Interpreter-mediated psychotherapy with trauma-affected refugees – A retrospective cohort study

Sander, Rikke; Laugesen, Henriette; Skammeritz, Signe; Mortensen, Erik Lykke; Carlsson, Jessica

doi:10.1016/j.psychres.2018.12.058

Cited by 28 publications

(18 citation statements)

References 46 publications

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“…Results showed that participants in both conditions demonstrated significant improvement from intake to termination, although participants who received CPT from a provider who spoke the same language exhibited a larger decrease in PTSD symptoms than individuals who received CPT from a provider using an interpreter. A more recent study (Sander et al, 2019) examined 825 trauma-exposed refugees who received a mixed form of cognitive behavioral therapy (e.g., trauma-focused therapy, stress management, and acceptance and commitment therapy). The authors found that individuals who received the treatment via an interpreter demonstrated less improvement on measures of PTSD, anxiety, and depression than individuals who received treatment from a provider who spoke the same language.…”

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

“…The ability to communicate effectively is a critical underpinning to all therapies, as it is needed to share ideas, promote understanding, and build rapport between the therapist and patient (Costa, 2010; Zheng & Gray, 2014). Given the central role that language plays in therapy, it is unsurprising that there is evidence in the broader psychotherapy literature that when providers and patients do not share the same native language, therapeutic effects are diluted (Griner & Smith, 2006; Sander, Laugesen, Skammeritz, Mortensen, & Carlsson, 2019).…”

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

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A Case Study of Interpreter-Mediated Prolonged Exposure Therapy for Posttraumatic Stress Disorder: Challenges and Recommendations for Effective Implementation

Woodward

Orengo-Aguayo

Stewart

et al. 2019

Clinical Case Studies

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Prolonged exposure therapy (PE) is one of the most efficacious and widely utilized treatments for posttraumatic stress disorder (PTSD); however, no empirical studies have examined PE when implemented using an interpreter for patients with limited English proficiency (LEP). This omission is at odds with data indicating the number of individuals in the United States who speak languages other than English has risen dramatically over the past few decades and is expected to continue to grow. Consequently, there is a need to understand whether evidence-based trauma interventions, such as PE, work when utilizing an interpreter to reduce barriers in access to care. This case study presents an overview of the case of Teresa, a 28-year-old monolingual Spanish-speaking Latina female who was treated for PTSD following an armed home robbery. Teresa was treated with PE using certified Spanish-speaking medical interpreters. Teresa received 13 sessions of PE and showed clinically significant reductions in both PTSD and depression. This article details the progression of her case, challenges associated with utilizing an interpreter in PE, recommendations for the incorporation of interpreters in the delivery of evidence-based trauma treatment, and directions for future research.

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Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

A Case Study of Interpreter-Mediated Prolonged Exposure Therapy for Posttraumatic Stress Disorder: Challenges and Recommendations for Effective Implementation

Woodward

Orengo-Aguayo

Stewart

et al. 2019

Clinical Case Studies

View full text Add to dashboard Cite

show abstract

“…In principle, it is conceivable that the involvement of (lay) interpreters could change both screening results and therapeutic processes for a variety of reasons, including omission of cultural taboos in the translation process, role difficulties that might lead interpreters to take a directive rather than a neutral role, and lack of professional understanding regarding mental health services [ 10 ]. In terms of therapy effectiveness, the few existing post hoc findings on interpreter involvement present a mixed picture [ 11 , 12 ], whereby the latest study found that the group with interpreters involved showed poorer results than the comparison group without interpreters [ 12 ]. However, there are very few quantitative findings on the effects of employing an interpreter in mental health settings in general and, to our knowledge, no studies on the effects on screening or diagnostic results in particular.…”

Section: Introductionmentioning

confidence: 99%

Screening for Posttraumatic Stress Symptoms in Young Refugees: Comparison of Questionnaire Data with and without Involvement of an Interpreter

Müller

Unterhitzenberger

Wintersohl

et al. 2021

IJERPH

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Background: The substantial number of young refugees who have arrived in Europe since 2015 requires rapid screening to identify those in need of treatment. However, translated versions of screening measures are not always available, necessitating the support of interpreters. The Child and Adolescent Trauma Screen (CATS) is a validated questionnaire for posttraumatic stress symptoms. Here, we report on the psychometric properties of the CATS in a sample of young refugees as a function of interpreter involvement. Methods: A total of N = 145 (Mage = 16.8, SD = 1.54; 93% male) were assessed with the CATS, with half of the screenings conducted with and half without interpreters. Post hoc analyses included calculating internal consistency using Cronbach’s α. We used confirmative factor analysis to investigate the factor structure. Results: The CATS total scale showed good reliability (α = 0.84). Differences in psychometric properties between the interpreter vs. the no interpreter group were minor and tended to be in favor of the interpreter group. Results of a confirmatory factor analysis were acceptable after the exclusion of items with low item-scale correlations. Conclusions: The sample and the administration of the assessment represent the situation of young refugees in Germany, where resources are low and translated versions not always available. The CATS may be a helpful screening tool for clinicians working with young refugees, even when administered with an interpreter. Limitations include the post hoc design of the analysis without randomization of participants and the lack of a third comparison group using translated questionnaire versions.

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“…In Turkey, PM+ is delivered by trained and supervised non-specialist peer refugees who have a minimum of 12 years of education. Using peer-Syrian providers as delivery agents overcomes language issues and has been found to modify the effect on patient outcomes [17]. In Turkey, Group PM+ is being used.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a randomized controlled trial: peer-to-peer Group Problem Management Plus (PM+) for adult Syrian refugees in Turkey

Uygun

İlkkurşun

Sijbrandij

et al. 2020

Trials

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Background: A large proportion of Syrians have been exposed to potentially traumatic events, multiple losses, and breakdown of supportive social networks and many of them have sought refuge in host countries where they also face post-migration living difficulties such as discrimination or integration problems or both. These adversities may put Syrian refugees at high risk for common mental disorders. In response to this, the World Health Organization (WHO) developed a trans-diagnostic scalable psychological intervention called Problem Management Plus (PM+) to reduce psychological distress among populations exposed to adversities. PM+ has been adapted for Syrian refugees and can be delivered by non-specialist peer lay persons in the community. Methods: A randomized controlled trial (RCT) will be conducted with 380 Syrian refugees in Turkey. After providing informed consent, participants with high levels of psychological distress (scoring above 15 on the Kessler-10 Psychological Distress Scale (K10)) and functional impairment (scoring above 16 on the WHO Disability Assessment Schedule 2.0, or WHODAS 2.0) will be randomly assigned to Group PM+/enhanced care as usual (Group PM+/E-CAU) (n = 190) or E-CAU (n = 190). Outcome assessments will take place 1 week after the fifth session (post-assessment), 3 months after the fifth session and 12 months after baseline assessment. The primary outcome is psychological distress as measured by the Hopkins Symptom Checklist (HSCL-25). Secondary outcomes include functional impairment, post-traumatic stress symptoms, self-identified problems, and health system and productivity costs. A process evaluation will be conducted to explore the feasibility, challenges and success of the intervention with 25 participants, including participants, facilitators, policy makers and mental health professionals.

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Interpreter-mediated psychotherapy with trauma-affected refugees – A retrospective cohort study

Cited by 28 publications

References 46 publications

A Case Study of Interpreter-Mediated Prolonged Exposure Therapy for Posttraumatic Stress Disorder: Challenges and Recommendations for Effective Implementation

A Case Study of Interpreter-Mediated Prolonged Exposure Therapy for Posttraumatic Stress Disorder: Challenges and Recommendations for Effective Implementation

Screening for Posttraumatic Stress Symptoms in Young Refugees: Comparison of Questionnaire Data with and without Involvement of an Interpreter

Protocol for a randomized controlled trial: peer-to-peer Group Problem Management Plus (PM+) for adult Syrian refugees in Turkey

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