(Mental) Health Care and Interpreting

In mental health, the interpreter ensures interlinguistic transfer, but can also exercise cultural agency. A few rare studies suggest that the interpreter also participates in the therapeutic alliance (TA) via relational agency within the triad (Boss-Prieto 2013; Elghezouani et al. 2007, Goguikian Ratcliff et al. 2019). We have explored this hypothesis through the thematic analysis of 19 semi-structured interviews and the discursive analysis of a case study using the conceptual tools of Brown and Levinson's politeness theory (1978) revisited by Kerbrat-Orecchioni (1992) and taking into consideration discourse markers (Dostie et al. 2007). Our results corroborate those of the scientific literature: the interpreter actively co-creates a supportive relationship in each of the three dyads that influence one another. In doing so, it may be that the interpreter co-constructs a triadic TA that promotes the patient's self-expression and underpins therapeutic work. Should these results be confirmed by further studies, the position of relational agent could eventually crystallise within the role of the mental health interpreter.

Abstract
The objective of this study is to contribute to a better understanding of the negotiation of meaning between the participants of a bilingual interpreter-mediated interaction by analysing the effects of the verbalization of the inferences by the interpreter. The conceptual tools of Relevance Theory were applied to three interpreted excerpts of Russian-French psychotherapeutic interactions. The results suggest that by verbalizing inferences, the interpreter co-creates a shared cognitive environment, reinforces intra- and inter-discursive coherence, diminishes the cognitive efforts of the recipient, and encourages primary parties to cooperate. The analysis of the cognitive processes at work in the excerpts tends to show that what has so far been treated as the interpreter’s “additions” or “expanded renditions” enables the latter to exercise cooperative coordination of interaction, and could therefore be more precisely called “collaborative renditions”.

Keywords: dialogue interpreting; Relevance Theory; cognitive processing; verbalization of inferences; collaborative renditions; cooperative coordination of the interaction

An interaction between a mental health professional and a person with a mental illness is in many ways different from an interaction between a general healthcare professional and a person with a physical condition. In a mental health interaction, elicitation and demonstration of symptoms, monitored testing, initial diagnosis, therapy, recovery and/or management of symptoms all occur via interactions where the ability to openly communicate, to build rapport and to gain the trust and confidence are critical. Where the mental health professional and the person with a mental illness do not have a common language, the work of the interpreter in building this relationship is critical. The mental health interpreter's renditions therefore play a key role in the work of the mental health professional, as s/he is reliant on these to work effectively with the patient.

The guidelines in this document provide the following: definitions of key terms, protocols, a discussion of ethical considerations, self-care in mental interpreting, content knowledge, and patients’ rights and legal terms. Information on medico-legal tribunals and legislation is also provided. These guidelines are intended to assist interpreters so that they can work optimally in mental health interactions with both mental health professional and patient.

Cette étude de cas examine le recours de l’interprète de dialogue à deux types d’énoncés à la troisième personne : les énoncés descriptifs (Locuteur : Je viendrai demain => Interprète : Elle viendra demain) et les énoncés avec l’inquit (Elle dit je viendrai demain), au cours d’une interaction à contenu fortement argumentatif. Située dans le cadre d’une analyse de discours intégrant la dimension rhétorico-argumentative, l’étude vise à identifier les facteurs d’ordre discursif et/ou rhétorico-argumentatifs susceptibles de déclencher le recours spontané de l’interprète à la troisième personne.

Abstract: Language barriers can have negative consequences for non-English speaking patients’ health and, what’s more, lead to an increase in costs for public health. One of the solutions would be to use professional interpreters. However, asking for the intervention of these professionals is not common practice yet and the reason often given is the lack of financial resources. Does the use of a professional interpreter positively impact the delivery of health care? What are the costs of such
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use? In order to shed light on this topic, we proceeded with a meta-analysis of 35 scientific studies conducted in the United States that address these issues. The main result is that the improvement in the medical management of the non-English speaking patient is noticeable and that the costs are minimal compared to the obtained benefits.
Keywords: Interpreting in medical settings; Costs and advantages of medical interpreting; Meta-analysis.

L’objet de cette thèse doctorale est de contribuer à éclairer le rôle de l’interprète en santé mentale. Notre objectif est de déterminer si l’interprétation en santé mentale comporte des spécificités non prises en compte dans le mandat professionnel de l’interprète. Pour le rencontrer, nous confronterons rôle normatif et actions discursives authentiques exercées par l’interprète, observées dans une perspective socio-discursive, interactionnelle, inductive, descriptive et qualitative.

BACKGROUND: The literature concerning interpretation in research primarily concentrates on rigorous techniques to eliminate bias. This article analyses other significant issues that arise when interpreters participate in research. MATERIAL: Empirical examples are drawn from a research project concerning mental ill health in a multicultural neighbourhood. DISCUSSION: Interpreters influence interview data in ways commonly unnoticed by researchers. One often-overlooked factor is that languages are dynamic and interpreters are not instruments. CONCLUSION: Research conducted with an interpreter is a complex undertaking. Solely relying on checklists to improve methodological rigour can result in a false sense of the material's validity.

This paper aims at clearly identifying and explaining the role conflict that interpreters in mental health settings often express. This is done through an analysis of the scientific literature addressing the issue of the interpreter’s role in these setting, and the conceptualization in all of its nuances of the very wide range of professional positions he/she
can adopt. It ends on an indication of the research areas that we believe are top-priorities to inform practice. This detailed state of the art is first adn foremost designed to stimulate reflection and encourage the interprofessional dialogue between therapists and interpreters.

Quels sont les principaux avantages, écueils et questionnements suscités par un suivi psychothérapeutique bilingue interprété ? Nous apporterons quelques éléments de réponse en nous appuyant sur la littérature scientifique portant sur l'interprétation en santé mentale, sur l'observation non participante (Soulé 2007) d'interactions interprétées en santé mentale, sur l'analyse thématique d'interviews semi-structurées (Paillé et Mucchielli 2013) menées avec des thérapeutes, des interprètes et des patients, ainsi que sur l'analyse de l'action collective (Méthode d'Analyse en Groupe-MAG, Van Campenhoudt et coll. 2005) effectuée lors de 5 rencontres interprofessionnelles thérapeutes-interprètes.
Depuis la perspective de la collaboration interprofessionnelle thérapeute-interprète, nous réfléchirons aux principaux enjeux communicatifs et relationnels de la thérapie interprétée, ainsi qu’aux éléments sous-jacents qui donnent corps à « l’entre-trois » thérapeute-patient-interprète. Nous passerons en revue les conditions sine qua non qui permettent la construction d’un tandem collaboratif thérapeute-interprète. Du point de vue communicatif, travailler en tandem permet de co-gérer de manière efficace l’échange, notamment au niveau des tours de parole, ainsi que les défis inhérents au transfert interlinguistique et interculturel. Nous verrons quels outils les deux professionnels peuvent partager afin de rehausser l’efficacité de cette co-gestion. Du point de vue relationnel, la confiance du patient, tout particulièrement en l’interprète, semble être la porte d’entrée de la thérapie interprétée. Nous mettrons en évidence les éléments essentiels qui construisent la confiance dans les trois dyades, à savoir entre le patient et l’interprète, entre le thérapeute et l’interprète, et entre le patient et le thérapeute. Nous discuterons le tissage relationnel dyadique et triadique en lien avec la construction de l’alliance thérapeutique et à la lumière de la juste posture déontologique adoptée par l’interprète. Nous aborderons enfin les probables implications symboliques, interpersonnelles, linguistiques et psychiques de la présence d’un interprète dans la thérapie.

Cette cartographie des principaux enjeux d'un suivi psychothérapeutique bilingue interprété offrira, nous l’espérons, des pistes de réflexion et d'action pour trouver des modalités d'accordage entre le thérapeute et l’interprète afin de co-construire un espace de parole sécurisant et soutenant au service du mieux-être du patient, en tenant compte de la singularité de chaque rencontre thérapeutique.

This paper aims at clearly identifying and explaining the role conflict that interpreters in mental health settings often express. This is done through an analysis of the scientific literature addressing the issue of the interpreter’s role in these setting, and the conceptualization in all of its nuances of the very wide range of professional positions he/she can adopt. It ends on an indication of the research areas that we believe are top-priorities to inform practice. This detailed state of the art is first adn foremost designed to stimulate reflection and encourage the interprofessional dialogue between therapists and interpreters.

BACKGROUND: The literature concerning interpretation in research primarily concentrates on rigorous techniques to eliminate bias. This article analyses other significant issues that arise when interpreters participate in research. MATERIAL: Empirical examples are drawn from ...

The objective of this study is to contribute to a better understanding of the negotiation of meaning between the participants of a bilingual interpreter-mediated interaction by analysing the effects of the verbalization of the inferences by the interpreter. The conceptual tools of Relevance Theory were applied to three interpreted excerpts of Russian-French psychotherapeutic interactions. The results suggest that by verbalizing inferences, the interpreter co-creates a shared cognitive environment, reinforces intra- and inter-discursive coherence, diminishes the cognitive efforts of the recipient, and encourages primary parties to cooperate. The analysis of the cognitive processes at work in the excerpts tends to show that what has so far been treated as the interpreter’s “additions” or “expanded renditions” enables the latter to exercise cooperative coordination of interaction, and could therefore be more precisely called “collaborative renditions”. Keywords: dialogue interpreting; ...

OpenEdition Books : https://books.openedition.org/pusl/26557

Abstract
This study aims to deepen the understanding of the negotiating of meaning between participants in an interpreted bilingual interaction, i. e. between two primary speakers (PSs) and the interpreter, by focusing on the effects of the verbalization of the interpreter's mental representations (inferences) as to the speaker's communicative intentions. We apply the conceptual tools of Sperber and Wilson's (1986) Theory of Relevance to two case studies, combined with those of Grosz and Sidner's (1986) Theory of Discourse Structure, as a methodological innovation. We show that the verbalization of the interpreter’s inferences not only contributes to creating a mutually evident cognitive environment between PSs (local effects), but also strengthens the intradiscursive coherence of the original discourse, which underpins the speaker's communicative purpose, as well as the interdiscursive coherence between PSs (global effects). These effects undoubtedly facilitate their mutual understanding.
Keywords: dialogue interpreting, verbalization of inferences, mutual cognitive environment, global discursive coherence, Theory of Relevance, Theory of discourse structure.

Résumé
Cette étude vise à approfondir la compréhension du processus de négociation du sens entre les participants d’une interaction bilingue interprétée, à savoir entre deux intervenants primaires (IP) et l’interprète, en se focalisant sur les effets de la verbalisation des représentations mentales (inférences) de l’interprète quant au vouloir-dire du locuteur. Nous appliquerons à deux études de cas les outils conceptuels de la Théorie de la Pertinence de Sperber et Wilson (1986) associés à ceux de la Théorie de la structure du discours de Grosz et Sidner (1986), ce qui constitue une innovation méthodologique. Nous montrerons que la verbalisation des inférences de l’interprète non seulement contribue à créer un environnement cognitif mutuellement manifeste entre les IP (effets au niveau local), mais encore renforce la cohérence intradiscursive du discours originel, ce qui étaye le but communicatif du locuteur, ainsi que la cohérence interdiscursive entre les IP (effets au niveau global). Ces effets facilitent sans aucun doute la compréhension entre les interlocuteurs.
Mots-clefs : interprétation de dialogue, verbalisation d’inférences, environnement cognitif mutuel, cohérence discursive globale, Théorie de la Pertinence, Théorie de la structure du discours