For patients who are fluent in ASL, nonsigning clinicians will need to employ a certified interpreter with specialized training in mental health interpretation. Finding such interpreters can be difficult, however. Dr Landsberger and colleagues call for specialized mental health training for ASL interpreters who work in psychiatric settings.
Challenges in Communication, Diagnosis and Treatment
Unfortunately, some deaf individuals have never had adequate exposure to or training in ASL or other communication systems used by the Deaf population. They may have serious language deficits, communicating mainly by gestures and mime. For these patients, the doctor may need to employ both a certified deaf interpreterwho is trained to help gather the intended message and put it into grammatically correct ASLas well as an ASL interpreter.
Correct diagnosis is another challenge. Evaluating for psychotic disorders, such as schizophrenia, in deaf patients can be especially difficult. A key question is whether the person has experienced hallucinationsespecially auditory hallucinations (hearing voices). But how does one explain the concept of hearing voices to someone who has been deaf from birth?
Another common symptom of psychosis is disorganized thoughts, which are usually diagnosed based on disorganized speech. Psychiatrists evaluating deaf patients need to be cautious to avoid misinterpreting language deficits as a symptom of psychosis.
Effectively providing "talk" therapythat is, different types of psychotherapyto deaf patients poses obvious challenges. The authors discuss ways of adapting psychotherapy to be more effective for deaf patients and how the presence of an interpreter may affect the doctor-patient therapeutic relationship.
"As with any cultural minority, providers should seek specific training and education to become culturally competent providers to deaf people," Dr Landsberger an
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Wolters Kluwer Health