Exploring staff experiences and perspectives on barriers in interpreter-mediated therapy within NHS England’s Talking Therapies

Abstract Existing research indicates that clients from diverse backgrounds often experience poorer access to and outcomes from psychological therapy in primary care mental health services in England. This issue is arguably compounded for clients with limited English proficiency or those who wish to access therapy in other languages. Guidance on interpreter-mediated therapy provides essential recommendations to ensure equitable access, effective communication, culturally sensitive care, and parity in outcomes. Despite these guidelines, they are not always consistently implemented in clinical practice. This study aims to explore and address staff experiences and perspectives on the barriers to interpreter-mediated therapy within Talking Therapies for anxiety and depression (TTad). An online survey was used to collect data on professionals’ experiences and perceptions of these barriers. A total of 133 staff working within TTad completed the survey. The data was analysed using reflexive thematic analysis (RTA), revealing four key themes: (1) individual level, (2) service level, (3) organisational level, and (4) overlapping barriers. The study highlights that while the barriers to effective interpreter-mediated therapy are distinct across individual, service, and organisational levels, they are also interdependent and often overlap. The findings suggest that addressing these barriers requires a comprehensive approach that considers the interconnected nature of these challenges. Improving training for both therapists and interpreters, enhancing administrative processes, ensuring sufficient funding, and promoting adherence to best practice guidelines are crucial. Future research and continued efforts to implement and monitor these changes are essential for improving access and outcomes for clients within TTad. Key learning aims (1) To explore the experiences of TTad staff in interpreter-mediated therapy, examining the practical barriers and interpersonal challenges they face in delivering effective care. (2) To identify and understand the distinct yet inter-related barriers to interpreter-mediated therapy, highlighting how these contribute to the overall challenges in delivering therapy. (3) To recognise the gap between existing guidelines for interpreter-mediated therapy and their implementation in clinical practice, emphasising the need for consistent application and better adherence. (4) To advocate for a strategic and comprehensive approach to addressing barriers that involve shared responsibility across all staff and levels of TTad. (5) To underscore the necessity of continued research and regular monitoring to improve interpreter-mediated therapy, ensuring that clients with limited English proficiency receive equitable access to mental health services in the long term.