Straub, Edward G

English

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JADARA 
Volume 10 Number 2 Article 7 
October 2019 
Interpreting for the Deaf in a Psychiatric Setting 
Edward G. Straub 
Educational Therapist, Mental Health Services for the Deaf, Resthaven Psychiatric Hospital, Los Angeles 
California 
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Recommended Citation 
Straub, E. G. (2019). Interpreting for the Deaf in a Psychiatric Setting. JADARA, 10(2). Retrieved from 
https://repository.wcsu.edu/jadara/vol10/iss2/7 
INTERPRETING FOR THE DEAF
IN A PSYCHIATRIC SETTING
Edward G. Straub, M.A.
Interpreting for the deaf using sign language is a relatively new field which
is growing rapidly because of an increase in awareness of the needs of the deaf.
Within a relatively short time large numbers of people have gained signing
skills enabling them to serve as interpreters and more and more social agencies
are calling on them to help them work with their deaf clients in more efficient
ways. Interpreters can be found working at universities, trade schools, junior
colleges, social service agencies and hospitals. Professional groups such as the
Registry of Interpreters for the Deaf and local groups are setting standards for
professionality for interpreters to insure that the deaf people receive the
maximum degree of service. As newer programs develop, however, the
standards the interpreters must follow are beginning to change with each
situation and a look into the aspects of each type of program where interpreters
find themselves is essential.
The purpose of this paper is to describe some of the unique aspects of
working in the mental health setting. Little has been written about the inter
preter in this situation; and it is no surprise since there are only 12 programs
of this type in the country (as reported by St. Elizabeth's Hospital in
Washington, D.C.). As increase in awareness of the great need for psychological
and psychiatric services for deaf patients surfaces, the need for qualified
interpreters will skyrocket. The ideal psychological program would have the
clinical staff proficient enough in sign language to provide therapy without the
need for interpreting support, but we must face the problem realistically. The
need for psychological services is with us now and the people who are
Mr. Straub is an Educational Therapist, Mental Health Services for the Deaf, Resthaven Psychiatric
Hospital, Los Angles, California.
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INTERPRETING FOR THE DEAF IN A PSYCHIATRIC SETTING
qualified signers to staff such programs are rare. At Resthaven Psychiatric
Hospital's Mental Health Services for the Deaf in Los Angeles we have under
taken to train the psychiatrist, social worker, psychologists, and activity
therapists about the aspects of deafness germane to their work, but even after
two years of intensive training one can hardly be called a proficient signer,
language learning capabilities of the participants aside. Possibly, greatest
benefit could be achieved with deaf therapists but their numbers are small and
the programs to train them are practically non-existent.
With this in mind, let us set the ideal situations aside and focus on the
more immediate problems that interpreters will face when assisting the clinical
staff. It is impossible in a paper of this nature to describe avenues to use which
will solve the problems the interpreter will encounter but some suggestions will
be made to help in this regard. Some of the problems seen in the mental
health setting are:
a. Reversing skills.
b. Interpreter understanding of his ability.
c. Psychological reasons for breakdowns in communication.
d. "Extra-interview" interactions between patients and interpreters.
e. Varying sign language grammars among patients.
f. Confidentiality.
REVERSING SKILLS
It is no secret that the most difficult aspect of interpreting is the ability to
reverse the deaf person, that is, to comprehend the sign language of the
speaker. This problem is compounded if the patient is unfamiliar to the
interpreter. I believe that it is safe to say that this is the major holdup of train
ing the clinical staff. Although on a one-to-one basis, the staff with adequate
receptive skills can hammer out short conversations with a closed set of topics.
The real skill of reversing is needed in the often heated group and individual
psychotherapy sessions. One of the major avenues of treatment of psycho
logical or emotional problems is to have the patient talk about what it is that is
bothering him. From his utterances, the therapist can draw out inferred or
suppressed meanings and thus aid the patient to look more realistically at his
situation. Obviously, the interpreter must be a highly skilled reverser as faulty
interpretations can lead to prolonged therapy or no benefit at all. When the
therapist receives the wrong message from an interpreter, his response may
confuse the patient who may already be feeling misunderstood by his world in
general.
Another problem is that of different meanings associated with the same
sign. For instance compare "I felt hurt" with "I felt (physical) pain." If this is
the opening remark to the therapist in the session apd the discrimination
between the meanings is not made the therapist could formulate false
impressions about the nature of the patient's complaint.
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Excellent reversing skills can only be achieved by the interpreter's diligence
in continued training in his profession and much experience in various
situations. The problems of misunderstanding patients can be lessened if the
interpreter becomes involved in clinical discussions of the patients he serves
and gains insight into their individual psychological problems and physical
difficulties. A demonstration of the interpreter's skill would be his ability to
recognize potentially ambiguous utterances and to bring them to the
immediate attention of the therapist, letting the therapist decide which
meaning is to be attached to what the patient says.
INTERPRETER UNDERSTANDING OF HIS ABILITY
Interpreters must recognize where their strengths and weaknesses are. An
overzealous interpreter who is anxious to become involved in work requiring
more advanced skills is apt to be a hindrance to his program. Also, when
working with mentally ill persons a different kind of problem can surface. One
is likely to be faced with loose association, that is, bizarre utterances which
either have no connection with the topic being discussed or which do relate to
the topic but not appropriately. This type of patient might also not seem to
understand the interpreter. It is important that the interpreter know that he
is doing an adequate job and that the mix-up is part of the patient's sympto
matology and not a failure to express the therapist's words. These are often
disturbing situations for the interpreter who realizes the importance of good
communication skills. In-service training of the interpreters can assist them
in developing more confidence in their abilities and consequently make their
interactions more efficient.
PSYCHOLOGICAL REASONS FOR BREAKDOWNS
IN COMMUNICATION
Often the patient will be confronted by the therapist with thoughts which
he does not want to face. The patient may then demonstrate resistance to what
the therapist says and this resistance may be manifested by the patient saying
that he does not understand the interpreter. Often, the issue at question may
not be accepted for several sessions. Interpreters should be cautioned to avoid
rephrasing when the patient claims that he doesn't understand them. The
therapist may have uttered the phrase in such a way as to drive home a point
to evaluate the patient's degree of resistance. Should the interpreter in his zeal
to be helpful alter the utterance, he could provide an avenue for the patient
to avoid the issue.
Again, the patient who cannot adequately deal with the realities of the
world may utter very unusual statements which have no association with the
discussion at hand. The interpreter, because of the ambiguity of the language,
may struggle to connect some meaning to the utterances and disguise an
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INTERPRETING FOR THE DEAF IN A PSYCHIATRIC SETTING
important diagnostic aspect of the patient's problem. It is advised that the
interpreter, if he is able to discern any meaning from the utterance which
might be ambiguous, give the meaning to the therapist and then quickly add
something such as "Possible ambiguity" or "Meaning may unintensional."
Then let the therapist handle it from there.
IDENTIFICATION OF THE INTERPRETER AS THERAPIST
There seems to be a tendency for the patient to see the interpreter as the
therapist, which is not so unusual since the patient might be perceiving the
words of understanding and advice coming from the interpreter. This is
complicated by some deaf patients who are resistant to associating with
hearing people who do not sign. Added to this are friendly conversations
between interpreters and patients during socialization periods. Thus, often
the patients will come to the interpreter for advice or ask such questions as
"When will I be discharged?", "Can you give me a pass for the weekend?", or
"When can my mother come to visit me here?" Often the interpreter knows
the answers to these questions from meetings with the clinical staff and they
do not hesitate to answer the questions. This should be avoided. A clinical
policy should be developed for handling these situations. It is important that
the patient know where the decisions are coming from regarding his life or
his stay in the program. In order to make the patient aware of his therapist's
involvement with him, it is our policy to direct him to his therapist to answer
all clinical questions.
The problem of identifying the interpreter as the therapist might be
averted by rotating interpreters in the individual psychotherapy sessions. This
can, however, lead to difficulties in developing trust in the interpreters,
especially with out-patients who only come to the facility to see their therapist
about their problem but who do not interact with the other patients and staff
at the facility. We believe that a highly professional staff of interpreters can
give the patient the feeling that he can trust them after a few sessions with
various interpreters. It might be beneficial for the therapist to identify to the
patient the possibility of the problem arising so that the patient can be more
aware of it should it develop.
One problem which arises must be dealt with according to the interpreter's
own feelings. Often, when conversing with patients over lunch or during
recreational activities, the patient may reveal something about himself to the
interpreter which may or may not be connected to his therapy or his problem.
An example would be the patient telling the interpreter that he smokes
marijuana. The interpreter must decide whether this information which was
told him out of trust is an important consideration for the therapist. Such
things which are mentally harmful such as LSD or other hallucinogens must
be revealed to the therapist but in the case of something questionable, such as
marijuana, the interpreter assumes the burden of dealing with this
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INTERPRETING FOR THE DEAF IN A PSYCHIATRIC SETTING
information. Such controversial things have varying degrees of impact on dif
ferent people and the issue should be discussed with the clinical staff to
determine a policy.
VARYING SIGN LANGUAGE GRAMMARS
The case load of the mental health program may cut across a large age
range of the patients. This will result in a variety of sign language grammars
used by the patients. The interpreter in this setting should become proficient
in all of the major sign language forms, or he should be aware of which patients
he is best suited to deal with. The task of learning the various sign language
grammars is not monumentally difficult as the differences are often minimal
to the person with a good sign language foundation. It is important in this
issue that we put aside our feelings about which sign language grammar would
be the best one for the patient to know and work with him as he comes to us.
It is his language and we should respect his right to use the form he is most
comfortable with.
CONFIDENTIALITY
Because there are so few interpreters available who qualify for difficult
assignments, those who do often work in more than one location. Some of the
interpreters on our staff also work at the nearby universities and trade schools.
Often, students from the universities or trade schools feel the need for
psychological counseling but hesitate to continue in the program because they
recognize the interpreters on the staff. The issue of confidentiality is crucial
to the success of the programs in mental health, not to mention laws which
would send a person to jail for failure to maintain confidentiality. Although
one cannot prevent the patient from having anxiety about lack of confidenti
ality, a professional image set by the interpreters can lessen the patient's fears
and encourage him to remain in therapy. On the other hand, indiscretion on
the part of the interpreter can lead to a breakdown in rapport between the
community and the program which is trying to serve that community.
CONCLUDING DISCUSSION
Interpreting in the mental health setting is very taxing to the interpreter.
Unlike the classroom or court room interpreter (whose job is by no means
easy) the mental health interpreter must make more decisions about his
language use and his interpretation when reversing. Other types of inter
preting do not for the most part have to deal with loose associations, bizarre
temper tantrums, flying ashtrays thrown at the therapist sitting next to you,
patients making overt sexual advances or exposing themselves. While the pace
of the interpreting may be less rigorous than classroom settings, it calls for
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more problem solving about ambiguities (which in the classroom is the
problem of the instructor) and personal involvement with the people served.
Other problems which could not be covered in this paper are the therapist's
reliance on the interpreter, emotional involvement between patients and inter
preters, interpreters seeing themselves as therapists, extra-interpreting duties
and demands placed on interpreters and scheduling difficulties to cover a
large hearing staff.
At our facility, the interpreting staff has identified a two hour time slot
which they use for in-service and discussion. This time slot was chosen after
monitoring the scheduling of patients and finding the least active period.
During the meetings, various aspects of the patient population are discussed
such as which interpreter can best work with a certain patient, who uses which
sign language grammar and what are the variations to look for, what situations
interpreters should not be involved in, and other related items which facilitate
and expand their services.
One thing to keep in mind when entering into this very rewarding type of
work is that nothing is routine and new situations are constantly arising for
which there is no manual to turn to for assistance. Preparation seems to be the
key to successfully adapting to this setting. At the end of this paper are some
suggested readings which may be helpful to the interpreter as far as under
standing the linguistic and psychological aspects of the people he deals with
whether it be in mental health or in other interpreting situations. More work
shops on mental health interpreting at national interpreting conventions
would also be of some help.
It is the responsibility of the interpreters to constantly strive to upgrade
the calibre of their services. The population we serve has long been neglected
and the opportunity to change all that is here now. The interpreter is an
important part of the mechanism and he should do his best to keep the
avenues of change open and accessible.
SUGGESTED READING
1. Gaeng, Paul A., Introduction to the Principles of Language, Harper and
Row, New York, 1971.
2. Hilgard, Ernest R., and Atkinson, Richard C., Introduction to Psychology,
Harcourt, Brace and World, Inc., New York, 1967.
3. Jacobs, Roderick A., and Rosenbaum, Peter S., English Transforma
tional Grammar, Xerox College Publishing, Waltham, Mass., 1968.
4. Johnson, Doris J., and Myklebust, Helmer R., Learning Disabilities,
Grune and Stratton (Publ.), New York, 1971.
5. Levine, Edna Simon, The Psychology of Deafness, Columbia University
Press, New York, 1960.
6. Mortensen, David C., Communication, McGraw Hill, New York, 1972.
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INTERPRETING FOR THE DEAF IN A PSYCHIATRIC SETTING
7. O'Rourke, Terrence J., Psycholinguistics and Total Communication: The
State of the Art, Amer. Ann. Deaf (Publ.), 1972.
8. Straub, Edward G., "Total Communication vs Oral Communication
Training", Hear: Bulletin of the So. Calif. Hearing Council, 28:1, Spring
1975.
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Interpreting for the Deaf in a Psychiatric Setting

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Interpreting for the Deaf in a Psychiatric Setting

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