Deaf off Drugs & Alcohol (DODA): Creating Culturally Appropriate Communications for Recovery From Substance Use Disorders

Background: Since 2008, Wright State University’s Deaf Off Drugs & Alcohol (DODA) program has offered substance use treatment and counseling for Ohioans using culturally appropriate communication through online conferencing and social and entertainment media. Individual consumers who are D/deaf or hard-of-hearing (HH) communicate with counselors fluent in American Sign Language (ASL) using videophone, email, text messaging and TTY. DODA’s online presence includes a Facebook page, a series of videos on YouTube, video productions of Twenty-Four Hours a Day: Daily Meditations and Daily Thoughts in ASL (produced in partnership with the Hazeldon Foundation), a following on Twitter, and online trainings in Deaf Culture and culturally appropriate substance use disorder assessment and services. DODA also offers confidential online meeting rooms that serve as a “virtual church basement” at no cost for Alcoholics Anonymous and Al-Anon meetings that are organized, hosted, and attended by D/deaf consumers across and beyond the continental US.  Although the Americans with Disabilities Act (ADA) and the Twenty-First Century Communications and Video Accessibility Act of 2010 require that health communication media be captioned for the D/deaf and HH, written English is often the second language of people who communicate using ASL. Therefore, video media using ASL is more culturally appropriate for non-hearing consumers and can impart information in a more direct and complete manner than written English subtitles. Participants need only access to a computer with a web-cam and an internet connection.

Program background: DODA is a collaborative effort of the Substance Abuse Resources and Disability Issues (SARDI) Program at the Boonshoft School of Medicine at Wright State University, the Consumer Advocacy Model Program in Dayton (Montgomery County, OH), the Deaf Community Resource Center, Communication Service for the Deaf (CSD) of Ohio, and the Ohio Department of Alcohol and Drug Addiction Services (ODADAS). Services delivered include: private counseling, group counseling, case management, and access to peer recovery support.  Approximately 90% of all private counseling in DODA has been delivered through technology, specifically video phone or webcam video conferencing technology.

Evaluation Methods and Results: Testimonials from Deaf consumers of DODA attest to the remarkable support for sobriety maintenance that these consumers have received from the program.  The success of the program is reflected in the no-show rates of the DODA program.  Since the program’s inception, no-show rates have averaged three percent (3%, or 142 no-shows of 4893 total sessions), which is considerably lower than the no-show rates reported for most publicly funded SUD treatment programs and for non-DODA SUD treatment at CAM (Moore et al., 2009).

Conclusions: Using these varied modes of communication allows individualized, cost-effective and culturally appropriate treatment and prevention resources for a traditionally underserved population.

Implications for research and/or practice: Persons with low-incidence disabilities have traditionally been disenfranchised from local substance abuse programs because of transportation barriers, behavioral/cognitive impairments, fragile medical conditions, or limited mobility.  Technology holds particular promise for improving treatment accessibility for persons with low-incidence disabilities.