Cognitive-Behavioral Therapy for Deaf and Hearing Persons with Language and Learning Challenges

by Glickman; Neil S.

• ISBN13: 9780805863994
• ISBN10: 0805863990
• Edition: 1st
• Format: Paperback
• Copyright: 2008-10-15
• Publisher: Routledge

Summary

The needs of deaf and hearing people with limited functioning can be a challenge for the mental health practitioner to meet. This text provides concrete guidance for adapting best practices in cognitive-behavioral therapy to deaf and hearing persons who are nonor semiliterate, and who have greatly impaired language skills or other cognitive deficits, such as mental retardation, that make it difficult for them to benefit from traditional talk-and insight-oriented psychotherapies.

Author Biography

Neil Glickman, Ph.D., is the Unit Director of the Mental Health Unit for Deaf People at the Westborough State Hospital in Massachusetts. He teaches at the Institute for Social and Rehabilitation Services at Assumption College, and consults to deaf schools and rehabilitation and mental health programs nationwide

Table of Contents

Series Preface	p. xi
Acknowledgments and Dedication	p. xiii
Introduction: Developing Psychosocial Skills and Life-Affirming Stories	p. xvii
A Really Good Story	p. xvii
Who Are the Clients This Book Addresses?	p. xviii
Theoretical Orientation	p. xxii
Plan of the Book	p. xxvi
The Wisdom of the Good Witch	p. xxix
Language and Learning Challenges in the Deaf Psychiatric Population	p. 1
Traditionally Underserved Deaf People	p. 3
Research on Deaf Psychiatric Inpatients	p. 9
New York Psychiatric Institute, 1960s	p. 9
Michael Reese Hospital in Chicago, 1969	p. 12
St. Elizabeth Hospital, 1978	p. 14
U.S. Public Psychiatric Hospitals Survey, 1983	p. 15
Springfield Maryland Hospital Unit for the Deaf, 1994	p. 17
Rochester, New York	p. 18
Whittingham Hospital, Great Britain	p. 19
Key Points From Previous Studies	p. 20
Method	p. 22
Participants and Procedures	p. 22
Assessment Tools	p. 24
Results	p. 29
DSM-IV-TR Diagnostic Results	p. 29
Cognitive Functioning	p. 31
Communication Scores of Deaf Patients	p. 33
Discussion and Conclusions	p. 36
CERF-R Rating Scale	p. 42
CERF-R Rating Scale	p. 43
Do You Hear Voices? Problems in Assessment of Mental Status in Deaf Persons With Severe Language Deprivation	p. 47
Introduction	p. 47
Example: A Psychiatric Patient With Severe Language Problems	p. 47
Selected Literature Review	p. 49
Language Dysfluency in "Traditionally Underserved" Deaf Persons	p. 51
What Is a Thought Disorder?	p. 53
Hallucinations	p. 54
Delusions	p. 60
Disorganized Thinking, Language, and Behavior	p. 64
Other Language Examples	p. 68
Language Dysfluency: Language Deprivation Versus Thought Disorder	p. 72
Interpreting for Language Dysfluent Persons	p. 75
Conclusions: Look for Redundancy in Evidence	p. 77
Acknowledgments	p. 78
Language and Learning Challenges in Adolescent Hearing Psychiatric Inpatients	p. 79
Overview of Our Adolescent Hearing Population	p. 80
The Neuropsychological Evaluation	p. 80
Intelligence	p. 81
Vocabulary	p. 81
Verbal Reasoning	p. 83
Visual-Spatial Skills	p. 83
Nonverbal Learning Disabilities	p. 84
Attention and Working Memory	p. 86
Speed of Information Processing	p. 87
Academic Abilities	p. 88
Learning and Memory	p. 89
Executive (Advanced Thinking) Skills	p. 90
The Interface of Language and Learning Problems With Major Mental Illnesses	p. 94
Data on Language and Learning Challenges in Our Population	p. 96
Summary and Implications for Counseling	p. 98
Conclusions	p. 101
Pretreatment Strategies to Engage and Motivate Clients	p. 103
Why Do So Many of Our Clients Appear Unmotivated for Mental Health Treatment?	p. 103
Our Clients Frequently Do Not Understand or Embrace Insight-Oriented Treatment Models	p. 107
Our Clients' Language and Cognitive Impairments Make Verbal Counseling Strategies Difficult	p. 109
Our Clients Resist the Disempowered Client Role and Story	p. 113
Pretreatment Strategies	p. 117
Presenting a Clear and Compelling Map of Treatment by Defining Recovery in Terms of Skills	p. 121
Noticing and Labeling the Skills That Clients Already Use	p. 123
Demonstrating Empathic Understanding	p. 129
Working Skillfully From One-Down and Collaborative Stances	p. 133
Collaborative Problem Solving	p. 141
Promoting Client Self-Evaluation Through Skillful Questioning	p. 142
Making Treatment Interesting and Fun	p. 149
Put Clients in the Helper, Teacher, or Consultant Role	p. 153
Developing the Client's Story of Strength, Resiliency, Recovery, and Resourcefulness	p. 157
Conclusions	p. 160
Coping Skills	p. 161
What Are Coping Skills?	p. 161
Meichenbaum's Early Work on Coping Skills	p. 162
Cognitive Therapy With Language and Learning Challenged Clients	p. 165
A Complementary Approach: Linehan's Dialectical Behavior Therapy	p. 170
Coping Through Distraction and Pleasurable Activities	p. 173
Coping Through the Senses	p. 174
Coping Through Problem Solving	p. 181
Meichenbaum's Later Work and the Development of Narrative Strategies to Assist With Coping	p. 184
The Art of Questioning	p. 185
Using Metaphors	p. 187
Using Stories	p. 192
Using Games	p. 196
Using Clients as Teachers	p. 198
Summary: A Framework for Developing Coping Skills in Language and Learning Challenged Clients	p. 199
Conflict Resolution Skills	p. 203
A Client Refusing to Collaborate	p. 205
Marshall Rosenberg: Nonviolent Communication	p. 214
Dudley Weeks: Conflict Partnership	p. 220
Bernard Mayer: Attitude Is Everything	p. 223
Fisher and Ury: Getting to Yes	p. 224
Conflict Resolution Skills in Dialectical Behavior Therapy	p. 224
Conflict Resolution With Children	p. 226
Foundation Conflict Resolution Microskills	p. 230
Discover the Conflict Resolution Microskills That Clients Already Have	p. 232
Collaborative Problem Solving	p. 235
Formal Conflict Resolution Skills Training	p. 238
Conclusions	p. 243
Relapse Prevention and Crisis Management Skills	p. 245
Introduction	p. 245
What Is Relapse Prevention?	p. 246
Sample Relapse Prevention Books	p. 248
Language and Translation Issues	p. 253
Warning Signs and Triggers	p. 256
Risk Factors	p. 262
Seemingly Unimportant Decisions	p. 265
Using Coping Skills and Social Supports	p. 267
Behavior Analysis Made Relatively Simple	p. 268
Self-Monitoring and Relapse Prevention	p. 277
Using Relapse Prevention Games and Stories	p. 279
What Use Are Relapse Prevention Skills With Very Low Functioning Clients?	p. 284
Crisis Intervention Work With Incompetent, Noncompliant, and Antisocial Clients	p. 288
Staff and Program Development	p. 295
Introduction: The Program Director's Role	p. 295
Five Great Challenges	p. 298
Communication	p. 298
Cross-Cultural Dynamics	p. 300
Violence	p. 302
Adapting Treatment	p. 303
Pretreatment	p. 304
Meichenbaum, Linehan, and Greene on the Role of Direct Care Staff	p. 304
The Parallel Process Between Staff and Clients	p. 307
Cross-Cultural Conflict Resolution Skills	p. 312
If the Problem Is Not Communication, What Is the Problem?	p. 320
Summary and Conclusions	p. 323
Summary of Main Points	p. 323
Conclusions	p. 331
A Unique Clinical Syndrome	p. 331
"Deaf-Friendly" Teaching and Counseling	p. 337
What Does It Take to Provide Appropriate Mental Health Care to Deaf People?	p. 343
How to Use the CD-ROM	p. 347
Skill Card Menu	p. 355
References	p. 379
Index	p. 391
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