ABSTRACT
What is unique or different about substance abuse treatment for deaf persons? The naïve person would say “nothing”; an addict is an addict. A somewhat more informed person would say that the treatment sometimes needs to occur in sign language or that at least an interpreter must be used. This person recognizes that there are language differences but may not appreciate the diversity of language skills among deaf people. Particular considerations include the high numbers of language dysfluent clients found in rehabilitation settings and the common fund of information gaps (Pollard, 1998) and Deaf cultural factors that require accommodations well beyond the provision of interpreters. To take some common examples, the 12-Step model of treatment, which is the oldest, most widespread, and familiar, is often very difficult for a subset of deaf persons, those with language and learning challenges (Glickman, 2009), to understand and use even when the steps are translated into American Sign Language (ASL). Common concepts used in cognitive behavioral therapy (CBT) such as triggers, warning signs, risk factors, and even the notion of “relapse prevention,” may not be part of the established fund of information about the world that some deaf consumers begin with when in treatment. Glickman 2009 has described how these concepts sometimes present translation difficulties. Translation difficulties are not the only barriers. Deaf people at all functional levels participating in hearing substance abuse treatment programs often feel disconnected from their peers and, valid or not, use the lack of deaf-accessible treatment as a reason for not engaging in recovery efforts (Guthmann, & Graham, 2004).
