How Do Therapists Experience Working with Interpreters, Particularly in Regard to Issues Relating to Power and the Therapeutic Alliance?

This study aimed to explore therapists’ experience of working with language interpreters in therapy, particularly in relation to issues of power and the therapeutic alliance.
Semi-structured interviews were conducted with ten qualified therapists working within an IAPT or secondary care psychology service from one London NHS Trust. The interviews were supplemented with a diagrammatic elicitation task.
The verbal data were analysed using IPA from a critical realist epistemological position, to support a contextual understanding of the experiences.
The analysis resulted in the development of three super-ordinate themes: “The system is the most powerful thing”, the knotty question of power, and dyadic and triadic alliances. Each was supported by several sub-ordinate themes, with the first super-ordinate theme considered as an overarching theme as it related to most aspects of participants’ experiences.
One of the key findings of the study related to an understanding of the context of the therapy setting as a driver of therapists’ experience of working with interpreters. Whether the therapist experienced the ‘system’ as pressured and demanding or supportive, appeared to link to how they perceived and related to the interpreter, particularly in terms of issues of power and alliances. A Kleinian psychoanalytic theoretical framework was drawn upon to contextualise the analysis and offer a way of understanding the impact of organisational factors
on the therapists’ experience.
The findings of the study suggest that an understanding of how therapists experience power dynamics and the therapeutic alliance when working with an interpreter is enhanced by contextualisation of the experiences. The new insights into how contextual factors may drive therapists’ experiences of working with interpreters offer a contribution to current research focusing on the interaction between organisational systems and the experiences of NHS and IAPT psychological therapists.