1 (617) 528-7410 ClientService@Linguist.com
Creating a Safe Space for Foreign Language Therapy

Creating a Safe Space for Foreign Language Therapy

How to Keep Interpreters from Stepping on the Therapy Process

Imagine a situation where, as a therapist, you’re working hard to build trust with a patient whose native language is not yours. And your language is not theirs.

You suspect they desperately need help. They may have experienced significant trauma, even physical or sexual abuse, in getting to their new country. Perhaps they’ve been here a while but finally worked up the courage to seek therapy, or they received the support to enable them to come forward.

Yet the process typically requires a patient to communicate in a second language, or for you to learn a new one. This is not ideal. Often our most traumatic memories are locked deep inside, accessed best — or only — by our native tongue.

” … interpreters can sometimes interfere with the counseling process [if they] do not understand psychotherapy or their role”


For these situations, foreign language interpreters can be a blessing. They are used often in trauma therapy situations where children, immigrants, or other non-natives are at a disadvantage by not knowing the therapist’s first language.

However, as Lisa Aronson Fontes detailed in her insightful article in Psychology Today (referenced below) which spurred our thoughts on this matter, interpreters can sometimes interfere with the counseling process. She cites several examples where interpreters who do not understand psychotherapy or their role inadvertently step on the process. For example:

  • An interpreter comforts a weeping client not to get upset;
  • An interpreter imposes their own value judgments on what is being relayed and advises the patient to modify what they are saying;
  • An interpreter “cleans up” the clients’ language — suppressing curse words, baby talk, incoherent phrases, or discussion of sexual matters;
  • An interpreter fails to convey certain statements – trying to “protect” the client or the client’s community from losing face;
  • An interpreter answers a client’s question without conveying the question to the clinician;
  • An interpreter fails to convey a clinician’s comment or question, believing it is inappropriate or overly intrusive.

So how do you safeguard against this “unintended” interference?

Linguistic Systems has developed a Code of Conduct that all interpreters must understand, acknowledge, and agree to before being placed in a job. The agreement stipulates, among other things, that the interpreters must:

  • Render a complete and accurate interpretation of the matter discussed, without altering, omitting, or adding anything, and without additional explanation or clarification, unless explicitly requested during the interpreting session;
  • Limit themselves to interpreting, without giving legal or other [medical or therapeutic] advice;
  • Faithfully preserve and convey the meaning of what is being said, including style, register, idiomatic expression, even tone of voice. Each spoken statement, including those that may appear obscene, rude, rambling, misleading, incoherent, or false, should be interpreted and rendered precisely and accurately as spoken in the source language;
  • Protect and uphold the confidentiality of all privileged information obtained during the assignment;
  • Ask permission from the parties to explain any potential interpreting problems that arise, and state the reason why such explanation is necessary;
  • Correct any potential errors in interpretation that may arise;
  • Conduct themselves in a professional and courteous manner.

No agreement can be a complete safeguard against interpreting issues that may arise. But by sharing written expectations with interpreters and by requiring their acknowledgement and agreement in advance, an agreement is a key training and compliance tool that helps interpreters to go into a job with the right mindset.

“Translating Trauma: Foreign Language Interpreting in Therapy” was published March 23, 2017 by Psychology Today. It was authored by Lisa Aronson Fontes, Ph.D., a Senior Lecturer at the University of Massachusetts Amherst, and author of numerous publications including the books: Invisible Chains: Overcoming Coercive Control in Your Intimate Relationship, Interviewing Clients Across Cultures, and Child Abuse & Culture: Working with Diverse Families.

EDITOR’S NOTE: Linguistic Systems has 7,500 translators and interpreters available to support you. All are carefully screened, tested, and certified, and they cover 120+ languages. 

Back Translations, Their Rationale and Value

Back Translations, Their Rationale and Value

Medical and Pharma Clients: Are You Using the Right Translation Tool?

For medical and pharmaceutical clients, back translations are necessary facts of life; they are absolute requirements for most clinical research documents that must be translated into other languages.

But for experienced professional translators and editors who work in this area, back translations seem a wrongheaded way to approach accuracy and faithfulness to the source document.

Why would governmental agencies require a back translation of all clinical trial documents as a matter of course? In a cogently argued article in ICT (International Clinical Trials, summer, 2008, pp.16 ff.), Simon Andriesen points out that,

  1. everyone involved needs to be informed about all aspects of the trial,
  2. the results of the research will need to be published,
  3. documents must be written in clear, unambiguous language,
  4. many trials are performed across national boundaries, and
  5. consequently, the research must be multilingual in design for accurate comparative cross-country evaluation.

To accomplish this, factors that need to be considered include evaluation of the source questions as well as the target translation.

For example, when a patient in India or China is asked to evaluate the level of discomfort (from 1-10) of a procedure and rates it a 2 (slight discomfort) because they are accustomed to living with a certain level of pain, is that really comparable to a 2 given by a patient in France or Germany, someone who is not accustomed to living with pain?

The people engaged in design of the research need to ensure that answers are comparable across national and linguistic boundaries. How can the source language and translations of a question help accomplish this?

Translators and linguistic editors are not concerned with evaluating research design nor for comparability of results across linguistic boundaries. They are concerned with linguistic accuracy, naturalness, and proper form, which are really very different from the concerns of a medical researcher or government agency.

“It is usually the case that the linguistic aspects of a clinical trial are given short shrift, and not enough time and effort are spent on how translations and back translations can aid the research process …”

And for translators, their arguments against back translations are perfectly valid: a good translation, along with good editing, is much to be preferred as valid linguistic procedures over back translation. This is especially true if both the translation and back translation are rushed to meet a tight deadline, and the people evaluating the back translation do not really know what they should be looking for.

For example, if a back translator uses the word “brave,” but the original English had “courageous,” the client should not be focused on this as an error in translation: it’s not, the meaning is exactly the same.

Another example would be judging it a mistranslation if a back translation uses “participates in” for “takes part in.” Minor variations like these do not indicate translation errors, they simply reveal the many correct, possible choices in a language.

Rather than criticizing a back translation for changed word order or slight, seeming differences in word choice from the source, which translators understand is the correct way to go about conversion from one language to another, Andriesen argues that people who evaluate forward and back translations should be looking at comprehensiveness (inclusion of all points in the source document) and comparability across languages.

True, this demands a great deal of time and trouble, but it is the true rationale behind requiring back translations. It is usually the case that the linguistic aspects of a clinical trial are given short shrift, and not enough time and effort are spent on how translations and back translations can aid the research process, provided they are performed correctly.

Andriesen concludes his excellent article with: “If back translations are merely done to be kept on file or to satisfy ISO auditors, the efforts and cost are a total waste. When taken seriously and done in a professional way, a back translation effectively can identify the shortcomings of a translation – although one may argue whether it is cost-effective. A final edit stage, with a detailed commentary or a double forward translation, will probably provide the same level of confidence.”

EDITOR’S NOTE: Linguistic Systems has decades of experience serving life sciences, biotech, pharmaceutical, and medical firms. Trust us with your next translation project.