Searching for psychiatrist who works with deaf community in ASL (without an interpreter)

[stoic]

---

Members don't see this ad.

Greetings -

I am in search of a psychiatrist who works with deaf patients in native ASL as opposed to using an interpreter. This is part of a project I've been commissioned to do and so far I've had little luck finding such a practitioner. The primary idea is since ASL is not a phonetic language and deaf culture is established as it's own communitive culture, I am very interested in how symptoms and treatments are expressed given the significant differences. If you are aware of any practitioners who fit the descriptions could you please pass their information along to me (or at least ask if they would be interested in participating in such a project?)

Thanks in advance for any insight you might be able to provide -
stoic

p.s. more details about the project are available via either PM or telephone/skype conversation, I just don't want some buzzfeed reporter scooping me on this story as I think it's unique and of value to both the psychiatric and deaf communities.

 

[masterofmonkeys]

Awesome project and I love this idea. Just throwing this out there, but I know you'll have more luck looking for master's level therapists who work in ASL.

 

[stoic]

av

Awesome project and I love this idea. Just throwing this out there, but I know you'll have more luck looking for master's level therapists who work in ASL.

I had not thought of using the masters level therapist, but the thought is a good one. I have a strong suspicion that much is lost in translation when psychiatrist work with ASL interpreters as intermediates between themselves and the deaf patients. It's a topic I really want to explore and have spoken to some psychiatrist who feel it might make a good publication (though that is not the primary goal.)

Thank you for the suggestion and please, if others in this community have suggestions, don't hesitate to mention them.

A million thanks,
stoic

 

[deleted452516]

There is a deaf inpatient unit at Sheppard Pratt

 

[stoic]

Though it appears they still rely heavily on interpreters, I believe the Sheppard Pratt approach would be of value to explore. Thank you for the recommendation.

 

[Shikima]

I use a pen and paper. More effective.

 

[stoic]

I use a pen and paper. More effective.

perhaps for patients who were once hearing. writing doesn't translate well into ASL (neither does speech.) I've got a meeting this weekend with a couple psychiatrist to go over the literature.

 

[Ironspy]

The state hospital in MA, WRCH, has a deaf unit also. Many of the staff sign but unsure about psychiatrists

 

[clausewitz2]

While I think the cultural differences between hearing people and the Deaf community make this an interesting project, I am not sure that more is lost in translation between ASL and English than between, say, English and Spanish. ASL, after all, is a fully fledged human language that appears to be processed very similarly in the brain as auditory human languagrs (even involving auditory association cortex, weirdly).


Probably the money here linguistically is in looking at the reactions of hearing people to the use of facial expression and gesture amplitude to convey grammatical meaning in ASL being erroneously interpreted as emotive.

Source: was a linguist

 

[clausewitz2]

I use a pen and paper. More effective.

This is not appreciably different from asking someone whose native language is Spanish to please answer written questions in English. That works just fine if they happen to also speak English, but if they don't, this buys you literally nothing.

ASL has no more intrinsic connection to English than it does to Japanese. It its own independent, unrelated language. While as a fact of the matter lots of Deaf people in the US have some degree of familiarity with English, this doesn't mean they can necessarily communicate in it very well or understand written English texts. Trying to clinically interview someone who is a non-native English speaker without a translator is very dicey, regardless of whether the language they actually speak is ASL or Swahili.

 

[stoic]

This is not appreciably different from asking someone whose native language is Spanish to please answer written questions in English. That works just fine if they happen to also speak English, but if they don't, this buys you literally nothing.

ASL has no more intrinsic connection to English than it does to Japanese. It its own independent, unrelated language. While as a fact of the matter lots of Deaf people in the US have some degree of familiarity with English, this doesn't mean they can necessarily communicate in it very well or understand written English texts. Trying to clinically interview someone who is a non-native English speaker without a translator is very dicey, regardless of whether the language they actually speak is ASL or Swahili.

In fact, it's my understanding (and I could be wrong) that what we would classify as inflection, tone, and volume are represented by the speed, force, and other nuances of ASL. I am interested in how this translates both through a translator to a psychiatrist as well (and actually more so) how deaf culture views mental illness in general. Outside of organic brain dysfunction (schizophrenia, etc) it is my believe that psychiatric diagnosis rarely survive the culture they are created in. For example, using ASL, how does one diagnosis BP1, personality disorders, ASD disorders, etc. The nuance of the patients ASL would have to be very well understood, which is why I am looking for a psychiatrist who works primarily and is fluent is ASL

Again, I have spoken to a number of psychiatrists about this idea and they universally think it's worth exploring. However, finding the practitioners who could help is proving exceptionally difficult. Surely there are a few out there, but for instance, and my local school for the deaf, they use ASL translators and I'd really like to study the outcomes of translator based psychiatric care vs. care given by ASL fluent practitioners. It is, of course, possible nothing of note will be found, but at the moment I'm really interested in the potential differences as are a few of my research partners. Additionally, some of the same studies could be applied to neurology, but that's many projects down the road.

Again, thank you for your help in this matter. I do appreciate it very much.
-stoic

 

[hamstergang]

I'd really like to study the outcomes of translator based psychiatric care vs. care given by ASL fluent practitioners.

Has such research been done for any spoken language?

I have never had a deaf patient through all of medical school, residency, fellowship, moonlighting, and now 6 months of attending-hood. I have often wondered where deaf patients go and how it works out.

 

[clausewitz2]

In fact, it's my understanding (and I could be wrong) that what we would classify as inflection, tone, and volume are represented by the speed, force, and other nuances of ASL. I am interested in how this translates both through a translator to a psychiatrist as well (and actually more so) how deaf culture views mental illness in general. Outside of organic brain dysfunction (schizophrenia, etc) it is my believe that psychiatric diagnosis rarely survive the culture they are created in. For example, using ASL, how does one diagnosis BP1, personality disorders, ASD disorders, etc. The nuance of the patients ASL would have to be very well understood, which is why I am looking for a psychiatrist who works primarily and is fluent is ASL

Again, I have spoken to a number of psychiatrists about this idea and they universally think it's worth exploring. However, finding the practitioners who could help is proving exceptionally difficult. Surely there are a few out there, but for instance, and my local school for the deaf, they use ASL translators and I'd really like to study the outcomes of translator based psychiatric care vs. care given by ASL fluent practitioners. It is, of course, possible nothing of note will be found, but at the moment I'm really interested in the potential differences as are a few of my research partners. Additionally, some of the same studies could be applied to neurology, but that's many projects down the road.

Again, thank you for your help in this matter. I do appreciate it very much.
-stoic

Definitely an interesting project, although I think there is a disconnect between what your are hoping to find and the rather ambitious methods you are pursuing.

You are right about ASL - it makes heavy use of nonmanuals, like mouthing, facial expressions, changes in amplitude and frequency of signs, and positioning in space to convey quite a lot of meaning. These sorts of changes are often used by hearing people to convey emotion or express a certain attitude about what they are saying which is not what a Deaf speaker would necessarily be trying to convey. For example, any verb sign "to do X" can be modified to have the meaning of "to do X carelessly" by sticking your tongue out between your teeth while producing the verb sign. This is going to cause a very different reaction among people who are fluent in ASL and people who are not. Probably no fluent therapists are making unconscious assumptions about the emotional states of who they are working with based on some of these differences that are just not warranted.. This is what would probably be interesting specifically about ASL v. English.

Have you given any thought to just having Deaf and hearing subjects do ratings of the emotions expressed by clips of an ASL conversation? This would be much easier to do and still be quite relevant to the question at hand. Alternatively, if you just want to know about making diagnoses in a different language with and without interpreters, you could use much, much easier populations to recruit subjects from (say English v. Spanish). Finally, if attitudes towards mental illnesses in deaf culture is the real question, why are you not just surveying Deaf people?

What is the real question of interest? What is is about the linguistic facts of ASL that makes it the language you want to investigate in this regard?

 

[stoic]

Definitely an interesting project, although I think there is a disconnect between what your are hoping to find and the rather ambitious methods you are pursuing.

You are right about ASL - it makes heavy use of nonmanuals, like mouthing, facial expressions, changes in amplitude and frequency of signs, and positioning in space to convey quite a lot of meaning. These sorts of changes are often used by hearing people to convey emotion or express a certain attitude about what they are saying which is not what a Deaf speaker would necessarily be trying to convey. For example, any verb sign "to do X" can be modified to have the meaning of "to do X carelessly" by sticking your tongue out between your teeth while producing the verb sign. This is going to cause a very different reaction among people who are fluent in ASL and people who are not. Probably no fluent therapists are making unconscious assumptions about the emotional states of who they are working with based on some of these differences that are just not warranted.. This is what would probably be interesting specifically about ASL v. English.

Have you given any thought to just having Deaf and hearing subjects do ratings of the emotions expressed by clips of an ASL conversation? This would be much easier to do and still be quite relevant to the question at hand. Alternatively, if you just want to know about making diagnoses in a different language with and without interpreters, you could use much, much easier populations to recruit subjects from (say English v. Spanish). Finally, if attitudes towards mental illnesses in deaf culture is the real question, why are you not just surveying Deaf people?

What is the real question of interest? What is is about the linguistic facts of ASL that makes it the language you want to investigate in this regard?

I appreciate you pointing out the different end points that could be studied and potential ways to go about those studies. We are still VERY early in the planning phase (as in, this idea is less that one week old) and we are meeting this weekend to look at possibilities in more depth. Would you be opposed to me bringing up the points you have made during this conversation during our meeting? I feel they could be very useful. The end goals are still loosely defined - but essentially we are interested in whether or not interpreters in psychiatric settings are able to accurately provide the nuance needed to make appropriate diagnosis and cultural differences in perceptions of mental illness and treatment. I grew up several deaf peers and am acutely aware of just how different deaf culture is from "normal" culture and would like to explore this difference in the context of mental illness.

I like the idea of using of using clips of interpreters compared to those who whose ALS and rating the difference in perceived meaning. It seems like a good place to start as well as to determine if additional study is needed. Thank you for the idea.

Finally, are there are primer books you could recommend (short of learning ASL, which is considered a second language)? My research partner and I would like to understand more of the cultural and communicative differences.

Interesting, this whole idea came about because I witnessed two non-hearing individuals using ASL to have a fight in a car at a stop light. It was fascinating to see how their signing changed as the argument escalated and I realized there might be something worth studying in this phenomenon. If you are interested in participating in the planning stages of this study or the potential study (if it happens) we would love to have your perspective as part of the team. Please PM me if this appeals to you.

P.S. I appreciate the warm reception (and this includes all of you who have participated in the discussion) I have received in the psychiatry forum even though I am not a psychiatrist by training. Thank you very much for your help and insights.

 

[TexasPhysician]

The quality of any interpreter varies significantly. The better ones in my opinion translate better than some psychiatrists can understand even when "fluent" in a 2nd language. Knowing the language is different than being forced to understand every aspect of the culture/language due to necessity.

My family is big into languages, and my mother taught at a deaf school. While I know quite a bit of ASL, I would prefer to still use a good interpreter as my skills are not maintained through constant immersion.

The same can be said of myself learning German for fun. Despite developing my skills and eventually being labeled "fluent", emotions are expressed differently by true Germans than Americans.

What is your plan to control for psychiatrists that are "fluent" in ASL vs those forced to understand every nuance?

My hypothesis is that a thorough interpreter would provide better understanding than an average fluent psychiatrist.

 

[stoic]

The quality of any interpreter varies significantly. The better ones in my opinion translate better than some psychiatrists can understand even when "fluent" in a 2nd language. Knowing the language is different than being forced to understand every aspect of the culture/language due to necessity.

My family is big into languages, and my mother taught at a deaf school. While I know quite a bit of ASL, I would prefer to still use a good interpreter as my skills are not maintained through constant immersion.

The same can be said of myself learning German for fun. Despite developing my skills and eventually being labeled "fluent", emotions are expressed differently by true Germans than Americans.

What is your plan to control for psychiatrists that are "fluent" in ASL vs those forced to understand every nuance?

My hypothesis is that a thorough interpreter would provide better understanding than an average fluent psychiatrist.

Again we are in the very earliest stages or planning. I do like the idea of using video clips of psychiatrists "fluent" in ASL vs. certified psychiatric interpreters as an initial starting point. As a secondary goal ,I am extremely interested in the cultural differences between speaking and ASL patients and their perception of the utility of in diagnosing and treating mental illness in the deaf community.

Unfortunately it is proving extremely difficult to find psychiatrist who are fluent in ASL, so this limits our options significantly. I do know a couple e family practice docs who are fluent in ASL and my ask them to contribute. My idea for controlling the fluency of both psychiatrists and interpreters is to involve the state school for the deaf (which is located about 10 miles from me). I have discussed this project with them via phone call and they are willing to participate. Again. I must point out just how early we are in planning the stages of tpotentialtial project - which is why I am so grateful for the good advice being provided in this discussion.

 

[clozareal]

There's a huge Deaf community in San Diego. Carol Padden and Tom Humphries wrote some exemplary textbooks in ASL and Deaf Culture in America and are professors at UCSD. They might have some connections with the psychologists/psychiatrists at UCSD.

 

[notdeadyet]

Check Gaulladet University. As the only deaf-focused university system (that I know of), they have an ASL-fluent psychiatry and psychology service for students.

 

[stoic]

Many thanks for this information notdeadyet

 

[stoic]

just wanted to say thanks for the help you have all given me. something interesting may come out of this and i am deeply in your debt for the discussion and resources provided.