Counselling Deaf and Hard of Hearing Clients: Part 1, Perspectives on Deafness

By Carolyn Cahen

Career and Employment Counsellors meet with a variety of clientele who have a multitude of strengths and challenges. Whether a client views his or her own characteristics as strengths, challenges or neither will affect the counselling process. This paper is the first of a two part series that summarizes some of the major counselling issues and techniques relevant to deaf clients. The first part outlines two disparate views of deafness in the community, an important distinction to understand before a counsellor can build a relationship with a deaf client. The second part, which will appear in the next issue of the Bulletin, will focus on communication issues with deaf clients, providing some practical applications for the counsellors.

Deafness can be defined as an inability to hear; however, this definition gives no real impression of how deafness affects a person’s ability to function in society and their challenges in communication. As will be described below, the impact of deafness can be viewed two ways, audiologically and culturally. In order to provide appropriate therapeutic intervention, the counsellor must be able to understand the individual’s perspective of their deafness.

The physical or audiological description of hearing loss is based on measurements of hearing, which determine the extent of a person’s audition. Often referred to as the medically-based model, this viewpoint of deafness refers to persons whose hearing impaired condition ranges from severe to profound and thus do not benefit significantly from mechanical amplification. Those persons who have difficulty understanding speech, with or without the use of hearing aids, are called deaf. Professionals who work according to this conceptualization of deafness focus much attention on functional hearing and advocates for the use of mechanical devices such as hearing aids to help deaf persons understand speech. Cochlear implants, which involves a surgical procedure to insert devices for receiving and transmitting information about sounds to the brain, are also often recommended.

On the other hand, the cultural view of deafness is vastly different and does not place significance on an individual’s hearing levels. Historically, the deaf have been viewed as deviant or impaired but since the 1980s, a new conceptualization of deafness has emerged. Rather than viewed as a disability, this new perspective of deafness is based on a model of ethnicity. Cultural definitions emphasize the use of sign language and the Deaf thus view themselves as a linguistic minority; different in the language they use but not disabled. The emphasis on and use of sign language is of utmost importance to culturally deaf persons. Ninety-two percent of all deaf people are born to hearing parents. Most of these families have had little experience with deafness and its implications. Interestingly, despite the reality that most deaf individuals are raised in hearing families, there is a preference for the deaf to marry other deaf partners which lends support to the ethnic or cultural conceptualization of deafness.

These differing perspectives of deafness often conflict and illuminate the reasons for the controversy that surrounds how deaf people should be educated and taught to communicate. The challenge of the therapist is to understand the context and or cultural orientation of how an individual views their deafness and attempt to provide treatment that is congruent. Depending on the client’s perspective, the condition may be viewed as a difference or conversely, as a disability. If the deaf person views their deafness as an impairment, a condition that prevents or hinders the participation in educational, professional, or social aspects of society, then the counsellor must accept this perspective and begin the treatment process according to this viewpoint. Conversely, if the client perceives himself or herself as belonging to an ethnic group then the counsellor must consider how their cultural background inter-dynamically related to their identity. The counsellor must accept and not attempt to influence or change the client’s interpretation of their condition and thus not let their own political or cultural beliefs interfere with the therapeutic process. The client has the right to determine which communication method is used in counselling and their preference must be respected and accommodations should be made.

Deaf adolescents confront multiple challenges and are an especially challenging group to treat. Like their hearing counterparts, they are in the process of asserting their identities and at a critical point in their journeys of self-discovery. As well, deaf teenagers struggle to come to terms with their deafness often without the support of parents who mean well but may not understand the cultural orientation of their children. Therapists must acknowledge that there are different ways of being deaf and respect the client’s right to self-determination.

Part Two of this series will appear in the next bulletin. Communication issues in the counselling process with deaf clients will be discussed.