Working With an Interpreter: Ensuring Successful Communication

Using an interpreter is different than having a regular conversation. When you use an interpreter, it is important to make sure that your client feels comfortable in the conversation and understands the information being exchanged.

These YouTube videos offer some tips on working with an interpreter when meeting with a client:

• Tips for Working with an Interpreter: https://www.youtube.com/watch?v=pVm27HLLiiQ
• Working with Telephonic Interpreters: https://www.youtube.com/watch?v=8WK4idN_6HM

Language Barriers & Literacy Levels: Understand Your Client’s Needs

Learning a new language is not easy! Many people who have immigrated to the U.S. face financial and psychological barriers that can make learning English difficult. And someone who speaks a primary language other than English may be ashamed about not knowing English, or reluctant to speak English because they are afraid of making mistakes or being ridiculed.

In addition to the importance of interpreter services for non-English speaking and hearing-impaired clients, it is also important to consider the literacy level of the person with whom you are working.

When someone has difficulty reading or writing in their primary or secondary language, it is not uncommon for them to hide this. Yet too often, difficulty completing forms and treatment plans due to low literacy can be misconstrued as resistance or lack of engagement.

Most people are unlikely to volunteer that they have difficulty reading and writing, or are unfamiliar with English forms, at least in the beginning. As you build a connection with your client, it is your responsibility to ask if they have difficulty in reading and writing, and to ensure that you are meeting their language needs.

The Interpreter’s Role

The essential role of an interpreter is to translate one language into another without the loss of meaning or misinterpretation. An interpreter provides basic translation and helps clarify communication so that both parties understand each other. An interpreter can also serve as an advocate for the client and a cultural resource for the provider, acting in the role of cultural broker.

If possible, try to meet with the interpreter prior to working with the client. Provide the interpreter with a verbal client summary and summarize the purpose of the session for the interpreter once confidentiality has been secured. Ask if the interpreter is familiar with the language and terms used in behavioral health services and whether they have experience working in this area. For those with less experience, let them know that you will be verifying by asking them to give back to you the message that they gave to the client.

It is also helpful to make sure the interpreter does not have any conflicts with the client’s heritage, origin, history, or issues that would make them uncomfortable working with that person. For example, two people may speak the same language, but may represent different religious sects or regions that have historically been in conflict.
 

Meeting With the Client

1. Allow time for the interpreter and the client to introduce themselves to one another.
2. Double-check with the client to ensure they feel comfortable with the interpreter, including the interpreter’s gender.
3. Confidentiality concerns are often present when bringing a third party into your conversation with the client. It is important to direct the interpreter to reassure the client that they will maintain confidentiality.
4. Sometimes a language has no words that have the same meaning in the other language. When there are no words to match, the interpreter will have to be more descriptive of the meaning, and this can take more time. Try to avoid jargon and idioms, as these can be very difficult to translate.
5. Your appointment will take longer when you are using an interpreter. Interpretation doesn’t take place simultaneously. You speak, the interpreter speaks, the client responds, then the interpreter translates the client’s response to you. It is important not to rush this process, or to make the client feel like you are hurried or it is an inconvenience.

Potential Challenges

1. Do not use family members for interpreting. Family members may misinterpret some words or may summarize or skip crucial information. They often also have close ties with the client and may bring emotional bias to the conversation.
2. Sometimes, the interpreter will answer for the client. This is not appropriate. Make sure the interpreter allows the client to answer questions and only relays the client’s response.
3. Occasionally, conflicts can arise between the interpreter and client. If this happens, you should cordially end the session, then ask the interpreter outside of the session what the issue was and explore using a different interpreter or a different language service.

Tips For a Successful Interpretation Session

Seating: Sit directly across from the client, with the interpreter to your side.

Environment: Provide good lighting. Minimize distractions and potential loud noises. Be aware of body language of self, interpreter, and the client.

Your conversation: Speak directly and clearly to the client, not the interpreter. Maintain appropriate eye contact with the client even when the interpreter is speaking. The dialogue also needs to be slower to enable good interpretation. Remember, the interpreter will be a few words or sentences behind the person who is speaking. Wait until they catch up so the client has time to comment or ask questions.

Your speech

1. Speak to the client in a normal tone and volume.
2. Use the first person ‘I’ and the second person ‘you’.
3. Don’t rush. Pause at the end of each statement to allow the interpreter time to interpret.
4. Give the interpreter time to finish so that the client can ask questions or join the discussion.
5. Avoid jargon, jokes, idioms, and sarcasm.
6. Explain any difficult concepts.

The interpreter: Although the interpreter plays a vital role, they are not part of the conversation. They should not voice personal opinions, fill in the meaning of the client’s response, or enter the conversation in any other way. Sometimes clients tell interpreters something and then ask them not to tell the staff. Make sure you let the interpreter know that this is inappropriate.

You and the interpreter: If you need to leave the room for any reason, let your client know and explain the reason. The interpreter should leave the room with you. Do not leave the interpreter on their own with the client.

The interpreter may need to clarify something that you or the client has said. If clarifying something directly with the interpreter is unavoidable, first explain to the client what you are doing.

Don’t engage in conversations with the interpreter during a client meeting. It leaves the client out of the picture. For people who are deaf, hearing impaired, or who have limited English proficiency, this can be a very familiar and very uncomfortable experience.

If you are meeting with the client and interpreter using video services, follow the same guidelines as you would when meeting in person with the client.

Planning Interpreter Services for Clients with Hearing Impairments

A client who is deaf or hard of hearing should not have to change their preferred method of communication when they meet with you. Individuals with a hearing impairment may use American Sign Language (ASL), Signed English, Cued Speech, Pidgin Signed English (simply defined as a combination of American Sign Language and English), gesturing, drawing, spoken English, or written English.

Pine Tree Society provides interpreters who are familiar with a variety of communication methods. As with translation services for non-English speakers, behavioral health terms and concepts can be technical, so prepare the interpreter ahead of time. Provide an overview of the session or educational materials and outline the objectives. Give handouts to the interpreter as well as the client.

If you need services for more than 90 minutes, you should request two interpreters. Schedule frequent breaks: this applies to any interpreter service. It is more mentally challenging to follow interpreters than to have a 1-1 conversation, so make sure to take this into account.

Hearing-impaired individuals often use visual cues and lip-reading, so place yourself in front of the client so that they can see your mouth and facial expressions. Scan the environment to make sure there is no glare and that your face is not obstructed and make sure the client can also see the interpreter’s face clearly.

Assistive Technology & Services for Hearing-Impaired Clients

According to the Americans with Disability Act (ADA), no one can be discriminated against because of a disability. The ADA further states that failure to take steps to ensure full and equal participation in services constitutes a form of discrimination. For individuals with hearing impairments, ensuring full and equal participation includes the use of interpreters and auxiliary aids/services.

You can find information and links to Speech/Language and Assistive Technology Services on the Resource Sheet provided with this manual.

Most likely, individuals who are hearing impaired are better versed in available auxiliary services than you are – they have been living with the disability. Therefore, it is important to assess their familiarity, access, preferences, and comfort level with services.

Older adults who have age-related hearing loss may not be as knowledgeable about various accommodations since their hearing impairment has occurred later in life. Maine law requires all individual health policies and contracts to cover the purchase of a hearing aid for each hearing-impaired ear if the hearing loss is documented by a physician or audiologist, so you may be able to help your client obtain hearing aids if needed.

Interpreters who are compensated for interpreting services for individuals who are deaf and hard-of-hearing must be licensed in Maine. Pine Tree Society meets this requirement and should be used for all KBH-requested interpreter services for clients with hearing impairments. If your client wishes to access other interpreter services for their needs outside of their work with KBH, you can find a list of resources here.

Tip Sheet for Working with Interpreters and Clients

1. When English is not the client’s first language, ask if they would prefer to use a different spoken language, or if they have difficulty reading or writing in English. Clients who are not fluent in English may be reluctant to share that they have difficulty reading, writing or speaking English.
2. If possible, obtain a Release of Information prior to the session.
3. Try to meet with and prepare the interpreter before your meeting with the client. If this is not possible in advance, try to meet with the interpreter a few minutes before your client is scheduled to brief the interpreter on the session, discuss each other’s roles, and discuss how you will work with the interpreter as well as the client.
4. Ask the interpreter if they are familiar with the language and terms used in behavioral health services.
5. At the beginning of the session, allow the interpreter and client to introduce themselves to one another.
6. Ensure that the client is comfortable with the interpreter, including the interpreter’s gender.
7. Review confidentiality with the client.
8. Remember that using an interpreter will take longer than the usual sessions.
9. Do NOT allow family members to serve as interpreters.
10. Prepare your environment. Make sure you have video set up if needed. Set up the space so that you are across from the client and the interpreter is visible to both you and the client.
11. Speak directly to the client in a normal tone using first-person language as “I” and “You”.
12. Don’t rush. Pause at the end of each statement to allow the interpreter time to interpret. The interpreter is a few words behind the speaker.
13. Give the interpreter time to finish so that the client can ask questions or join the discussion.
14. Avoid jargon, jokes, idioms, and sarcasm.
15. Explain any difficult concepts.
16. If you need to leave the room for any reason, let your client know and explain the reason. The interpreter should leave the room with you.

YouTube videos on working with an interpreter when meeting with a client:

• Tips for Working with an Interpreter: https://www.youtube.com/watch?v=pVm27HLLiiQ
• Working with Telephonic Interpreters: https://www.youtube.com/watch?v=8WK4idN_6HM

Resource Sheet: Assistive Technology & Services for Hearing-Impaired Clients

Maine Department of Labor Assistive Technology Resource Guide

https://www.maine.gov/rehab/dod/resource_guide/assist_technology.shtml

Deaf Services Program & Telecommunications Equipment Program (TEP)

https://drme.org/our-services/programs/deaf-services/

The Deaf Services Program at Disability Rights Maine serves Maine people statewide who are D/deaf*, Hard of Hearing, Late Deafened, Deaf-Blind (dual sensory loss–sight and sound), or who use signs and gestures to communicate. We also work with agencies and individuals who provide support, services, education, housing, or employment to individuals.

The Telecommunications Equipment Program (TEP) provides no or low-cost adaptive phone equipment for Maine residents who cannot use their home’s conventional telephone due to a physical, sensory, or cognitive disability. The program was established to assist low-income residents, and most clients pay nothing for the phone equipment they receive. Examples of equipment include tablets, amplified telephones, captioned telephones, voice-activated telephones, large-button phones, electrolarynxes, personal listening devices, flashing call signalers, and more.

*D/deaf indicates both people who do not hear well enough to understand speech and also those who identify as a member of Maine’s Deaf Community–a socio-linguistic minority with a shared language, culture, history, art, and life experience.

Assistive Technology Demonstration and Loan Program (ATDLP)

https://at4maine.org/

The goal of the Assistive Technology Demonstration and Loan Program is to give Maine residents the opportunity to see how assistive technology (AT) works and test it out before buying it. Clients or their caregivers can create a free online account with AT4Maine to view hundreds of AT devices and arrange for a demonstration or process a short-term loan to borrow the equipment.

Pine Tree Society Speech/Language and Assistive Technology Services

https://pinetreesociety.org/adults-and-families/speechlanguage-and-assistive-technology-services-adults/

Pine Tree Society’s speech language pathologists provide a full range of speech, language, and assistive technology services for children and adults with disabilities to support communication, learning, and employment.

Services include:

• Speech Language Evaluations & Speech Language Intervention
• Individualized one-on-one therapy at school or at Pine Tree Society’s clinics in Bath and Scarborough
• Group therapy & Social Language Social Pragmatics sessions
• Assistive Technology Assessments, Consultations, and Support
• Device set-up and programming
• Support and training for the individual, his or her family, and team
• Ongoing technical support
• Professional development training and workshops
• Device demonstrations and loans