The language barrier is one of the biggest obstacles to effective cross-cultural research, testing, and counseling. Translation methods are specialized procedures designed to make possible the communication between people who speak or read different languages. Four translation methods have been identified. The first two are oral methods: (1) simultaneous oral translation, also known as interpretation, and (2) language switching. The other two are written methods: (3) written translation, and (4) back translation. These methods are implemented in three main contexts in the field of counseling. First, translation methods are utilized to communicate with clients in the context of a clinical counseling relationship. To communicate verbally with non-English-speaking clients during intakes, assessment interviews, and early interventions, the most efficient method is the use of trained interpreters who use a simultaneous translation method also known as interpretation. For treatments, a common method utilized in an ongoing clinical situation is the oral translation method known as language switching. Second, translation methods are utilized to turn research and testing material originally conceived in one language into another language. The most researched translation method for research and testing is the method known as back translation. Third, translation methods are utilized in counseling agencies and other institutions to translate written materials from one language into another. The consensus is that institutional forms, such as informed consent, HIPAA (Health Insurance Portability and Accountability Act), and other written materials, need to be translated by a professional translator.
Historical Background of Translation Methods
Translation methods grew out of the intercultural and cross-cultural communication needs that expanded toward the second half of the 20th century in the United States. The services of professional translators and interpreters became common in a variety of settings, including business, industry, health care, law, and education. In the clinical counseling field, translation and interpreting was incorporated as immigration from Asia, Latin America, and Eastern European countries increased the number of clients requesting help at counseling agencies. Increases in demand for non-English-speaking counseling in the United States, coupled with a shortage of non-English-speaking counselors, have forced organizations to become responsible for offering interpreters and translators as part of their intake, assessment interviewing, and short-term intervention services. The high expense of hiring professional interpreters has led to the need to incorporate the utilization of paraprofessional foreign language interpreters. The increased need of translators continues to pose challenges. Few counseling organizations hire certified interpreters, and many erroneously utilize the services of bilingual staff not trained in translation methods or mental health, or the relatives of the clients requesting services. The American Counseling Association’s ethical guidelines of 2005 include the new recommendation of providing interpreters or translators for non-English-speaking clients.
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The initial attention paid to the role of language and translation in long-term clinical counseling comes from the psychodynamic tradition. In the 1970s, authors argued that accessing certain material is more difficult for people who have had an early encoding in a different language and that bilingual clients have different experiences of self according to which language they use. Recent contributions to the psychodynamic literature posit that bilinguals may have two different language codes and that each language system may be related to different experiences of the self. Treatment proposals include analyzing the dual experience of language by utilizing a translation method called language switching.
The method of back translation used in research and testing has its origins in the fields of health and nursing, which, in turn, influenced the field of psychiatry. Most assessment and research instruments were developed originally in English. Researchers and practitioners in other parts of the world who wish to use certain instruments use the back translation method. In 1990, the National Institutes of Health in the United States enacted a policy requiring the inclusion of minorities in study populations, which prompted translation of research instruments. Though there continue to be challenges in the attempts to standardize back translation principles for tests, questionnaires, and assessment instruments, translation of instruments from one language to another for cross-cultural use has become a widespread activity.
Interpretation of Translation Methods
Bilingual capabilities are not sufficient for providing interpreting services. The ability to speak a second language is sometimes confused with the ability to interpret. However, when language match cannot be ensured, the services of an interpreter are required. Simultaneous translation, also known as interpretation, is a professional activity. In the counseling field, both professional and paraprofessional interpreters are used in a variety of clinical situations, including psychiatric, substance abuse, forensic, and other assessments and in short-term interventions. According to scant literature on the subject, working with foreign language interpreters is an acceptable, beneficial, and common use of bilingual paraprofessionals who can be trained to deliver appropriate, ethical services provided that each party in this three-way communication process can agree on some basic procedures. When counselors are trained to work with an interpreter, they learn how to ask one question at a time, speak in short sentences, and wait for the interpreter to finish sentences. When interpreters are trained in the field of counseling, they learn to be the transparent mediator between the client and the counselor. The interpreter’s role needs to be inconspicuous and provide a direct and simultaneous translation of counselor’s and client’s words, without analyzing, summarizing, or explaining but rather directly and literally translating utterances. The interpreter, thus, needs to be able to translate what has been heard, without correcting, improving, or changing the client’s words. It is recommended that the interpreter use first person when translating, as if he or she were speaking for him- or herself, instead of in third person.
Counselors need to develop alliances with interpreters and learn to communicate effectively with an interpreter in the room. For example, clients and counselors can be encouraged to speak directly to each other, engaging in direct eye contact with each other. For optimal effectiveness in the use of interpreters, time should be allowed for pre-session orientation between the counselor, the interpreter, and the client to clarify the roles in the process, to orient the client, and to answer any questions the clients may have regarding confidentiality or any other aspect of the process of engaging in a session with the presence of an interpreter.
With non-mental health paraprofessionals used as interpreters or with professional interpreters who do not have the clinical mental health background, prior meetings between the counselor and the interpreter are needed to discuss areas of possible difficulty, identify specialized vocabulary that might be needed during the session, and voice ethical concerns.
With few exceptions, long-term counseling relationships between non-English-speaking clients and English-only-speaking counselors is difficult, if not impossible, to sustain. It is possible, however, for the monolingual counselor to work with bilingual clients provided that they have the capabilities to engage in an intimate conversation in English. It is in these treatment situations that the method of language switching has been proposed as a form of oral translation. Clients who have had encoding in more than one language often have different ways of accessing affective reactions depending on which language they are using. Researchers recommend assessing the language acquisition history and current usage to find out what experiences are associated when each language is encoded and how the languages are currently used. Language switching is a method whereby a client can be encouraged to say something in English first and then switch to say the same thing in the language in which the experience was encoded, even if the counselor cannot understand it. The counselor can then ask about affect, memory, or other differences that are elicited by the use of two languages. Bilingual clients’ language switching can serve to disclose traumatic or emotionally charged content that may not be accessi-ble otherwise. Also, language switching offers the opportunity to explore clients’ different sense of self in both languages and the different cognitive and affective components of each.
Written translation is a professional occupation that requires native written fluency in the target language and the ability to render a cultural adaptation of the original text into a new version that is coherent, well written, and culturally accurate. Bilingual capabilities are not sufficient credentials for providing written translation services, and oral proficiency in one language does not guarantee written proficiency. Professional translators are writers who can effectively render the message of the original text with accurate style and terminology. Bilingual individuals may speak two languages fluently but may not necessarily know how to move information between the two in writing. When counseling organizations do not use professional translators for their written material, translation mistakes can ensue that may be costly, embarrassing, and disrespectful.
Back translation is used when researchers use testing instruments with populations in non-English-speaking countries or with linguistic or cultural groups that differ from the population used to develop the instruments. Back translation methods are also used to translate instruments into American Sign Language. The goal of the back translation method is to ensure that the original and the translated versions of the instrument are semantically and culturally equivalent. The translation of concepts across cultures poses challenges to the researcher interested in adapting instruments for use in languages other than the original. There is evidence that suggests that an inadequate translation and cultural adaptation of an instrument can result in one that is less reliable or valid than the original version. The most widely used translation model in research consists of a series of repeated forward translation and back translation exercises conducted by a team of bilingual translators blind to the previous translations. This process continues until the back translation is considered to reflect congruence of meaning between the original version and the translated one. A challenge to the researcher is to ensure that the assessment tools are equivalent across groups, that the questions capture the same constructs, and that the instruments are culturally equivalent in both languages. Care needs to be taken to ensure that a systematic method of translation renders content and conceptual equivalency, in addition to semantic equivalency. To achieve cross-cultural adaptation more fully, researchers may also rely on committees of expert panels, field testing, and pilot studies, in addition to back translation.
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