Working with interpreters fundamentally changes the dynamics of therapy sessions. What works in standard one-on-one therapy often falls short when communication flows through a third person. Therapists who master interpreter-mediated sessions deliver better care, maintain compliance, and improve outcomes for patients with limited English proficiency. This blog provides clear, actionable practices for conducting effective therapy through interpreters, helping you transform potential communication barriers into pathways for connection and healing for your non-English-speaking patients.
Always arrange for trained professional interpreters with healthcare or mental health experience. Professional interpreters are trained specialists with expertise in medical terminology, ethics, and confidentiality protocols. Their specialized skills ensure accurate communication while protecting patient safety and privacy throughout the therapeutic process.
Interpreted sessions typically take twice as long as monolingual appointments. Build this additional time into your scheduling to prevent rushing, which can lead to misunderstandings or incomplete care. This extra investment pays dividends in better therapeutic outcomes and patient satisfaction.
Take a few minutes before the appointment to share context with the interpreter. Mention the patient's basic demographics, presenting issues, and any challenging content likely to arise. Review clinical terms or acronyms that might come up during the session. This preparation allows the interpreter to deliver more accurate interpretations from the start.
Address the patient in the first person as if having a direct conversation, not through the interpreter. Say, "How have you been feeling?" rather than "Ask her how she's feeling." The interpreter will relay your words in the first person, preserving the patient's voice and strengthening the therapeutic relationship.
Communicate in straightforward language, avoiding jargon, idioms, and acronyms when possible. If you must use technical terms, briefly explain them in plain language for accurate relay. This clarity benefits not just the interpretation process but also patient comprehension.
Different cultures have varying norms around eye contact, emotional expression, and discussing personal matters. When working with interpreters, be open to their guidance about cultural sensitivities. They can serve as cultural brokers, helping you navigate potential misunderstandings. This cultural awareness demonstrates respect and builds patient trust.
Avoid using the patient's family members, friends, or untrained staff as interpreters except in true emergencies. Ad-hoc interpreters are prone to errors, may censor information, and can compromise patient honesty and confidentiality. Using family members places an inappropriate burden on them and potentially exposes them to distressing information.
We explore this critical issue in greater depth in our article "Why a Patient's Family Member Should Never Be Their Interpreter," which examines the real-world consequences of relying on family members for medical interpretation.
A common mistake is focusing on the interpreter rather than the patient. Avoid side conversations with the interpreter or phrases like "Can you ask her about..." This makes the patient feel like an outsider in their own therapy session.
Speaking too quickly or delivering long monologues without pausing overloads the interpreter's memory and forces the patient to wait before hearing the translation. Break your speech into manageable segments, one question or a couple of sentences at a time. This pacing creates a more natural conversation flow for everyone.
Don't try to conduct an interpreted session in the same time allotted for a monolingual appointment. Rushing sacrifices quality, pressures the patient, and increases the likelihood of errors. If you're running short on time, acknowledge it and schedule a follow-up rather than speeding through important points.
Remember that interpreters convert languages; they don't provide clinical answers or take over your role as a therapist. Don't ask them to explain medical concepts or give advice to patients, as these remain your responsibilities as the provider. Clear role boundaries maintain the integrity of both the therapeutic and interpreting processes.
If an interpreter signals they need clarification or indicates that a patient hasn't understood something, pay attention. These interventions are crucial for maintaining accurate communication. Working with the interpreter as a professional collaborator, rather than around them, leads to better outcomes.
For therapy sessions, video remote interpretation (VRI) often provides advantages over telephonic interpretation. VRI preserves visual communication, facial expressions, gestures, and body language, which is especially important for emotional nuance in therapy. However, telephonic interpretation remains valuable for urgent situations, brief check-ins, or when patients aren't comfortable on camera. Both modalities have their place in a comprehensive language services strategy.
Implementing these do's and don'ts creates more effective, culturally responsive therapy sessions for patients with limited English proficiency. Though working with interpreters requires additional preparation and awareness, the investment yields substantial returns in patient satisfaction, improved outcomes, and reduced risk.
By following these guidelines, your clinic can ensure that language differences strengthen rather than hinder the therapeutic journey. Professional interpretation transforms potential communication barriers into bridges that connect providers and patients across languages and cultures.
Many clinics find that formalizing these interpreter protocols into a comprehensive Language Access Plan (LAP) helps ensure consistent quality of care across all departments and providers. Such plans provide structure for needs assessment, staff training, documentation standards, and accessibility protocols tailored to your unique patient population. If you're looking to develop or enhance your clinic's approach to language services, our free Language Access Plan template offers a practical framework to guide this important work.