Practice dialogue: Cognitive behavioural therapy

The DPSI Health exam is tough, and the interpreting portion of the exams require a lot of practice on your own. Past interpreting topics for the Health exam include age-related macular degeneration (an eye disease), myocardial infarction, haemodialysis for failing kidneys, and Alzheimer’s. Given that the Health pathway of the DPSI is not offered very frequently, you definitely want to prepare as much as possible so you can pass all the units on your first attempt. In the spirit of helping other interpreters in the public service interpreting community, here is a free dialogue related to mental health.

If you work in Chinese-English like I do, you might find the following terms useful for this dialogue: cognitive behavioural therapy认知行为疗法; depression 抑郁症; thought想法 or 念头; behaviour 行为; emotion 情感; physical sensation身体感官. You might also want to read an introduction to cognitive behavioural therapy provided by the NHS: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

Context: This dialogue is between a patient and a therapist. The patient has been recently diagnosed with depression and anxiety; she is having her first session of cognitive behavioural therapy over the phone. The patient is non-English-speaking and the therapist is English-speaking. You may change the name of the patient to something more suitable in your language pair. Please note that the telephone numbers provided in this dialogue are fake.

Therapist: Hi, Miss Liu, today is your first session of CBT, or cognitive behavioural therapy, which will be performed over this phone call. Do you have an hour to complete the therapy with me today?

Patient: Yes, I will be free and available.

Therapist: I remember last time we spoke you had some background noise from your kids and you said it was because you had to look after your children as there was no one else at home. May I ask, do you have any family members around to help look after the kids today, just for one hour?

Patient: Yes, my partner is at home. I will send the kids to his room right now. // OK, we can start now.

Therapist: Before we start, I would like to tell you some basics about this call. During your therapy sessions with us, you can pre-cancel two sessions, and we can rearrange the time for your cancelled appointments. However, if you cancel more than three times, we will have to discharge you, because we believe that only if you attend your weekly sessions on time can we help to improve your mental wellbeing. Do you have any questions about this?

Patient: No, I’m fine. Thank you for letting me know.

Therapist: Secondly, all of our calls will be recorded and kept confidential. We won’t disclose any information with any third party. However, if we believe that you might pose a risk to yourself or other people, or might potentially commit a criminal offence, we will report it to the relevant party. We will inform you of our disclosure in advance. Do you have any questions regarding this?

Patient: No, thank you.

Therapist: Is Wednesday at 1 pm always the best time for you to do a CBT session?

Patient: Yes.

Therapist: And can you make sure your partner will stay in the house in order to look after the kids for you?

Patient: Yes, I will make sure he is in. If not, I will ring you to rearrange the session to a different time.

Therapist: That’s great, thank you. May I ask whether you are taking any medication to treat your mental health?

Patient: Yes, I am taking 50 mg of sertraline every day.

Therapist: Good. Do you find the tablet useful for you?

Patient: Yes, it has worked for me. However, it has been making me very sleepy during the day.

Therapist: Yes, that is one of the side effects of the tablet. If you do find your mental health has improved, and you don’t think that you will need it anymore, you can call your GP to check whether you can stop your medication. Now, I need to ask you something a little sensitive: have you had any thoughts of ending your life or harming yourself in any way in the past week?

Patient: No, not at all.

Therapist: Good. Do you have any positive things that make you cherish your life, for example, family, or hobbies?

Patient: Yes, I have two children to look after, and I have my family that I care about.

Therapist: That’s very good. If you have a mental breakdown and need help, do you know a number to call?

Patient: No, I usually talk to my partner.

Therapist: I will give you two numbers to call. Please get a pen and a piece of paper to write this down. You can call your local emotional support team at 016123123, or the crisis team at 0800652286. Do you need me to repeat the numbers?

Patient: No, I’ve got it, thank you.

Therapist: Now, I want you to think about something that happened last week that led to a mental breakdown for you. And I want you to think about the trigger, thoughts, emotion, behaviour, and physical sensation if there was any. Can you think of any examples?

Patient: Yeah, just sometimes I feel that I have so many things to do. For example, when I was tidying up the house last week, I suddenly felt there was too much work for me to do, I didn’t think I could get it all done, and I felt angry, so I quit and sat on the sofa, just spacing out and not doing any housework at all.

Therapist: That is a very good example. Then I want you to write these down: The trigger was having too much housework, and the thought was “I can’t get it all done”, and the behaviour was to avoid doing any of it, and the emotion was being angry. Do you think that’s accurate?

Patient: Yeah, I think so.

Therapist: OK, now I will give you a task to do in the following week. Try to capture and write down the trigger, thought, behaviour, emotion, and physical sensation if any, when you feel worried, have a panic attack, or have a mental breakdown. We will discuss them in our next session. Do you think you can do that?

Patient: Yes, I will try to do that, although I tend to forget things.

Therapist: You can set an alarm to remind yourself if that helps. Just finish one per day, that will be good.

Patient: Thank you, I’ll do it.

Therapist: OK, I will see you Wednesday at 1 pm for our next session. 

Michelle Deeter (NRPSI, DPSI Law) is a Chinese-English interpreter based in Manchester. She teaches public service interpreting at Newcastle University. She has over 450 hours of experience interpreting for medical and legal assignments. If you have questions about translation, interpreting or taking the DPSI, you can contact her at www.michelledeeter.com