ERIC ED477918: Synergy, 2003. Australian Transcultural Mental Health Network.

43 Pages·2002·0.84 MB·English

by  ERIC

DOCUMENT RESUME
ED 477 918
CG 031 946
Synergy, 2003. Australian Transcultural Mental Health
TITLE
Network.
INSTITUTION
Australian Transcultural Mental Health Network, Parramatta.
PUB DATE
2002-00-00
NOTE
42p.
AVAILABLE FROM
Australian Transcultural Mental Health Network, Locked Bag
7118, Parramatta BC, New South Wales 2150, Australia.
PUB TYPE
Collected Works
General (020)
EDRS PRICE
EDRS Price MF01/PCO2 Plus Postage.
DESCRIPTORS
Acculturation; Community Health Services; *Cultural
Pluralism; Foreign Countries; *Health Promotion; Immigrants;
*Mental Health; *Public Health; Refugees; Second Languages;
Social Support Groups; Well Being
IDENTIFIERS
Australia
ABSTRACT
Each issue in the 2002 edition of the Australian
Transcultural Mental Health Network (ATMHN) newsletter represents a theme
critical to mental health practitioners. The Winter 2002 issue features
articles on the psychological consequences of interpreters in relation to
working with torture and trauma clients, addressing language issues on mental
health, and specialist advocacy services for people from culturally and
linguistically diverse backgrounds. The Autumn 2002 issue focuses on
promoting well-being in multicultural communities and presents an article on
the "New Arrival Refugee Women, Health and Wellbeing Project," The issues
contain reports on current ATMHN-funded projects, book reviews, and lists of
additional mental health resources. (Contains 25 references.)
(GCP)
Reproductions supplied by EDRS are the best that can be made
from the original document.
J
Synergy
2003
Australian Transcultural Mental Health
Network Newsletter
U.S. DEPARTMENT OF EDUCATION
Office of Educational Research and Improvement
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received from the person or organization
originating it.
Minor changes have been made to
improve reproduction quality.
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TO THE EDUCATIONAL RESOURCES
document do not necessarily represent
INFORMATION CENTER (ERIC)
official OERI position or policy.
1
-zr
0)
0
ESTCOPYAVAILABLE
.0
ranscultural Mental Health Network
Australian
O
WORKING WITH
Winter 2002
INTERPRETERS
Inside This Issue:
-31"&
Diversity in Health 2003
3
psychosocial
Diversity in Health 2003
Innovation... Creativity... Harmony
consequences for
INNOVATION- CREATIVITY- HARMONY...
interpreters working
Following the outstanding success of the first Diversity in Health Conference,
with torture and
Sharing Global Perspectives, held in Sydney in 2001 readers will be excited to
trauma clients
learn that Diversity in Health 2003: Innovation... Creativity... Harmony will be
held on October 27-29, 2003 at the Sydney Convention and Exhibition Centre.
9
addressing language
issues in mental
Diversity in Health 2003 will concentrate on new and innovative approaches to health
It will
health in
and well-being and will showcase creative solutions to health service delivery.
focus on the cultural, spiritial and emotional aspects of health, stressing the importance of
Queensland
a whole of life approach to physical health and psychological well-being in a harmonious
community.
10
national noticeboard
Almost one thousand people attended "Diversity in Health" over three days in 2001.
International keynote addresses by speakers from Malaysia, the USA and New Zealand
12
complemented presentations by invited guests from the UK, South Africa, India, Malawi
development of
and Zimbabwe and eminent experts from around
guidelines for
Australia. Symposia, a hypothetical on men's
translated MH
health, moderated by ABC Science commentator,
information in WA
Robyn Williams, lunchtime "Meet the Expert"
informal discussions, the "Great Diversity Debate"
and a film festival highlighting multiculturalism as
13
it is portrayed in Australian television and cinema,
specialist advocacy
made Diversity in Health an overwhelming
services for people
success with delegates. One participant asked
from CALDB with a
"How can you top this? What next one wonders?"
disability
Once again eminent international and Australian
18
speakers will join delegates in a meeting designed
Synergy index
to facilitate learning, networking and exchange of
1999-2002
experience and information, as well the chance to
catch up with colleagues and make new contacts.
efroi
19
Mark the date today, join the Diversity 2003
events calendar
mailing list, and be part of the most innovative
Scenes from
and exciting multicultural health and well-being
Diversity in
conference in Australia
Health 2001
Diversity in Health 2003
Innovation... Creativity... Harmony
Registration Brochure - mid 2003
Call for papers - early 2003
See page 7 for more information
Q
Inside This Issue
SYNERGY is the newsletter of
the Australian Transcultural
Mental Health Network
Features
(ATMHN).
The Australian Transcultural
The psychosocial consequences experienced by interpreters in
Mental Health Network
relation to working with torture and trauma clients: a West
Locked Bag 7118
Australian perspective
3
Parramatta BC
NSW 2150
Australia
Telephone: [phone]
Facsimile:
News and Views
02 9840 3388
Email: [email protected]
Website:
Addressing language issues in mental health in Queensland ...9
www.atmhn.unimelb.edu.au
Correspondence with the Editor
...voices with no feelings
... a
discussion of the role of
Tel: [phone] or email:
interpreters in psychotherapy
8
[email protected]
Disclaimer
Development of guidelines for translated mental health
Contributions to this newsletter do
information in WA
12
not necessarily reflect the views of
the ATMHN.
Specialist advocacy services for people from CALDB with a
Editorial Board
disability
13
Media & Communications Officer
(editor)
Web news
14
ATMHN
Sam Febbo
WA Transcultural Mental
Health
Centre
-
Project Manager
Commonwealth Dept. of Health
and Ageing
National Noticeboard
10
Meg Griffiths
ATMHN National Coordinator
Events Calendar
19
Abd Malak
NSIV Transcultural Mental
Transcultural contacts
20
Health Centre
Nicholas Procter
University of South Australia
-
The ATMHN is an initiative
supported by the National Mental
Health Strategy and funded by the
Commonwealth Department of
Health and Ageing.
Future Issues
national
mental
Anyone interested in contributing to future issues of Synergy please
contact The Editor at:
y
atrnhn @wsahs.nsw.gov.au
or
etg
si 'Ina
phone [phone]
www.atmhn.unimelb.edu.au
-
-
j
NI
NI
A A
-
A
The difference between interpreters and other professionals is not
only the level of training that is provided to the workers, but also
the difficulties imposed on the Interpreter due to the nature of the
As Australia continues to
In addition to language skills, awareness and ability to deal
work.
become an increasingly
with difficult material and 'maintain appropriate boundaries' are
multicultural society, the
also important professional requirements of an interpreter (Tribe,
services of trained language
1999). However, little has been done to examine the stress engen-
interpreters will also increase in
dered by a work environment that exposes mental health interpret-
demand. Against the
ers to detailed descriptions of torture and trauma that may neces-
background of continuing
sarily emerge as part of the therapeutic process (Figley, 2001,
personal communication). As language interpreters, the job requires
refugee migration, bringing an
recounting these incidences in a different language, without ad-
influx of people who have
Their anxiety is
equate time for emotionally processing the details.
experienced torture and trauma
further compounded by their concern for accurately representing
prior to arriving here, who are
the client in terms of 'semantic and emotional content' (Tribe,
more likely to subsequently
1999).
present with mental health
problems. Therefore, the need
Negative emotional aspects of interpreters' work are often not, if
In her study,
at all, addressed appropriately within the workforce.
for interpreters specifically
Tribe (1999) found that the feeling of being overwhelmed by the
trained for the mental health
material they must translate in the context of an interpreting
setting (ie. 'mental health-
session, or that fear of becoming overwhelmed by the content of a
trained interpreters'), will
session, are significant issues confronted by interpreters.
continue to increase. This WA
study presents the case that
The mental health system within Australia therefore has a 'duty of
interpreters working in a mental
This 'duty of care' is necessary to
care' towards the interpreters.
ensure that interpreters are given adequate support and supervision
health context are not
in order that their own mental health does not deteriorate; and, in
necessarily trained to implement
the interest of the client, to maintain the quality of the interpreting
strategies to deal with highly
work. However, the lack of research into the effects of vicarious
sensitive material that may
traumatization on bicultural interpreters has resulted in a relative
potentially be psychologically
lack of knowledge about the psychosocial consequences experi-
detrimental to them.
enced by interpreters resulting from vicarious traumatization. As a
result, the following literature review is based on literature avail-
able regarding various other professions that have been instructed
through training and supervision to encourage professional bound-
Bicultural interpreters practicing in
aries and recognition of self.
Western Australia do not receive training in this area.
In the early 1980s attention to the effects of traumatic information
Continued Overleaf
Synergy Winter 2002
3
5
and events on professional helpers became a focus for
trauma, but occurs due to the long term effects of
It has been recognized in
investigation (Fig ley, 1995).
exposure to the distress of others, and the necessity to
the literature that the demands on professional helpers
empathize with the clients' therapeutic content.
of empathic listening when working with clients
Pearlman and McCann (1990) and Fig ley (1995)
whom have experienced torture and/or trauma,
suggest that any professional working directly with
requires sufficient absorption of the information to
clients suffering from torture and/or trauma over
a
allow for a greater understanding of the clients
period of time, are at risk of developing some kind of
experience. This level of empathic listening and
psychological trauma in relation to the constant
absorption of information have been found to con-
barrage of distressing information to which they are
front the psyche of the professional and become
exposed.
a
source of change to the worldview of that person.
Little information is available surrounding the issue of
Pearlman and Saakvitne (1995) assert that time spent
interpreters confronting situations that could lead to
with family was seen to be very helpful in coping with
traumatic stress in their daily work. The majority of
personal and professional self-care. Other workers
the literature has focused on tertiary trained profes-
were reported to have described disruption to family
sionals (Hudnall-Stamm, 1995; Fig ley, 1995; Clark &
life as they became isolated, distant or angry within
Gioro, 1998; Alexander, 1990; Black & Weinreich,
the home environment as a result of empathic listen-
2000; McGorry, 1995; McCann & Pearlmann, 1990).
ing and engagement with traumatized clients.
These cohorts of professionals are provided training
throughout their education and professional practice,
Another area that may be interrupted in the everyday
through supervision, boundary setting, debriefing and
life of the traumatized professional is that of personal
peer support. This type of support provides the
safety and connection to the known. Various authors
professional with objective support in working
have indicated that areas of personal safety have often
through the issues of distressing information.
been reported by traumatized professionals as being
Interpreters, on the other hand, are often only trained
effected to the exposure to traumatic descriptions
to pass on information that is given to them, and
over time (Black & Weinreich, 2000; Clark & Gioro,
generally only provided training in mental health
1998; McCann & Pearlman, 1990).
terminology, and other basic skills, with little or no
training in boundary setting, and little or no supervi-
Interpreters in Western Australia are governed by a
This situation may leave interpreters open to
sion.
set of professional ethics that requires total confidenti-
traumatisation either via revisiting their personal past
ality.
Roberts-Smith, Frey & Bessell- Browne (1990,
experiences or through the transmission of informa-
clearly define the role of interpreters as '... being
p.24)
tion that is familiar to others they have known,
or
They further
complete once the interview is over.'
their inability to integrate the information appropri-
confirm that it is inappropriate for interpreters to
ately.
receive debriefing after an interview, and that the
interpreter and client should leave the office at the
The double bind that interpreters may experience, is
same time.
This issue raises serious questions about
the necessity to not only listen empathetically to
the needs of professional interpreters and how they
information that may be distressing, but they are also
are addressed.
required to repeat it, often finding it necessary to
locate language that will appropriately transmit the
Throughout the literature it is clear that peer support,
clients meaning. (Tribe, 1999).
This assertion appears
supervision and debriefing are major tools in the
to be based on the expansion of the Diagnostic
reduction of traumatization on professionals working
Statistical Manual, 4th Edition (American Psychiatric
with torture and trauma clients (Tribe, 1999; Black &
Association, 1994), where it is recognized that direct
Weinreich, 2000; Fig ley, 1995; Pearlman & Saakvitne,
exposure to torture or trauma is not a necessary factor
1995; McCann & Pearlmann, 1990; Clark & Gioro,
of traumatization, but that fear for another is suffi-
1998). The literature clearly identifies that through
cient to cause post-traumatic stress disorder.
the use of these strategies, professionals can reduce the
Vicarious traumatization is a response to ongoing
likelihood of not only traumatization, but also the
exposure to traumatic information (Pearlmann &
extreme effects of burnout, where professionals can
Saakvitne, 1995, p. 280).
This type of traumatization
no longer work within their professional environ-
does not necessarily require somebody to have
ment.
directly experienced the exposure to violence
or
Synergy Winter 2002
4
Psychosocial consequences for interpreters
Within the literature there is some debate as to the
Guidelines on working with
efficacy of debriefing workers who have experienced
interpreters
traumatization through exposure to crisis situations.
Kenardy et al (1996, p.37) argue that through their
The Victorian Transcultural Psychiatry Unit has
research into the effects of exposure to traumatic
produced a manual on how to work effectively with
events in Newcastle, Australia, of 195 helpers, 'there
interpreters in a clinical mental health setting.
was no evidence of an improved rate of recovery' after
However, this is
coun-
workers received debriefing.
It outlines possible structures for establishing and
tered in many other readings (Dyregrov, Kristofferson
operating an interpreter service and provides
& Gjestad, 1996; Alexander, 1990) where the delivery
information on factors which need to be considered
of debriefing after a traumatic even has provided
when working with interpreters. Section include
significantly perceived assistance to workers.
assessing the need for an interpreter, crisis
situations, booking an interpreter, steps to take
This pilot project informs the development of debrief-
before, during and after the interview and
unsatisfactory practices.
ing intervention workshops, which will provide
support and supervision to mental health interpreters
The Guidelines can be accessed on the VTPU
who are affected by stress, related to exposure to
website, www.vtpu.org.au Just click on to
torture and trauma details divulged by their clients.
"Programs"
and then on "Service Development"
This study aimed to gain a greater insight into the
,
and scroll down. The document can be
difficulties that interpreters face when working with
downloaded in
its entirety.
traumatic information, with particular emphasis on
those working with torture and trauma clients.
For any queries or more informtion contact Malina
The objectives of this study were therefore to deter-
Stankovska on [phone].
mine the psychological coping mechanisms utilized by
language interpreters to cope with work-related
stressors (e.g., graphic details they must interpret
torture and traumatic experiences) particu-
relating to
larly working with refugees. We further aimed to
Queensland Transcultural Mental
gather data surrounding the psychosocial effects of
interpreting for torture and trauma survivors within
Health Centre (QTMHC)
the refugee population. A better understanding of
Glossary of Mental Health Terms
these psychosocial issues impacting on language
interpreters when working with refugee clientele
would inform the development of appropriate debrief-
The Old Transcultural Mental Health Centre
ing/supervision intervention that would be required
(QTMHC) has developed the Glossary of Mental
to minimize the adverse impact of working with
Health Terms for use by interpreters and
torture and trauma survivors.
translators working in mental health settings as
well as for bilingual mental health workers.
The
METHODOLOGY
glossary contains key terms used in mental
health care and an explanation of those terms in
This research, cross sectional and retrospective in
various community languages.
nature, utilised the ethnographic interview style as
This style of research was
devised by Spradley (1979).
Glossary of Mental Health Terms I
also considered the most likely method to provide the
Chinese, Italian, Spanish &
English
`in-depth' information necessary to ascertain the needs
Vietnamese
of interpreters in relation to debriefing requirements
given the varying cultural practices, religions, and
Glossary of Mental Health Terms II
beliefs that must be considered.
Arabic, Bosnian, Croatian, Farsi,
English
Samoan, Serbian & Tagalog.
The primary form of data gathering was conducted
through in-depth interviews with 15 (mixed gender)
To order a copy of the above publications,
language interpreter informants during February,
please contact the QTMHC on [phone] or
by email penny d'[email protected]
Continued overleaf
I I
5
7
vided a copy of the transcript of their interview to
.111'
-II
ensure that information has not been lost, confused,
or altered in any way.
All interviews were taped and subsequently
2001.
transcribed to further gain an understanding of each
Given the sensitivity of the information accessed,
informant's personal experience with distressing
informants were invited to utilize debriefing with a
information they encounter when interpreting for
senior Clinical Psychologist, provided by the Steering
refugees who relate details of torture and trauma.
Committee, on an 'as required' basis.
Question items were developed by a Steering Com-
mittee with expertise in psychiatric concepts and
RESULTS
extensive knowledge of interpreter and refugee issues
within transcultural mental health.
Questions were
Consistent with the qualitative nature of this study,
constructed to be generally worded to facilitate
and the subjectivity of the data collected, the results
informants to steer the interview.
Interview topics
have been written in a 'verbatim' narrative manner,
were not restricted to set protocols as informants were
where appropriate.
given the opportunity to initiate topics they felt to be
Hence grand and mini tour questions were
relevant.
Issues surrounding empowerment, information
posed (Spradley, 1979). In addition to those items that
gathering, employment, perceived outcome of work-
specifically elicited issues relating to working with
ing within the profession,
emotional response pertain-
survivors of torture and trauma, questions were also
ing to their role of interpreters and the psychosocial
posed about the extent to which work related stres-
impact that the task of hearing and interpreting
sors, originating from exposure to torture and trauma
torture and trauma details has on their functioning
details, impacted on their personal relationships and/
were derived as themes or commonalties which
or family dynamics. The end result of this strategy
emerged from the transcribed interview data.
highlighted the informants' own understandings of the
situations they have experienced
The interview responses revealed that, at the outset of
their careers, interpreters have an altruistic perception
Question items were then piloted on interpreters to
about their work. This revolves around an expecta-
ascertain their appropriateness and pertinence to the
tion that the work would 'empower' them to not only
area of investigation. NUD.IST Ethnographic Soft-
assist their own settlement process in a new country
ware (QSR, 1995) was utilized to enable recognition of
but also would 'help others' particularly fellow ex-
patterns, themes and comparisons within the data.
patriots who have left the same country of birth to
settle here in Australia. A consistent pattern emerges
Interpreters over the age of 18 years, working with
for each interpreter interviewed where the profession
refugee survivors of torture and trauma, were ac-
they have entered sets them on course on a continuum
cessed by utilizing a snowballing selection method.
beginning with high aspirations through to a realiza-
All interpreters who participated are contracted by
tion that the sense of fulfillment they had hoped
the Translators and Interpreting Service of the Com-
cannot be achieved in their professional role.
monwealth Department of Immigration and Multicul-
tural Affairs and have also undergone a course in
Assisting 'own people'
mental health interpreting.
Indeed, for many of the interpreters interviewed, the
perception of 'helping others' from their own country
Ethics approval for this research was obtained
of origin was the primary reason for becoming
through the University of Western Australia. All
professional interpreters.
Several interpreters felt they
informants were provided full information on the
were able to provide some assistance by providing a
purpose of the study, and signed a written consent
`voice' for their 'own people' and by doing so, would
form prior to commencing the interview.
Further-
fulfil their own need to actively 'help' fellow migrants.
more they were notified of their right to withdraw
The term 'rig people' was a common phrase used by
from the study at any time. All
informants were
informants and suggested a sense of responsibility and
asked to provide a pseudonym at the time of signing
duty towards those coming from their homelands.
the written consent form. This pseudonym has been
utilized throughout the study, both during the taped
Information gathering
interviews and at the point of transcription to ensure
At a more practical level, respondents considered their
confidentiality of that informant. All tapes used in the
work as an avenue for accessing a wealth of informa-
interview process were erased as soon as they were
tion that would otherwise not be available for them.
transcribed to hard copy. All informants were pro-
The information inadvertently gathered through their
Synergy Winter 2002
6
Psychosocial consequences for interpreters
details for which the interpreters must interpret
is one
It transpired that
of disempowerment and frustration.
interpreters generally become progressively aware that
work with many agencies was then utilized to assist
they actually have a limited capacity for completely
themselves and other members in their ethnic commu-
assisting their fellow ex-patriots.
nity to further familiarize themselves with the cus-
In addition to the tendency to experience distress
toms of the host society.
about the content of the information, interpreters
may also become distressed by the perceived or actual
Empowerment
inappropriate behaviour(s) of the professional who
Other interpreter respondents perceived their profes-
conducted the session.
sion as providing them a sense of empowerment
through achieving professional status:
'over there
The reported sense of 'powerlessness' is also associated
[country of birth],
or
this profession is very much respected.' *
with the service provider's perception of their role
as a means of gaining a sense of belonging:
you are
and the perception that they are not regarded as
regaining your confidence.. . part of the healing process... letting
but merely as an
`professionals' in their own right,
go of fear'.
`adjunct' or an 'instrument' compounds the sense of
disillusion interpreters experience about their profes-
Employment
sion. The original ideal goal of using the interpreting
They all acknowledged the role of employment and
profession as a vehicle to 'help' fellow ex-patriots
income as a reason for occupational choice but for
becomes progressively an illusion. One respondent
many these appeared to be secondary to the other
described her feelings as follows: '[Other profession-
factors. Many of the interpreters who were inter-
clarifying that
als]
treat you as a second rate employee',
viewed had tertiary qualification or were professionals
she did not
but very
'feel like a second rate employee!'
in other areas in their country of birth but were not
much felt like she was treated that way.
able to continue in that profession due to qualifica-
Statements such as this raise the question about how
tions not being recognized in Australia.
practitioners perceive the professional status of
interpreters.
Perceived outcome
The subsequent perception that develops as the
.-
interpreters continue to interpret for ex-patriots
particularly refugees who divulge torture and trauma
011"0111
-,114111111'
Diversity in Health 2003
INNOVATION
CREATIVITY. HARMONY.
I
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Synergy Winter 2002
7
....voices with no feelings...a discussion of the role of interpreters in
psychotherapy
in
Diversity and Mental Health in Challenging Times
edited by Beverley Raphael, AM and Abd-Elhasih Malak
theoretical ideas around the interpreting process
"INTERPRETERS' EXPERIENCE OF WORKING IN A TRIADIC
within psychotherapy in bilingual settings.
PSYCHOTHERAPY RELATIONSHIP WITH SURVIVORS OF
TORTURE & TRAUMA: SOME THOUGHTS ON THE IMPACT
Issues raised during the debriefing day included
ON PSYCHOTHERAPY" by Rise Becker and Robin
Bowles, forms just one chapter of this new publication
interpreters' experience in general
about the relationship between culture and mental
their relationships with torture and trauma clients
health.
and with the psychotherapist
supervision and debriefing, and
This chapter deals with debriefing of interpreters
psychotherapy and boundaries
involved in counselling, particularly psychotherapy,
with non-English speaking background survivors of
Becker and Bowles conclude that interpreters are still
It includes an international
torture and trauma.
often seen as voices with no feelings and ideas of their
literature review, material obtained from a "psycho-
own, and advocate for increased understanding of the
educational debriefing day" held with experienced
importance of the complex and vulnerable role that
health care interpreters who have worked closely in a
interpreters may play when working with counsellors
counselling relationships with psychotherapists and
in a psychotherapeutic setting.
clients of STARTTS (NSW), and a discussion of some
Diversit and Mental Health
in Challenging Times
Diversity in Mental Health in Challenging Times
Edited by Beverley Raphael, AM and Abd-Elmasih Malak
is a collection of innovative ideas and findings which will stimulate the readers' thinking about
the relationship between culture and mental health
Academics, researchers and mental health professionals have contributed valuable insights in a
variety of chapters that make up this eighth monograph in the Culture and Mental Health series
Diversity
from the NSW Transcultural Mental Health Centre. The theme throughout concerns the ways in
and Mental
which cultural diversity and mental health interact in a complex and challenging world.
Health in
Challenging
Times
The eight chapters of Section I cover aspects of the mental heath system and the community: from
igt
the NSW Mental Health Tribunal, through consumer and carer participation, to the problems facing
refugee parents and their adolescent children, to issues in suicide prevention and strategies for the
Ileserlev Itaptud, AM
prevention of mental health problems among communities from other cultures.
Abd-ElmuIll Maid,
Section II focuses on people, their mental health problems and strategies for understanding,
Culture and Mental Health
managing and coping with such problems. These ten chapters range over cross-cultural aspects of
anxiety, trauma, depression and stress. AUD$33 (inc GST) + postage & handling
For information contact
the Resources Officer
Diversity and Mental Health in Challenging Times
on [phone] or fax [phone]
is of value to all who are interested in improving mental health.
Synergy Winter 2002
8