Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Alcoholism as a Diagnostic Concern

There is an old parlor game in which a person whispers a story into the ear of the person next to them who, in turn, whispers that story to the next and so on. At the end, the final person states what they have heard, and we are always amazed at how it differs from the original.

I share your concerns regarding the use of interpreters, and this is a growing problem:

The nonEnglish-speaking patients are dependent upon someone to assist with communication to and from them:

The patient has no way of determining if what they are saying/feeling is being accurately communicated.

We have no way of knowing if this is precisely what the patient means.

We have no way of knowing if what we are telling the patient is being accurately communicated back to them

We must be certain that the interpreter is objective and is not slanting communication to meet the needs of whoever recommended them for this translation job. This becomes of particular concern when the same interpreter is repeatedly assigned to the same patient. While this may meet the dependency needs of the patient, over time, some interpreters assume an authoritative role, believing they know what the patient wishes to communicate without asking.

Additionally, they are not medical personnel, and there is every likelihood that they also do not understand what is being said by the clinician, and further distort the information.

It is for this reason that I refuse to do a psychological evaluation with an interpreter previously known to the patient. I want to know what the patient’s perception of their problem is, and I do not want their feelings filtered through someone else’s perceptions, especially someone with a stake in a specific outcome.

The other, very real reason for having a new interpreter present is that many patients do not wish to share intimate details of their life in the presence of someone whom they will be seeing again. It diminishes their spontaneity and ultimately, honesty.

And finally, having an interpreter who is in tune with my office procedures, ensures more efficient and objective assistance in this difficult world of cross-cultural barriers.

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