The aim of the cross-sectional and longitudinal study was to compare interpreters’ work-related characteristics and wellbeing (psychological distress, work-related exhaustion, and CS) between four different main work settings (psychotherapy, counselling, medical setting, authorities) in the care of refugees. Overall, the results indicate differences between the four settings regarding work-related characteristics. Specifically, the settings differed with respect to the proportion of interpreters with a degree in interpreting, the weekly working hours, and the amount of interpreted traumatic content. Additionally, mostly female interpreters participated in the study, which was similar as in previous studies with interpreters in Germany [1, 5]. Moreover, significant differences in interpreters’ wellbeing emerged across the settings. Interpreters in the counselling setting showed the highest levels of psychological distress and work-related exhaustion, whereas no significant differences between the four work settings were found for CS.
Differences regarding interpreter characteristics and working conditions
A primary aim of this study was to explore and compare work-related characteristics between the four work settings in order to gain a better understanding of the various context-related difficulties with which interpreters may be confronted.
In this regard, interpreting in an authorities setting stood out from the other work settings in terms of several work-related characteristics. First, this setting was most often indicated as the main work setting in both the cross-sectional and longitudinal sample. Furthermore, the highest proportion of interpreters with an interpreting degree, and of interpreters with the most working hours (31-40 h per week), indicated authorities as their main work setting. One reason for these findings might be that the authorities setting included a broad spectrum encompassing different work environments, such as social services, but also police stations, court, and asylum hearings. Furthermore, all refugees have to go through the process of asylum hearings, while only some require general and mental healthcare. Asylum hearings imply specific conditions within the authorities context, as sworn or professional interpreters are preferred over lay or untrained interpreters [28, 29]. Assuming that interpreters with a degree are more likely to work for authorities due to their qualification, this might explain why the highest proportion of interpreters with a degree was found in the authorities setting.
In addition, significant differences emerged with regard to the traumatic content that was reported by the interpreters in their main work settings. The highest amount of traumatic content was interpreted in counselling and psychotherapy settings. This is in line with several qualitative studies in which interpreters frequently reported interpreting traumatic experiences in psychotherapy and counselling (e.g., [13, 22]). Moreover, in trauma-focused therapies, reporting traumatic experiences is an essential part of the therapy.
The frequency of supervision, peer-to-peer support, and training did not differ significantly between the main work settings. There are still no regulations or criteria on the frequency of support structures such as training or recommendations for qualifications for interpreters in Germany . Therefore, it is not specified whether and with what kind of preparatory training interpreters can start their work and in what way further training should be offered to interpreters during the performance of their work. Consequently, the training that prepares or accompanies interpreters' work can vary greatly. Although the BAfF recommends regular supervision and intervision (in terms of peer-to-peer support) in its guide for practitioners and interpreters in the care of refugees , our data suggest that these recommendations may not yet have been implemented sufficiently in practice. Future studies may focus on examining in more detail the different types of training interpreters have received in order to get an overview of the extent to which interpreters have been prepared for their work and how this might affect their wellbeing.
Differences in psychological distress, work-related exhaustion, and CS
Our second aim was to compare interpreters’ wellbeing in terms of psychological distress, work-related exhaustion, and CS between the four main work settings. Significant differences in psychological distress and work-related exhaustion were found. Interpreters working mainly in the counselling setting showed significantly higher psychological distress than those in the authorities setting and significantly higher work-related exhaustion than those in the medical setting.
The increased levels of psychological distress and work-related exhaustion in the counselling setting may be related to the traumatic content, as interpreters working in the counselling setting reported interpreting the highest amount of traumatic content. A systematic review found higher rates of secondary traumatic stress (STS) among professionals (e.g., counsellors, therapists) confronted with a high trauma caseload . Such findings may reflect mechanisms similar to those found in our sample regarding traumatic content and work-related exhaustion and psychological distress. The differences regarding psychological distress and work-related exhaustion may further lie in the frequency with which patients are seen and the objectives of the treatment they receive. In the counselling setting, clients are not usually treated on a long-term basis, and interpreters do not get the opportunity to experience a potential improvement in symptoms, which could contribute to higher psychological distress. Indeed, in previous research, seeing traumatized clients recover was often reported as rewarding in the context of interpreting in a therapy setting (e.g., [2, 22]) and as eliciting positive feelings such as a sense of growth, hope and inspiration . Besides witnessing the course of treatment and probably also the recovery process, another reason for the lower level of psychological distress in the psychotherapy setting may be that interpreters are assigned to a case or a psychotherapist who is fully responsible for long-term treatment [10, 33, 34]. This may help to establish a solid and trustful working relationship within the triad and therefore reduce distress.
Interpreters in the authorities setting showed less psychological distress and work-related exhaustion than those in the other three settings. Altogether, interpreters in the authorities setting indicated the highest level of experience in their work setting, worked the most hours per week, were more likely to have a university degree, and almost half reported being employed (as opposed to freelance) in this field. In general, this may point to a more settled working situation compared to the other settings, which may contribute to the lower psychological distress and work-related exhaustion. However, asylum hearings as a specific work location within the authorities setting may pose a highly stressful and pressured situation for interpreters due to the responsibility of the interpreter in the process of the asylum hearing [17, 28, 35]. Therefore, it may be relevant to investigate this specific context separately within the authorities setting in future research.
With regard to CS, no significant differences emerged in any of the group comparisons; thus, the values for CS were relatively similar in all four work environments in both the cross-sectional and longitudinal analyses. Interpreters in our study showed similar CS levels to other psychosocial professionals like mental health or clinical counsellors and social workers . Our results thus indicate that the work setting may not have an influence on interpreters’ CS. This is in line with previous studies in medical, counselling, and healthcare settings, in which interpreters often stated that their motivation to work with refugees was simply to help them [9, 13, 37]. In legal contexts, interpreters most frequently report challenges such as the difficult position in the asylum hearings and the emotional nature of the work [16, 17]. A reason for the similarly high levels of CS in the authorities setting may be that helping through interpreting is an integral part of interpreters' work, regardless of the main work setting. As such, CS may be experienced in the authorities setting in the same way as in the other main work settings.
The longitudinal analyses showed no significant differences between the four groups regarding the average changes in interpreters’ wellbeing in any of the investigated areas. In particular, the four groups had similarly high scores for psychological distress and CS in both the longitudinal and cross-sectional data. This might indicate that the average change does not differ between the groups and that effects in the cross-sectional analyses may be stable over time in all four work settings.
In general, it is difficult to investigate the interpreters’ wellbeing regarding a specific work setting because interpreters usually work in several work settings. Therefore, we applied the concept of the main work setting, as we assumed that this would have the greatest impact on the interpreters' wellbeing. Future studies may ideally examine wellbeing for different work settings to gain a better understanding of the relationship between specific work settings and wellbeing.
Strengths and limitations
First, due to the voluntary nature of the online survey, it is likely that a highly motivated convenience sample was reached. In addition, only paid interpreters were included in the study, which excluded all volunteer interpreters. Overall, the present sample may therefore not be representative of interpreters in Germany. However, due to the online approach, a reasonably large sample took part at t1 and more than two thirds of the participants took part at t2. To the best of our knowledge, this is the first longitudinal study to investigate interpreters’ wellbeing in the care of refugees and the study with the largest cross-sectional sample in this area. Second, the study sought to investigate differences in work-related characteristics between main work settings of refugee care. The four main work settings were determined and assigned by the authors and discussed with interpreters at the Zentrum ÜBERLEBEN. Accordingly, some of the main work settings comprise several work locations, e.g., the authorities setting included job centres and asylum hearings among other locations, and might have been categorized differently by other researchers. Additionally, encounters between psychiatrists and clients in an inpatient psychiatric setting may not have been clearly assigned to one of the settings (e.g., medical setting or psychotherapy) which may have confounded the results. Third, even though the working conditions were asked regarding the main work setting this was not the case for the outcomes regarding the interpreters’ wellbeing. The small groups did not allow us to explore relationships between the interpreters’ wellbeing and work-related characteristics in a specific work setting. Possible explanations for differences in wellbeing were only inferred from exploratory group comparisons, meaning that it is not possible to draw causal conclusions regarding the wellbeing due to the main work setting. Replacing the word help in the ProQOL with ‘interpret’ may also have influenced the results. However, we thought the word ‘interpret’ may have helped to focus better on the interpreting context.
Taken together, interpreters in the counselling setting seemed to be under the highest amount of burden. Furthermore, stable work-related circumstances such as secure employment, professional vocational training and work experience might mitigate high levels of psychological distress and work-related exhaustion. Due to insufficient sample sizes in each group, we were unable to conduct regression analyses to examine the relationships between working conditions and the investigated outcomes for each setting. Therefore, the results need to be interpreted with caution, against the background of the methods carried out, and further research with larger sample sizes is needed.