Supporting the Deaf Community in Therapy: A Call for Action

11 Nov

Imagine a client in your therapy room struggling with hearing loss. How equipped would you feel to support them? The reality is that most therapists encounter gaps in their understanding, as many training programs don’t sufficiently address Deafness or hearing loss. In this article, we’ll explore the challenges Deaf and hard-of-hearing clients face and examine the crucial steps therapists must take to create an inclusive and supportive therapeutic environment.

Understanding Deafness and Hearing Loss in Therapy

Deafness isn’t just about a lack of hearing; it’s about identity, culture, and a rich history. Deafness with a capital "D" signifies membership in a cultural community, one in which sign language is the primary form of communication, and values and social beliefs are shared (Padden and Humphries 1988:2). This community faces unique barriers, particularly in mental health, where inclusive therapy remains limited.

Hearing loss affects over 12 million people in the UK alone, with 151,000 using British Sign Language (BSL) as their first language (RNID,2022). With the incidence of hearing loss rising, therapists have a duty to be informed and ready to provide accessible care. As practitioners, we must be prepared to support this growing population.

The Overlooked Mental Health Needs of the Deaf Community

Deaf individuals and those with hearing loss often face compounded mental health challenges, yet they are underserved in therapeutic settings. Without access to adequately trained therapists, many turn to substances like alcohol to cope—a situation that speaks to our failure as a field to provide inclusive services (National Institution for Mental Health England 2005). Research shows that Deaf individuals are at a higher risk for anxiety, depression, cognitive decline, and even psychosis (Help.Org).

Despite these alarming statistics, there is a striking lack of Deaf-inclusive mental health research and resources in the UK. While neurodiverse populations like those with ADHD, 2.6% of the population, (ADHD UK) are increasingly receiving specialised support, Deaf individuals—constituting around 17% of the population—are still left behind.

Are We Meeting the Deaf Community’s Needs?

Our therapeutic community risks leaving 12 million potential clients underserved. Organisations like the BACP, UKCP, and NCPS need to include Deaf awareness in their training and accreditation requirements. Are we ignoring or discounting the Deaf community by not addressing their specific needs? For therapists, becoming Deaf-aware and understanding the unique dynamics of Deaf culture and grief in hearing loss are vital steps toward closing this gap.

Understanding Grief in Hearing Loss

The experience of hearing loss is a profound one, often accompanied by a process of grief similar to that experienced after the death of a loved one. The well-known Kübler-Ross model of grief (1969) —denial, anger, bargaining, depression, and acceptance—can apply directly to the experience of losing one’s hearing.

In my journey, the denial phase lasted over two decades. As a child, I resisted using hearing aids, internalising the stigma that hearing loss somehow made me less capable. Anger surfaced as my hearing declined, bringing frustration and a search for a cure that led me nowhere. Acceptance came slowly, but with it, a renewed sense of self and an ability to adapt. For clients experiencing hearing loss, therapists must be prepared to hold space for this nuanced form of grief, one that may not be immediately recognized but carries significant weight in the therapeutic process.

Why We Need Deaf-Aware Therapists

Deaf-aware therapists are essential, and general Deaf-awareness training isn’t enough to equip them. Deaf clients need professionals who understand the unique demands of the Deaf community, are familiar with communication challenges, and are open to using sign language, even at a basic level, to help foster trust, although I would assert that a basic level of signing is not enough to work long-term with a native British Sign Language user.

There is also a historical context to consider. Deaf individuals have long been marginalised, stemming from events like the 1880 Milan Conference, where influential figures advocated for banning sign language in education. This exclusion fostered an "us vs. them" mentality that echoes to this day, impacting the community’s trust in mental health professionals. (Deafhistory.eu)

Addressing Accessibility and Communication Challenges

To truly support Deaf clients, therapists must consider their physical therapy space. Something as simple as the layout of the room can create barriers. For example, visual distractions or dim lighting can hinder a Deaf client’s ability to read lips and feel secure. Adjustments like a plain background or optimal seating arrangements can make a significant difference in client comfort and communication.

In the UK, there are small but important steps towards accessibility, such as the BSL Act of 2022, which requires government communications to be accessible in BSL. However, therapeutic spaces are still lagging behind. Current therapist directories rarely allow clients to filter for BSL proficiency. This lack of transparency creates an additional barrier for Deaf clients seeking mental health support.

Moving Forward: Building Inclusive Therapeutic Practices

It’s time to take actionable steps. Therapists must begin with specialised Deaf-awareness training, beyond the general introductory courses, to develop the tools needed to support Deaf clients. Our profession also needs to adjust its expectations and frameworks: interpreters, for example, should not be viewed as simple translators, as they bring their own perspectives into the therapeutic space. Without specialised training, the client’s experience could become distorted by the interpreter’s frame of reference, diminishing the authenticity of the therapeutic relationship.

A Call to Action

Mental health care for the Deaf community needs urgent expansion. The question remains: are you ready to be a part of this change?

Do you have the skills and sensitivity to work with the Deaf and hard-of-hearing community?
Are you willing to become a Deaf-aware therapist?
Will you help bridge the gap for a community that has been underserved for far too long?

It’s time to step up and build a future in which Deaf clients find not only acceptance but understanding and support in our therapy rooms.

Reference:

Padden, C. and Humphries, T. (1988) Deaf in America, Cambridge, Mass, Harvard University Press.
RNID. (n.d.). Prevalence of deafness and hearing loss. [online] Available at: https://rnid.org.uk/about-us/research-and-policy/facts-and-figures/prevalence-of-deafness-and-hearing-loss/.
Deaf History. 1880: the Milan Conference. [Online]. www.Deafhistory.eu. Available at: https://deafhistory.eu/index.php/component/zoo/item/1880 [Accessed 26 July 2023].
Help.Org. (2023). Hearing Loss and Mental Health. [Online]. Help.org. Last Updated: 17 October 2023. Available at: https://www.helpguide.org/articles/illness-disability/hearing-and-mental-health.htm#:~:text=Research [Accessed 26 November 2023].