When Dilshad Charania immigrated from India 25 years ago, she knew she wanted to use her native language as an asset. After working as a court interpreter for several years, she was introduced to interpreting in the behavioral health setting in 2017.
“That was a life changing decision for me because this training was organized by the Department of Virginia Refugee Healing Partnership under the Department of Behavioral Health and Development Services and the Department of Social Services,” Charania said. “They were piloting curriculum for interpreting in the behavioral health setting created by professionals in the fields of psychiatry and interpreting. That was how I was introduced to work in the refugee environment.”
This experience inspired Charania to co-found a nonprofit called Capaz+IT with her colleague Spencer Turner, where she is the co-executive director. Based out of Richmond, Capaz+IT supports the career growth and wellness of immigrant communities through digital skill-building, language access, and workforce training.
“Since 2022 we have been providing interpreter training in partnership with continuing adult education programs through Chesterfield, Henrico, and Richmond Public Schools,” Charania said. “The reason we partner with adult education departments is because that’s where you find newcomers who want to learn English and are waiting for their transcripts or work experience to get transferred so they can pursue work opportunities in this country.”
Training as an interpreter through Capaz+IT allows participants to use their native language as an asset while helping other nonnative English speakers access medical and behavioral health services.
“Some of the individuals that participate in the trainings or become interpreters are already healthcare professionals in their own country, but they can’t practice due to lack of certifications from the United States. This gives them the opportunity to stay within their own profession and continue to do the work that they can do in a more qualified manner,” Charania said.
Programs like those at Capaz+IT are helping train more interpreters for refugees and other bilingual Virginians.
“Mental health is a concern for individuals that are either immigrants or refugees,” Charania said. “You can imagine the trauma a person experiences after they have been uprooted from their home and have to start all over in another country. You need your language to express your stress, trauma, or culture.”
Through a 48-hour course, individuals can earn a certificate of completion to provide interpretation services in person or remotely through video or phone.
Preparing Interpreters for Virtual Mental Health Care
The interpreters trained through Capaz+IT are prepared to work across multiple formats offered by language service providers, including in-person and remotely. Remote options typically take two forms: phone-based services or video-based platforms, such as iPads or Zoom-style connections where the interpreter appears on screen. These flexible formats are especially important for supporting patients and providers in telehealth settings.
“The online modality was introduced during COVID and that’s how we’ve been able to reach more people.”
Charania also emphasized the importance of working with interpreters that are qualified specifically in behavioral health, not just medical.
“Behavioral health training is very different from being a medical interpreter because behavior isn’t tangible like an x-ray or blood work.” Charania said. “The role of the interpreter is not limited to just interpreting word for word, but also interpreting a patient’s behavior, word choice, nonverbal cues, and cultural context.”
Best Practices for Engaging Interpreters in Virtual Therapy Sessions
Using interpreters in virtual therapy sessions requires deliberate planning and adaptive communication strategies to preserve therapeutic alliance, accuracy, and patient safety. Key best practices include:
- Pre-session briefings
- Meet briefly with the interpreter before the session to review goals, terminology, cultural/contextual issues, privacy expectations, and potential sensitive topics
- Clarify roles, such as when the interpreter may interrupt for clarification or cultural mediation
- Maintain direct connection with the patient
- Address the patient directly, not “through” the interpreter, to preserve patient agency and rapport
- Use the interpreter as a conduit, not a conversational partner, unless invited
- Use clear, manageable segments of speech
- Speak in short, digestible sentences, and pause frequently to allow interpretation
- Avoid jargon, idioms, or long monologues that strain working memory
- Check for comprehension throughout
- Periodically pause to ask both patient and interpreter if the meaning is clear or needs clarification
- Encourage interpreter to flag ambiguous or culturally loaded language when needed
- Attend to nonverbal and relational cues
- Observe facial expressions, tone shifts, and body posture to monitor emotional states and misunderstandings
- Explicitly name transitions (e.g., “Now we’ll shift to talking about X”) so the interpreter and patient stay synchronized
- Ensure technical readiness and contingency planning
- Test audio/video connections ahead of time for both the therapist and patient
- Use platforms that allow stable triadic communication (therapist–interpreter–patient)
- Have a backup plan, such as a phone line, if the video connection fails
- Respect confidentiality and ethical boundaries
- Remind the patient and interpreter about privacy and confidentiality, especially in virtual spaces
- Keep a neutral clinical boundary with the interpreter. Avoid side conversations or debriefing in front of the patient
- Post-session debrief and reflection
- After the session, meet with the interpreter to reflect on what went smoothly, what challenges arose, and what adjustments to make next time
- Debrief on any culturally related feedback that may affect diagnosis and treatment
To date, Capaz+IT has trained nearly 100 interpreters. Visit their website to learn more.