Working Effectively with an Interpreter Nikki Lopresti Director of Operations All Access Interpreters, LLC March 22, 2012

Video: Communicating Effectively Through an Interpreter An instructional video for health care providers Created by The Cross Cultural Health Care Program

Interpreters can do the following to ensure clear communication: No opinions, no advice Cultural insights Transparent communication Less intrusive Pre-session Unobtrusive position Use of the 1st person Accurate interpretation, not a literal interpretation

Providers can do the following when working with an untrained interpreter: Maintain control Do a pre-session Seat the interpreter unobtrusively Speak to the patient, not the interpreter Assume and insist that everything be interpreted Remember lack of equivalence Speak in shorter sentences Ask one question at a time Avoid slang and difficult terminology Check for understanding Stay positive

Purpose of the Interpreter To facilitate understanding in communication between people who are speaking different languages.

Roles that are inappropriate for an Interpreter: Interpreters are not social workers Interpreters are not the patient’s emotional support system Interpreters are not the patient’s best friend Interpreters cannot guarantee that the patient will be happy with the interview Nor can they guarantee that the provider will be happy

The interpreter merely acts as a bridge between people who speak different languages.

Training for Medical Interpreters Bridging the Gap Developed by The Cross Cultural Health Care Program A 40-hour training program for interpreters and bilingual employees who work in a medical setting.

BTG is a nationally recognized training program that covers: Basic interpreting skills and managing the flow of the session. Information on the U.S. health care system, anatomy and basic medical procedures. Culture Communication skills and appropriate advocacy Professional conduct and self care.

Training for Mental Health Interpreters 12-week certificate program Mental health delivery systems and the professionals who work in the field Mental health diagnoses and interventions Dynamics of therapy Roles & Ethics of interpreters

National Council on Interpreting in Health Care (NCIHC) The NCIHC is a multidisciplinary organization whose mission is to promote and enhance language access in health care in the United States. Developed a National Code of Ethics and Standards of Practice www.ncihc.org

Code of Ethics for Medical Interpreters by the NCIHC 1. Confidentiality 2. Accuracy 3. Impartiality 4. Maintain professional boundary 5. Cultural awareness 6. Be respectful 7. Advocacy 8. Professional development 9. Act in professional and ethical manner

Who is NOT an appropriate choice for an Interpreter? Friends of any LEP patient Family member of LEP patient Minor Children Anyone who has not demonstrated proficiency in both languages Anyone who has not received training in interpretation Anyone who does not have an understanding of ethics and interpreting practices

Reasons for encouraging Providers not to Use Friends, Family or Minor Children as Interpreters: May cause a breach of confidentiality LEP patient may be reluctant to reveal important information Upsets familial relationships and hierarchies that are deeply rooted in culture It is better to use someone who not only is a trained professional, but who is also able to be objective and who is removed from the situation.  

More Reasons for encouraging Providers not to Use Friends, Family or Minor Children as Interpreters: Some family members may omit possible risks in a medical procedure in not wanting to scare the patient Family members may answer questions for the patient without asking the patient first

Title VI of the Office of Civil Rights of 1964 Can not discriminate on the basis of race, color or national origin, if you are receiving federal funds Can not require that an LEP patient bring a friend or family member to interpret Can not ask that an LEP patient pay for an interpreter

Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards) Issued by the U.S. Department of Health and Human Services’ Office of Minority Health. The aim of the standards is to contribute to the elimination of racial and ethnic health disparities and to improve the health of all Americans.

14 CLAS Standards Organized by themes: Culturally Competent Care, Language Access Services and Organizational Supports for Cultural Competence For example: Standard #4 states: Health Care Organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient / consumer with limited English proficiency at all points of contact, in a timely manner during all operations www.ThinkCulturalHealth.hhs.gov

Types of Interpreting On-Site Over-the-phone Video

Demo of Video Interpreting Interpreters at your fingertips.

Tools for Providers http://www.lep.gov/resources/ISpeakCards2004.pdf “Language Identification Flashcard: http://www.lep.gov/resources/ISpeakCards2004.pdf www.LEP.gov/resources/resources.html Cross Cultural Health Care Program www.xculture.org

Contact Information: Nikki Lopresti Director of Operations All Access Interpreters, LLC 3225 S. Brentwood Blvd., Suite 209E St. Louis, MO 63119 nlopresti@aai-vri.com 314-259-1010 888-508-8538 www.aai-vri.com