Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword: Desire and commitment: essential ingredients in learning about culture and mental illness
- 1 Is trauma-focused therapy helpful for survivors of war and conflict?
- 2 Will ethnopsychopharmacology lead to changes in clinical practice?
- 3 Does cognitive–behavioural therapy work for people with very different cultural orientations and backgrounds?
- 4 Can you do meaningful cognitive–behavioural therapy through an interpreter?
- 5 Are particular psychotherapeutic orientations indicated with specific ethnic minority groups?
- 6 Can psychotherapeutic interventions overcome epistemic difference?
- 7 On the role of culture and difference in evaluation, assessment and diagnosis
- 8 Necessary and sufficient competencies for intercultural work
- 9 On the validity and usefulness of existing Eurocentric diagnostic categories
- 10 Benefits and limitations of the cultural formulation in intercultural work
- 11 Barriers to the intercultural therapeutic relationship and how to overcome them
- 12 How does intercultural interpretation work in the mental health setting?
- 13 Do the power relations inherent in medical systems help or hinder in cross-cultural psychiatry?
- 14 Recovery and well-being: a paradigm for care
- 15 Social perspectives on diagnosis
- 16 Public mental health and inequalities
- 17 Can you do psychotherapy through an interpreter?
- 18 Can race and racism be acknowledged in the transference without it becoming a source of therapeutic impasse?
- 19 Cultural competence: models, measures and movements
- 20 Religion, spirituality and mental health
- Index
4 - Can you do meaningful cognitive–behavioural therapy through an interpreter?
- Frontmatter
- Contents
- List of contributors
- Foreword: Desire and commitment: essential ingredients in learning about culture and mental illness
- 1 Is trauma-focused therapy helpful for survivors of war and conflict?
- 2 Will ethnopsychopharmacology lead to changes in clinical practice?
- 3 Does cognitive–behavioural therapy work for people with very different cultural orientations and backgrounds?
- 4 Can you do meaningful cognitive–behavioural therapy through an interpreter?
- 5 Are particular psychotherapeutic orientations indicated with specific ethnic minority groups?
- 6 Can psychotherapeutic interventions overcome epistemic difference?
- 7 On the role of culture and difference in evaluation, assessment and diagnosis
- 8 Necessary and sufficient competencies for intercultural work
- 9 On the validity and usefulness of existing Eurocentric diagnostic categories
- 10 Benefits and limitations of the cultural formulation in intercultural work
- 11 Barriers to the intercultural therapeutic relationship and how to overcome them
- 12 How does intercultural interpretation work in the mental health setting?
- 13 Do the power relations inherent in medical systems help or hinder in cross-cultural psychiatry?
- 14 Recovery and well-being: a paradigm for care
- 15 Social perspectives on diagnosis
- 16 Public mental health and inequalities
- 17 Can you do psychotherapy through an interpreter?
- 18 Can race and racism be acknowledged in the transference without it becoming a source of therapeutic impasse?
- 19 Cultural competence: models, measures and movements
- 20 Religion, spirituality and mental health
- Index
Summary
There is evidence that when interpreters are necessary and used well and appropriately in therapy, the benefits for both client and therapist include greater understanding, better engagement and more accurate cooperation (Faust & Drickey, 1986; Tribe, 1999). D'Ardenne et al (2007) report that cognitive–behavioural therapy (CBT) resulted in significant improvements in routine clinical outcomes of three groups of patients with post-traumatic stress disorder: refugees who required interpreters; refugees who did not require interpreters; and English-speaking non-refugees.
The pragmatic approach of CBT, especially the option to use its behavioural component rather than techniques such as Socratic dialogue and the downward arrow procedure (vertical descent technique), make it possible to conduct CBT successfully through interpreters.
The role of the interpreter in therapy is complex and there have been many debates about the interpreter's effect on the therapeutic alliance, empathy and transference. Orlinsky et al (1994) see therapy through interpreters as a group process, whereas Raval (2003) describes the interpreter as potentially encompassing the roles of translator, bilingual coworker, cultural broker, cultural consultant, advocate for the service user, intermediary, conciliator, community advocate and link worker. At their worst, therapy sessions conducted through an interpreter can be described as the blind leading the blind; at their best, the interpreter can help understanding and enhance the therapeutic relationship. Fear of breach of confidentiality, especially if the interpreter is from the patient's community, has been voiced; and if a family member takes on the interpreting role, there are often many conflicts of interest (Rathod et al, 2010).
Factors that determine the type of interaction and success of interpreted CBT
The training and experience of the interpreter is an important consideration. In the successful study mentioned above (d'Ardenne et al, 2007), the interpreters had at least 1 year's experience in healthcare interpreting. The researchers closely matched patients to interpreters in terms of gender, ethnicity and any political sensitivity, and the same interpreter was used throughout treatment, unless the patient requested a different one. Untrained and inexperienced interpreters, such as family members, friends or support staff, make more errors in interpreting, and the use of trained professional interpreters and bilingual healthcare providers can improve patient satisfaction, quality of care and outcomes (Flores, 2005).
- Type
- Chapter
- Information
- Elements of Culture and Mental HealthCritical Questions for Clinicians, pp. 17 - 20Publisher: Royal College of PsychiatristsFirst published in: 2017