Language Problems in Therapeutic Communication

Psychologists perform their service for a patient by engaging in meaningful talk. When a patient suffers from limited language ability, a therapist can fail at the time he establishes the doctor-patient relationship to make a diagnosis. The language a patient uses to talk from the beginning of therapy can prevent a doctor from making the right treatment decision.

Talking Without Good Language

• A psychologist talks to a patient so she can hear the patient explain exactly what is wrong. When a patient's language problem prevents a clear explanation, a psychologist might try to talk the patient through a methodical assessment and fail. Even worse, the patient, concerned about the doctor's understanding and agreement, might become frustrated because the doctor simply proceeds to ask all the wrong questions. Once a patient loses trust in the doctor, the relationship suffers.

Therapist Competence

• The American Psychological Association publishes ethics requiring a therapist to perform competently when a patient is difficult to comprehend. Either the doctor learns how to talk to his patient in the language the patient needs or refers the patient to a therapist who can. A patient's consent to assessment and therapy depends upon effective communication. Conducting sessions with patients held back by poor communication can involve choosing suitable methods learned in training or experience.

Knowing the Way the Patient Talks

• A psychotic inappropriately declaring a far-out claim about himself presents a classic case of a doctor needing to know what a patient truly is trying to communicate. Often, the language a psychotic chooses does not clearly express what he means. The key to giving therapy to a psychotic is learning the way the patient talks. Taking transcripts on the truths stated by the patient can enable a psychologist to study the patient's communication until the psychologist can sit before the patient and know the true meaning of his statements. With detailed transcripts that take note of intonation, pauses and the patient's gaze, the doctor can study more of the full expression.

More Methods

• When the brain's language function is impaired, a psychologist might choose to rely on non-verbal communication, such as posture or gesture. In a patient with aphasia suffered from a stroke, which impairs language, the doctor can assess a condition in the absence of a reliable verbal explanation in interviews or on questionnaires. Observing behavior that shows a psychological condition, such as crying over sadness, helps a diagnosis. What the doctor cannot learn from the patient, he can learn from the patient's family. Psychologists use the Stroke Aphasia Depression Questionnaire for the behaviors family members observe.

Patients Using Foreign Language

• Language problems can prevent progress during therapy when cultural differences worsen the communication difficulty. For example, a doctor who speaks only English and who has a patient born in China and knows only Chinese may need a language interpreter familiar with the Chinese community's cultural values and beliefs and fluent in Chinese. The interpreter can be a valuable addition to a clinical discussion for obtaining a patient history. In English, the interpreter can tell the doctor the full explanation she hears in the patient's Chinese and sees in his body language and facial expressions.