INTRODUCTION 9
Background to the study 10
Psychological assessment forms a large and essential component in the practice of psychology in South Africa. This increasing use of psychological services by previously disadvantaged groups in South Africa calls for the development of psychological assessment tests that are normed, standardized and administered in indigenous languages.
Problem statement 10
Significance of the study 10
Several authors have argued whether providing psychological assessment feedback is beneficial to the client. One of the participants reported mixed feelings about sharing the same language with the client/caregiver.
LITERATURE REVIEW 12
Introduction 12
Psychology in South Africa 13
According to Foxcroft and Roodt (2005), psychology was introduced as a way to exert power and control over groups that were perceived as minority, causing the majority of the population to view them negatively. Furthermore, access to mental health care has been largely denied to the majority of the population due to socio-economic factors.
The use of Psychological tests 13
Furthermore, this has enabled psychology to exclude the everyday life experiences of the Black majority (Volgelman et al, 1992), resulting in a lack of development of psychological tools in Indigenous languages. It further represents the possibility of "test contamination" due to raters' subjective assessment of concepts that need to be translated and re-translated, which can reduce the psychometric properties of the test through standardization of administration and reporting of results.
Test classification 14
Tests such as the South African Zulu Intelligence Scale (ZSAIS) allow users to communicate in IsiZulu; however, the psychometric results are generated in English, which then requires the evaluator to translate those results for the client into a language they can understand and relate to their context. Inquiries to Jopie van Rooyen Psychometrics regarding the tests they offer as one of the main suppliers of assessment tools in South Africa revealed that they do not distribute IQ scores in languages other than English and Afrikaans because translation is extremely difficult and expensive. assessments and standardize the assessment for South Africa, instead offering assessments of non-verbal cognitive abilities that have South African norms that can be used with non-English speakers, such as the Colored Progressive Matrices Test (Pilkington-Williams, JVR, 2013).
Language in the helping profession 15
- A communication tool 15
Working with people who are bilingual or who use their second language using all psychotherapies has been perceived as less effective compared to using their first language. Language has been found to have a significant impact on symptom presentation, and when people express themselves in second language misunderstandings, shorter responses and higher occurrences of speech distress may occur (Farooq & Fear, 2003).
Language obstacles 16
Engelbrencht (2010) in the training of psychologists in South Africa, there has been very little attention to the issue of language. One of the highlighted criteria in the selection of doctors who came to South Africa was that the doctors were able to communicate in English.
Language and Culture 19
Language, Culture and Identity 19
Participants expressed concerns about how much results they could share with the client/caregiver. Some participants felt that the use of IsiZulu limited the amount of information given to the client and carer.
Indigenizing Psychology 20
Closing the language gap 20
- The training of Psychologists 20
- Recent developments in training 21
Despite the above argument, linguistic diversity has not appeared much in the training of Psychologists in the country (Drennan, 1999). In contrast to the above, when we take a closer look at the training of psychologists in the last decade, it is imperative to note that in some of the training institutions the ability in an indigenous language has become a requirement for admission to the program.
Language equivalence 21
This is largely due to the country's history of limited access to education for Afrikaans speakers and the time required for training requires funds that the majority of the population cannot afford. Also, some of the diagnostic terms listed in the Diagnostic Statistical Manual of Mental Disorders (DSM IV) either have no equivalent terms or have a different meaning within African languages.
Working with interpreters 22
Furthermore, lower levels of both types of symptoms were associated with the absence of an interpreter. Of the 522 Hispanic/Hispanic patients with limited English proficiency, 210 had a language concordant physician and 153 did not have a language concordant physician (Schenker et al, 2010).
Factors associated with the translation of Psychological measures 25
- Process of translation 25
- Test construction 26
- Cross-cultural testing and adaptation 26
An approximately measured ability or trait plays the same role in the organization of the behavior of members of the new culture as it does in the original culture. Experiential equivalence – required when there is a marked cultural distance between the attitudes, beliefs and experiential worlds of the source and target languages.
Issues and challenges: South Africa 27
Grieve and Van Eeden (2010) when translating intelligence tests from English to Afrikaans and administering this test to Afrikaans speaking individuals found that some words in English have different meanings when translated into Afrikaans. They argue that most differences, such as the lack of appropriate concepts for equivalence in the target language and the difficulty of translating idiomatic expressions often found in African languages, make these issues less important in English-Afrikaans translations.
Issues and challenges: Internationally 29
In psychological assessments, language is the key to communication between the clinician and the client and during the feedback process the results must be effectively communicated to the client. Literature on psychological assessment feedback will be presented below with a specific focus on language use between the clinician or assessor and the client.
What is assessment feedback? 30
Importance of feedback 30
The final stage of assessment feedback revolves around providing a summary of key findings and making recommendations in collaboration with the client, as well as answering any questions the parent or student may have at the end of the assessment process (Tharinger et al, 2008). . In a survey conducted by Foxcroft et al (2004), approximately a third of practitioners reported that the home language of the clients they see is Xhosa or Zulu, but only 3.8% of practitioners converse with their clients in Xhosa and 4.7% in IsiZulu. .
Communicating assessment results 32
Two of the participants reported that speaking the same language as the client/caregiver created certain expectations that they did not know how to manage. In addition to the general preparation of feedback, participants reported that they considered factors related to the recipient of the results.
Conclusion 34
RESEARCH METHODOLOGY 35
Introduction 35
Collecting more history improves the clinician's formulation of the case and may improve the intervention recommended to the client. What were some things you had to keep in mind while preparing for the feedback process?
Aims/objectives 35
Research questions 35
Research methods 35
- Validity, Reliability and Rigor 36
- Theoretical framework: Rationale for the study 37
Reliability refers to "the degree to which data change over time and changes made in the researcher's decisions during the analysis process" (Graneheim & Lundman, 2004). To ensure reliability, the researcher avoided extending the data collection period to ensure consistency in results.
Sample description and study site 37
They reported that when given negative results to the client/caregiver, they were quick to suggest solutions. Probes: What are some of your thoughts on how the results were explained to the client/caregiver.
Data collection 38
Procedure 38
Data analysis 38
Ethical considerations 38
Four participants reported that using the client's language helps them build a relationship with the client/caregiver. In addition, asking the client to reflect the explained results to the evaluator was used to ensure understanding of the information.
Costs 40
RESEARCH FINDINGS 41
Introduction 41
- Diagram of themes 42
Benefits of communicating with client/caregiver in their primary language 44
- Clinician and therapeutic benefits 44
- Facilitation of clinical history 44
- Facilitating the establishment of rapport 44
- Clinicians perception of the client and caregiver 45
- Ease of communicating using mother tongue 45
- Clinicians perception of shift in anticipated anxiety regarding language of
- Clinicians perception of potential effects on test performance 46
- Clinicians perception of adequacy of presenting emotional states in
Language obstacles 47
- The translation process 47
- Finding appropriate terms and phrases to retain semantics 48
- Lack of equivalent words 50
- Client obstacles regarding language transition 50
- Maintaining the meaning of results when moving to another language 51
- Equivalence 51
- Perceived difficulties that may arise with standardizes test material during testing 53
- Role expectations embedded in the language used 54
- Time constraints with regard to feedback in IsiZulu 55
One participant questioned fairness in relation to the client being assessed and the language used for that assessment. One participant expressed concern about the cultural equity of the test when used in another language.
Strategies used by assessors to overcome the obstacles occurred during feedback 56
- Using both languages interchangeable 56
- Tracking 57
- Reflecting 57
- Clarifying and repeating 58
- Inviting client to collaborate 58
- Problem solving strategies when disseminating negative results 58
- Using examples 59
- The use of descriptive language 60
- Summarizing the results due to language limitation as a problem solving strategy 60
- Using the assessment tool qualitatively 61
- Preparation for feedback 62
- Preparation before time 62
- Supervision 63
- Consulting with experts in your language 63
- Following the report 64
Another participant reported that referring to the client's history helps him understand the caregiver when giving feedback. I don't think the effects are negative it mainly depends on the nature of the results the more negative it is the more you have to explain and worry about the customer'.
Assessors perception of their competence in providing feedback in Indigenous language 65
The same participant reported that he was satisfied with how he facilitated the feedback process at that time. Two participants highlighted that they gained the general skills required when giving feedback, but not on a linguistic basis.
Factors considered when selecting tests for assessment 68
- Language in the selection of tests 68
- The presenting problem 68
- Which language to use for testing? 69
It would have been helpful if the participants had shared their feelings with the client and heard their views on the process and their perceptions of the results, rather than keeping to themselves. Clinicians perceived the use of IsiZulu in communicating the psychological results as burdensome for them due to the language limitations they experience.
DISCUSSION 71
Introduction 71
Identified barriers of communicating with clients/caregivers in their mother tongue 71
- Barriers in relation to content issues 71
- Barriers in relation to process issues 74
Participants in this study felt the need to explain further until the results are accepted by the client/caregivers. The use of these skills facilitated collaboration with the client or relative and enabled them to ask questions.
Processes engaged in to overcome barriers experienced 75
Identified benefits of communicating in the client’s primary language 77
- Issues related to the process: Therapeutic relationship and clinical assessment 77
- Content issues: Information gathering and communication 78
Participants further noted that when a client is tested in their primary language any anxiety that may be experienced in a second language is eliminated. In the current study, communicating with clients and caregivers in their primary language allowed the assessor to gather a comprehensive clinical history.
Assessors perception of their competence in providing feedback in mother tongue 79
If this is not established, the assessment results may not be a true reflection of the client's abilities and functioning (Foxcroft et al, 2004). This study highlights that psychological assessment in South Africa requires the development of psychological tools that are relevant to the majority of the population, especially to native language speakers.
Conclusion 80
Conclusions regarding the research questions 81
Further clinicians were concerned about the use of standardized test material in another language, which may have interfered with the psychometric properties of the tool and thus altered the meaning of the results. In addressing barriers, experienced clinicians relied on the use of examples through descriptive language, referring to the client's story to ensure that the client and caregiver understood the results.
Implications for theory and practice 82
Implications for research 82
Study limitations 82
As part of my degree requirements, I am conducting research on the benefits and barriers to using the native language of clients/caregivers in psychological assessment feedback among trainee psychologists. What were some of the processes you engaged in when preparing for feedback.
Conclusions about the study 83
Informed consent form 93
Please note that you will not be disadvantaged if you choose not to participate in the study. I have received answers to my questions regarding the study and I understand what will be required of me if I participate in this study.
Interview schedule 95
How did you ensure that the results retained their meaning while making sense to the recipient. Other Probes: (Note: These probes will be related to tests administered by the assessor and explore specific concepts unique to the test).
Ethical clearance 97
