6+-+Working+with+Interpreters

= Working with Interpreters =

During your visits with clients at MAGMA, an interpreter may be arranged in order to facilitate communication.

What is interpretation? Explaining the meaning of one language, especially in speech and oral communication, into another language.

This can be broken down into **linguistic** interpretation (only spoken word) and **cultural** interpretation. Cultural interpretation conveys both the literal meaning and the cultural context of spoken and unspoken communication (e.g. body language, mannerisms). This can provide helpful information about cultural traditions, topics that are acceptable and unacceptable to discuss, and interpretations associated with the situation as well as the language.

Interpreters can facilitate trust between client and provider. For this to work, everyone must understand the interpreter's role and that confidentiality is assured. This is helpful to discuss at the beginning of the interaction. To use interpreters effectively, healthcare providers need suitable education and experience.

"When working with family and friends as interpreters, healthcare providers need to be aware of the potential influence of both family and interpersonal dynamics. In many cultures, role relationships between generations and genders are extremely structured and defined. There may be strong objections to even mentioning sexual organs or their functions to members of the opposite sex or members of a different generation, and clients may avoid discussing symptoms or concerns. "

Sometimes, interpreters may revise or omit questions thought to be inappropriate, insulting or embarrassing. For example, in cultures that believe words precipitate deeds, non-professional interpreters may not mention complications of surgery or other simliar information. Interpreters may also offer their own advice, or may selectively interpret what the client says in order to present the culture in a positive light.

Interpreting isn't easy!

 * Often interpreters report their role as stressful, frustrating, and unsupported
 * Interpreters deal with painful and conflictive communication, which can affect them personally (especially with trauma or abuse)
 * Those who are from refugee communities may have had similar experiences to the clients for whom they are interpreting
 * Sometimes they find themselves providing emotional support
 * Interpreters may feel personally responsible for failures in diagnosis and care

Types of interpreters
Able to interpret consistently and accurately, they also adhere to a code of ethics. They often have certification including language assessment, training related to medical terminology, ethics, and working in healthcare teams.
 * //Professional Interpreters//**

Used by many healthcare agencies. Staff are often provided with some basic training, guidelines and support. Employees are easy to access, may be viewed as trustworthy by clients, and will have knowledge of healthcare terminology. But... speaking the same language does not mean there will be ethnic or cultural compatibility, and not all support staff have professional knowledge of health issues or related terminology. One study found 50% of encounters resulted in miscommunication, with the healthcare provider misunderstanding the problem, having contending agendas, and missing cultural metaphors or context. They may also be rushed as this service is often in addition to their regular work.
 * //Bilingual healthcare staff//**

Family, friends and community volunteers. They are convenient, but there are many problems with using these people as interpreters. Confidentiality, disclosure, and errors in interpretation are issues seen frequently.
 * //Ad Hoc interpreters//**

Family and friends are acceptable for:
 * Factual and non-sensitive information (name, age, phone numbers)
 * Information about appointments or directions
 * Simple instructions for procedures

If using Ad Hoc interpreters, be sensitive to interpersonal dynamics and be alert to any signs of discomfort on the part of either the client or the interpreter.

Also, family members who act as interpreters can often unintentionally become proxy decision makers, especially if there are questions about the client's ability to make their own decisions.

In immigrant families children often become interpreters, placing them in awkward and potentially traumatic situations, and the role reversal can adversely affect the entire family unit. It is generally recommended that children never be used as interpreters.

Helpful guidelines for working with interpreters:

 * Allow extra time for the session
 * Use trained bilingual/bicultural interpreters
 * Never use children of a client
 * Consider the gender, ethnicity, language/dialect, and other characteristics of the interpreter
 * Beware of:
 * Words that can't be translated
 * Jargon or terminology
 * Being too rushed
 * The interpreter answering for the client
 * Conflict between interpreter & client - if it happens, stop the session immediately
 * Verify to avoid misunderstandings, mistakes and distortions

**The Interpretation Session**
Before starting, introduce yourself to the interpreter and get to know them.
 * Identify the objectives of the interview, topics to be covered, and time available
 * Provide a brief summary of the client
 * Ask the interpreter if he/she has any cautions, concerns or issues regarding this client or the situation
 * Remind the interpreter to interpret everything using the first person
 * Ask the interpreter to share cultural insights with you as the healthcare provider, but to differentiate these from the interpretation itself
 * Reinforce confidentiality

During the interpretation session: Speak directly to the client using the first-person Maintain control - insist that all conversations be interpreted
 * ** The provider (you): ** || ** The Interpreter: ** ||
 * Face the client directly

Use short sentences only

Ask one question at a time Ask that the client repeat instructions given Verify interpretations of any non-verbal behaviour directly with the client If there are long translations to your short questions, ask about these immediately Can request "time out" to clarify issues || Sits next to or behind the client Should have unobtrusive posturing and eye contact Should speak in the first person Interprets directly using short sentences Asks one question at a time Can request "time out" to clarify issues ||


 * In Canada, a telephone interpretation service is available:** [|www.languageline.com]