Fam Proc 23:205-213, 1984

Family Therapy with Deaf Persons: The Systemic Utilization of anInterpreterMICHAEL A. HARVEY, PH.D.a

aExecutive Director, D.E.A.F., Inc., 215 Brighton Ave., Allston, Massachusetts 02134; Adjunct Professor, Boston University Schoolof Education and Gallaudet College. Department of Counseling, Washington, D.C.

This paper discusses the theory and practice of providing family therapy to families in which there are hearingparents and at least one Deaf child, particularly regarding the optimal utilization of an interpreter. The therapist mustbe knowledgeable about the psychosocial effects of deafness, the cultural aspects of deafness, and preferably be able touse American Sign Language and Signed English. The therapeutic benefit of utilizing an interpreter extends far beyondsimply facilitating communication between each family member whose primary language is either spoken English orSign Language. The presence of an interpreter helps the therapist to modify family rules that deny the implications ofdeafness and prohibit the use of Sign Language, to modify the balance of power in the family, and to encourageparticipants to exhibit the ego defense mechanisms of projection and transference. The family therapist can utilize thosesubtle yet profound influences to therapeutic advantage.

The fields of family psychotherapy and deafness are relatively new. The field of family therapy recently celebrated its firstquarter century of existence (5). Similarly, Levine (11) noted the "unprecedented interest in the psychological aspects of ...auditory disability" (p. 3). Perhaps as a result of Rainer et al. (20) noting the "combined deleterious effects of a disruptivehome environment and deafness" (p. 227) and of the frequently stated need for early family intervention following adiagnosis of deafness (7, 31), these two fields have begun to "cross-pollinate" each other, to share the knowledge andtheories from their unique perspectives. There has been a recent proliferation of theoretical and case study reports onproviding family therapy to families in which there are hearing parents and at least one Deaf1 child (e.g., 1, 4, 16, 17, 24,27, 28, 29).

Despite the apparent recent interest in family therapy with Deaf persons, a review of the family therapy and deafnessliterature reveals surprisingly few articles that integrate theory with treatment procedures, particularly in regard to theoptimal utilization of interpreters. Interpreters for the Deaf have unfortunately been heretofore described as a necessarythird party to the treatment process, whose function is solely to facilitate communication between the Deaf and hearingmembers of a therapy session. The present paper delineates the theoretical and pragmatic considerations of using aninterpreter in family therapy when there are hearing parents and siblings and at least one Deaf child or adolescent whoseprimary and preferred mode of communication is American Sign Language (ASL). Particular attention is devoted todescribing the influence and systemic utilization of an interpreter for the Deaf in order to provide treatment moreeffectively.

This paper is specifically in reference to a therapist who is skilled in Sign Language and knowledgeable about thecultural and psychosocial aspects of deafness. It is based on ten families that received family therapy at D.E.A.F., Inc.2between 1980 and 1981. The treatment was provided by me and utilized manual and spoken communication. Aninterpreter was utilized, in part, to facilitate communication among family members.

BackgroundSchein and Delk (26) report that at least 90 per cent of the Deaf population in the United States have two hearing

parents. The reactions of such parents following the initial diagnosis of deafness typically include shock, denial, anger,depression, and finally acceptance (31). Although these stages of mourning characterize parental reaction to the diagnosisof any type of severe disability, I believe that the stage of denial is particularly prolonged for parents of Deaf children. Thereasons for this are two-fold. First, until recently, the diagnosis of deafness in an infant or a child under three years of agewas tenuous at best and in a real sense a medical dilemma (13). Unless the infant was at obvious risk for hearingimpairment? with a history of hereditary deafness or maternal rubella during the first trimester of pregnancy? thepossibility of congenital hearing loss was largely ignored (31). Many pediatricians dismissed the possibility of hearing lossand attributed observed developmental lags simply to slow development. Second, the disability of deafness, as opposed toother disabilities, has been called "invisible" because of its relative lack of overt manifestations. Cerebral palsy, forexample, is often clearly visible by spastic fine or gross motor movements; blindness is evident by the use of a cane. Incontrast, deafness most often becomes clearly visible when the Deaf person chooses to assert that communication with ahearing person is difficult or when he or she uses Sign Language to communicate.

An important consequence of hearing parents' denial that one or more of their children are Deaf is their attemptfrequently to "mold" the particular child to be "normal," or "hearing." This is manifested when parents mandate the

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exclusive use of lipreading,3 oral speech, and residual hearing and prohibit the use of Sign Language. It is not surprisingthat 88 per cent of hearing parents of Deaf children do not know Sign Language (20, 21).

Regarding the Deaf population itself, there is a clearly delineated culture of American Deaf people (18, 19), with itsunique language, poetry, values, norms, social relations, and literature. Padden (18) and Trybus (33) note that the primarylanguage of the Deaf culture is American Sign Language (ASL), and indeed, 80 per cent of the Deaf population in theUnited States rate their own signing skills as fair or good (26). ASL is the visual/gestural language naturally developed andused by Deaf people. This language is linguistically distinct from other forms of signing systems, such as Signed English,even though both forms are considered manual communication. The former has its own syntax and is not derived fromEnglish, whereas the latter follows the same syntax as English. Acceptance into the Deaf community is determined, not somuch by the degree of audiological hearing loss, but more by one's usage of and attitude toward ASL.

It becomes evident that most Deaf children and their parents are unable to communicate via the former's preferred andprimary mode of communication: American Sign Language.

This conclusion has important ramifications for treatment. As the members of a prototypical family include hearingparents, at least one Deaf child, and at least one hearing sibling, it is evident that two distinct cultures and languages arerepresented. Therefore, family therapy by a therapist who is a member of the hearing culture and has normal hearingbecomes a cross-cultural and bilingual phenomenon. In addition to being knowledgeable about the psychosocial effects ofdeafness, the family therapist must be sensitive to the cultural aspects of deafness, particularly as they influence thecross-cultural therapeutic joining (à la Minuchin, 15) and as they relate to understanding the structure of biculturalsubsystems within the family. The theory and techniques of cross-cultural psychotherapy are described elsewhere (12) andwill not be elaborated here.

It is preferable that the family therapist be able to communicate directly with the Deaf client through his or her preferredmode of communication. Most often this is via one or both of two manual communication systems, namely, ASL or SignedEnglish. As Stewart (32) said, "It seems axiomatic that counselors long acquainted with both sign language and its nuances... will be ahead of other counselors of compatable abilities and skills in their ability to be 'with' the deaf client" (p. 138).

The prototypical family therapy session with families in which there are hearing parents and at least one Deaf memberincludes an interpreter for the Deaf. Such an interpreter should be fully certified through the Registry of Interpreters for theDeaf (22) to translate Sign Language to spoken English and translate spoken English to Sign Language. The reasons forusing an interpreter deserve further mention. Even though a therapist may be fluent with manual communication and becertified as an interpreter, it is the author's opinion that it is not feasible or therapeutically prudent to interpret for all of thefamily members while simultaneously providing treatment. One function of an interpreter, therefore, would be to facilitatecommunication between the Deaf and hearing members of the family.

Another function of an interpreter, and one more germane to the present discussion, would be to influence the contentand process of the family treatment sessions. In spite of the fact that the "only function of an interpreter is to facilitatecommunication" (my emphasis; RID Code of Ethics, 22) and by implication not to influence the participant's behaviorbeyond what one would expect from making effective communication possible, this simply does not and cannot happenduring a family therapy session. An interpreter affects the interaction in many subtle yet important ways. Rather than viewthe interpreter as a necessary "nuisance," the therapist can view the interpreter as part of the family system and use his orher presence to therapeutic advantage.

The Influence of an Interpreter for the DeafBy arranging or requesting permission for an interpreter to be present during a session, the therapist immediately breaks

a common family rule prohibiting the use of manual communication.4

The presence of an interpreter traumatically confronts a homeostatic equilibrium that serves to deny the implications ofdeafness. Such families may have implicitly or explicitly agreed that "we will not talk with our hands to our Deaf child,"with the justification that she or he "is not like [not as stupid as] those other Deaf people who need to sign," or with thejustification that "we [parents] want our son/daughter to learn how to function in a hearing society." The therapist's behaviorof requesting or mandating the use of an interpreter (who signs) is often viewed as insulting by the family and therefore canprecipitate extreme defensiveness or anger.

Immediately upon commencement of the first session of treatment, a complex series of expressed and nonexpressedcommunications take place between the family therapist and family in connection with the use of an interpreter. Thefrequent reactions of anger, defensiveness, and hurt by the family members may be expressed indirectly by overtacquiescence regarding the utilization of an interpreter but simultaneous sabotage or termination of the therapeutic process.Consider the following example. A family requested psychological treatment for their 15-year-old prelingually Deaf sonbecause of withdrawal and other depressive symptoms. When I inquired about using an interpreter, the boy immediatelysmiled and, with animated signs, indicated his approval of the idea. Although both parents overtly acquiesced, theirapparent anger was expressed by continually speaking at too rapid a pace for the interpreter. Their behavior persisted in

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spite of repeated reminders and instructions.Another influence of an interpreter during a family therapy session can be explained with reference to the hierarchical

power organization of the family. Hierarchical delegation of power to each family sibling can either be explicit or implicitand is traditionally formulated and enforced by the parents. The reverse hierarchical organization, namely, that a givensibling (the "parental child," 15) controls the parents or other children, may represent a family's healthy adjustment toeconomic crises (e.g., both parents working full-time and "putting the oldest sibling in charge"), culturally defined roles(10), or familial dysfunction.

Stein and Jabaley (31), Shapiro and Harris (29), and my own experience suggest that, with families having at least oneDeaf child, the mother is often overly involved with the Deaf child; the father retreats, usually by excessive work or alcoholconsumption; and the hearing siblings often become the parental children. These siblings "mind the house" and supervisethe Deaf sibling while the mother is investigating various educational and treatment programs for the Deaf child and whilethe father is "busy." Such a balance of power is typically a result of a family myth that the Deaf child is relatively helpless,immature, and generally not too bright. The justification of this myth is that the Deaf child often does not communicate in anarticulate manner, which is incorrectly defined as poor English and oral/aural skills. In addition, the child may expressanger in a passive manner: acting helpless and incompetent. Thus, one or both parents are obliged to do additional choresand undergo other inconveniences. This tactic of acting helpless and "sick" as a means of expressing anger is relativelycommon in families of all types and is described in detail by Haley (6).

The presence of an interpreter immediately changes the stance of helplessness of the Deaf child and threatens the balanceof power; the Deaf child often communicates quite articulately and, in fact, eloquently via ASL. An interpreter simplyvoices in English what the child signs in ASL. The elimination of the intrafamilial linguistic communication barrier makesit possible for the family to realize that this child is not helpless; or, in rehabilitation jargon, that being disabled is not beinghandicapped. The family is faced with evidence of the non-necessity and destructiveness of overprotecting the child. Thefather is obliged to become more involved within the family, the mother to disengage herself from the Deaf child, and thehearing siblings to relinquish their roles as parental children. As one might predict, there is resistance to changing thathomeostatic balance of power; objective evidence does not always dictate actions.

As treatment progresses, family members often report being fascinated by how the interpreter "waves his hands." Whatfamily members characteristically do not report, however, and what is clinically relevant, is that they often feel increasingguilt for not having learned ASL; "that interpreter can communicate with my child but I cannot." Paradoxically, theirfeelings of guilt represent the flipside of their other feelings of anger or rejection of the use of ASL. In my experience, thatambivalence of the parents typically becomes more pronounced as treatment progresses.

The third major influence of an interpreter on therapeutic interaction is a consequence of his or her well-defined role:simply to facilitate communication and not to volunteer any opinions or personal information (RID Code of Ethics, 22).From a psychological perspective, the interpreter is a tabula rasa, a blank slate. Thus, family members, and indeed thetherapist, are free to fantasize about the interpreter's thoughts and feelings regarding the sessions or regarding anyparticipant in the sessions. Specifically, the psychological lack of identity of the interpreter encourages participants toexhibit the ego defense mechanisms of projection and displacement or transference.5

With regard to family therapy, family members are apt to transfer their feelings about the Deaf child onto the interpreter.A father may experience or express anger toward his Deaf child and toward the interpreter; a father may feel rejected by hisDeaf child and by the interpreter; or a Deaf child may feel overprotected by the mother and by the interpreter. Furthermore,in each of these examples and others, the interpreter may become the person for whom the feelings are experienced insteadof the appropriate person. Thus, a father may not experience anger toward his Deaf child but instead experience angertoward the interpreter. (The family therapist will recognize this particular process as similar to triangulation [3]). Thefeelings that result from projection and transference are, of course, not only seldom expressed but are usually beyond thelevel of awareness and thus cannot be readily articulated by the individual.

Perhaps the most obvious influence of an interpreter is related to confidentiality. Interpreters, despite their well-definedcode of ethics, are sometimes viewed as intruders into the private therapist-client relationship, as causing a lessening ofconfidentiality, particularly when sensitive information is being discussed. This issue is discussed by Bornstein et al. (2)and Stansfield (30) and will not be elaborated here.

The Utilization of an InterpreterStansfield (30) cogently describes some procedures of using an interpreter in a mental health setting when that

interpreter is specifically used to bridge the communication gap between Deaf and hearing persons. He recommendspresession and postsession meetings between therapist and interpreter to foster mutual respect and trust and recommendsclarification of psychological issues that may occur. He does not, however, discuss the influences of an interpreter as adirect consequence of being triangulated into the therapist/family system. Given that those influences on family interactionhave now been delineated, it behooves the family therapist to make therapeutic use of them.

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One objective of an initial interview with a family in need of treatment is to maximize the likelihood of their returning forsubsequent sessions. Toward that end, the strict rules of confidentiality for the therapist and interpreter should be carefullyexplained. In addition, it should be clarified that an interpreter is strictly forbidden to disclose personal information oropinions (RID Code of Ethics, 22). Both initial clarifications help to build rapport between the therapist and interpreterwith each family member. It is critical, however, for the therapist immediately to establish rapport with, or, usingMinuchin's (15) terminology, to "join" the most powerful member of the family system: the member who is able toencourage or "force" the rest of the members to come to a second session. (Of course, it is preferable to join all themembers, but this is not always possible.) It is therapeutically unwise to focus on establishing rapport with a Deaf child if itis at the expense of alienating the parents, who are likely to prohibit the child from receiving treatment from, in their words,"that unskilled" therapist.

One should not underestimate this possibility of premature termination from treatment as a direct consequence of thepresence of an interpreter during the initial session. As was previously discussed, the interpreter makes the invisibledisability of deafness visible and thus more difficult to deny or avoid, and the parents often react defensively. The commonreactions of overt anger (i.e., "our child is not dumb? he can lipread") or passive anger (i.e., while smiling, the father asks,"Doctor, is an interpreter really necessary?") must be elicited, if present, and dealt with carefully and immediately.

There are many methods of handling this common initial reaction of parents. The simplest and most direct method is tostate authoritatively that an interpreter is necessary for therapy to be effective. The therapist could also say something to theeffect that "of course, we all agree that she [the Deaf child] needs to feel comfortable in order for me to help her; I think aninterpreter will help her feel more relaxed." The therapist can ask the child to confirm this opinion.

If the family's level of denial of deafness is inordinately high, these methods of introducing an interpreter are not alwaysappropriate. If the most powerful member of a family system (often, but not always, one or both parents) strongly objects tothe presence of an interpreter, then the following method might be appropriate. The therapist should obtain permissionfrom the Deaf child and family to excuse the interpreter from the room, stating, particularly to the child, "I hope you trustmy judgment." The therapist then should begin a discussion but make no effort to aid the Deaf child to follow any of thevarious permutations of dialogues between any two people in the room. (For a family of five and one therapist, the numberof permutations equals 360!) At the same time, however, the therapist should meticulously demonstrate the child's lack ofcomprehension of the content of the discussion and how essential this comprehension is. Assuming that the therapist hasalready begun to establish rapport with the protagonist of the family? in this case, the member who enforces the rule todeny deafness? and has begun to earn the family's respect as an expert, the therapist can smile, scratch his or her head in aperplexed manner, and playfully ask for advice or hint that the interpreter should be invited back into the room.

In that interaction, the therapist is simultaneously communicating two messages: (a) the verbal message that he or she isconfused and needs help, and (b) the nonverbal message that he or she is not confused and that the presence of theinterpreter is essential. If sufficient rapport has developed between the therapist and the protagonist of the family, the latterwill often answer the former's communication also with two simultaneous communications: (a) the verbal messagesuggesting that it is now permissible to use the interpreter and giving permission for the therapist to invite the interpreterback into the room, and (b) the nonverbal qualifier that he or she only reluctantly and defensively acquiesces to the use ofthe interpreter. It is important that the protagonist, at least verbally, control whether an interpreter is present. In thismanner, subsequent resistance is decreased.

After the interpreter is invited back into the room by the family protagonist (again, usually one or both of the parents), acritical therapeutic task is necessary. The therapist must rejoin the Deaf child by overtly or subtly communicating thereasons for the interpreter's having been excused from the room. The therapist must also help the family to examine theirconflictual thoughts, feelings, and behaviors about having a hearing-impaired family member. The vehicle foraccomplishing this laudable but formidable goal is to help the family understand that the interpreter serves as a catalyst forclarifying each family member's conflictual thoughts, feelings, and behaviors regarding the hearing-impaired member.

Following the initial session and throughout the duration of treatment, each member's reactions to the presence of aninterpreter can be elicited. The acute observation of cues, such as the family members' comments about the interpreter, theiravoidance of, or frequent observation of the interpreter, their body and seating position relative to the interpreter, allprovide a wealth of clinical data that can be used to therapeutic advantage. For example, a Deaf child may always look atthe interpreter in order to understand what a parent is saying. This behavior may precipitate a variety of feelings by theparents, such as inadequacy ("We do not know Sign Language"), guilt ("We should have learned to sign"), anger ("My childdoes not need to use that interpreter"), or relief ("We can finally communicate!"). On the other hand, a Deaf child may statethat the presence of an interpreter is unnecessary but, on closer examination, may occasionally peek at the interpreterduring a conversation. The therapist can use this observation to examine the child's conflict between breaking the familyrule that "we do not need to use interpreters" and being able to comprehend what is being spoken.

The interpreter can also be utilized as an object of transference. Similar to the stages of shock, denial, anger, depression,and acceptance that characterize the experience of many parents in reaction to their child being diagnosed as Deaf (17, 31),parents will often experience the same stages when first confronted by the presence of an interpreter during a family therapy

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session. The therapist can help the family to understand that the interpreter also serves as the symbolic Deaf child.The family therapist has an opportunity to help family members accept the Deaf child by eliciting their reactions toward

the interpreter, the symbolic Deaf child. It has been stated in this paper that the presence of an interpreter often modifies thestance of helplessness of that child to one of assertiveness of power; the interpreter not only becomes his or her "voice" butalso augments it. Because of this close "connection" between the interpreter and the Deaf child, this paper also explainedthat, from the family members' perspective, their separate identities merge, greatly increasing the likelihood of transferenceand projection reactions. Family members may react toward the interpreter as if she or he were the Deaf child (transferenceor displacement) or falsely believe their own feelings to be emanating from the interpreter (projection? i.e., "Theinterpreter is angry with me for not having learned Sign Language," when, in reality, it is the parent who is angry at himselfor herself).

The therapist can utilize those perceptual distortions of the parents. For example, if it seems too threatening to ask theparents directly about their fears as to what their Deaf child may think of them, the therapist has an option of eliciting theparents' fears as to what the interpreter may think of them. At a later time, the parents can be helped to realize that whatthey fear may actually be the opinions they have themselves. Consider the common familial reaction of rejection of a Deafmember (17). The parents may first think that the interpreter views them as rejecting, then realize that they think their Deafchild views them as rejecting, and finally realize that they themselves may actually be experiencing feelings of rejectiontoward that child. Once these feelings can be brought to a level of awareness, they can be dealt with by the parents; theparents gain control of these feelings, instead of vice versa.

ConclusionHarris (7) stated that "the emotional problems of many deaf adults are rooted in the responses of their families to them as

children" (p. 220). The therapeutic utilization of an interpreter in family therapy facilitates the modification of thoseresponses. The family therapist who is knowledgeable about the psychosocial/cultural aspects of deafness can utilize thepresence of an interpreter with families in treatment to elicit and "work through" their various maladaptive feelings andbehaviors toward the Deaf child. Although an interpreter is strictly prohibited from disclosing any feelings or opinions,even if requested by the family members or therapist (RID Code of Ethics, 22), nevertheless, an interpreter immediatelybecomes a part of the family/therapist system and profoundly influences its interactions. Perceiving and utilizing thoseinfluences significantly improves the quality of treatment.

REFERENCES

1. Bennington, K. F., (1972) "Counseling the Family of the Deafened Adult," J. Applied Rehab. Counsel., 3,178-187.

2. Bornstein, H., Woodward, J. C. and Tully, N., "Language and Communication," in B. Bolton (ed.), Psychology ofDeafness for Rehabilitation Counselors, Baltimore, Md., University Park Press, 1976.

3. Bowen, M., Family Therapy in Clinical Practice, New York, Jason Aronson, 1978. 4. Freeman, R. D., Carein, C. F. and Boese, R. J., Can't Your Child Hear? Baltimore, Md., University Park Press,

1981. 5. Guerin, P. J., Jr., "Family Therapy: The First Twenty Five Years," in P. J. Guerin, Jr., (ed.), Family Therapy:

Theory and Practice, New York, Gardner Press, 1976. 6. Haley, J., Strategies of Psychotherapy, New York, Grune and Stratton, 1963. 7. Harris, R., "Mental Health Needs and Priorities in Deaf Children and Adults: A Deaf Professional's Perspective

for the 1980's," in L. K. Stein, E. D. Mindel, and T. Jabaley (eds.), Deafness and Mental Health, New York,Grune & Stratton, 1981.

8. Harvey, M. A., "The Influence and Utilization of an Interpreter for the Deaf in Family Therapy," Am. Ann. Deaf1984, in press.

9. Jackson, D. D., (1965) "Family Rules: Marital Quid Pro Quo," Arch. Gen. Psychiat, 12, 589-594. 10. Jones, D. L., (1979) "African-American Clients: Clinical Practice Issues," Social Work, 24, 112-118. 11. Levine, E. S., The Psychology of Deafness, New York, Columbia University Press, 1960. 12. Marsella, A. J. and Peterson, B. (Eds.), Cross-Cultural Counseling and Psychotherapy: Foundations, Evaluation

and Cultural Considerations, New York, Pergamon Press, 1981. 13. Meadow, K., (1968) "Parental Response to the Medical Ambiguities of Congenital Deafness," J. Health Soc.

Behav., 9, 299-309. 14. Menninger, K., The Theory of Psychoanalytic Technique, New York, Harper & Row, 1958. 15. Minuchin, S., Families and Family Therapy, Cambridge, Mass., Harvard University Press, 1974. 16. Murphy, A. T., (1979) "Members of the Family: Sisters and Brothers of Handicapped Children," The Volta

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Review, 81(5), 352-362. 17. Mindel, E. and Vernon, M. C., They Grow in Silence, Silver Spring, Md., National Association of the Deaf, 1971. 18. Padden, C., "The Deaf Community and the Culture of Deaf People," in C. Baker and R. Battison (eds.), Sign

Language and the Deaf Community, Silver Spring, Md., National Association of the Deaf, 1980. 19. Philip, M. J., Deaf Culture, Paper presented at Massachusetts State Association of the Deaf Convention, Ashland,

Mass., 1981. 20. Rainer, J., Altshuler, K. and Kallman, F., Family and Mental Health Problems in a Deaf Population, 2d ed.,

Springfield, Ill., Charles C. Thomas, 1969. 21. Rawlings, B., "Characteristics of Hearing-Impaired Students by Hearing Status, United States: 1970-1971," Series

D, No. 10, Office of Demographic Studies, Gallaudet College, 1973. 22. Registry of Interpreters for the Deaf, Code of Ethics, Silver Spring, Md., 1976. 23. Rice, B. D. and Simmons, G. P., Serving Deaf Rehabilitation Clients: Fundamentals of Communication for the

General Counselor, Little Rock, Ark., Arkansas Rehabilitation Research and Training Center, 1974. 24. Robinson, L. D. and Weather, O. D., (1974) "Family Therapy of Deaf Parents and Hearing Children: A New

Dimension in Psychotherapeutic Intervention," Am. Ann. Deaf, 119, 325-330. 25. Satir, V., Conjoint Family Therapy, Palo Alto, Calif., Science and Behavior Books, 1967. 26. Schein, J. D. and Delk, M. T., The Deaf Population of the United States, Silver Springs, Md., National

Association of the Deaf, 1974. 27. Schlesinger, H. S. and Meadow, K. P., Sound and Sign: Childhood Deafness and Mental Health, Berkeley,

Calif., University of California Press, 1972. 28. Schwirian, P., "Effects of the Presence of a Hearing-Impaired Preschool Child in the Family on Behavior Patterns

of Older 'Normal' Siblings," Am. Ann. Deaf, 121, 373-380, 1976. 29. Shapiro, R. J. and Harris, R., "Family Therapy in Treatment of the Deaf: A Case Report," Fam. Proc., 15, 83-97,

1976. 30. Stansfield, M., (1981) "Psychological Issues in Mental Health Interpreting," R.I.D. Interpreting J., 1, 18-32. 31. Stein, L. K. and Jabaley, T., "Early Identification and Parent Counseling," in L. K. Stein, E. D. Mindel, and T.

Jabaley (eds.), Deafness and Mental Health, New York, Grune & Stratton, 1981. 32. Stewart, L. G., "Counseling the Deaf Client," in L. K. Stein, E. D. Mindel, and T. Jabaley (eds.), op. cit. 33. Trybus, R., "Sign Language, Power, and Mental Health," in C. Baker and R. Battison (eds.), Sign Language and

the Deaf Community, Silver Spring, Md., National Association of the Deaf, 1980. 34. Watzlawick, P., Beavin, J. H. and Jackson, D. D., Pragmatics of Human Communication, New York, Norton,

1967.

Manuscript received November 9, 1982; Accepted May 10, 1983.

1"Deaf" with a capital "D" refers to the Deaf community/culture as opposed to audiological deafness, in accordance withPadden's (18) definition.

2D.E.A.F., Inc. (Developmental Evaluation and Adjustment Facilities) is a rehabilitation and psychological service center forhearing-impaired children, adolescents, and adults.

3Studies have shown that only 33 per cent of speech is clearly lipreadable.

4Although this is not always the case, that rule is all too well known to practitioners in the field of family therapy and deafness.

5It is important to note that, other variables being equal, transference and projection are most likely to affect one's perception andinteractions with another person when the latter volunteers little or no personal information (14). This is the sine qua non ofinterpreting!

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