vicarious trauma & professional interpreters · spoken language interpreters working in various...
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VICARIOUS TRAUMA& PROFESSIONAL INTERPRETERSBy Ludmila Golovine
Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
Parameters of 2001 AIIC study:
The results of this extensive study placed interpretation in the category of high-stress professions.
Consequences: Burnout, Vicarious Trauma. Stress can pose an impediment to our performance.
Source: AIIC Workload Study Executive Summary (2001)
Psychological Physiological
Physical Performance
INTERPRETING IS A HIGH STRESS PROFESSION
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Multiple studies* of job-related stress for sign language and spoken language interpreters working in various settings:• Refugee and asylum seeker services
• Mental health & therapy
• Community/public services
• Trauma & violent crime survivors care
• Healthcare & clinical settings
• Legal investigations & courtroom proceedings
*Multiple resources (please see References and Resources)
UNIQUE TRIGGERS OFVICARIOUS TRAUMA IN INTERPRETERS
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Commonly identified causes of vicarious trauma and job-related stress in language professionals:
UNIQUE TRIGGERS OFVICARIOUS TRAUMA IN INTERPRETERS
Linguistic & paralinguistic
aspects
Cultural, moral & ethical
mediation
Confidentiality vs. need to
debrief
Isolation & lack of supervision
Utilitarian view of interpreter
role
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The phenomenon generally associated with the “cost of caring”.
Also referred to as:
• Compassion fatigue• Secondary traumatic stress• Secondary victimization
§State of tension and preoccupation with trauma experiences/stories§VT affects professionals through changes in their beliefs about themselves, their world, their faith, and their psychological functioning
Sources: “Vicarious Trauma. Fact Sheet #9” by the American Counseling Association (2011) and “Effects of Client Trauma on Interpreters” by Mailee Lor (2012)
VICARIOUS TRAUMA
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• Impacts interpreter performance
• Increases turnover
• Affects customer experience & customer satisfaction
• Impacts the bottom line and retention
Human factor:
• Relationships
• Morale
WHY IS THIS IMPORTANT?
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The Stages of Burnout have been identified as:
BURNOUT
Sources:Understandingtheburnoutexperience:recentresearchanditsimplicationsforpsychiatry.WorldPsychiatryJournal.2016Burn-Out- StagesofDisillusionmentintheHelpingProfessions.HumanSciencesPress.
Apathy1.Frustration1.Stagnation1.Enthusiasm
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• Biological, psychological, and social exhaustion and dysfunction
• Feeling like “I have nothing left to give”
A cumulative combined effect of Burnout and Vicarious Trauma:
COMPASSION FATIGUE
Burnout+
Vicarious Trauma
Compassion Fatigue
Sources:CompassionFatigueamongHealthcare,EmergencyandCommunityServiceWorkers:ASystematicReview.InternationalJournalofEnvironmentalResearch&PublicHealth,2016.Stamm,B,PhD.TheConciseManualfortheProfessionalQualityofLifeScale.2010.
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HOW DO WE PROCESS INFORMATION?We filter information differently using:
• Deletion• Distortion• Generalization
Based on:• Meta programs
(unconscious filters)• Values• Beliefs• Attitudes• Memories• Past decisions
Diversity Wheel – Adapted from: Gardenswartz, Lee, and Anita Rowe. Diverse Teams at Work: Capitalizing on the Power of Diversity. Chicago: Irwin Professional Pub., 1994. Print.
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“Interpreting is more than just transposing one language to another … it is throwing a semantic bridge between two people from different cultures and thought worlds.”Source: “Reflections on the training of simultaneous interpreters: A metalinguistic approach” by Claude Namy (1977)
HOW DO INTERPRETERS PROCESS INFORMATION?
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"Interpreters seem to experience vicarious trauma differently than other professionals providing aid since they do more than witness the trauma; they channel it*.”
Vicarious trauma leaves an emotional residue of exposure to clients’ distress, their pain, fear, emotional turmoil
Countertransference and shared trauma: unconscious redirection of the client's feelings upon oneself
*Source: “Vicarious Trauma and the Professional Interpreter” in Psychology Today (August 2, 2013)
HOW DO INTERPRETERS PROCESS INFORMATION?
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Interpreters are often left with the burden, and power, of choosing whether their translation should (or shouldn’t) convey the covert concepts or euphemisms directly. In many settings interpreters are forced to navigate imbalances of power and control.
There is nothing more we can do for you; we’re going to make you as comfortable as possible
Source: “Consumers and Service Effectiveness: A Practice Profession Perspective” (2005) by Robyn K. Dean & Robert Q. Pollard, Jr.
BEHAVIORAL DECISIONS
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INTERPRETER IMPARTIALITY IMIA Guide on Medical Interpreter Ethical Conduct:
Impartiality: "To remain impartial, interpreters should not share personal opinions or allow personal beliefs and relationships to affect communication. Impartiality, or professional distance, does not imply lack of concern for patients and assignments but speaks to the integrity of the profession and the process."
Benefits of Impartiality for Interpreter
• Impartiality makes us better interpreters
• It helps us avoid burnout
• It promotes longevity & well-being
Benefits of Impartiality for LEP, Provider
• Message is delivered more accurately
• Interpreter is part of an interdisciplinary team promoting effective communication
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Interpreters are human: Remaining professional & impartial may leave us feeling guilty.
This guilt may have cultural causes or implications.
These feelings of guilt or powerlessness add to job-related stress and must be mitigated.
PROFESSIONALISM AND STRESS:
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A study revealed that 30% of interpreters’emotional difficulties were linked to dealing with service providers:
• Lack of understanding of interpreter role
• Lack of respect for the profession
• Viewed as “machines”, “conduits” or “common consumables”
• Feeling dehumanized
Source: “Interpreters’ Experiences of Transferential Dynamics, Vicarious Traumatisation, and Their Need for Support and Supervision: A Systematic Literature Review” (2016) by Emma Darroch & Raymond Dempsey
INTERPRETERS AS “TOOLS”
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Studies about interpreters revealed:
SHORT-TERM AND LONG-TERM EFFECTS
56% emotionally impacted by their work
67% couldn’t stop thinking about their clients’ troubles – 56% up to half an hour after sessions and 23% from several hours up to days after sessions
33% stated that work had an impact on their personal lives
28% reported difficulties in taking other assignments; described feeling weary, distracted and in emotional turmoil
Source:“Interpreters’ Experiences of Transferential Dynamics, Vicarious Traumatisation, and Their Need for Support and Supervision: A Systematic Literature Review” (2016) by Emma Darroch & Raymond Dempsey
Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
“I also have a lot of cases that [when] I go home, I feel pretty sad about...You know, the voice needs to be heard. ...But sometimes I also kind of take it a little bit personally. I mean it’s hard to program yourself like a rock, a stone face in a courtroom and not worry about [it]."
Source:"WhoseTraumaIsIt?VicariousTraumaanditsImpactonCourtInterpreters"Sonali Rana,Purvi Shah,Kajori Chaudhuri.Proteus:NewsletterofNAJIT.Winter2009-2010VolumeXVIII,No.4
CASE STUDIES
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"I can walk away from it, but I can't to some extent [be]cause I've got that knowledge.”
"if something bad happens...I think I internalize it a little bit too much, I've not yet developed that strategy that I can just cut off from it."
Source:SignedLanguageInterpreting:Preparation,Practice,andPerformance.ed.LorraineLeeson,Svenja Wurm,MyriamVermeerbergen.Routledge,2014.
CASE STUDIES
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“It’s not that I am feeling sorry for them and empathize with them, it’s that I am becoming them.” (1)
“I have to become that person, so everything what she or he says to me, I have to say it, and you know, we’re only humans, you can’t sort of completely switch yourself off or detach from emotions and when people sometimes say things like ‘oh my life is not worth living’, ‘I don’t want to live no more’, …saying things like that, I find it quite difficult because it doesn’t agree with me…”(2)
Sources:(1)“TheRoutledgeHandbookonInterpreting”editedByHollyMikkelson &ReneeJourdenais (2015).(2)“Community interpreters speaking for themselves: The psychological impact of working in mental health settings” by Clare Louise Shakespeare (2012).
CASE STUDIES
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1. Raise awareness2. Develop wellness programs3. Set up mentor programs
Provide practical tools to prevent and mitigate stress:• Pre-session• In-session• Post-session
HOW CAN WE SUPPORT LANGUAGE PROFESSIONALS?
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BEFORE | DURING | AFTERthe session?
What do we do
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Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
Be prepared• Know where you are going
• Pen/paper for note taking
• Clear up any questions/instructions
• Dress code
Be on time (or early)“5 Minutes Early Is On Time; On Time Is Late; Late Is Unacceptable”
Eliminate distractions• Silence and put away your phone
BEFORE:MINIMIZE TASK RELATED STRESS
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Develop a ritual • (ex, hand washing)
Mental grounding • (ex, “I am not my emotions”)
Remind yourself to only focus on the task at hand.
BEFORE:GET IN THE ZONE
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Essential tool to:
• Clarify roles
• Understand the context
• Define purpose
• Discuss strategy with the provider
• Set the tone for the session
BEFORE:PRE-SESSION BRIEFING
*Source:Dohertyetal(2010).Howdoesitfeelforyou?Theemotionalimpactandspecificchallengesofmentalhealthinterpreting.MentalHealthReviewJournal,15(3),31-44.
ofinterpretersreportnotbeingbriefedpriortosessionsasparticularlydifficult*
78%
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Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
BEFORE | DURING | AFTER5 Steps for interpreters by interpreters
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Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
Sometimes we find ourselves feeling overwhelmed or overcome by feelings. This can affect how we perform. Ignoring our emotions will not help us mitigate their impact. To begin to diffuse a negative emotion, the first step is to take a moment to recognize what we are feeling and give it a name.
“Simply recognizing and naming an emotion quells its effect, making thoughtful management of subsequent behavior more likely.”(“When Labeling an Emotion Quiets it” – Tom Valeo, 2013)
DURING - STEP 1:RECOGNIZE AND NAME THE EMOTION
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Second, inconspicuously shift your focus from the epicenter of stress using one of these techniques:
• Taking notes • Rub your hands• Focus on moving the big toe• Move your feet
DURING - STEP 2:CHANGE FOCUS
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Third, we can take a step back to assess the encounter or scenario that caused us to feel this emotion. By seeing a bigger picture that involves not only our own reaction or perception of reality but that of others involved and even the perspective of a neutral or objective observer, we gain clarity.
DURING - STEP 2:DISTANCE YOURSELF FROM THE EMOTION
Own RealityYou are fully associated into
the problem or situation
2nd PositionYou are now one step
removed from the situation
3rd PositionYou are now two step
removed from the situation
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Think of re-setting and hitting “refresh” on your thoughts.
Move forward deliberately and thoughtfully while leaving the emotion and associated stress behind.
RESET
Discreet and Invisible Tools
• Take deep breaths
• Stand straight
• Look up
• Mental grounding: “I am not my emotions”
• Reset and refocus: come back to neutral
DURING - STEP 4:
Where are you?Research shows that:• 46.9% of the time our mind
is somewhere else• Focus only on the task at
hand• Be in the here and now
("A Wandering Mind is an Unhappy Mind." Matthew Killingsworth and Daniel Gilbert, Harvard University, 2011)
STEP 5:BE PRESENT
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Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
the session?
What do we do
BEFORE | DURING | AFTER
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Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
Tap into potential sources of support in your professional network.
Avoid professional isolation!
Debrief Partners:Are not there to make you feel better, they LISTEN.
A Debrief Partner does not:• Say “I understand...”• Claim to relate• Offer advice
Just listen…
AFTER:HAVE A DEBRIEF PARTNER
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WHAT ABOUT HIPAA, Confidentiality and Ethics?
Understanding the law, the tenet of Confidentiality and the information that we must protect allows us to effectively and ethically unload our emotional burdens(sharing our experience without disclosing individually identifiable health information protected by HIPAA, etc.)
AFTER:HAVE A DEBRIEF PARTNER
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• Allow the language professional to time to heal and reset
• Be open to hearing that a language professional needs to accept a different type of assignment
• Keep an open mind and an open heart
This will lead to better outcomes (reduce turnover, improved quality of interpreting and customer service)
CREATE A COLLABORATIVE ENVIRONMENT
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Cognitive• Write things down
• Review previous successes
HEALTHY COPING STRATEGIES
Behavioral• Do activities that you enjoy
Physical• Aerobic exercise
• Routine sleep patterns
• Eat well-balanced meals & drink water
• Take mini-breaks
Emotional• Name the emotion
• Give yourself permission to ask for help
Spiritual• Mediation and/or prayer
• Find spiritual support
Interpersonal• Talk with a debrief partner
• Take time to enjoy the company of trusted friend
Source: (Compassion Fatigue Educator (CFE) Certification. Figley Institute, 2012)
Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
• http://proqol.org/uploads/ProQOL_5_English.pdf Professional Quality of Life Scale (free resource)
• https://www.naadac.org/assets/2416/sharon_foley_ac15_militarycultureho2.pdfSecondary Traumatic Stress Scale (free resource)
• https://www.wpspublish.com/store/p/3011/tabs-trauma-and-attachment-belief-scaleTrauma and Attachment Belief Scale (available for purchase through WPS Publishing*)
* MasterWord is not associated with WPS Publishing and does not promote or endorse WPS’ products or services.
WAYS TO ASSESS
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“Excellent self-care and excellent service are inextricably linked.
Take care of yourself, so you can take care of business.”
~Julie Alexander,Core Health Partners, PLL
Information contained in these slides is confidential and proprietary to MasterWord Services, Inc.
Ludmila “Mila” [email protected]
www.masterword.comwww.masterword.com/wellness-connection
CONTACT INFORMATION
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QUESTIONS& ANSWERS
• American Counseling Association (2011). Vicarious Trauma. Fact Sheet #9. Available at: https://www.counseling.org/docs/trauma-disaster/fact-sheet-9---vicarious-trauma.pdf?sfvrsn=2
• Baillot, H., Cowan, S. & Munro, V.E. (2013). Second-hand emotion? Exploring the contagion and impact of trauma and distress in the asylum law context. Journal of Law and Society, 40(4), 509-540. doi: 10.1111/j.1467-6478.2013.00639.x
• Darroch, E., Dempsey, R. (2016). “Interpreters’ Experiences of Transferential Dynamics, Vicarious Traumatisation, and Their Need for Support and Supervision: A Systematic Literature Review”, The European Journal of Counselling Psychology, 2016, Vol. 4(2), 166–190. Available at: https://ejcop.psychopen.eu/article/view/76/html
• de Bruin, E. & Brugmans, P. (2006). The psychotherapist and the sign language interpreter. Journal of Deaf Studies and Deaf Education, 11(3), 360-368. doi:10.1093/deafed/enj034. Available at: https://academic.oup.com/jdsde/article/11/3/360/2530033
• Dean, R. K. & Pollard, R. Q., Jr. (2001). Application of demand-control theory to sign language interpreting: Implications for stress and interpreter training. Journal of Deaf Studies and Deaf Education, 6, 1-14. doi:10.1093/deafed/6.1.1. Available at: http://paperity.org/p/39680780/application-of-demand-control-theory-to-sign-language-interpreting-implications-for
• Dean, R. K. & Pollard, R. Q., Jr. (2005). Consumers and Service Effectiveness in Interpreting Work: A Practice Profession Perspective. 10.1093/acprof/9780195176940.003.0011. Available at: https://www.researchgate.net/publication/232581309_Consumers_and_Service_Effectiveness_in_Interpreting_Work_A_Practice_Profession_Perspective
• Doherty, S. M., MacIntyre, A. M. & Wyne, T. (2010). How does it feel for you? The emotional impact and specific challenges of mental health interpreting. Mental Health Review Journal, 15(3), 31-44. doi:10.5042/mhrj.2010.0657. Abstract available at: http://www.emeraldinsight.com/doi/pdfplus/10.5042/mhrj.2010.0657
• Dysart-Gale, D. (2005). Communication models, professionalization, and the work of medical interpreters. Health Communication, 17(1), 91-103. doi:10.1207/s15327027hc1701_6. Abstract available at: http://www.tandfonline.com/doi/pdf/10.1207/s15327027hc1701_6?needAccess=true
• Gardenswartz, L. & Rowe, A. (1994). Diverse Teams at Work: Capitalizing on the Power of Diversity. Chicago: Irwin Professional Pub.
• Gomez, A. (2012). Vicarious trauma and posttraumatic growth: A study of how interpreters working in psychotherapy are impacted by their work (Doctoral dissertation, Dublin Business School, Dublin, Ireland). Retrieved from http://esource.dbs.ie/bitstream/handle/10788/480/ma_gomez_a_2012.pdf
• Green, H., Sperlinger, D. & Carswell, K. (2012). Too close to home? Experiences of Kurdish refugee interpreters working in UK mental health services. Journal of Mental Health, 21(3), 227-235. doi:10.3109/09638237.2011.651659. Abstract available at: http://www.tandfonline.com/doi/abs/10.3109/09638237.2011.651659?journalCode=ijmh20
• Harvey, M. A. (2003). Shielding yourself from the perils of empathy: The case of sign language interpreters. Journal of Deaf Studies and Deaf Education, 8(2), 207-213. oi:10.1093/deafed/eng004. Abstract available at: https://www.jstor.org/stable/42658653?seq=1#page_scan_tab_contents
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• Hsieh, E. & Kramer, E. (2012). “Medical Interpreters as Tools: Dangers and Challenges in the Utilitarian Approach to Interpreters’ Roles and Functions”. Patient Educ Couns. 2012 Oct; 89(1): 158–162. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462307/
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REFERENCES AND RESOURCES