Sign Language Resources, Inc.

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Mental Health Interpreting

Mental Health Services
Certification and Experience


For mental health settings, Sign Language Resources, Inc. believes that interpreters must be certified. Certification assures at least a minimum skill level of the interpreter. Then training and experience with established mental health interpreting professionals is essential. SLR interpreters have these qualifications to perform services such as regulary scheduled out-patient therapy sessions, and in-patient situations requiring cognitive assement and/or crisis intervention.
Before and After an Appointment
Pre- and post-sessions with the interpreter are recommended. A few minutes of your time provides a critical resource for effective interpreted communication. Before the session begins, it is wise to discuss the following information with the interpreter:

  • The Deaf person's stated preference for language and communication method, if you happen to know it

  • Room configuration and seating

  • The purpose of the visit and goals for the session

  • Your previous theraputical experience with Deaf and hard of hearing people and/or working with an interpreter

  • If you are working with a Deaf person for the first time, the interpreter may offer some information about Deaf people and their culture

  • And any questions you might have about working with Deaf clients and interpreters, including where and how to obtain further information

  • Post-session time allows for a brief check-in with the interpreter, specifically about any language or communication issues that may have occurred during the session. The interpreter may make communication suggestions that may be utilized on the next visit.


    Not every interpreter will be a "good fit" with every client. The experienced interpreter will self-assess their ability to continue on subsequent visits and if needed will assist you in arranging for a replacement. Consistency of services and the quality of interpretation for ongoing sessions is the ultimate goal.

    Role of the Interpreter


    Sign language interpreters are required to follow a stringent Code of Conduct. Confidentiality is foremost and it is recommended that mental health providers will explain the entitlement of privacy to clients at the appropriate time during the first session.


    All of the following aspects are based on the RID Code of Conduct and the advice of experts:


  • Do not leave the interpreter alone with a client at any time. This will prevent the interpreter being given any information best given directly to you. Escort the interpreter to the staff lounge or office upon arrival and allow them to accompany you out of the session if you need to leave, even briefly.

  • Interpreters do not take on a case management role and are limited to the role of facilitating communication with you present. They do not escort clients/patients to other appointments or locations, interpret documents without staff present, or provide any supervision, monitoring or substituting for regular staff.

  • An interpreter is not permitted to do any editing, omissions or additions to anything said by you or the deaf person, nor adding any of their own opinions/reactions. The interpreter must stay true to the intent of all parties, matching tone and affect.

  • If the deaf person's language is dysfluent the interpretation will reflect this. People who are dysfluent in Sign Language may be experiencing a breakdown or decompensating, or may be considered what is referred to as being "highly visual".

  • The interpreter's presence increases the opportunity for transference. Therefore, if the deaf person's addressing the interpreter directly in an overt manner or one that interferes with the process, the mental health professional will need to gently gear the discussion back to patient/therapist. The addition of a third party may pose some challenges, and present opportunites to be creative, however, most Deaf people are used to proceding with important life events with an interpreter present. Comfort and trust on the part of all three persons, the therapist, the deaf patient, and the interpreter, are crucial for therapy to be effective.

  • Language and Communication Method


    The interpreter may need a couple of minutes at the beginning of the session to quickly assess the most readily understood language of the deaf or hard of hearing person, as there are a variety of sign languages and sign systems in use, or the person's illness may be interfering with his thought process, and rendering his expressive and receptive communication fragmented and nonsensical. To assist with this assessment, before the sessions begins, it is helpful to ask a few questions of a more introductory nature such as where a person lives, job information, or general family configuration. In more complex situations such as those with highly visual deaf people or one who is decompensating, if the deaf person is not from the local area, or there is more than one deaf person present, an interpreter may need more time to assess the most effective language strategies.


    If a person is more "highly visual" the interpreter may choose to work in a consecutive manner instead of their usual method of interpreting at the same time you are speaking or the deaf person is signing.


    There may also be a need to include a Certified Deaf Interpreter (CDI), whose primary skills and training are geared toward working with those whose language is disjointed, highly visual, or is not a native American Sign Language user (or a foreign-born deaf individual). The CDI is a Deaf person who is trained and certified as an interpreter, and may be called upon to work as an intermediary to insure the most effective communication. This is especially recommended for situations involving in-depth assessment, testing, or where life-altering decisions will be reliant upon outcome, as well as in ongoing cases of extremely highly visual deaf persons.


    The sign language interpreter may work with a spoken language interpreter if there are other hearing parties involved, say in family therapy, who do not speak English.

    Quick Tips


  • Introduce the interpreter to the deaf person at the beginning of the session.

  • When speaking, look directly at the deaf person even though their eyes may be on the interpreter much of the time.

  • Speak as you normally would. Some people are inclined to over-enunciate or speak unnaturally slowly, which can make understanding even more difficult.

  • Try to avoid addressing the interpreter directly during the session or including them as a participant in the session.

  • It is normal to experience a slight delay in the communication and response time due to the nature of interpreting.

  • Initial interviews and ongoing therapy may take more time than you usually allow.

  • Any concerns that the deaf or hard of hearing person has about the interpretation should be discussed with the interpreter present.

  • Giving examples and being specific is more culturally appropriate when working with people who are deaf and hard of hearing.



    Also see NAD Healthcare and Mental Health Issues


    Also see NAD Position Statement, Mental Health Interpreting


    Also see RID Standard Practice Paper, Interpreting in Mental Health Settings


    Also see Crump/Glickman: Mental Health Interpreting with Language Dysfluent Deaf Clients