Found in translation

I was really happy to see your February article “Found in translation,” on using interpreters in mental health care. I am a freelance Spanish interpreter, but the Monitor arrives at our house because my partner is an APA member.

Few people outside the profession understand exactly what is going on in an interpreter’s head from a cognitive and linguistic viewpoint. In addition, speaking through someone else’s voice is anything but a natural way of communicating. That means people definitely have to be taught the techniques needed to communicate effectively through a conduit. The article’s pointers were all just right for that purpose.

I am a court interpreter, which means that the mental health interpreting I do is primarily for competency evaluations. While the setting and intent are different, the interactions provide the same challenge of trying to make the client sound as emotional and as coherent or incoherent in English as he does in the second language. We interpret not word by word, but by units of meaning. Linguists call them “chunks” and the cognitive activity of separating out those units of meaning, “chunking.” How does one chunk a thought or a sentence that doesn’t make sense to begin with, then interpret it into an equally nonsensical expression in English? This can be more difficult than interpreting the technical language of an expert witness or the flowery prose of a closing statement. And mental health interpreters may have to do this every day.

Having a mental health worker who is aware of how to navigate the session with the interpreter frees up my mind to do what I’m there to do. My resulting utterances will be truer to the original, and thus more accurate and helpful to the mental health professional, if she is smoothing the interaction along by using the techniques in this article. Thank you for running this article.

Verla Viera
Renton, Wash.

The Little Albert mystery isn’t solved

The January “Upfront” piece, “Little Albert Regains His Identity,” describes an investigation by Beck, Levinson and Irons published in the October American Psychologist, which revealed that an infant by the name of Douglas Merritte was Little Albert. However, Douglas Merritte remained with his mother until he died at age 6, whereas Albert, according to Watson (Behaviorism, 1924 Vol. 25, p. 167), was adopted by an out-of-town family. Until such discrepancies can be accounted for, it might be best to reserve judgment on whether the real Albert has finally been identified.

Russell A. Powell, PhD
Grant MacEwan University

Privacy vs. protection

The very interesting article, “Improving care for people with serious mental illness” (October Monitor), neglected to deal with an important issue. In many, if not most, jurisdictions, health-care providers are forbidden to share patient information with families. This grew out of a social movement in which patients in Massachusetts are now called “consumers,” not patients. I happen to believe this is one of the reasons that there has been a marked decrease in support for mental health programs. Legislators don’t get very enthusiastic, or guilty, about providing services for “consumers.”

I know a number of families that very much want to help their adult children but can get no information to facilitate that help. There are other victims, as well.

On Jan. 25, the parents of two young children whose aunt carried them to their deaths on a highway in 2008 sued McLean Hospital in Belmont, Mass., for allegedly failing to properly treat the woman’s mental illness. The parents contend that the aunt’s physicians provided inadequate care and never told family members about the risk she might pose to others or herself. The family said they never would have let their relative take care of the children if they had known she might be dangerous. The hospital was not allowed to inform them because the risk was not obvious enough to generate the obligation to warn. (The outcome of the case is pending.)

I understand, and even sympathize, with the reasoning behind these changes in how we regard and deal with the rights of the mentally ill. However, we have not taken enough cognizance of the fact that many patients do not always have the cognitive capacity and judgment to control their behavior with respect to their own safety and the safety of others. It is time to take a fresh look at the issue of the privacy of patients with mental illness.

Lewis B. Klebanoff, PhD
Dennis, Mass.

The slam against psychology

I was surprised to read the selection of letters published in the February Monitor concerning the recent call for a more sound scientific approach to the training in and application of psychological principles by Timothy B. Baker et al. (2009.) (See report in December issue, “Disputing a slam against psychology.”) All the letters were both negative and condescending. They all also ultimately proved the points made by Baker et al. If there is not a sound evidence base for clinical psychology, we have made very little progress as a science. Baker et al. may be a bitter pill to swallow for those who think that psychological science should not apply to clinical practice, but it is a necessary and important step forward. Recognizing scientific principles is not “scientism”; attempting to equate the scientific method with extremist religious philosophy is, to be blunt, sophomoric and embarrassing. If these letters are representative of the thinking of clinical psychologists, clinical psychology is worse off than I previously suspected. These statements have a familiar ring. They are reminiscent of arguments invoked by those suggesting that evolution is just a theory among many equally plausible but ultimately unscientific theories. A field that aspires to be accepted as a science but ignores or minimizes its empirical foundation risks being trivialized.

John S. Searles, PhD
Charlotte, Vt.

Editor’s note: The Monitor did not select which letters to run. We ran all the letters we received on this article.

Stop the singlism

In the February “In Brief” section, the Monitor proclaimed that “married people generally trounce singles on measures of emotional well-being.” Even setting aside the smug gleefulness of the “trounce” word, the statement is simply wrong.

Cross-sectional studies comparing the currently married to the divorced, widowed and always-single typically show that it is the previously married who tend to look worse than the currently married (reviewed in Singled Out). Lifelong singles often fare very similarly to the married. Even if such studies showed big differences favoring the currently married, though, they could not support the suggestion that getting married makes people happier. The married group does not include all people who ever married, but only those who married and stayed married. Imagine how much more compelling all of our research would seem if we could set aside the 40-plus percent of our participants who did not comply with our hypotheses. Longitudinal research also shows that getting unmarried matters more to well-being than getting married.

What about the downside of “emotional well-being”: Do people become less depressed when they marry? A longitudinal study showed that if you get married, you may end up less depressed if you start out among the 20 percent most depressed people to begin with, if you don’t get divorced, if you end up in a marriage that is happier than most, and if assessment ends after the first few years.

Bella DePaulo, PhD
University of California, Santa Barbara

Please send letters to Sara Martin, Monitor editor, at the APA address. Letters should be no more than 250 words and may be edited for clarity or space.