​I 2022 tilbragte ph.d.-studerende Saskia Hanft-Robert fra University Medical Center Hamburg-Eppendorf i Tyskland nogle måneder på CTP. 

Her indsamlede hun kvalitative data blandt psykologer på CTP, og blev herved klogere på betydningen af tolke i den terapeutiske alliance. Dette er et vigtigt emne når vi ved, hvor vigtigt den terapeutiske alliance er for et vellykket psykoterapiforløb. 

Det arbejde er blevet til en artikel med konkrete anbefalinger, som netop er publiceret i Frontiers in Psychology. Titlen på artiklen er:A Balancing Act: How Interpreters Affect the Therapeutic Alliance in Psychotherapy with Trauma-Affected Refugees. A Qualitative Study with Therapists.  

Artiklen open access, og kan læses på:

https://www.frontiersin.org/files/Articles/1175597/fpsyg-14-1175597-HTML-r2/image_m/fpsyg-14-1175597-t001.jpg​ 

I artiklen fremkommer Saskia Hanft-Robert med en række kliniske anbefalinger:

To Therapist

• Being aware that the interpreter is an active part of the alliance

• Creating a personal bond and agreement on tasks and goals of the therapy with patient and interpreter

• Attention to (distrust, ruptures and conflicts in) all three dyadic alliances

• Finding a balance between closeness and professional distance in the working alliance with the interpreter

• Use of qualified (professional) interpreters and recognition of interpreters' professionalism

• Briefing the interpreter about therapeutic interventions and goals to avoid contradictory behavior on part of the interpreter

• Explain interpreters' role and their obligation to adhere to professional ethical principles, such as confidentiality, impartiality and transparence

• Appropriate handling of conflicts during or after the session, depending on whether the conflict affects the patient and therapeutic process directly

• Focus on nonverbal behavior to strengthen the therapist-patient alliance, including body language (e.g., leaning a bit forward toward the patient), tone variation in the voice, having eye contact with the patient also when the interpreter is talking, active listening (saying “hmm," nodding), and reacting with facial expressions toward the patient when the interpreter speaks

• Arrange seating position so that the patient and therapist have eye contact

• Awareness of that interpersonal trauma can prolong and complicate alliance formation and use of interventions focusing on strengthen the TA

• Cultural-sensitive psychoeducation:

- Exploring patients' understanding of mental health disorders and psychotherapy/healing and creating a shared understanding (i.e., shared goals and tasks of the therapeutic process)

- Explaining the framework of psychotherapy

- Clarifying therapists' role to the patient in contrast to other authorities

To Interpreter

• Shifting patients' attention toward the therapist by eye movements or gentle hand gestures

• Continuous presence

• Sufficient language skills in both languages

• Adherence to professional ethical principles, such as confidentiality, impartiality, transparence, interpreting completely

• Emotional attunement by adapting the way of interpreting (e.g., tone of voice, volume, tempo, timing, body language)

• Finding balance in terms of personal and emotional involvement depending on the therapeutic process