IJSP Number 6, 2024

107 understanding the cultural norms of the client. In an early article on the topic, Markos [3] found that interpreter distortion can lead to misevaluation in a psychiatric setting with non-English speaking patients. He identified several sources of the distortion including lack of language competence and interpretation skills, lack of psychiatric knowledge, and attitudes of the interpreter toward the patient. The interpreters in this study were workers in the hospital in other roles who were asked to perform the task but reported feeling overwhelmed by the responsibility and uncomfortable with topics in a typical psychiatric evaluation including sex, finances, and suicidal and homicidal tendencies. Cornes [4] found that interpretation for deaf clients in mental health settings held some of the same potential pitfalls. Cornes [4] highlighted that although interpreters abide by a code of ethics, they are more likely to “step outside” of that role due to the demands of mental health settings including discomfort with the content of conversations, comments on the deaf person’s linguistic capabilities, and other reasons that have to do with the deaf community as a cultural minority group. Beyond the issue of familiarity with the customary practice in the mental health and interpretation communities by their respective professionals, and the added emotional intensity, is the issue of trauma that is encountered in mental health settings. Knodel [5] found that when American Sign Language (ASL) interpreters were questioned about their experiences working in a mental health setting, 83% reported vicarious trauma as a result of the work, but 58% reported receiving no training on how to manage the emotional impact. Knodel concluded that a significant gap exists in training mental health interpreters to mitigate the effects of vicarious trauma. Geiling et. al. [6] found that interpretation for refugee groups exposed interpreters to stress and trauma and challenged their well-being. The idea of having good communication between the professionals involved, both mental health and interpretation (as in any project where collaboration is needed) seems self-evident. Bischoff [7] found that when medical practitioners were trained to work with interpreters, the confidence in the effectiveness of the clinician increased as rated by the patient. Also, there was increased use of interpreters by mental health clinicians. Costa and Briggs [8] did a related study and concluded that training for therapists in managing the triangular relationship between therapist, interpreter, and patient could positively impact patient satisfaction. Regarding training for interpreters, Berdeus-Domingo [9] advocated for understanding cultural context as well as languages and interpretation techniques. She also concluded that using non-professional interpreters is not recommended due to the tendency to act as information filters, especially when the non-professionals are family members of the patient. In addition, to the professional relationship issues raised when psychotherapists and interpreters work together, Hamerdinger and Karlin [2] also addressed the topic of interpreting in groups, which has direct relevance for this paper. They raised two important considerations: The fact that the interpreter is