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The treatment of depression and simple phobia through an interpreter in the North East of England: a case study

Published online by Cambridge University Press:  22 April 2013

Layla Mofrad  and
Lisa A. D. Webster
Layla Mofrad*
Affiliation:
Talking Changes, Bede House, Belmont Industrial Estate, Durham, UK
Lisa A. D. Webster
Affiliation:
Wolfson Research Institute, School of Medicine, Pharmacy & Health, Durham University, Queen's Campus, University Boulevard, Thornaby, UK
*
*Author for correspondence: Miss L. Mofrad, Talking Changes, Bede House, Belmont Industrial Estate, Durham DH1 1TW, UK (email: l.mofrad@nhs.net).
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Abstract

A 35-year-old Middle Eastern woman, experiencing moderate depression compounded by animal phobia was referred to an Improving Access to Psychological Therapies (IAPT) service. Shared understandings were gradually developed using written functional analyses translated in session. Activity scheduling was integrated with graded exposure to increase access to positive reinforcement. Questionnaires and subjective data indicated a reduction in phobic avoidance and functioning increased. Despite the complexity of working as a triad, a positive therapeutic relationship was achieved with increased mutual cultural understanding. Indirect communication led to difficulties maintaining guided discovery and focus. There is limited evidence to support CBT when delivered through an interpreter. IAPT recommendations suggest staff reflect the community; the North East has one of the lowest foreign-born populations in the UK indicating that IAPT services may be ill prepared to work with ethnic minorities. Learning points for the therapist were: maintain simplicity, take time to formulate incorporation of cultural difference, and use transcultural interventions. The interpreter brought advantages; providing means of communication and understanding of cultural differences. Disadvantages were the potential for bias or lost information, increased time and complexity of delivering therapy. This case indicates a deficit in high intensity training and lack of literature to support therapists.

Keywords

CBTcognitive therapy trainingdepressionphobiatherapist competencetraining
Type
Practice article
Information
the Cognitive Behaviour Therapist , Volume 5 , Issue 4 , December 2012 , pp. 102 - 111
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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References

Recommended follow-up reading

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Westermyer, J (1990). Working with an interpreter in psychiatric assessment and treatment. Journal of Nervous and Mental Diseases 178, 745–749.Google Scholar

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