Working with interpreters

Video: Tips for service providers when working with interpreters

With Grace Eagan (Manager, Business Development - Language Services, Access Alliance)

When we talk about training in interpreting, the training isn't only for the interpreters, but it's also to provide training and tips to service providers. And those tips start off even before the encounter begins. So, when you're scheduling the appointment when an interpreter is going to be required, plan for a little bit of extra time because when there's an interpreter there things are repeated, things do take longer and it's a good thing because it means that effective communication is going to be the result. Then when you're placing the request for an interpreter, we found, particularly in the case for refugees, that it's important to be extra mindful if there might be a specific need for a particular gender of interpreter or a specific dialect of that language. Make sure that when the interpreter arrives, they're not going to be waiting in the same space as the client because an interpreter is never supposed to be alone with a client. Allow for some time to have a quick briefing with the interpreter. This is the chance for the interpreter to find out about the type of encounter that's going to take place, any particular assessments that the clinician might be using and any other information that the clinician thinks is relevant, perhaps the goal of that particular encounter. It gives a chance for the interpreter to ask any questions that they need, just to go in as prepared as possible. Then once everyone is in the room, it's important to give the interpreter time to deliver their introduction. So it's almost like setting the stage for the interpreting. For example, what they'll do is they'll remind everyone to speak in short sentences, one or two sentences at a time, to speak directly to each other. And also it's a reminder that the interpreter may ask for an interruption or a little time out to ask for clarification, to ask for something to be repeated just so that all of that is transparent and it's good to remember that when an interpreter asks for a clarification, it's a good thing. Once the encounter is over, we really encourage service providers to have the opportunity for a debrief with an interpreter. And this is another aspect that is particularly relevant to interpreting for refugees because there is an increased risk of vicarious trauma to have been experienced by the interpreters.

When requesting an interpreter for a client's appointment, consider the following:

Explain to the client the reason for an interpreter and address any concerns the client may have about working with an interpreter.
Screen the preferred language and the dialect where applicable (e.g., what language do you feel most comfortable using when speaking with your health service provider?).
Identify the country of origin and specific cultural or ethnic background.
As much as possible, respect the client's preferences in terms of gender, background and particular ethnicity of the interpreter (especially if otherwise the objectives of the encounter might be compromised).
Make sure the interpreter is qualified and trained for mental health settings.
If working on multiple sessions with the client, it may be beneficial to work with the same interpreter for all the sessions in order to establish consistency and trust.

Different stages of the appointment

In working with interpreters, there are different factors to consider at each stage: before, during, and after the appointment.

Before
During
After

Communication tips

If providers have not worked with a qualified interpreter before, or if they find it challenging working with interpreters, the following tips will help ensure the process is as seamless as possible.

Allow more time than for a language-concordant appointment as everything that is said will have to be repeated in the target language.
Guide and direct the interview just as in language-concordant appointments.
Address the client directly (instead of telling the interpreter “Ask her how she's feeling,” ask the client directly: “How are you feeling?”);
Maintain eye contact with the client to encourage speaking directly with the client.
Leave time between questions to ensure the interpreter has time to fully relay what has been said.
Use plain language, avoiding jargon and idioms as much as possible.
Ask for or verify cultural precisions to ensure understanding of what has been said. Direct these questions to the client and not to the interpreter.
Ensure the interpreter repeats everything that is said, even if the client speaks directly to the interpreter.
Pay attention to body language and all non-verbal cues.
Avoid leaving the interpreter alone with the client to preserve each other's framework of intervention.

Interpreter conduct in the professional environment

A professional interpreter is expected to adhere to the standards and ethics of the profession. If the interpreter engages in what is perceived to be unprofessional behaviour at any time during the appointment, the provider should interrupt and, if necessary, step outside the room to address the interpreter's conduct.

Unprofessional conduct includes:

Not interpreting everything said by all parties present.
Having side conversations with the client.
Answering a question rather than waiting for the client's answer and interpreting it.
Providing comment on the client's cognition or mental health status.
failing to turn off cell phone and/or being distracted during the encounter.
Any behaviour toward the client that may be perceived as demeaning or discriminatory.
Always report unprofessional behaviour to the interpreter's supervisor or agency.

Main course

Module 1: Immigration and social determinants of health

1.1 — Understanding mental health in Canada

1.2 — Understanding immigration in Canada

1.3 — Mental health of immigrants and refugees

Module 2: Intro to Mental Health

2.1 Understanding mental illness

2.2 Common mental disorders

Module 3: Key populations - women

Module 4: Key populations - children

Module 5: Key populations...

5.1 Older adults

5.2 Survivors of torture

5.3 LGBTQ2+ immigrants and refugees

5.4 People living with disabilities

Module 6: Treatment and support

6.1 Treatment

6.2 Treatment interventions

6.3 Psychotherapy and counselling

6.4 Pharmacotherapy

Module 7

7.1 Health equity

7.2 Anti-Racism

7.3 Intersectionality

7.4 Anti-oppression and allyship

Module 8: Service delivery + pathways to care

8.1 Pathways to Care

8.2 Facilitating effective service use

8.3 Working with interpreters

Module 9: Partnerships + mental health promotion

9.1 Strategies for promoting mental health

9.2 Social Supports

9.3 Community development and partnerships

Module 10: Self-care