The February BABCP Article of the Month is from the Cognitive Behaviour Therapist (tCBT) and is entitled “Interpreter-mediated CBT – a practical implementation guide for working with spoken language interpreters” by Beverley Costa.

I was recently contacted by an IAPT service that wanted to reduce the number of patients spending over a year on their waiting lists. All the patients needed a spoken language interpreter to access therapy. I assumed that the service was having trouble finding suitable interpreters. But I was wrong. What they couldn’t find were therapists within their service who were prepared to work with an interpreter. Many therapists are not keen to work with an interpreter. Many don’t even believe it is possible to deliver therapy effectively via an interpreter. But often therapists, frequently dealing with competing demands, may just assume that someone else will do it.

It is understandable if CBT therapists, not trained in interpreter-mediated therapy, find the idea of a triadic – rather than a traditional dyadic – relationship in the room daunting. But it doesn’t need to be like that. Many therapists, who have received training and are prepared, work very productively with interpreters. They often find that working with an interpreter can enhance patients’ therapeutic experiences. Most patients are profoundly grateful for the chance to be heard.

Patients who need a spoken language interpreter are among the most vulnerable members of our society. They are often people who have endured and witnessed experiences that most of us could not even imagine – asylum seekers, refugees, survivors of torture, victims of trafficking. They are all denied access and equity of support with their mental health needs because they require their own words and the words of their therapists to be translated. That just doesn’t seem right for a service called Improving Access to Psychological Therapies.

This implementation paper, written together with my spoken language interpreter colleagues, draws from two decades of training therapists to work with interpreters. The paper brings together research findings, a wide variety of case examples, exercises, and implementation tips. We hope it will help CBT therapists to feel confident and perhaps also enthusiastic about working with spoken language interpreters.

As a mental health practitioner and a CBT therapist you will, we hope, share our aim with this paper. No patient who needs an interpreter should find themselves discriminated against because of their linguistic skills, excluded from therapy that should be available to everyone. Equal access to therapy won’t happen on its own.  It requires everyone to make an effort. Someone else won’t do it.

From Richard Thwaites, the Editor-in-Chief of tCBT: Why I chose this article:

Reading the blog above, it is hard to add to this regarding why I chose this paper to be Article of the Month. Clearly the final paragraph makes the case for change explicitly and I have often heard complaints that there is no detailed guidance on how to work with interpreters for CBT therapists. This paper builds on the IAPT BME Positive Practice Guide and provides that guidance and I think is essential reading for therapists and supervisors working with interpreters in their service.

Author Bio

Beverley Costa grew up in East London in a family with three languages and two religions and cultural practices. After training as a psychotherapist, she set up Mothertongue multi-ethnic counselling service (2000-2018). In 2009 she created a pool of mental health interpreters within Mothertongue and she set up the Bilingual Therapist and Mental Health Interpreter Forum in 2010. Beverley founded The Pásalo Project in 2017 www.pasaloproject.org to disseminate learning from Mothertongue. She is a Senior Practitioner Fellow at Birkbeck, University of London. She has written a wide variety of papers and chapters on therapy across languages, including the book Other Tongues: psychological therapies in a multilingual world (2020). Together with Professor Jean-Marc Dewaele, they won the 2013 British Association for Counselling and Psychotherapy, Equality and Diversity Research Award. Beverley has delivered training and supervision to statutory and voluntary sector health and social care organisations for the past two decades.