The interpreter as institutional gatekeeper: The social-linguistic role of interpreters in Spanish-English medical discourse

Increases in immigration have led to an enormous growth in the number of cross-linguistic medical encounters taking place throughout the United States. In this article the role of hospital-based interpreters in cross-linguistic, internal medicine ‘medical interviews’ is examined. The interpreter's actions are analyzed against the historical and institutional context within which she is working, and also with an eye to the institutional goals that frame the patient-physician discourse. Interpreters are found not to be acting as ‘neutral’ machines of semantic conversion, but are rather shown to be active participants in the process of diagnosis. Since this process hinges on the evaluation of social and medical relevance of patient contributions to the discourse, the interpreter can be seen as an additional institutional gatekeeper for the recent immigrants for whom she is interpreting. Cross-linguistic medical interviews may also be viewed as a form of cross-cultural interaction; in this light, the larger political ramifications of the interpreters' actions are explored. ‘Interpreters are the most powerful people in a medical conversation.’ Head of Interpreting Services at a major private U.S. hospital, May 1999.     

Racial/Ethnic Intermarried Couples and Marital Interaction: Marital Issues and Problem Solving

Abstract

Throughout history interracial/interethnic marriages have been considered an extreme deviation from the marital norm and thus inappropriate by the standards of mainstream society and minority communities. Even today, societal views of intermarried couples often remain negative in nature. This negative perception is frequently sustained by the assumption that intermarried couples experience race / ethnic-based differences in social, moral, and living standards that result in marriages that are fraught with conflict and instability. The mate selection literature however, would suggest that intermarried couples are not socially deficient, but are similar to those who marry within their racial / ethnic group. This research is intended to fill a gap in the literature by exploring the interpersonal, interactive aspects of interracial/interethnic marriages. In particular, this study evaluates intermarried couples as they interact during videotaped sessions of cooperative problem solving to determine if they are similar to, or distinct from, intramarried couples. Data from two aspects of the marital interaction are presented: the types of marital problems encountered and the manner in which couples attempt to resolve these issues. Findings show that while race/ethnicity did not emerge as an issue for intermarried couples, they were confronting different marital issues than intramarried couples. In addition, intermarrieds often employ different interactional styles than intramarrieds when dealing with their marital issues.     

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Abstract

Cardiac patients frequently experience anxiety and depression as major responses to a life-threatening event. Well-timed intervention by the social worker can assist in alleviating these responses and enhance psychological well-being by the use of counselling and other therapeutic techniques. Two case-studies are presented illustrating the range of work undertaken in a comprehensive approach to working with patients in both the acute and rehabilitation phases of cardiac crisis.     

A Pilot for Improving Depression Care on College Campuses: Results of the College Breakthrough Series–Depression (CBS-D) Project

Abstract

Objective: To implement a pilot quality improvement project for depression identification and treatment in college health. Participants: Eight college health center teams composed primarily of primary care and counseling service directors and clinicians. Methods: Chronic (Collaborative) Care Model (CCM) used with standardized screening to identify, treat, and track depressed students for 12 weeks to monitor predetermined process and clinical outcomes. Results: Of all students receiving primary medical care services between January 2007 and May 2008, 69% (n = 71,908) were screened for depression. A total of 801 depressed students were treated and tracked; most predetermined treatment process and clinical outcome targets were achieved. Conclusion: The CCM for depression shows promise for improving depression identification and care for college students.     

Constructing meaning: Strengthening the policy-practice link

This paper provides an examination of the theoretical orientation of constructivism and its application to social work practice as well as the application of social constructionism to understanding and influencing social welfare policy. Explored are the ways in which these postmodern concepts when applied in social work practice and policy courses and reinforced in fieldwork training, provide a means to more readily link the content of these courses. Finally, it is argued that the concepts of constructivism and social constructionism offer a means to open the doors of inquiry and to the development of a range of new opportunities, theories, and interventions conducive to social work practice in its broadest sense.     

Preparing Social Work Doctoral Students for Teaching

The results of a national survey of 51 social work doctoral program directors indicate that, although the majority of doctoral programs include preparation for teaching as a program objective, they offer limited formal course work and few opportunities for supervised teaching experiences. The authors discuss the results of this survey and make recommendations for better preparing social work doctoral students for their roles as teachers.