Imagine that you’re in an in or out patient recovery, and you can’t see. That’s not as easy to wrap your head around, but for me, that was the reality 12 years ago. Not much might have changed since LaAmistad violated my rights and the rights of other blind patients, so let me break down what it is we the blind may need in a recovery circle.
First and foremost, since blind people cannot read standard Print, it is the utmost importance that treatment providers must, even if it means changing policy, provide spoken or Braille materials for blind people to better understand and/or participate in recovery. Using HIPAA is not a good enough excuse not to allow a blind person to read their own recovery tools. Emailing recovery materials may be an option, and since most providers have a signature about confidential information, keep that signature, but send all materials as attachments. Braille materials can be embossed from these attachments or the treatment provider could pay a transcriptionist or emboss it themselves using a computer with a Braille embosser in sync with a transcriber program such as Duxbury or Perky Duck or something similar. Blind people must have full and equal access to all material related to them and their recovery. That’s the most important thing. Without it, your practice could end up in the same category as LaAmistad or any other company that violates the rights of blind people.
Secondly, as with autistics, all threatment providers should talk to their client directly, not expecting eye contact. Blind people with shrunken eyes like myself can’t give you the “evil eye” and other eye related expressions but we can face you when you talk, and we exist, so unless the client has a vocal disorder or speech impediment, please, please talk to your client directly. Find out the reason the client is in therapy. A representative such as a parent or public guardian may have forced your client into mental health counseling for all the wrong reasons, so be sure that this is not the case. 80% of blind females may need rape crisis counseling and another 10% may be added for the high rate of abuse such as sex abuse, physical battery, or emotional/verbal and mental abuse. Females with disabilities are seen as less valuable and not desirable, so it is often said that they are “sexless saints.” They aren’t. As a treatment provider, your job is to treat the whole picture, not “fix my child” in the case of parents begging you to, for instance, convert a gay person to a state of heterosexuality. Applied behavior analysis should never be used on blind autistics, just as with sighted ones. Parents should not be allowed access to your client if they say so. Participation of families may be hard because either the client is battered by one or both parents or a guardian, so take the reason for treatment seriously.
Your relationship with the client matters. If you say or do misconceiving things to your blind client such as ask them why they can’t open their eyes, they may be off put. IF your client uses a guide dog, allow them access to your facility because really, it’s the law. Ask your client the question of the dog’s purpose but not so much whether that’s a pet or service dog. If a client uses a wheelchair, your practice should comply with the Americans with Disabilities Act, including not have architectural barriers such as lack of a ramp or no elevator so the client can remain mobile. Some blind clients do use wheelchairs, so be aware of what needs to be done.
As you progress in therapy with your blind and physically disabled client, do what you normally do in asking about the client’s life story, talk about the onset of your client’s disability. Some disabilities are a direct result of abuse, so don’t be shy about the onset questions.
For some blind people, art is great for coping with stress and abusive situations. For children, use of three dimensional play things is fine, as with regular children who are not blind. The difference with blind clientel is that we prefer to have differing ways to artistically express ourselves such as weaving, clay sculpting, or three dimensional and tactile artwork. Collages are great ways to build art projects, and paper folding art such as the Japanese origami is a really good way to allow your clients to express themselves. Art therapy is excellent, but what if your client isn’t an artist? As with regular clients, blind clients may want outdoor activities supervised by a therapist such as horseback riding, playing fetch with a dog, or a nature walk. Some therapists’ offices are cramped, so this might work. You can come up with all kinds of creative things to do outdoors with a blind client who might have suffered anything from rape/abuse to night terrors/nightmares. The possibilities are endless, but make sure you get the logistics and resources before you do what you want to do.
Blind clients who are deaf will likely need Braille materials or computerized Braille files to participate in recovery. Sign language may not be the best, unless you want tactile interpretation like in the case of Helen Keller’s teacher Annie, who had to spell into her hand. The best way to address a deafblind client depends on the level of hearing loss but the best way I see to address said clientel is to use something like the Deafblind communicator, and use of writing software such as that can break down barriers of communication common in the deafblind arena. Sighted or hearing treatment providers should always be aware of what the deaf and blind client’s needs are just as with anyone else.
Group therapy can be a challenge for blind people, both in and out patient being where groups abound. Always make sure Braille materials are available, and allow your blind clients to bring whatever works for writing down answers and filling out worksheets. Allow them to email you the results if they must be turned in. When homework is assigned, make sure the client is given the same assignments as the rest of the group, but there may be triggers in some of the content of group discussion. Allow all clients equally to discuss things, but set your group rules as you would with regular clients. Blind clientel may need time to get to know group members’ voices, so icebreaker activities can be a great way for all members to remember each other. Blind people may be unable to transport to certain places by bus or train such as a field or horse barn, so if you are a treatment provider, and you wish to do therapy in a field, be sure to provide some form of assistance with transportation for your blind client as they can’t get a license to drive. IF a representative is unwilling to drive, you may be able to put some backbone into why they should, and be sure to remind the rep why the client benefits from your services. This step applies to treatment providers in rural areas where buses and trains may not be present.
In the advent of technology, some blind people may benefit from e-therapy. Some therapy resources are available through electronic means such as the phone or computer. E-therapy through a platform such as Google Hangouts or Skype might work, provided you don’t use an accessible counseling or e-therapy platform. Online counseling must be delivered in a way that benefits the blind clients, so use a screen reader or Braille display or both when testing e-therapy options.
I hope you find these tips helpful.