Academic journal article American Journal of Psychotherapy

Sign-Language Interpretation in Psychotherapy with Deaf Patients

Academic journal article American Journal of Psychotherapy

Sign-Language Interpretation in Psychotherapy with Deaf Patients

Article excerpt

Sporadic encounters with deaf patients seeking psychotherapy present a challenge to general clinicians outside of specialized services for the deaf Skills for working with people who do not share one's own language mode and culture are not routinely taught in most training programs, so clinicians may be unprepared when they first encounter a deaf patient. While it would be ideal to be able to match deaf patients with therapists fluent in their preferred language mode, this is often not feasible in smaller centers. Working with a trained professional sign-language interpreter can be a productive alternative, as long as patient, therapist, and interpreter understand and are comfortable with the process. Peer-reviewed literature on sign language interpretation in psychotherapy is sparse, but some practical guidelines can be gleaned from it and supplemented by information provided by the deaf community through the Internet. This paper arose from one psychiatric resident's first experience of psychotherapy working with a sign-language interpreter, and summarizes the literature search that resulted from a quest for understanding of deaf culture and experience, of the unique characteristics of sign language, and of the effects on the therapeutic relationship of the presence of the interpreter

As psychiatrists in training, we are taught that "language is the mirror of thought" (2, p. 156). Implicitly, we learn that language means speech, for we find, in revered textbooks, amid detailed descriptions of the wealth of information gleanable from the speech of psychiatric patients, remarks like this: "eliciting the history and mental state becomes impossible in a mute patient" (2, p.163). Thus, believing speech to be the primary window on thought, we learn to listen carefully to the speech of patients. To understand the patient's experiences and sources of distress, in order to find a way to help, we attend to what is said, and extrapolate what is not said. We practice encouraging the flow of words when it falters, and curbing the flow when it threatens to flood. Behaviors and facial expressions are important, too, we learn, but we expect to connect with our patients mainly through words. So, most of all, we learn simply to listen, and thus to begin, in a private dyadic relationship, that therapeutic conversation known as psychotherapy. With language as our primary tool, we are especially challenged when asked to help deaf patients whose language is entirely different from our own. As Annie Steinberg (3) writes:

Working with deaf clients may be the ultimate challenge for mental health professionals, requiring them to explore the nature of the relationship between thought and language and between the communication of thought and the development of a personal identity (p. 380).

I encountered this "ultimate challenge" in my first year of residency. Ready to listen, armed with a pad and pencil for noting down key words later to be synthesized into a coherent narrative and diagnostic formulation, I arrived in the emergency room one morning. I had been called to see a desperate and suicidal young man, who was fighting an addiction to prescription drugs. I opened the door to find, not one, but two men awaiting me: my patient and his sign-language interpreter. No one had told me he was deaf. With hands as quick and alert as his eyes, he signed the first message he wanted relayed to me: that he preferred to communicate by sign, that he was not comfortable communicating in writing, and that, until his usual interpreter was available, he would rather not delve too deeply into personal matters. Judging by the speed and fluidity of his signs, he was at no loss for words. I, however, felt very much at a loss. Nothing in my training had prepared me for this. I had met other deaf patients before, even taken their histories and treated them. Until now, however, the presenting complaints I had had to deal with were simple and concrete-an abdominal pain, a broken ankle. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.