raised questions about coercion, lack of autonomy, and effectiveness in reducing hospitalizations and improving service users’ quality of life. This study examined the experiences of clients and clinicians when CTOs are used in combination with Assertive Community Treatment (ACT) in a recovery oriented approach. Eleven clients who were or had previously been on a CTO and eight ACT clinicians were interviewed. Although most clients had negative feelings about CTOs, some acknowledged their lives had improved. Clinicians reported that the decision to employ a CTO is sometimes debated within the team but they agreed that combining CTOs and ACT resulted in regular access to mental health supports, fewer hospitalizations and overall improvement of quality of life for their clients.     

Incorporating Spirituality and the Strengths Perspective into Social Work Practice with Addicted Individuals

Abstract

In the last two decades, the social work profession began to confront the professional avoidance of alcoholics and other drug addicts, and discussions of spirituality. While acknowledging the importance of 12-Step Programs of Alcoholics/Narcotics Anonymous, we also acknowledge that spirituality is a major aspect of addiction and recovery from an addiction. The authors present the Strengths Perspective and apply key concepts to Steps 1-3 of the 12-Steps to increase our understanding of addiction and recovery from alcoholism and other drug addiction. The article concludes that social workers must continue to increase their understanding of the recovery and spiritual issues of alcoholics and other drug addicts.     

Deaf or hard of hearing inmates in prison

Despite laws in the United States enacted to protect individuals with disabilities in prison, there is ample case law to demonstrate that the intent of these laws has not been achieved. Using the existing US legal and social science literatures and experiences, this article considers: the problems hearing-impaired offenders face in prison that are not encountered by non-deaf or hard of hearing inmates; the services and accommodations prisons provide for deaf or hard of hearing inmates so that they can function at least as well as non-deaf or hard of hearing inmates; and the types of scientific research that should be conducted to understand the possible types of deaf or hard of hearing experiences in prisons, the consequences of these experiences, and the best way to address pathological sequela of being deaf or hard of hearing in prison. We argue that the creation of rules to protect this population is of no value unless these laws are implemented as intended. Without monitoring the law in action and studying why the intent of the law may be thwarted, an atmosphere in which deaf or hard of hearing offenders are neglected and even abused will likely occur.     

Planned Change in the Disability Community

Abstract

Planned change with people, who are physically or mentally disabled, as with other special populations, requires a range of skills and knowledge; several specific aspects of the change process are identified and discussed in this article: the characteristics of the change agent, the timing of the change event, and creating a vision for change. These aspects are illustrated through the writer's own experiences as a change agent working a long-range change event to improve access¹ to mental health services in the US with and for people who are deaf and hard of hearing.     

Integrating Art Therapy Methodology in Brief Inpatient Substance Abuse Treatment for Adults

ABSTRACT

Decades of drug addiction research and clinical work have underscored the need for multifaceted and comprehensive treatment responses in order to sufficiently address the varied needs of individuals struggling with addiction. One valuable treatment component that can be incorporated into traditional treatment protocols to expand the comprehensive nature of treatment response is art therapy. A conceptual framework is presented, detailing the integrative opportunities and benefits of including an art therapy component to short-term hospital-based inpatient substance abuse treatment programs. A creative arts component can be particularly beneficial for brief inpatient programs, where the client population is diverse, in crisis, and at high-risk for relapse; and where clinicians need to obtain comprehensive client information from multiple sources in a short amount of time. Art therapy methodology can provide a mechanism for collecting such collateral information for assessment purposes, can be employed to facilitate therapeutic change, and is used to track and document client progress and clinical change over time. Practice guidelines and specific treatment techniques are presented through short case examples.     

Beyond “Dry Drunkenness”: Facilitating Second Stage Recovery Using Wilber's “Spectrum of Consciousness” Developmental Model

ABSTRACT

The usefulness of Wilber's “Spectrum of Consciousness” developmental model in the treatment of substance abuse is demonstrated by a case study that illustrates how underlying emotional pain and intimacy issues can be worked through in the counselling process with a client during the second stage of recovery from addiction. Wilber's model allows for narcissistic, critical self, social, identity, intimacy, existential, and psycho-spiritual issues to be integrated into the counselling process for long-term recovery. This model provides social workers and addictions counselors with a useful map in embracing client recovery.     

Natural Recovery from Substance Dependency

Abstract

The literature on cessation of drug and alcohol dependency without benefit of treatment or participation in self-help groups spans nearly forty years. While this literature is substantial and analyses of the processes of natural recovery well-developed, discussions directed at treatment providers around the value of these analyses for practice has been sparse. Drawing on our study as well as the research of others, this paper explores two dimensions of natural recovery that hold important implications for treatment providers who work with substance dependent clients. These include the common strategies used by remitters and the concept of recovery capital as a way to capture the embeddedness of these natural recovery strategies within a unique structural context of personal attributes and social environments.     

Auditory status and experiences of abuse among college students

Studies that explore experiences of abuse among deaf or hard of hearing college students are sparse and usually focus on lifetime experiences rather than the college years. A random sample of more than 1,000 college students at a campus in Upstate New York provided the data for this study. An institute for the deaf or hard of hearing was one of the colleges at the university and provided a unique opportunity to explore experiences among this demographic. Victimization rates and experiences by auditory status--deaf and hard of hearing or hearing--were examined. Binomial regression analyses were employed and findings indicated a significant association with being deaf or hard of hearing and physical and psychological abuse at the hands of a partner. Implications for policy and future research are discussed.     

Culturally responsive social work practice with D/deaf clients

ABSTRACT

D/deaf individuals are often marginalized in our society. A lack of cultural understanding among social workers serving this population, coupled with communication barriers, inconsistent access to interpreters, or misperceptions of culture, adds to the potential for further marginalization. D/deaf individuals seeking mental health and social services live in a unique cultural context with which social workers may not be familiar and experience persistent issues surrounding access to mental health and social services. This article reviews some useful best practices, cultural points to be aware of, and suggests some strategies for providing culturally responsive social work when working D/deaf clients.     

Dealing with Resistance: Working with Involuntary Clients in Community-Based Drug Treatment Programs in China

ABSTRACT

This study explores strategies for dealing with client resistance that are commonly used by a group of selected counsellors who work closely with illicit drug users in the community-based compulsory treatment programs in China. Through semistructured in-depth interviews with 16 counsellors, this study finds that different forms of client resistance were experienced in their day-to-day practice, encompassing passive and active behaviours. Five typical strategies are used by Chinese counsellors in this study to deal with client resistance: showing respect and caring and expressing empathy; attending to the needs of the clients; making effective use of peer influence; altering clients’ unwillingness to change; and strategically enhancing clients’ self-determination. Considering these strategies can also be seen as general principles for dealing with involuntary clients in other fields of social work services, the findings of this study may have broader impact.

IMPLICATIONS

• Effective ways that can be used by counsellors for reducing illicit drug users’ resistance during treatment include: showing respect and caring, and expressing empathy; attending to the needs of the clients; making effective use of peer influence; altering clients’ unwillingness to change; and strategically enhancing clients’ self-determination.

• Professional social work training is urgently needed among community-based drug treatment social work practitioners in China, to achieve efficient practices and better outcomes.

     

Child Abuse Investigation and Treatment for Deaf and Hard of Hearing Children

Abstract

Deaf children are more susceptible than other children to abuse in home and institutional settings. Many helping professionals are unaware of the unique vulnerabilities and needs of the deaf; this lack of awareness limits the effectiveness of their services to that population. Laws and ethical standards mandate that social workers and others use communication methods that deaf clients can understand; however, many human service agencies rely on less than adequate means of communication in child abuse investigations and other procedures. Such ineffective intervention practices fail to protect a vulnerable population of children who literally cannot speak for themselves.     

Narratives of Low-Income Mothers in Addiction Recovery Centers: Motherhood and the Treatment Experience

ABSTRACT

This study examines the narratives shared by low-income women in addiction recovery centers about the meaning they attach to being a parent in recovery and how they view current program models that include children in daily treatment. Their stories reflect the centrality of the mothering role to women in recovery and offer insights that can guide treatment and program planning with families.