An episode of Changing the Conversation podcast
Karran Larson shares strategies for increasing accessibility and creating welcoming recovery services for people who are deaf and hard of hearing with host Ashley Stewart.
December 23, 2024
Ashley Stewart, Host (00:05): Hello and welcome to Changing the Conversation. My name is Ashley Stewart, and I am delighted to be your host for this very special episode. This session features live interpretation. To view and engage in this conversation with ASL, please join us on YouTube via the link in the show notes.
Ashley (00:24): Today, to talk about recovery, accessibility, and inclusion for folks who are deaf and hard of hearing, I am joined by my wonderful guest, Karran Larson. Karran Larson is a person in long term recovery. She is a licensed addiction mental health specialist, a deaf recovery coach, and is coordinating and advocating for recovery services for the deaf and hard of hearing community. Karran is joining us and calling in from Western Massachusetts. Hi, Karran.
Karran Larson, Guest (01:02): Hello, Ashley. Thank you so much. I’m really very happy to be here.
Ashley (01:07): I’m very happy to be here, too. And I’m so happy to be able
to have this conversation with you. I know this is something that you and I have talked about before, and to bring it to the Changing the Conversation podcast is so exciting, important, and an honoring experience for me. It’s so, so important. And, I’m glad that we’re having the opportunity to do this now.
Karran (01:32): It’s a very important conversation, Ashley, I am really delighted that we’re starting it, and I hope it will continue.
Ashley (01:39): It absolutely should and needs to continue. So let’s get it started. I think it would be helpful first to introduce the audience to who you are, right? I had the opportunity to hear you speak at a national convening for SAMHSA’s Program to Advance Recovery Knowledge, [SPARK], And in that context, we were talking about the historical context of hearing-based exclusion. And your work has really been to amplify and draw attention to those disparities, that are present for deaf and hard of hearing communities. So I would love to know a little bit more about you and how you got into that work. And then we can talk a little bit about the historical context of exclusion.
Karran (02:24): I think it’s starting with who I am as a person who grew up in the 1950s and, there was very little support services, or awareness when the goal back then was to kind of separate you if you could talk or lip-read, your chances were pretty good that you were going to somehow be successful if you could fit in, if you could blend in. But it really robbed me and many deaf and hard of hearing people of our authenticity and our opportunity to join a community that had a language and culture. So I grew up in that world and it was very difficult, but I basically found a way to, make it look because — I was a good lip reader and I could talk.
(03:21): I never met another deaf person until I was 21 years old, and I moved to New York City. I started to learn sign language and it literally changed my whole life. I became a whole person. It was like parts of me that had just never been there before. And I just became whole. And I think it’s important to recognize that historically, deaf have always been marginalized, literally institutionalized. We were put into asylums and then.
(03:54): But I think a major event that we focus on is in 1880, when a powerful group of men all hearing were in Milan, Italy, and they had a tremendous amount of power, literally, to impact how things would work in the court system, an educational system for deaf and hard of hearing for almost 200 years. Those men decided that it would no longer be allowed, that deaf people, deaf children, be allowed to use American Sign Language in the schools. All of the deaf teachers without and replaced by hearing people and any signing, or gesturing was open to capital punishment.
(04:44) So, that history basically, American Sign Language went underground and it was really very shameful, stigmatized to see people who were signing. Well, I think that until the 1960s that American Sign Language was recognized again, and in the 1970s that they actually started offering courses and, training for interpreters. Before that, it was all fam– So really, historically, there’s a great deal of marginalization and, oppression, that we’re starting to really now see more empowerment. So thank you.
Ashley (05:28): Yeah. You know, I think about the, like, idea that this is a historical context, and it is this is the history of it, but we’re talking about the 1960s, 1970s that folks were even, you know, able to communicate utilizing ASL. What’s important to acknowledge about that is that there’s a very short amount of time for the stigmatization of using ASL to be addressed, and folks can say that the 60s or 70s was a long time ago, but this is a very contemporary current social issue. And in a time where we’re talking a lot more about accessibility and inclusion and equity, this is not a conversation that I see happening often, nor is this a context of this something that I think a lot of people know. I appreciate you sharing it, and I really appreciate you sharing your personal story as a part of this context too.
(06:28) We also know that people’s experiences are intersectional. People’s identities, their gender, their race, their sexuality, all intersect with their experiences. And one that we often don’t talk about is what that looks like in the context of recovery. So can you talk a little bit about accessibility in recovery, specifically as it relates to the deaf and hard of hearing community?
Karran (06:56): I’m happy you brought that up because there’s a tremendous amount of diversity in the deaf community alone. Not all deaf use American Sign Language some deaf are lay deaf, and some deaf are people of color. Some are from different cultures, some are gay or lesbian or transgender. So in addition to just trying to create equity linguistically and culturally, like you need to try to create environment that are equitable for the diversity that exist within a very small community. And when it comes to treatment and recovery access, there’s very little available. There’s literally almost nothing that is designed for deaf or hard of hearing. It’s been tried.
(07:45): And then those programs have generally failed because of the way the system addresses funding. And the funding is based on data. And it’s really that alone is also sort of an example of where the inequity lies within our systems. So when a deaf or hard of hearing person goes into a treatment program first of all, they’re usually going to be the only one there. There’s a tremendous amount of, anxiety going into those programs because they really are, for many ways similar to how it was out in the real world where they had to try to fit in with the families, most deaf and hard of hearing have hearing parents, who they don’t communicate very well with, they go to schools where they had to struggle to access their education, and then they go into a treatment program. And none of the counselors have ever met a deaf person before, usually. So… You see anxiety all over.
(08:47): Usually the counselors are interested, they’ve never worked with a deaf person and the person in recovery going, what am I doing here? Nobody understands. So it’s hard. And I think that that’s the reason why, generally, in my experience, I see many deaf and hard of hearing end up leaving after 3 or 4 days because it’s so dreadful to be there.
(09:11): And we really need to work on — That’s part of my work is trying to develop treatment programs that are welcome and friendly and accessible and have a sense of like, you are in the right place and you are safe. And this is where you can find recovery and hope. We’re working on it. We’re working on that. Yeah.
Ashley (09:33): We are working on it and committed to continually talking about it. As an equity strategist, I fervently and wholeheartedly believe that these intersections are things that we can, should, and will continue to pursue. I think it’s also really important to name at a very foundational level, when we talk about accessibility, that we’re still missing the mark in a lot of ways. For example, we’re talking about linguistic diversity. There are multiple different, ways that folks can engage with sign and communicate with sign.
(10:09) Further, when we think about someone navigating a system like a mental health, behavioral health, or substance use treatment or prevention, facilities, there’s often a lot of language and jargon and acronyms that are used that American Sign Language may or may not have a direct, sign for, or it may take longer to spell out. So there’s some really foundational gaps as well in terms of how people can even engage or, have the opportunity to engage because of those barriers to us having limitations to technology, to interpretation and, you know, some systemic structural issues with how we talk about recovery. I’m wondering what you think.
Karran (11:06): Well, first of all, we talk again about equity. There’s the, common belief that if we’re providing interpreters, then all that, that you we have interpreters and while interpreters, first of all, are not addiction specialists, and they’re not people generally who — they’re not necessarily people in recovery. And they may be coming into the program with their own biases or attitudes about what addicts or people using alcohol are like.
(11:41): So you need to address internalized and unconscious biases with everyone who’s in the environment that that person, including the interpreter, need to have more training about their own biases about people in recovery. And then when you go into the program, you have, deaf who probably have never met a deaf person having assumptions going up to a deaf person and saying, hey, can you talk? Hey, do you lip read?
(12:15): And, wow! Microaggressions all over the place with attitudes and just completely unknowing that that’s not okay. And better off to say, What’s your language preference? You know, and then they’ll go, Oh I prefer to talk, actually. Or I prefer talking, but I need someone to sign for me, like I’m doing right now. I’m talking because I can. And I grew up where I was more or less hard of hearing I lost my hearing as I got older. Now I’m totally deaf and I rely on sign language interpreters because auditorily it doesn’t help me anymore. So too structurally, we need to take into account that most of the people that need a lot of training about how to be appropriate and examine biases, examine possibly privileges.
(13:17): We talk a lot about privilege. We talk a lot about, you know, the idea that there is white privilege, but also hearing privilege and to examine that and talk about what that looks like and audism about the attitude — audism is prevalent and in the belief that the more that you are like the dominant culture, the better off you are and the better your chances of success are. That’s a lot to look at. And to work through. I think we can. I think we can get there but it means people have to be willing to look at some uncomfortable things. You know, it’s never going to be comfortable. Like, it’s it brings up a lot of like, “but that doesn’t make me feel very good.”
(14:05): I’ve actually had people say when I say, you know, there is audism, there is unconscious bias that’s hearing privilege and I’ve had hearing people say You know, I don’t– that doesn’t make me feel very good. Well I’m very sorry about your feelings. You know? Too bad!
(14:26): So I think there are a lot of things we can do to make it more equitable. We can put up more visual signs. One of the hardest things for deaf and hard of hearing people is asking people their names. Names are so hard to lip read or asking for directions. How do I get to the bathroom? How do I get to? So if you have visual signage within the spaces. And you have signs that said my name is this, it takes away a lot of the anxiety around whether you actually can understand and navigate your spaces. You know?
(15:03): Having the staff take some sign language classes. Download some apps on the phone that can help make communication easier. I mean, technology has just taken off and, you know, really leveling off the playing field. So that’s kind of what I’m trying to do here is to go into programs and talk about this. And I just, I when I leave, people are basically like, wow, thank you. That was so helpful. I think people are open to it. Mostly. They just never have had the chance to. So.
Ashley (15:40): Karran I think — I — just taking a moment to recognize, you know, your leadership and your advocacy, in having those conversations. It is, your passion and your profession. And it also requires a level of emotional labor. And so I’m very grateful for the way that I’ve been able to see you do that and, and support people and acknowledging that, it a lot of people are being challenged in what is literal ignorance, not knowing.
(16:11): And so some of the strategies that we talked about are addressing biases, right? Implicit biases, addressing more explicit, biases or forms of discrimination or oppression like audism. We talked about the important incorporation of simple environmental things like signage. We talked about ensuring that the technology is appropriate, such as, you know, captioning doesn’t solve everything. And many captioning softwares aren’t accurately addressing or, translating what people are saying. And we talked about recognizing that while it is absolutely essential and beneficial to invite and have interpreters, it is also important to be thoughtful and considerate of whether those interpreters have the context to be able to communicate clearly.
(17:09): So we’ve named and list some strategies and something that’s really resonating and I want to highlight is, I think folks try to do some of these things and perhaps someone’s listening saying, well all of that – doing all of that feels like a lot. What we’re really talking about now is the importance of culture change. These are things that should just be embedded in the culture. We should always be talking about addressing microaggressions and audism in our staff training and professional, capacity building. We should always be thinking about signage in buildings. We should always be thinking about the technology that we’re leveraging whenever we’re using multimedia in presentations or webinars or even in service provision. And so it really is leaning into the importance of this critical culture change. I’m wondering, have you seen this be done effectively or efficiently in spaces, and what impact does that have on the culture?
Karran (18:11): One thing that I think that’s making a difference in the recovery world is the availability of persons who are themselves in recovery, and they’re becoming recovery coaches. And now I think it’s making a difference here at Massachusetts because we have a recovery coach team who are deaf and hard of hearing, and it’s helping to bridge the gap between not having treatment programs that were specifically designed for deaf and hard of hearing. And when someone goes in for, a short term day, a treatment just to get day beds, they can leave and go into the community with someone there to support them. And walk with them into a new way of life. Literally. It’s the idea of, where are you going? And can I go with you?
(19:09) I mean, the whole idea of connection. I think one of the biggest, I just got shivers when I thought of it. But we hear over and over again that the opposite of addiction is connection. And that is the part that’s missing right now. A deaf or hard of hearing person goes into a treatment program unless they have others there who are, like them. But generally speaking, it’s hard for them to feel connected. A lot of times the person that they feel most connected with is the interpreter. And the strange thing — well, that’s the strange part, the trend is
(19:54): Right now for most — a lot of interpreting is happening remotely because of Covid. And after the Covid pandemic, many of the interpreters were working remotely and like it that way. And so they are less willing to go into, in-person programs. It’s harder. And that means the other challenge then is that the technology, the WiFi, the bandwidth, everything has to be really up there. Otherwise, you have frozen, blue images, on remote and interpreting screens.
(20:43): But anyway, to get back to about culture. I think that there’s a lot of work still to be done, there’s a tremendous amount of information missing in the community. We talk a little bit about font of information and incidental learning and things that people pick up just standing in the grocery store. Or listening to the radio. And those are just missing. And for people who can’t hear even information about recovery, knowing what is it, many have never even heard of a cross cut program, you know, or any other pathway.
(21:25): So I think we’re working more on trying to get rid of the stigma, the belief that, that people are defective or have a more and really getting into the anti-stigma movement to help people understand that people who are using drugs or alcohol are not necessarily bad people. So I think that’s making a difference in, cultural movement. I’m not sure that what you were addressing, but that what came to mind when I heard your question. Is that what you were talking about?
Ashley (22:01): Yes.
Karran (22:02): Okay!
Ashley (22:03): Yes, you answered, and added so much more that I think is important to highlight as well. We’re talking about the importance of addressing issues connected and tied to isolation, and we know that isolation and social isolation is a huge issue on a national level. We see the Surgeon General’s report on the impact of isolation, and what we’re talking about are compounded elements and layers of isolation, that process of destigmatization, of informing people, of addressing bias is inherently a communal process, too. And so when we are targeting or addressing things in individual capacity, we’re really missing the opportunity to bring folks together and realize that this is a cultural, structural, communal — of communal importance to all of us to be able to create an environment that is truly equitable, welcoming, inclusive, and prioritizing belonging.
(23:11): So I’m grateful for your comment about isolation. I’m wondering, do you know of any initiatives that are happening to address isolation within the deaf and hard of hearing community?
Karran (23:24): Well I will say that even my own personal experience because where I live in Western Mass, there are not very many deaf or hard of hearing people. If I want to go to a deaf event, I have to drive at least an hour to go see more deaf people and you know, entertainment, events. Mostly, maybe two out of three hours away here. So. Oddly enough, Covid brought the opportunity for reducing isolation by bringing us Zoom and Zoom meetings have popped up for recovery. A lot, we had — I — back when I started a Zoom recovery meeting every night of the week, and we had 12-step meetings, We had all recovery meetings, we had dharma recovery meetings. We had — just — and people joined in from Florida and Michigan and California. And these people — actually, we’ve become friends. And last year I flew to Arizona and I met up with all of the deaf that I have met on Zoom, and we went to a great retreat in Prescott, Arizona, and it’s so fun to see them all that to me made a big difference. And even though I can’t, I don’t touch them, I can’t hug them.
(25:03): But I do feel that sense of community. And we do plan to get together and meet, that makes the difference for us because our numbers are so small. I’m not sure. I mean, statistically, two out of a thousand people have, enough hearing loss that they have to depend on visual cues. So the numbers are small. So that’s why there’s, different ways and creative ways of reducing isolation, so that comes up for me.
(25:35): And also, as I said, the recovery communities all around the state that are popping up, the, drop in centers, there are recovery centers and there are deaf recovery coaches who are getting together recently, we had a recovery coaching, people that they were working with, and we had a, I don’t know what you call it, they usually call them Sip and Paint, but we don’t drink at these events. We just had, you know, soda and we painted together. So that’s another way that we are trying to reduce isolation by being a little bit more creative. I think it’s helping, I know I enjoy it, it’s been great for me and a person in recovery. I need that too.
Ashley (26:28): Community is important, connection is important. And being in places where folks can empathize, connect with, but also just have that shared experience of knowing what it’s like to navigate, a society, a society that in many ways is inherently ablest, then also experience additional stigmatization as a person in recovery is refreshing, is necessary, is needed. And so there is the, need to continue to create these spaces.
(27:07): And so in our conversation today, we’ve covered a lot of intentional things that people, organizations, states, whomever can do to increase accessibility, to be thoughtful, to be, considerate. We talked about the importance of the intersections of accessibility and recovery. And so I’m thinking for some of our listeners who this might be their first time really engaging in this conversation, but to your point earlier, Karran, are really interested and passionate about learning more. What would you recommend as a next step for someone, a provider, a network, or a group of folks who are committed to increasing accessibility for the deaf community?
Karran (27:58): Almost all states have an organization that supports deaf and hard of hearing whether it’s a commission, or an advocacy group, or an independent — I mean, it’s different for every state. I think almost all or a lot of colleges and universities are offering sign language classes. I think one of the best ways to go to create inclusive and welcoming spaces is to have at least the minimal knowledge of sign that says, basically, welcome. I’m happy you are here and how can I support you?
(28:44): You know, those words are the most critical words to hear, that you’re in the right place and there are people here who will help you and work with you, it doesn’t mean you have to become fluent. I mean, sign language is a language like any other language, and it takes a long time to learn it fluently. But just the basics. Just like any language, just the basics, shows a sense of like, I matter, I matter and you care.
(29:17): And I think invite in someone to your organization to talk and train. Kind of like you invited me to come to the SAMHSA conference back in May and talk about this. We reached so many people in that group. It was awesome. And I’ve stayed in touch with a lot of them. I think that, those are some of the first steps that we can take.
(29:47): Also becoming aware of people who are not signers I’ve worked with people who never learned how to sign, and when they went into the treatment program, they were required to go to a group that had over 20 people in the group, and they were expected to lip read all of those people. And I went, I said, okay, it’s not going to work. We need to create a group, maybe five people, six people that will sit in a circle, and then that person can potentially engage with these people, have, enough access to be able to use their oral skills.
(30:30): So we need to take a look at what we think of as being just the way things are, and be creative about how can we change that and make it, and why do the things that we call “just the way they are.” Why do they really matter so much? Why can’t we make a smaller group? Why does the group have to be so big? You know? So I think that’s kind of where I would start with trying to create more inclusion and friendly spaces.
Ashley (31:02): Thank you so much, Karran, for taking the time to be here with us, for sharing your insights, your perspectives, your brilliance, the things that you’ve learned. You know, there’s a lot of things that we shared today that are very quick, immediate action steps that people and organizations can do to create an environment where folks can feel more welcome, where folks can engage and where folks have access.
(31:29): And so I really hope that, as viewers are listening to this, they make note of that and they do it right away. We’re so grateful to have had you on the podcast and hoping to continue the conversation soon, but I want to thank you for your time and for joining me.
Karran (31:48): Well, it was a pleasure, Ashley, and thank you so much for inviting me. And, I definitely look forward to continuing the conversation.
Ashley (31:58): And to our listeners, join us next time on Changing the Conversation.
Erika Simon, Producer (32:03): Visit www.c4innovates.com, and follow us on Twitter, Facebook, LinkedIn, and YouTube for more resources to grow your impact. Thank you for joining us. This episode was produced by Erika Simon and Christina Murphy. Our theme song was written and performed by Peter Hanlon. Join us next time on Changing the Conversation.
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