The purpose of this study was
to determine which of a variety of demographic, attitudinal
and other background variables impacted upon desired treatment
outcomes among Deaf and Hard of Hearing persons who had completed
treatment at The Minnesota Chemical Dependency Program for
Deaf and Hard of Hearing Individuals (MCDPDHHI). The MCDPDHHI
is a model inpatient treatment program which is hospital based
and has received federal funding from the Center for Substance
Abuse Treatment and the Office for Special Education and Rehabilitation
The program represents a unique
approach to the study of Deaf and hard of hearing individuals
who have completed alcohol and/or drug treatment. A formative
evaluation was conducted using client demographic profiles
and a variety of descriptive and statistical analyses. The
study goals were to (1) make recommendations for the enhancement
of program effectiveness and (2) to determine the relationship
between selected demographic variables and treatment outcomes.
At the time of this study, there were no other programs in
the country with which to make comparisons. This paper therefore
represents an evaluation of the program and provides recommendations
for its improvements.
Although there have been some attempts at doing
prevalence studies to determine the incidence of substance
abuse in the Deaf community, there have been no follow-up
studies of Deaf and hard of hearing individuals who have completed
treatment. The following article will report the results of
a study that was completed at The Minnesota Chemical Dependency
Program for Deaf and Hard of Hearing Individuals and involved
a follow-up study of 100 individuals who had completed inpatient
treatment. These individuals were followed for a year to determine
if they maintained sobriety and if they reported an enhanced
quality of life.
The Minnesota Chemical Dependency Program for
Deaf and Hard of Hearing Individuals (MCDPDHHI) is a specialized
program designed to meet the communication and cultural needs
of Deaf and hard of hearing persons in chemical dependency
treatment. The program utilizes a twelve step model with behavioral
components and is the recipient of several training grants
from the Office for Special Education and Rehabilitation Services
(OSERS, 1991-present) as well as a Critical Populations Grant
from the Center for Substance Abuse Treatment(CSAT, 1990-1995).
The grant funds enabled program staff to provide outreach
and training, to modify and develop materials as well as to
provide treatment to Deaf and hard of hearing individuals.
Each client is viewed as unique and staff strives to meet
treatment needs in an individualized and therapeutic manner.
Attention is given to client diversity with respect to ethnic
background, education, socialization, cultural identity, family
history and mental health status. An additional goal is to
provide the necessary tools for replication of this model
program nationally. While treatment is important in intervening
in substance abuse, real recovery work begins after treatment.
A part of that work involves the recognition of the prevention
of relapse. Many variables can influence relapse but the lack
of accessible resources can be a major factor for Deaf and
hard of hearing people. Specialized materials which take into
account the communication and cultural needs of Deaf and hard
of hearing persons can positively contribute to the process
of recovery. Support services such as aftercare, vocational
rehabilitation and self help groups can help to encourage
ongoing pursuit of a recovering lifestyle but only if they
can be accessed by the Deaf or hard of hearing person.
The majority of clients who have entered the
MCDPDHHI report use beginning at approximately ten years of
age. Since opening the MCDPDHHI in March, 1989 to December,
1997, 609 clients have been served. Of those served, 17 have
been under the age of 18 and another 20 were 18 at the time
of admission even though use was reported to begin much earlier.
Purpose of the Study
When clients finish treatment at the MCDPDHHI,
an aftercare plan is set up. It was difficult however, to
track all of the consumers to determine if they had continued
to maintain their sobriety. Because of this, a follow-up survey
was developed that could be administered with local clients
in a face to face interview, via the tty , or administered
in person by a professional who works with the client and
then returns the survey to our program. This follow-up study
investigated which variables contribute to the success or
failure of Deaf and hard of hearing clients admitted into
the Program for treatment. The research identified program
strengths, weaknesses and omissions and made recommendations
which will enable corrections and improvements to be made.
The purpose of this study was to determine which of a variety
of demographic, attitudinal and other background variables
impacted upon desired treatment outcomes among Deaf and hard
of hearing persons who had completed treatment at The MCDPDHHI.
In addition, the information thus obtained will impact the
larger Deaf and hard of hearing communities by indicating
which program components contribute to the provision of the
most effective treatment for this population. This information
will be available for use on a national basis and will assist
in replication of a model treatment program for Deaf and hard
of hearing chemically dependent individuals.
It should be noted that this study was done
using internal data because there are no other programs in
the country with which to make comparisons. It was therefore
necessary to analyze the program and its results in order
to determine how to improve it.
Study participants included one hundred individuals
who completed chemical dependency treatment at the MCDPDHHI.
They were from numerous states within the US and ranged in
age from 17 to 72 years. Clients were asked to complete five
instruments: (1) A pre-treatment survey administered through
a signed, voiced and captioned videotape that is completed
upon entering treatment. This survey measures attitudinal,
behavioral and knowledge changes, as related to substance
abuse, that may occur while in treatment; (2) a post-treatment
survey administered through a signed, voiced and captioned
videotape measuring attitudinal, behavioral and knowledge
changes, as related to substance abuse, that occurs upon the
completion of treatment; (3) a demographic questionnaire;
(4) A client satisfaction survey; and (5) a follow-up questionnaire
which is completed through an interview between staff and
former clients after discharge at 1,3,6 or 12 month intervals.
Description of the study
The study included a description of predictor
variables, including deafness characteristics, demographics,
treatment readiness indicators, pro-recovery attitude, background
information, consequences in the major life areas (i.e. social,
family, legal, financial, and school/work) and referral information.
Outcome variables of interest included drug/alcohol status,
employment/school status, living arrangement, psychosocial
improvements, psychosocial assets, status of problems now,
and aftercare participation.
The research investigated the relationships
of client, treatment involvement and treatment outcome variables
in the hope that this knowledge would assist in outcome predictions
and assist in future treatment modifications. This research
ascertained if a positive change occurred within the first,
third, sixth, or twelfth month after the completion of treatment
related to a client's health/mental health status, vocational/school
status, functional living, or ability to reduce or stop the
use of alcohol/drugs. The results were broken down into short-term
(first and third month follow-up calls) and long-term (sixth
and twelfth month follow-up calls). The goal of the study
was to determine which client and treatment variables had
the highest rate of predictability of the desired array of
outcomes. Information gathered in this study was used to assist
in the further development of effective treatment programs
for this population.
The independent variables were broken down into
categories that consisted of overall demographics, overall
communication/deafness, overall treatment/aftercare, short-term
demographics, short term communication/deafness, short-term
treatment/aftercare, long-term demographics, long-term communication/deafness
and long-term treatment/aftercare.
The five dependent variables examined include
follow-up measures of general improvement, abstinence, alcohol
use, marijuana use and aggregate drug use. General Improvement
was measured as a composite of the following four questions
taken from the follow-up survey. 1.) "I have less problems
now as compared to before I entered treatment;" 2.) "I
have less family problems now as compared to before I entered
treatment;" 3.)"I have less money problems than
before I entered treatment;" 4.) "I have better
health now than before I entered treatment."
The dependent variables were collapsed into
two categories: 1.) General Improvement and 2.) Abstinence.
Abstinence was thought to encompass variables dealing with
drug and alcohol use, since the overall outcome goal was abstinence
from all use. Therefore, analyses of general improvement and
abstinence were emphasized.
Limitations of the Study
This study represented the first known effort
nationally to examine outcome data of Deaf and hard of hearing
individuals who have successfully completed an inpatient chemical
dependency treatment program. As with any such initial study,
there are inherent limitations existent that the investigator
must identify and address. The first limitation of this study
is that it was based on internal data only since no comparable
chemical dependency programs were available to use in the
comparison. The second limitation was the relatively small
number of individuals available to use in the research sample
since only 600 persons have been admitted into the program
since it began in 1989. A third limitation was that the five
survey instruments that were used were designed with other
purposes in mind than supporting research of this kind. For
example, the research would have been more definitive if a
survey had made a clear distinction between obtaining employment
and going to school after treatment as compared with some
situations prior to entering the program. A fourth limitation
is related to language limitations of the population in regard
to the use of the follow-up survey. Ideally, the follow-up
process should be completed in a face to face interview using
the preferred communication style of the participant. Because
the MCDPDHHI is national in scope, it was not possible to
have all individuals interviewed in person. The majority of
the follow-up surveys were completed via a TTY and as a result,
some questions were either not answered or possibly misunderstood.
In these cases, an attempt was made to contact referral sources,
family members or other individuals who could provide corroborating
There were 14 independent variables that showed
statistically significant linear relationships with respect
to general improvement. These variables were: AA/NA attendance,
contact with sponsor, family counseling attendance, employment
status, method of payment, highest grade completed, recommend
program to a friend, return to the program if relapse, program
help you, degree of alcohol use, degree of marijuana use,
degree of other drug use, talk to friends about sobriety and
talk to family about sobriety. There were four independent
variables that showed statistically significant linear relationships
with respect to abstinence. These variables were: AA/NA
attendance, employment status, talk to friends about sobriety
and talk to family about sobriety. The three variables
that were significantly related to both general improvement
and abstinence were: AA/NA attendance, ability to talk
with family and employment status.
Eight independent variables showed statistically
significant linear relationships between both short and long
term data and general improvement. These variables were: degree
of alcohol use, degree of marijuana use, degree of drug use,
attending AA/NA meetings, contact with sponsor, employment
status, method of payment and talk to family about sobriety.
Four independent variables showed statistically
significant linear relationships between both short and long
term data and abstinence. These variables were: AA/NA attendance,
the ability to talk with family about sobriety, employment
status and time since last use.
The three variables that were significant for
the short/long term data related to both general improvement
and abstinence were: AA/NA attendance, the ability to talk
to family about sobriety and employment status.
Therefore, the variables that were significant
for the overall and short/long term follow-up data with respect
to both general improvement and abstinence were: AA/NA
attendance, ability to talk with family about sobriety and
Taking into account all drugs(i.e., alcohol,
marijuana and other drugs), abstinence was reported by 36%
of the clients at follow-up, while an additional 15% reported
using a single drug less than monthly. Post-treatment drug
use was computed for specific drugs as well. This analysis
was organized around two separate follow-up client groups:
those for whom short-term (three or fewer months) post-treatment
data was collected and those for whom long term post-treatment
(six or twelve months) outcome was obtained. Alcohol was used
more often for both follow-up groups (45.2% and 55.4%, respectively),
compared to marijuana (17.9% and 17%, respectively) and other
drugs (23.3% and 15.7%, respectively). Thus, the majority
of nonabstainers at follow-up, regardless of the time period,
preferred using alcohol compared to other drugs. However,
a small but appreciable percentage of clients were using more
than one substance during the post-treatment period. Another
observation from the alcohol follow-up results is that a significant
proportion of nonabstainers reported weekly or daily use;
this level of use was present among 79% of the nonabstainers
in the short-term group and among 45% in the long-term group.
Perhaps the popularity of alcohol at follow-up is not too
surprising; at intake, 60% of the full sample gave alcohol
a preferred drug rating.
As previously indicated, three predictor variables
were significant predictors of abstinence for either the short-term
or long-term follow-up groups: employment status at follow-up,
availability of family to talk to during follow-up, and AA/NA
attendance. Thus, clients were more likely to be abstinent
or using less drugs at follow-up based on if they were employed,
had a family with whom they could talk to about sobriety and
participated in post-treatment services such as AA/NA.
The most significant finding of this study is
the relationship between employment and sobriety. The majority
of clients entering treatment are on some kind of public assistance
and unemployed. There needs to be a stronger relationship
between treatment providers and vocational rehabilitation
to assist in the ability to increase the number of clients
who are able to become employed upon the completion of treatment.
Each state has different criteria related to the length of
sobriety required before services can be provided. While one
state may be able to work with a client immediately upon discharge
from treatment, other vocational rehabilitation offices require
six months of sobriety. The time immediately following treatment
is a crucial time period for vocational services to begin
to be provided with the counselors staying involved even after
the client is placed on the job.
While there were only three variables with respect
to abstinence that were determined to be significant, fourteen
variables showed statistically linear relationships with respect
to general improvement. Clients report overall general improvement
in their life at follow-up if: they are in contact with
a sponsor, attend AA/NA meetings, attend family counseling,
have friends or family with whom they can talk to about their
sobriety and are employed. Degree of alcohol, marijuana
or other drug use was also determined to be significant, as
was method of payment for treatment, highest grade completed,
if they would recommend the program to a friend and felt the
One demographic, highest level of education,
was a significant predictor of general improvement. Clients
were more likely to report overall general improvement if
they had a higher educational level, as shown by the positive
relationship with general improvement.
Demographic data indicated that 36% of those
admitted to treatment that participated in this study were
on some kind of public assistance and were not employed or
in school. Individuals who were receiving public assistance
were also able to stay in treatment longer. The number of
treatment days was related to method of payment: Those under
public assistance tended to have a greater number of treatment
days compared with those under private pay. The number of
treatment days was related to employment status at follow-up:
Employed individuals tended to spend fewer days in treatment
versus unemployed individuals.
Those employed at follow-up were typically ones
classified as private pay. Those not employed at follow-up(36%)
tended to be under public assistance. This would lead one
to speculate that if individuals who are employed are shown
to maintain abstinence for a greater length of time than those
who are unemployed and their treatment stays are shorter,
the length of time in treatment may not be a significant factor
as to whether clients are able to maintain sobriety.
Once the study was completed, the author was
interested in comparing the findings with the hearing population.
Several studies have been completed with hearing individuals
that have had similar outcomes to this study. Menaja Obinali(1986)
completed a study in conjunction with Camarillo State Hospitals
Alcoholism Treatment Unit based on factors that contribute
to successful or unsuccessful treatment completion. Findings
indicated that successful completion was related to the following:
employment history, involvement in psychotherapy and environmental
milieu and attendance at Alcoholics Anonymous meetings. Three
of the four factors listed were found to be significant in
this study recently completed with Deaf and hard of hearing
individuals. The Camarillo study also found that although
not statistically significant, higher levels of education
were associated with successful completion. Higher levels
of education were found in the study with Deaf and hard of
hearing individuals to be related to overall general improvement.
A study by George Vaillant(1988)which included 100 heroin
addicts and 100 alcohol-dependent individuals investigated
long-term follow-up as related to relapse and prevention of
relapse in addiction. Findings indicated that primary factors
were: compulsory supervision (parole, employment), substitute
dependence (AA/NA, parole), new social supports (sponsor,
AA/NA) and inspirational group membership(12 step meeting
attendance). These results were very similar to the findings
of this study.
The study developed twelve general recommendations
related to chemically dependent Deaf and hard of hearing individuals.
Each of these major recommendations, if implemented, may have
a significant impact on future treatment programs attempting
to serve Deaf and hard of hearing individuals. All of the
recommendations are based on the relationship between the
overall, short/long term independent variables listed under
the categories of: typical demographics, deafness/communication
demographics and, treatment/aftercare with respect to the
dependent variables of abstinence and general improvement.
The recommendations are as follows:
1. Make vocational rehabilitation a strong
component of inpatient treatment and the aftercare that follows.
This could be done by involvement on a consulting or formal
This research has indicated that there is a
strong relationship between abstinence and employment. This
would seem to indicate that there must be an emphasis on career
exploration by individuals while in treatment and the linkage
of vocational rehabilitation services with treatment. One
previous study (Gorski, 1980) found that up to a third of
the disabled individuals applying for vocational rehabilitation
services may be alcoholic. This supports the need to explore
additional linkages with vocational rehabilitation. This linkage
can either be done by hiring a staff member who is a certified
vocational rehabilitation counselor for the Deaf or by contracting
with a consultant trained in this area. During the final phase
of treatment, the staff should spend time specifically on
strategies related to employment and job readiness skills.
The vocational rehabilitation counselor would be responsible
for assessing the individual's potential related to employment
while in treatment and if they are from the local area, they
would follow their case upon discharge and assist in job training
and placement. If the individual is from out of state, the
vocational rehabilitation counselor would be a liaison with
the home community and assist in accessing appropriate services
at time of discharge. Consideration will have to be given
to special arrangements for those that are from out of state.
2. A curriculum must be developed that focuses
on the importance of employment and teaches some basic skills
related to how to seek, access and retain employment.
The first recommendation will not be effective
unless individuals in treatment understand the whole relationship
in the work world of securing employment, holding a job and
being satisfied while doing so.
Many of the individuals who enter treatment
are on some kind of public assistance and not employed. As
the demographic data indicates, 36% of the subjects admitted
to treatment were on some kind of public assistance and were
not gainfully employed or in school. This is an issue that
needs to be addressed since there is little, if any, motivation
for some Deaf and hard of hearing individuals on public assistance
to get off of it. In some situations, parents and others before
them were also on public assistance. The tendency of our welfare
and assistance programs to financially penalize individuals
who obtain income from jobs, needs to be thoroughly examined.
All of this makes the preparation of the curriculum difficult,
but very important.
3. Departments of Vocational Rehabilitation
in various states need to have consistent policies which support
the need for assistance during and upon discharge from treatment.
Presently there is no such consistency. In order
for national standards to be developed, attention must be
paid to uniform provisions. Currently, individuals in some
locations are required to demonstrate a specific period of
abstinence ranging from 6 to 12 months, prior to becoming
eligible for vocational rehabilitation services. This research
shows this to be a paradox since abstinence is related to
having employment. Some treatment professionals would argue
that in order for an individual who has successfully completed
treatment and is not employed, to maintain sobriety, they
need to immediately secure work and be involved in a solid
support program. On the other hand, some vocational rehabilitation
agencies won't provide support to individuals who are chemically
dependent because they don't want to place them on a job and
have them relapse. They feel that six to twelve months of
sobriety is necessary to prove that they can be reliable employees.
4. Training programs need to be established
for vocational rehabilitation counselors, social workers,
chemical health assessors, teachers, administrators, psychologists
and mental health counselors serving Deaf and hard of hearing
individuals. This training should focus on provision of knowledge
about the unique considerations related to this population.
Presently, difficulties are created for the
Deaf and hard of hearing chemically dependent population because
professionals working with them have had no training related
to substance abuse. This training should include: chemical
dependency assessment, how to recognize signs and symptoms
of use/abuse, prevention strategies, clinical issues, and
the referral process and aftercare options. Staffing a specialized
treatment program such as the MCDPDHHI also becomes a major
challenge because there are few if any trained professionals
in this area who are fluent in sign language. The research
highlighted the need for support services such as AA/NA meetings.
Without proper training, the professionals serving the recovering
Deaf and hard of hearing population will not fully understand
the importance of advocating for this type of service for
their clients. It is essential for cultural identity to be
explored as part of the recovery process in a specialized
program serving Deaf and hard of hearing individuals (Myers,
5. Courses related to substance abuse and
deafness should be required of students interested in pursuing
careers in vocational rehabilitation, education, administration,
social work, psychology, mental health, ministry, etc. A major
career area should be developed that would provide the opportunity
for certification related to counseling the chemically dependent
Deaf and hard of hearing population.
Currently, there are few if any collegiate training
programs for professionals interested in working with Deaf
and hard of hearing individuals. This research indicates the
need for strong support systems related to talking about sobriety
with friends/family and attending self help groups such as
AA/NA. Colleges and universities provide no formal education
to those people who will work with this population related
to how to recognize if a problem exists, the barriers these
individuals face and appropriate tools to deal with them.
Such courses need to be offered to all individuals entering
the field of deafness if proper services are to be provided.
After the courses have been developed, the method
and need for certification of counselors working with the
Deaf and hard of hearing chemically dependent population should
be investigated. Deaf counselors need to be trained and hired
at treatment centers for Deaf substance abusers (Rothfeld,
1982). This kind of approach will foster greater communication
and provide positive role models to individuals in treatment.
6. A hotline should be created that would
be available for Deaf and Hard of Hearing individuals if they
need help in accessing treatment, self help groups (i.e. AA/NA),
other support services or maintaining sobriety. The
phone number should be available 24 hours a day, toll free,
tty accessible and available on a national basis.
The research indicated the need for support
systems such as AA/NA and friends/family to talk to about
sobriety. There is a serious shortage of resources available
on a national basis to serve chemically dependent Deaf and
hard of hearing individuals. Often these people end up in
crisis because of the lack of awareness of professionals and
the Deaf community as to how to access support. The hotline
would serve this purpose by providing support to family members,
friends, concerned persons, significant others and substance
abusers. Without this service a number of the problems disclosed
by the research will not be completely solved even with the
recommendations included here.
7. Methods need to be developed to emphasize
the importance of the inclusion of family members and friends
of the subjects in structured portions of the full treatment
Since the independent variable of the ability
to talk with family about sobriety is significant, this component
needs to be addressed during treatment. Professionals, caregivers,
family members and friends when trying to ease their own pain,
enable the disabled individual to continue his or her chemical
dependency. Family, friends and other concerned persons encourage
the use of alcohol or drugs believing that this will help
the person who is disabled to socialize, obtain happiness
or satisfaction, and perhaps even feel equal to able bodied
people (Schaschl and Straw, 1989). These feelings and behaviors
displayed by family members and friends must be dealt with
if the individual is to maintain sobriety. Treatment programs
need to continue to focus on the importance of finding sober
friends to talk to about problems. One way of doing this is
to invite a friend to participate during family week when
family members and significant others are encouraged to spend
one week learning about substance abuse and engaging in a
therapy group with their family member. Educational information
related to Alanon and other support services available should
be provided to an individual's friends and family during treatment.
8. Additional information should be provided
to subjects related to the role of a sponsor in their recovery
This research indicated there was a relationship
between abstinence and access to a friend with whom clients
could talk about sobriety. In general, this describes the
role of a sponsor in a Twelve Step Program. However, there
is a shortage of recovering individuals who are Deaf or fluent
in American Sign Language and appropriate to be a sponsor.
This research was not able to demonstrate a relationship between
abstinence and having a sponsor. This writer questions whether
subjects use their friends in the same manner a sponsor should
be used because of the shortage and lack of awareness of how
to utilize a sponsor.
9. There is a national need for additional
accessible self help groups such as AA/NA/Alanon, CA, etc.
Feedback during follow-up indicated that subjects
were not attending AA/NA meetings as consistently during the
first six months following treatment as from six to twelve
months. One of the theories behind this may relate to the
ability of some of the subjects to "white knuckle it"
and survive on a "treatment high". This is typically
felt by subjects who become sober, complete a treatment program
and think that because of all they have learned, they will
never use drugs or alcohol again. They tend to continue with
the same relationships, same friends and same lifestyles.
At some point, something triggers a relapse and they risk
falling back into the same using patterns. This study indicates
that once a person has been out of treatment for six months
or longer, it isn't as possible for them to stay sober if
they don't participate in a self help program such as AA/NA.
But it is clear that there is a need for more accessible AA/NA
meetings. Until there are more available meetings on a national
basis, subjects will not be aware of the positive support
and results they may access at all times. It is difficult
for counselors and service providers in this field to tell
their clients they need to attend twelve step meetings to
stay sober, but then not have accessible meetings in the client's
10. There is a need to establish additional
services related to aftercare.
Overall, aftercare continues to be one of the
greatest obstacles in assisting clients to maintain sobriety
and improve their quality of life. The biggest gap seems to
be related to accessing safe and sober living environments
upon the completion of treatment. This relates to the research
findings involving the importance of having a support system
available to maintain abstinence. Most states have no continuum
of service available in this area. In some states inpatient
or outpatient services are provided, but no long term sober
living options are available for Deaf and hard of hearing
chemically dependent individuals.
11. Additional funding through grants and
other methods for outpatient treatment, inpatient treatment,
prevention services, aftercare, and sober living environments
should be sought.
With today's economy, organizations need to
be innovative and creative in finding ways to fund programs
for specialized populations such as for the Deaf and Hard
of Hearing. Examples of the continuum of care needing additional
monies are part of this recommendation. Special attention
needs to be paid to grant writing strategies because they
are needed by professionals interested in developing comprehensive
treatment services as reductions continue to occur at the
federal, state and local level, and alternative funding sources
need to be found. Grant writing is recognized as one important
skill to have and training is beginning to be offered to some
professionals to assist them in accessing funding for specialized
services such as those discussed above.
12(a). This research study should be revised,
continued and expanded because the small number of available
subjects may not have completely validated its' conclusions.
This study consisted of 100 subjects because
at the time the research project was initiated, there was
not a larger number available for inclusion. The results appear
to be significant and may provide support for future recommendations
at the MCDPDHHI and other programs that may choose to utilize
this research. The nature of the studied population makes
it important to have as much information available as it is
possible to obtain. Before making major changes in current
programs such as the MCDPDHHI, or making recommendations to
others who want to duplicate the MCDPDHHI's efforts, it is
necessary to be sure that the conclusions of this study are
valid. One method of ensuring this would be to propose a replication
of this study using a larger sample when it is available.
12(b) Additional research, including more
longitudinal studies, is also strongly suggested.
Additional research is needed in the area of
substance abuse and deafness. A national data base should
be established related to demographic and other appropriate
research involving substance abuse and deafness. Longitudinal
studies offer reassurances of reliability which short-term
studies cannot and help to discount the effects of other present
factors of inadequate research.
The number of facilities emerging to meet the
needs of Deaf and hard of hearing substance abusers is increasing
and existing resources are gradually attempting to make their
services accessible to Deaf and hard of hearing people. The
increase in attention being given to preventive efforts is
applauded, and it is hoped that more and expanded focus in
this area will continue. The integration of community models
and public health concepts offers a promise of a wider perspective.
This appears to be a wise approach to addressing problems
Ideally, individuals who successfully complete
an alcohol/drug treatment program should be able to return
to the environment that they lived in prior to entering a
treatment program. However, that environment must include
a sober living option, family/friend support, professionals
trained to work with clients on aftercare issues and accessible
twelve step meetings. There are at least two problems in achieving
this result. One is that the local education facilities, support
groups, counselors, family and friends vary widely from one
part of the country to another. Some individuals can return
to a positive healthy living situation that is supportive,
while the majority of individuals leaving treatment do not
have that opportunity available to them. Secondly, current
laws sometimes inhibit good opportunities to intervene with
these individuals at an early age.
The Mayo Clinic Health letter (April, 1995),
discussed the importance of a support system and being well
connected. It found that the more social ties a person has,
the better the person feels emotionally and physically. The
article supports the need for people to have family and friends
to talk with as well as belonging to structured organizations
such as twelve step groups. The Mayo Clinic study conforms
with the conclusions reached in this study.
It is interesting to note that the major conclusions
of this research relate to the environment which the subject
enters after leaving treatment. This is the same kind of discussion
that is occurring nationally in relation to child abuse, juvenile
delinquency, teenage violence and similar problems. It appears
that there is a belief that it will not work to return an
individual with problems to the same situations that existed
prior to their difficulties. Children who have been abused
should not be returned to the abusing adults. Teenagers who
have been violent should not return to their parents and old
neighborhoods and instead should go to a different more supportive
location. Similarly we have found that chemically dependent
Deaf and hard of hearing individuals need to be in a supportive
environment after treatment in order to be successful in their
This research appears to demonstrate that pre-conceived
opinions that Deaf and hard of individuals are at greater
risk of addiction than the general population may not be correct.
When Deaf and hard of hearing individuals receive the same
treatment as hearing persons, outcomes appear to be the same
and aftercare needs are similar and equally important. We
will not fairly measure the risk factor until Deaf and hard
of hearing individuals receive the same consideration as hearing
persons in regard to prevention, intervention, accessible
treatment and adequate aftercare. That is not the case today.
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Program. (University of Tennessee, 1985) Dissertation
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