Health Care Interpreter Service (HCIS)

Working with Interpreters

The Role of a Professional Interpreter

The interpreter is there to:

• Facilitate communication, not conduct the interview. 
• Ensure the message gets across accurately and without being "filtered". They are not there to give advice or opinion and are required to be objective and impartial. 
• Interpret what is said. The interpreter will interpret only what is said by the service provider or the patient/client, without adding or subtracting information. 
• Assist with the immediate communication needs, not to act on either party's behalf, fill out long forms, take comprehensive patient/client histories, or conduct in depth information sessions. The interpreter will interpret as the service provider takes details or a history. 

Preparing for an Interview with an Interpreter

Before the patient/client arrives:

• Brief the interpreter about the history of the case and about your role if appropriate (e.g. in a counselling interview). 
• Discuss whether you have ever used an interpreter, and whether you and the interpreter have a preferred style. 
• Discuss the reasons for this particular interview. The interpreter can do a better job if they have an idea of the overall aim of the session. 
• Talk to the interpreter about any cultural or religious issues that may arise or be of importance.
• If you are planning to use assessment tools, show them to the interpreter in the briefing session as the majority of tools have been developed for English speakers and some items may not be appropriate for clients from other languages/cultures. The level of difficulty of tasks may change and affect the test results. Discussing the tests will give you and the interpreter the opportunity to work out strategies for dealing with challenging items.

Working with an Interpreter during an Interview

During the interview:

• Introduce yourself and the interpreter and make sure the patient/client knows that you are conducting the interview and what the interpreter's role is. Remember that the interpreter has to say what you tell them so don't be reticent. It is your interview, not the interpreter's. 
• Sit so that you are directly facing the patient/client, and maintain eye contact with them, if culturally appropriate. Interpreters usually sit next to the patient and slightly back. Exception is made in case of Auslan or Sign Language interpreters who sit next to the service provider while signing to a Deaf patient/client. 
• Tell the patient/client what is going to happen and allow them to raise any concerns they might have. 
• Advise the patient/client through the ¬interpreter that the discussion is totally confidential, and the interpreter is bound by a strict Code of Ethics. 
• Always speak directly to the patient/client (“I” and “you”, or “Mrs Prasad, tell me …”). Speak through the interpreter, not to the interpreter. 
• Speak only a little more slowly than usual. Pause frequently and avoid slang, jargon or jokes. Give simple, full explanations as you would with any patient/client. Just try to ensure that the information is in manageable "chunks" for the interpreter. 
• Use the tone of voice you would use with any patient/client. Show interest, concern, confusion, etc, as would be appropriate in English. 
• Avoid "private" conversations with the interpreter. If you need to clarify something, then do so - but make sure you tell the patient/ client, through the interpreter, exactly what you are doing. 
• Conversely, the interpreter may ask you to clarify or paraphrase a point. Be patient, and explain to the patient/client what is happening. 
• Remember sometimes there is no direct translation, so the interpreter needs more time (and more words) to explain concepts, which may not be familiar to the patient/client. This can be useful, as long as the interpreter keeps you informed at each step. 
• If it appears to you that the interpreter is taking over, stop the session and quietly remind them that you are conducting the session. 
• Think carefully about whether or not your patient's/client's relatives should be present. In some cases it is better to ask family members to wait outside while you speak with the patient/client. In other cases their presence might be helpful and culturally appropriate ¬- but it is your interview - do not hesitate to ask them to leave if you feel they are hindering the process by interrupting, adding their own opinions, or trying to control the interview. The interpreter's work will become impossible if you allow several people to talk at once, and you may need to intervene to control the session.  

 

After the Interview with an Interpreter

Following some interviews you may debrief the interpreter if required. Debriefing serves a dual purpose as follows:

• It provides the interpreter with an opportunity to vent feelings that may have come up in the interview. Interpreters may have an emotional response to what they have interpreted particularly when news of terminal illness was conveyed to the patient or when the interpreter had personally experienced similar traumatic events.
• It provides the healthcare provider with an opportunity to clarify questions arising from the interview, e.g. queries regarding language presentation, cultural/religious issues or matters relating to standardised assessment.

Working with an Interpreter in Teleconference Session 

When working with an interpreter over the phone, similar techniques apply to a face-to-face interview. The major difference from the point of view of the interpreter is that he/she has no access to visual cues available in an on-site encounter and it is also more challenging to manage the flow of talk in order to achieve accuracy. Below are some tips on working with an interpreter in a teleconference that will ensure optimal effectiveness:

• If possible, use a hands-free telephone or a dual handset (2 phones connected to one telephone line). Normal handsets are acceptable for occasional or emergency calls, but dual cordless handsets or the use of a loudspeaker facility (in a consultation room) is best for longer calls. 
• The operator may not immediately have a person available in the requested language, but will put you in contact with an appropriate interpreter as soon as possible. 
• Introductions and briefing are essential to a successful teleconference. 
  • Tell the interpreter who you are 
  • Clearly identify all the participants in the conference. It is an additional burden on the interpreter’s processing capacity if they have to work out who is speaking.
  • Brief the interpreter about the case.
• When using an ordinary phone, speak to the interpreter, then hand the phone back to the patient. Be mindful if the patient keeps the phone for a long time after they have finished talking. Some patients find it hard to understand that they have to pass the phone back to the healthcare provider in order for the interpreter to interpret the information. The interpreter on the other end of the line may be having a hard time trying to get the patient to hand the phone back.
• If you are at the same location as the patient/client, maintain eye contact with him/her. The conversation is still between both of you. Use the patient’s name in the conversation - take the interpreter's lead for pronunciation. 
• When using a hands-free phone, sit facing the patient and close to the microphone.
• Speak directly to the patient as you would in a face-to-face interview. For example "What is your name?" not "Ask her what her name is". 
• Pause frequently to allow information to be taken in by the interpreter, and then passed to the patient/client.
• When there are a number of participants in a teleconference, i.e. the patient is accompanied by relatives or multiple healthcare providers are present, they may forget about the interpreter and start speaking quickly or at the same time. Interrupt and ask everyone to speak one at a time and pause for the interpreter. Otherwise the interpreter will not be able to interpret everything accurately.
• Compensate for the lack of visual cues by explaining to the interpreter what is happening. For example, tell the interpreter that you are writing and will be silent for a while.
• Phone interpreting is a quick and cost effective way of accessing interpreter services. However, it may not be appropriate for some assignments. For example, it does not work well in some mental health interviews, particularly when simultaneous interpreting is required for patients suffering from disturbance of thought. These appointments may need to be re-booked with an on-site interpreter.
• On the positive side, additional anonymity of phone interpreting may be an advantage for some patients/clients who are particularly concerned about disclosing their identity.