Crossing the Language Barrier: It’s More Than Just Words

When your patient is a non-English-speaking adult, it may seem expedient to ask for translation help from younger members of the patient's family who have a better command of the language.

However, psychiatrist Vikram Kashyap, MD, of The University of Texas Medical Branch at Galveston strongly recommends physicians not use a child to interpret for his or her parents. "It's an unhealthy power shift to put the child in charge of what information reaches his parents from his doctor," says Dr. Kashyap. The potential hazards of a parent-child role reversal are especially problematic for traditional Asian and Hispanic families, where the parents hold great authority, he said.

Dr. Kashyap offers these suggestions for working with translators:

  • Be aware that translations may lead to omissions, additions, or substitutions during the assessment.
  • Use translators who share the racial and ethnic background of the client. Don't blindly assume that all Hispanic cultures are interchangeable. For example, the experiences of a third-generation Puerto Rican are profoundly different from those of a first-generation immigrant from Mexico.
  • Allow the translators, the patient, and his or her family time to "warm up," to compare experiences and backgrounds. It is disadvantageous to start the interview too abruptly.

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