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Interpreter-mediated CBT – a practical implementation guide for working with spoken language interpreters

Part of: Being an Anti-Racist CBT therapist

Published online by Cambridge University Press:  07 February 2022

Beverley Costa
Beverley Costa*
Affiliation:
Birkbeck University of London, 26 Russell Square, London WC1H 5DT, UK; www.pasaloproject.org
*
Email: beverley@pasaloproject.org
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Abstract

In the UK, over three-quarters of a million people cannot speak English well enough to access cognitive behavioural therapy (CBT) in English. If they are to receive an equitable service, they need to be able to access (spoken language) interpreter-mediated therapy. This means that CBT therapists may need support, through training and supervision, to feel confident and positive about incorporating an interpreter into the therapeutic relationship. The requirement for CBT therapists to be able to work effectively with an interpreter is currently acknowledged in the new BABCP minimum training standards and core curriculum, which are recommended for adoption (BABCP, 2021). Understandably, therapists can feel anxious about working with a third person in the room, but when these anxieties are honestly addressed and explored, creative solutions can be found. Therapy is usually conducted in a dyad. A triadic relationship requires attention to the systems at play inside and outside of the therapy room. With careful preparation and planning, interpreter-mediated therapy can be an effective and positive experience for the patient. After an introductory section, the paper is divided into six implementation sections: preparing for interpreter-mediated therapy; meta communication; boundaries; managing three-way relationships; working with interpreters remotely; and support needs of interpreters. Using a case example approach, interpreter-mediated therapeutic situations, which illustrate challenges and solutions, and examples of good practice, are explored. The paper offers practical guidance and illustrations which can form the basis of a training programme which teaches CBT therapists how to form a collaborative working relationship with an interpreter, how a therapist can stay active and maintain their clinical authority in a session in which they do not understand what is being said, and how CBT therapists can ensure that the therapy session remains safe and effective for all three of the participants in the interpreter-mediated encounter.

Key learning aims

  1. (1) To help CBT therapists feel more confident and positive about working with spoken language interpreters.

  2. (2) To prepare CBT therapists to create a more accessible service for those patients who do not speak sufficient English to engage in therapy without support.

  3. (3) To provide CBT therapists with key principles for managing the pulls and pushes in a triadic relationship when you do not understand the language(s) spoken in the room.

Keywords

clinical authoritycollaborativeinterpreterinterpreter-mediated therapyspoken languages
Type
Invited Paper
Information
the Cognitive Behaviour Therapist , Volume 15 , 2022 , e8
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading and resources

British Psychological Society Guidance – Working with interpreters online or via the telephone. h ttps://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-%20Files/Working%20with%20interpreters%20online%20or%20via%20the%20telephone.pdf Google Scholar
Experiential, practical training courses for working effectively with spoken languages interpreters. https://www.pasaloproject.org/trainingconsultancy.html Google Scholar
NICE (2011). (Update of) Crossing the language barrier with a dedicated Mental Health Interpreting Service. https://www.nice.org.uk/sharedlearning/update-of-crossing-the-language-barrier-with-a-dedicated-mental-health-interpreting-service Google Scholar
The Royal College of Speech and Language Therapists guidelines for working with interpreters. https://3959e25e-b3e4-4cf0-92ed-b4c50fc1442d.filesusr.com/ugd/7f9695_e2618d3af15c43d5ab5057ad54e5cd97.pdf Google Scholar
Training films for therapists working with interpreters: https://www.pasaloproject.org/resources.html#TIWT and https://www.gla.ac.uk/research/az/gramnet/research/trainingmodel/ Google Scholar
Multilingualism and mental health training resource. https://www.pasaloproject.org/multilingualism-mental-health-and-psychological-therapy---course-content.html Google Scholar
UNHCR Handbook for interpreters in asylum procedures. https://www.unhcr.org/dach/wp-content/uploads/sites/27/2017/09/AUT_Handbook-Asylum-Interpreting_en.pdf Google Scholar

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