scholarly journals Evaluating the effectiveness and cost-effectiveness of British Sign Language Improving Access to Psychological Therapies: an exploratory study

2017 ◽  
Vol 5 (24) ◽  
pp. 1-196 ◽  
Author(s):  
Alys Young ◽  
Katherine Rogers ◽  
Linda Davies ◽  
Mark Pilling ◽  
Karina Lovell ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Sign Language ◽  
Exploratory Study ◽  
Service Providers ◽  
Cost Effective ◽  
Deaf People ◽  
Deaf Community ◽  
Psychological Therapies ◽  
British Sign Language ◽  
British Sign

BackgroundImproving Access to Psychological Therapies (IAPT) is a National Institute for Health and Care Excellence-approved approach to intervention for depression and/or anxiety. This exploratory study sets the groundwork for comparing psychological therapies for Deaf sign language users experiencing anxiety and/or depression, delivered in British Sign Language (BSL) by a Deaf therapist with usual access through an interpreter within the IAPT national programme.Objectives(1) To explore the following questions: (a) is BSL-IAPT more effective than standard IAPT for Deaf people with anxiety and/or depression? and (b) is any additional benefit from BSL-IAPT worth any additional cost to provide it? (2) To establish relevant BSL versions of assessment tools and methods to answer research questions (a) and (b). (3) To gauge the feasibility of a larger-scale definitive study and to inform its future design.DesignA mixed-methods exploratory study combing an economic model to synthesise data from multiple sources; a qualitative study of understanding and acceptability of randomisation and trial terminology; statistical determination of clinical cut-off points of standardised assessments in BSL; secondary data analysis of anonymised IAPT client records; realist inquiry incorporating interviews with service providers and survey results.SettingsIAPT service providers (NHS and private); the Deaf community.ParticipantsDeaf people who use BSL and who are clients of IAPT services (n = 502); healthy Deaf volunteers (n = 104); IAPT service providers (NHS and private) (n = 118).InterventionsIAPT at steps 2 and 3.Main outcome measuresReliable recovery and reliable improvement defined by IAPT; Deaf community views on the acceptability of randomisation; BSL terminology for trial-related language; clinical cut-off measurements for the BSL versions of the Patient Health Questionnaire-9 items (PHQ-9) and the Generalised Anxiety Disorder-7 (GAD-7); a valid BSL version of the EuroQol-5 Dimensions five-level version (EQ-5D-5L); costs, quality-adjusted life-years and incremental cost-effectiveness ratios.Data sourcesIAPT service provider anonymised records of the characteristics and clinical outcomes of Deaf BSL users of BSL-IAPT and of standard IAPT; published literature.ResultsRandomisation may be acceptable to Deaf people who use IAPT if linguistic and cultural requirements are addressed. Specifications for effective information in BSL for recruitment have been established. A valid EQ-5D-5L in BSL has been produced. The clinical cut-off point for the GAD-7 BSL is 6 and for the PHQ-9 BSL is 8. No significant difference in rates of reliable recovery and reliable improvement between Deaf users of standard IAPT or BSL-IAPT has been found. Whether or not BSL-IAPT is more cost-effective than standard IAPT is uncertain.LimitationsThe small number of participating standard IAPT services who have seen Deaf clients means that there is statistical uncertainty in the comparable clinical outcome result. Clinical cut-off scores have not been verified through gold standard clinical interview methodology. Limited data availability means that whether or not BSL-IAPT is more cost-effective than standard IAPT is uncertain.ConclusionsThere is a lack of evidence to definitively compare reliable recovery and reliable improvement between Deaf users of standard IAPT and BSL-IAPT. Instrumentation and prerequisites for a larger-scale study have been established.Future workA prospective observational study for definitive results is justified.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Conscious artistic translanguaging onstage

2019 ◽  
Vol 10 (1) ◽  
pp. 73-92
Author(s):  
Kelly Fagan Robinson
Keyword(s):  
Sign Language ◽  
Stage I ◽  
Deaf People ◽  
Field Observations ◽  
Language Choices ◽  
British Sign Language ◽  
Political Outcomes ◽  
Globe Theatre ◽  
British Sign

AbstractThis article is drawn from field observations of deaf-led Deafinitely Theatre as they produced The DREAM for Shakespeare’s Globe Theatre in London. Focusing on a goal of the company to ‘put BSL [British Sign Language] centre stage’, I examine the ways that different languages and modes (including signs, speech, gestures, text, music) co-existed in the same space in spontaneous, unexpected, and hybridised ways. I suggest that the carefully chosen arrangements of the languages employed in the production exerted particular messages that went beyond BSL translations of Shakespeare, establishing clear articulations of the artists’ understandings of the positions that signed and spoken languages hold in day-to-day British life. The aim of this article is to disentangle the translingual, multimodal imperatives born within ‘deaf-led’ theatre, where deaf people and sign language are maintained as key grounding forces. Of interest is both language choices utilised in praxis, as well as how these decisions prompted debates between signers and non-signers, triggering reconsideration of preconceived notions of what ‘being deaf’ means. In re-presenting for an audience different people’s translingual and multimodal resources and experiences, I argue that these artists intentionally harnessed a form of conscious translanguaging to advance both practical and political outcomes.

scholarly journals Delving Into the Unknown: An Experience of Doing Research With d/Deaf Prisoners

2019 ◽  
Vol 26 (3-4) ◽  
pp. 355-368 ◽  
Author(s):  
Laura Kelly-Corless
Keyword(s):  
Qualitative Research ◽  
Sign Language ◽  
Visual Language ◽  
Small Scale ◽  
Deaf People ◽  
Methodological Issues ◽  
Structured Interviews ◽  
British Sign Language ◽  
Key Issues ◽  
British Sign

This article acts as a reflexive account of my experience of doing qualitative research with d/Deaf people in a prison setting. This research was the first in England and Wales (excluding small-scale unpublished undergraduate dissertations) to include semi-structured interviews with multiple d/Deaf prisoners, and thus the journey documented is both innovative and unique. Because I was entering unmarked territory methodologically, my experience was laden with obstacles, as is discussed throughout. Key issues explored relate first to the process of gaining access to d/Deaf prisoners, second to researcher–participant language barriers, and third to issues of ethics and authenticity generated by the Deaf participants’ preference for a visual language (British Sign Language) in a setting like prison. Guidance is given throughout about how to overcome complex methodological issues, and concluding remarks include a set of recommendations for prospective researchers.

scholarly journals Investigating Lexical Variation in British Sign Language in Leeds

2018 ◽  
Vol 4 (2) ◽  
pp. 2-13
Author(s):  
Lily Blount
Keyword(s):  
Sign Language ◽  
Strong Predictor ◽  
Deaf Community ◽  
Lexical Variation ◽  
British Sign Language ◽  
Lexical Change ◽  
British Sign

This research investigates lexical variation in British Sign Language (BSL) in Leeds, and the extent to which variation in signs for the numbers one to twenty correlate to signer age. Previous studies have compared regional varieties of BSL in eight different UK cities examining the number signs one to twenty, but none so far have explored the deaf community in Leeds. The work presented here is therefore the first to address this area. Overall, age is concluded to be a strong predictor of variation. Younger signers were found to use significantly fewer traditional signs that are regionally distinct to BSL in Leeds than the older generation of signers. This may be seen as evidence of dialect levelling. This research suggests that lexical change in BSL is taking place and also presents the first documentation of Leeds specific variants, some of which have not been documented in the current BSL literature.

scholarly journals An illusion of inclusion? – Can counselling psychology do more to ensure equality and access to psychological therapies for deaf people, through their work with interpreters?

2018 ◽  
Vol 7 (1) ◽  
pp. 14-30 ◽  
Author(s):  
Emma Darroch
Keyword(s):  
Equal Access ◽  
English Speakers ◽  
Deaf People ◽  
Subjective Experiences ◽  
Psychological Therapies ◽  
British Sign Language ◽  
British Psychological Society ◽  
Professional Guidelines ◽  
British Sign ◽  
Discriminatory Practice

There is evidence that the British Psychological Society (BPS) guidelines on working with interpreters are not being applied sufficiently for psychologists to be meeting requirements for anti-discriminatory practice. The present study aimed to explore British Sign Language (BSL)/English interpreters’ subjective experiences, to identify whether psychologists are adhering to guidelines designed to safeguard anti-discriminatory practice and equal access for non-English speakers. An IPA approach to data was adopted, which resulted in three superordinate themes emerging: 1. knowledge and understanding, 2. interpreters’ experiencing and 3. development, with eleven supporting subordinate themes. The overall findings of the study suggest that the professional guidelines are not being sufficiently applied and as such interpreters are frequently not being adequately supported in order to provide the most effective interpretation for d/Deaf clients. The current findings are consistent with previous research thus, establishing training and communication between both the interpreting and psychology professions has been advised.

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