Mind your language: working with interpreters in healthcare settings and therapeutic encounters

Abstract

national and international consultancy work and training work with a range of organisations. Her clinical and research interests focus on all aspects of trauma, culture and mental health, professional and ethical practice, working with interpreters in mental health, the mental health of refugees, and asylum seekers and organisational development.Aneta Tunariu is a principal lecturer in psychology at the University of East London and field leader for programmes in guidance, counselling and coaching. She also works as an honorary psychotherapist at a National Health Service clinic in London and has been active in national and international training programmes. Her research interests include the topics of close intimate relationships, sexuality, emotions, subjectivity and relatedness, and psychotherapy. AbstractThe National Health Service and specialist agencies within the UK are striving to ensure that they offer services that are inclusive, accessible and appropriate to all users seeking their services. As such, language interpreters will be required to work alongside health professionals to ensure that service users who are not fluent in the English language can gain full access to health and therapeutic provisions. In addition to reasons of governance, equity of service provision and national legislation there are also sound clinical practice reasons with respect to facilitating work with interpreters. Language is not merely a neutral, descriptive medium but has an active role in shaping and constructing how people view and experience the world. The range of meaning-making possibilities that lay or professional language opens up is always already greatly indebted to the speaker's local culture and has particular relevance in the therapeutic encounter. Working with an interpreter can be a challenging but enriching experience. The benefits of working in close partnership with an interpreter are discussed both at generic level when working as a therapist/clinician in any adult mental health setting and, more specifically, when working with sex and relationships problems using clinical material as illustrations.

Medical interpreters as tools: Dangers and challenges in the utilitarian approach to interpreters’ roles and functions

“…Because of the changing boundaries of medicine, culture, and language in bilingual medical encounters, providers and interpreters often need to negotiate their roles, responsibilities, and expertise [5]. Although our findings suggest providers have used interpreters mostly as passive instruments, expecting interpreters to “don’t speak unless spoken to” fails to recognize the complex utility an interpreter can offer in culturally sensitive care [16, 24]. When interpreters are viewed as smart technology, there will be a mutual-learning process between the interpreter and the provider.…”

A qualitative meta-synthesis on the experience of psychotherapy for deaf and hard-of-hearing people

“…Extensive research has been conducted surrounding the issues presented when a hearing person who requires an interpreter meets a therapist within a therapeutic encounter (Tribe & Tunariu, 2009). However, sign language is unique in that it is a multidimensional, visual-gestural language which distinguishes it from verbal languages.…”

The role of interpreters in mental health care

“…A systematic review conducted by Karliner, Jacobs, Chen, and Mutha (2007) found that the use of trained interpreters in healthcare settings vastly improves the quality of service delivery to the extent that it approaches and in some instances equals that for clients without language barriers. Research has found that the use of trained interpreters contributes to improved service delivery through improved communication, clinical outcomes, and users’ satisfaction with care (Tribe & Tunariu, 2009; Yakushko, 2010). Furthermore, trained interpreters are more likely to have adequate knowledge of medical terms and less likely to commit interpretation errors.…”

“…When no staff member is available, healthcare practitioners often find themselves reliant on family members to translate, which can obstruct objectivity and have serious ethical implications (Fatahi et al, 2008). The use of untrained interpreters further potentiates the deleterious effects already inherent in this process; several studies have suggested that the use of ad hoc interpreters increases the risk of serious adverse outcomes resultant from miscommunication, misdiagnosis, and inadequate roll-out of treatment plans (Tribe & Tunariu, 2009). Although the monetary cost of using professionally trained interpreters is a significant barrier to use, particularly in countries with limited resources, it should be noted that the consequence of using untrained interpreters is less explored and could potentially be more costly in the long term (Ku & Flores, 2005; Smith & Claire, 2008).…”