Psychotherapy research in the deaf community: pilot clinical trial lessons learned

Abstract At the time of publication, there are no evidence-based psychotherapies to treat any behavioral health condition with Deaf clients. This article describes unique study design considerations for psychotherapy clinical trials conducted in the U.S. Deaf community. We synthesized emergent themes from participant exit interviews with feasibility data and real-life challenges that our team encountered when implementing the Signs of Safety pilot clinical trial, conducted from 2019 to 2022. Particularly illustrative participant accounts were selected to demonstrate five major lessons learned—expanding reach for recruitment; formally assessing participants’ ASL fluency; selecting ethically-sound control groups; streamlining video fidelity monitoring; and making crystallized outcome assessments ASL-accessible. These lessons learned informed the design of the first-ever full-scale psychotherapy trial in the U.S. Deaf community, to be conducted from late autumn 2024 through 2028. This trial will potentially validate the first evidence-based therapy for Deaf people and provide a vital roadmap for conducting Deaf community-engaged clinical trials.