Inclusive psychotherapy: How people with hearing or visual impairments can receive better care

Studies show: People with hearing or visual impairments have a higher risk of developing mental disorders such as depression or anxiety disorders than people without impairments. There are many reasons for this: impaired sensory perception often leads to social isolation, impairs communication and can limit independence. These burdens have a direct impact on mental well-being.

Hurdles in the healthcare system

Insufficient communication options, a lack of knowledge among therapists and a lack of accessible therapy materials and rooms make it even more difficult to access psychological support.

Bastian Hardt, a doctoral student at the Chair of Clinical Psychology and Psychotherapy II at Witten/Herdecke University (UW/H), has investigated how therapy services for people with hearing or visual impairments can be improved - and where the greatest need to catch up lies.

Hardt and his team analysed the existing results in a meta-analysis, i.e. a systematic evaluation of many previous studies: For people with hearing impairments, there are promising therapeutic approaches that use cognitive-behavioural therapy methods. For people with visual impairments, on the other hand, academically sound programmes are still very limited.

"We can clearly see that there are gaps in research and that specific therapeutic approaches urgently need to be developed further," explains Hardt.

In a supplementary study, Hardt and his team conducted interviews with patients and therapists. The responses show how complex the barriers are in everyday life: there is often a lack of sign language interpreters or visual aids, registrations and forms are not designed to be accessible, and many patients report misunderstandings or prejudices. At the same time, experts and those affected emphasise how much technical aids, self-help groups, targeted training for therapists and active participation in therapy by patients can help to overcome these barriers.

Inclusive psychotherapy is possible

The studies show: When therapists and patients work together to recognise barriers and develop solutions, therapy can be effective and accessible. This is particularly important:

• Visualised content and joint forms of communication for hearing impairments
• Adaptations to auditory content, accessible materials and orientation guides for visual impairments
• Use of technical aids such as microphones, screen readers and Braille displays - devices that translate texts into tactile dots so that blind people can read them
• Exchange in self-help groups and personal support

Bastian Hardt emphasises: "With our results, we hope to provide an impetus for more research, awareness-raising and concrete improvements in practice. Ultimately, the question is whether healthcare is really accessible to everyone - or whether entire groups continue to be excluded."

Further information:

The results of the two studies have now been published in international journals:

Meta-analysis: Hardt, B., Graser, J., Heidenreich, T., & Michalak, J. (2025). A systematic review and meta-analysis of psychological interventions for persons with hearing or vision impairment: Research gaps and call to action. Clinical Psychology: Science and Practice, 32(2), 135-154. https://doi.org/10.1037/cps0000229

Qualitative study: Hardt, B., Heidenreich, T., Hunger-Schoppe, C., Adam, N., Heinen, J., Hopf, J., Röhlig, A., & Michalak, J. (2025). Barriers and accessibility-improving strategies in mental health services for persons with hearing or vision impairments: Perspectives from professionals and clients - A qualitative interview study. Psychology and Psychotherapy: Theory, Research and Practice. Advance online publication. doi. org/10.1111/papt.70006