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The misunderstood Spanish-speaking patient

F Kline, F X Acosta, W Austin

    The American Journal of Psychiatry
    |December 1, 1980
    PubMed
    Summary
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    Therapist perceptions of patient understanding and engagement differed significantly when an interpreter was used. Patients felt understood, but therapists perceived less understanding and desire to return, highlighting a communication gap.

    Area of Science:

    • Psychiatry
    • Clinical Psychology
    • Cross-cultural Communication

    Background:

    • Effective communication is crucial in therapy, especially across language barriers.
    • The use of interpreters in mental health settings can impact patient and therapist perceptions.
    • Understanding these differing perceptions is key to improving therapeutic alliances.

    Purpose of the Study:

    • To examine and compare the perceptions of Spanish-speaking patients and their therapists regarding communication effectiveness during initial therapy interviews.
    • To investigate differences in perceived understanding, helpfulness, and treatment continuation intentions when an interpreter is used versus when patients are bilingual.

    Main Methods:

    • Survey questionnaires were administered to 21 patients who used an interpreter, 40 bilingual patients, and 16 psychiatric residents conducting the interviews.

    Related Experiment Videos

  • Evaluations focused on therapy effectiveness, communication quality, and patient engagement.
  • Statistical analysis was used to identify significant differences in perceptions between patient and therapist groups.

    • Main Results:

    • Patients interviewed with an interpreter reported feeling understood, helped, and expressed a desire to return for future sessions.
    • Therapists, however, perceived patients seen with an interpreter as feeling less understood, less helped, and less inclined to continue therapy.
    • Significant discrepancies were found between patient and therapist evaluations of the therapeutic encounter when interpreters were involved.

    Conclusions:

    • A notable divergence exists in how patients and therapists perceive the therapeutic process when an interpreter is utilized.
    • The findings underscore the need for increased numbers of bilingual and bicultural therapists.
    • Therapist training should emphasize the value of their work with patients requiring interpreters and address potential misperceptions.