Application of Demand-Control Theory to Sign Language Interpreting: Implications for Stress and Interpreter Training

“I’m taking a mental health day.” Most people are fa-miliar with this colloquial sentence and its implicationabout the impact of stress on work productivity. It issignificant that such commentary (and behavior) origi-nates from employees, not employers. However, takinga brief respite from work to recover from stress is not asanctioned reason for absenteeism in most settings. Yetthe common need to do so has resulted in this vernacu-lar and, arguably, some normalization or social accep-tance of this phenomenon. It also suggests a lack ofeffective or acceptable coping mechanisms available toemployees to reduce the negative consequences ofstress.

Researchers and theorists in the field of occupa-tional health have been educating employers and em-ployees about workplace stress for decades. Studiesshow occupational stress is linked to injury, disease, ab-senteeism, and low productivity (Karasek, 1979; Kara-sek & Theorell, 1990; Schnall & Landsbergis, 1994;Theorell & Karasek, 1996), including in the interpret-ing profession (DeCaro, Feurerstein, & Hurwitz, 1992;Heller, Stansfield, Stark, & Langholtz, 1986; Watson,1987). Although there has been interest from the busi-ness sector in reducing employee stress, the interven-tions considered are typically limited to changes in thephysical environment or promoting change in em-ployee behaviors. Examples of the former include theinstallation of noise reduction barriers, ergonomicseating and keyboards, glare-reducing lights or filtersfor computer screens, and greater open space in officebuildings. Examples of employee-focused interventions

The translation work of sign language interpreters involvesmuch more than language. The characteristics and goings-onin the physical environment, the dynamics and interactionsbetween the people who are present, and even the “innernoise” of the interpreter contribute to the accuracy, or lackthereof, of the resulting translation. The competent inter-preter must understand and respond appropriately to the lan-guage and nonlanguage aspects of each interpreting assign-ment. We use the framework of demand-control theory(Karasek, 1979) to examine the complex occupation of signlanguage interpreting. Demand-control theory is a job anal-ysis method useful in studies of occupational stress and re-duction of stress-related illness, injury, and burnout. We de-scribe sources of demand in the interpreting profession,including demands that arise from factors other than thoseassociated with languages (linguistic demands). These includeenvironmental, interpersonal, and intrapersonal demands. Kara-sek’s concept of control, or decision latitude, is also explored inrelation to the interpreting profession. We discuss the preva-lence of cumulative trauma disorders (CTD), turnover, andburnout in the interpreting profession in light of demand-control theory and data from interpreter surveys, including anew survey study described herein. We conclude that nonlin-guistic demand factors in particular and perceived restric-tions in decision latitude likely contribute to stress, CTD,burnout, and the resulting shortage of sign language inter-preters. We make suggestions for improvements in inter-preter education and professional development, includingthe institution of an advanced, supervised professional train-ing period, modeled after internships common in other highdemand professional occupations.

Correspondence should be sent to Robyn K. Dean, University of Roches-ter Medical Center, Box 650, Rochester, NY 14642 (e-mail: [email protected]).

� 2001 Oxford University Press

Application of Demand-Control Theory to Sign Language

Interpreting: Implications for Stress and Interpreter Training

Robyn K. DeanRobert Q Pollard, Jr.University of Rochester School of Medicine

include “brown-bag” seminars on nutrition and stressreduction, discounted memberships to health clubs,and on-site exercise and child-care facilities.

Although these environmental and employee-focused interventions may contribute to the reductionof stress, their impact is limited by the frequent as-sumption that stress in the work environment is inevi-table and therefore must be “coped with” rather thanreduced, changed, or eliminated (Karasek & Theorell,1990). Their impact is also limited because such inter-ventions treat the individual and the work environmentas distinct entities, either of which can be acted uponseparately. This type of compartmentalization of theproblem precludes consideration of an entirely differ-ent class of stress interventions, those that reflect aninteractional viewpoint wherein the individual and thework environment are considered simultaneously bothin the definition of the problem and consideration ofeffective stress interventions.

An Interactive Theory of Occupational Stress

Robert Karasek (1979), frequently collaborating withTores Theorell, has developed a theory of occupationalstress, termed the demand-control model, based on aninteractive consideration of workers and their employ-ment environments. The model posits two phenome-nological dimensions that affect workers in a given set-ting or situation. These dimensions are termed demandand control, and the “strength” of each dimensionranges from low to high.

Unlike popular views of workplace stress, Karasekand Theorell’s model rejects the assumption that occu-pational stress is inevitable. In fact, they reject the termstress as too simple to capture the nature and complex-ity of the range of employee-job interactive experiencesthe model envisions. As shown in Figure 1, the demandand control dimensions yield a four-quadrant occupa-tional environment wherein the resulting experienceemployees will have can vary widely. The term demandrefers to the requirements of a job, which may includeaspects of the environment, the actual task being per-formed, and other factors that “act upon” the individ-ual. The term control refers to the degree to which theindividual has the power to “act upon” the demandspresented by the job, perhaps by making decisions,bringing skills or resources to bear on the task, or alter-

2 Journal of Deaf Studies and Deaf Education 6:1 Winter 2001

ing the environment or other aspects of the task de-mand. Job demands themselves are not necessarily“bad” nor do they inevitably lead to stress. The impactof occupational demands in light of the control re-sources available to the individual is the key to pre-dicting job stress or job satisfaction.

For example, emergency room nursing certainly isa job with high demand but it may bring great joy andperceived value to a well-trained nurse who can ade-quately respond to the demands she or he faces on thejob. Demand-control research suggests that individualsin high demand, high control occupations do not expe-rience problematic degrees of stress (especially over thelong term), and they experience lower incidences ofstress-related illness and absenteeism than persons inhigh demand, low control occupations (Karasek, 1979;Karasek & Theorell, 1990, Theorell & Karasek, 1996).Therefore, stress is not an inevitable outcome of a highdemand job. As indicated in quadrant I of the figure,when increasing job demands are adequately balancedwith higher degrees of control, Karasek and Theorellrefer to the work situation as active and suggest thatlearning is the primary outcome or experience of the

Figure 1 Interactive dimensions of demand-control the-ory. Reprinted from “Job demands, job decision latitude,and mental strain: Implications for job redesign” by R. A.Karasek, published in Administrative Science Quarterly (1979),24: 288 by permission of Administrative Science Quarterly.Copyright 1979 by Cornell University. Adapted with per-mission.

not perceive these situations as stressful or unsatisfac-tory, but there clearly is a mismatch between the job’slimited demands and the control resources of the indi-vidual.

Finally, quadrant III includes work situations inwhich the demands of the job and the control availableto the worker are both limited. There is not the imbal-ance that exists in quadrants II and IV, which arethe more stress-inducing work environments. Instead,there is a greater degree of balance, as in quadrant I,but in this case, both demands and control are low. Ex-amples of low demand, low control situations would in-clude assembling fast-food hamburgers at a restaurantthat is rarely busy, or monitoring a security camera andresponding to a problem by calling the police. Theseare passive work environments, according to the theory,which are not particularly stressful but do not result inlearning (as opposed to quadrant I).

Interpreters and Stress

Before an analysis of the profession of sign languageinterpreting in light of demand-control theory is pre-sented, a review of the existing literature on interpreterstress is warranted. Several interview and survey-basedstudies of job satisfaction, stress, and burnout in theinterpreting field have been reported (Branam, 1991;Heller et al., 1986; Neville, 1992; Swartz, 1999; Wat-son, 1987). Some describe findings of high burnoutrates among interpreters (Watson, 1987) whereas oth-ers do not (Neville, 1992). All indicate multiple factorsassociated with job satisfaction, stress, and burnout,but interpreter reports of inadequate training for therealities of the working world and frustration with thelack of professional support available after graduationare particularly emphasized in these studies.

Clearly, numerous occupational demands affect theoverall translation task that may contribute to inter-preter stress and burnout. The static, restrictive natureof the interpreter’s role (“role strain”) was cited byHeller et al. (1986) as a primary factor causing stress,according to their survey data. This strain arose from avariety of factors, including working conditions, unat-tainably high performance expectations, conflictingviews among consumers’ understanding of the inter-preter’s role, emotional reactions and duress with nooutlet for dealing with them, involvement in private

Demand-Control Theory and Sign Language Interpreting 3

individual. Most professional occupations would fallwithin quadrant I, presuming the individual has a nor-mal degree of access to the control resources commonin that profession. Occupational research suggests thatjob satisfaction is highest when demand and control areboth high in the work environment (Karasek, 1979;Karasek & Theorell, 1990, Theorell & Karasek, 1996).

The general public’s perception of stress is mostsimilar to quadrant II in the demand-control theoryfigure. Here, a job environment presents a high degreeor number of demands. But in this case, the individual’scontrol over those demands is limited. Perhaps a gen-eral has insufficient troops, supplies, or information tocarry out a mission, a factory worker has little controlover the pace of the assembly line or assembly tasks orinventory quality, or an inadequately trained or inexpe-rienced person nevertheless has the responsibility tolead a major project. The term Karasek and Theorellprefer for characterizing this work experience is high-strain. They avoid the term stress because other undesir-able combinations of demand and control are stressful(in the lay sense of the word) but arise from differentdynamics of the individual-job interaction.

Quadrant IV portrays a combination of demandand control that some may find quite unpleasant andstressful. Here, an individual has many skills, re-sources, or opportunities to respond to the demandspresented in his or her job but the work does not pres-ent many demands. The individual’s control resourcesare underutilized. Whereas some may find this situa-tion relaxing, others may react negatively, by feelingbored or unfulfilled or underappreciated in a low de-mand job. The crew of an aircraft carrier on a routinedomestic patrol mission is in a high control, low de-mand situation. So is a college professor proctoringa final exam or even teaching an introductory levelcourse if she has done so for many years. Some consul-tants or CEOs specialize in working for flounderingcompanies. After successfully leading a company to ef-ficiency and profitability (i.e., effectively shifting theirwork situation from quadrant I to quadrant IV), thistype of individual often prefers to leave his or her posi-tion and seek more challenging work elsewhere thanstay in an environment where the demands have dimin-ished. Karasek and Theorell refer to quadrant IV em-ployment situations as low-strain. Depending on “per-sonality” or occupational goals, a worker may or may

and sensitive situations, limited ability to help consum-ers other than through the direct translational role, andreal or perceived skill inadequacies (the most com-monly cited source of stress). Branam’s survey (1991;cited in Neville, 1992, pp. 10–11) found that hostilityexpressed toward interpreters by some consumers was aprimary reason for burnout. Harvey and Gunther(1994) discuss the vicarious stress that interpreters ex-perience when working in situations that involve unfairtreatment or prejudice affecting deaf people. Heller etal. (1986) note that some interpreters perceived thatmerely having emotional reactions to their work wasunprofessional and even a violation of their code ofethics.

In the interpreting profession, attention also hasfocused on the high incidence of cumulative traumadisorders (CTD) such as carpal-tunnel syndrome, ten-dinitis, and bursitis (DeCaro et al., 1992; NationalTechnical Institute for the Deaf [NTID], no date; Nor-ris, 1996; Peper & Gibney, 1999; Registry of Interpret-ers for the Deaf [RID], 1997; Sanderson, 1987; Stedt,1992). The pain and dysfunction associated with CTDhave led to significant loss of work time for many inter-preters and forced some to abandon the profession en-tirely, in part contributing to the national shortage ofsign language interpreters (Jackman, 1999; Matthews,1994; Sanderson, 1987). Whereas some authors linkonly physical types of stress to CTD among interpret-ers (e.g., muscle fatigue, impact, cold environments),others also focus on the contribution of psychologicalstress to CTD (NTID, no date; Sanderson, 1987).However, as with most approaches to reducing occupa-tional stress and injury in the business sector, the majoremphasis on CTD prevention in the interpreting liter-ature has been on interventions focused on the inter-preter herself or himself or changes to the work envi-ronment. Advice on CTD prevention (e.g., NTID, nodate; RID, 1997; Sanderson, 1987) focuses primarilyon stretching and strengthening exercises, proper posi-tioning of the hands during signing and rest, and othersomatic practices, and on environmental interventionssuch as ergonomic seating, lumbar support, and com-fortable room temperature. Although some CTD pre-vention literature recommends psychological inter-ventions, such as self-exploration or self-assessment,constructive thinking, reflection, venting, prayer,(NTID, no date, Section 5, pp. 8, 9, 21), guided imag-


ery, and meditation (Sanderson, 1987, p. 75), these in-terventions are still typically short-term ones focusedon the interpreter, not the interaction between inter-preters and the demands of their work; they seem topresume that stress is an inevitable aspect of the occu-pation.

Conceptualizing Demands in theInterpreting Profession

Applying demand-control theory to the profession ofsign language interpreting poses several challenges.The first is identifying demands that interpreters face.On the surface, the ultimate task of the occupation isto facilitate accurate translation between a signed anda spoken language. However, this task is composed of,and influenced by, a great number of different types ofdemands. The first category of demands includes thosedirectly or indirectly related to language. We will referto this as the linguistic demand category. Many linguisticfactors ultimately influence the task of translation.They include the language fluency of the parties in-volved in the communication exchange, their clarity inarticulation or signing, the interpreter’s own knowl-edge and fluency in each language, and more. Yet, uponfurther analysis, and as suggested in the preceding re-view of interpreter stress literature, factors other thanlinguistic ones also affect the work of interpreters and,arguably, the translations that are the product of thatwork. We group these nonlinguistic factors into threeadditional demand categories. They include environ-mental demand, factors related to the setting in whichthe interpreting assignment takes place; the interper-sonal demand, factors related to the interaction of indi-viduals participating in the communication process(who are often from different sociolinguistic and cul-tural backgrounds), as well as other parties who may bepresent in the environment; and the intrapersonal de-mand, physical and psychological factors pertaining tothe interpreter alone. These four demand categories,and examples of specific demands within each category,are shown in Table 1.

A second challenge in applying demand-controltheory to the interpreting profession is the importanceof recognizing the simultaneous contribution of de-mands from each of these four categories to the overalldegree of demand the interpreter experiences during a

courtroom interpreting is always stressful, or even highdemand, would not be accurate. Consider a situationwherein the presiding judge and attorneys understandthe uniqueness of American Sign Language (ASL) andDeaf culture, the deaf consumer is well educated on hisor her legal rights and responsibilities, both the hearingand deaf consumers’ communication styles are easilyunderstandable, and the legal situation at hand is notemotionally taxing, such as a business merger hearing.The overall demand of this assignment is not as highas might have been first presumed, and interpreterscompetent with legal vocabulary (one aspect of the in-terpreter’s control) would not be expected to find theassignment stressful. In contrast, consider an assign-ment that might be presumed to be low demand: inter-preting for a kindergarten class graduation attended bydeaf parents. But in this case, the graduates sing an un-intelligible series of songs that the interpreter was nottold about previously, the deaf consumers’ view of theinterpreter is continually blocked by camcorder-totingparents, the deaf parents’ child forgets the words to hersolo and starts crying (which upsets everyone), and theparents ask the interpreter if she would hold their 3-month-old child while they comfort the crying kinder-gartner. A presumed low demand assignment has be-come a high demand nightmare and may well be astressful one, depending in part on the interpreter’scontrol resources.

A third challenge in applying demand-control the-ory to the interpreting profession is to appreciate theshift in demands that can occur between various inter-preting assignments or even during the same assign-ment. The two previous situations may have been ex-perienced by the same freelance interpreter on thesame day. Or attentive kindergarten staff might havebetter controlled the parents with the cameras anddealt with the crying child themselves so as not to re-quire the deaf parents’ intervention. Conceptualizingone static level of demand for the occupation of signlanguage interpreting does not seem appropriate.

Whereas Karasek and Theorell typically discussdemand-control dynamics as if they are static in a givenoccupation, they acknowledge that these dynamics canshift if the situation changes. Some occupations mayinvolve considerable variation in demand-control dy-namics, with resulting variation in the impact on theindividual, on a daily or even hourly basis. To appreci-


given assignment. These varied and simultaneous de-mands build on and even influence one another, mak-ing it necessary to view a given interpreting situationfrom all four demand perspectives before concludingwhere the assignment ultimately falls on the demandcontinuum. (Whether or not a given interpreting as-signment is stressful must further await a considerationof the control resources available to the interpreter, inthis theoretical framework. This will be addressedbelow.)

Interpreting in court is often considered among themost difficult of assignments. Yet the presumption that

Table 1 Categories and examples of demand sources insign language interpreting assignments

Type of demand Sources

Linguistic Clients’ communication modalitiesClients’ linguistic fluencyClients’ communication speedClients’ communication clarityVoice volume; signing spaceInterpreter’s receptive skillsInterpreter’s expressive skillsUse of technical vocabulary

Environmental General nature of assignmentSpecific setting of assignmentSight linesBackground noiseRoom temperatureChemicals and odorsSeating arrangementsLighting qualityVisual distractions

Interpersonal Parties’ understanding of theinterpreter’s roleParties’ adherence to expected rolenormsCommunication directed to theinterpreterPower and authority dynamicsOppression, dishonesty, unfairness, etc.Communication control, e.g., turn-taking

Intrapersonal Dynamic nature and intensity of eventVicarious reactionsSafety concernsPhysiological responses and distractionsDoubts or questions about performanceAvailability of supervision and supportAnonymity and isolationNo legal cloak of confidentialityLiability concerns

ate the sometimes shifting nature of demand-controldynamics, and the resulting occupational stress conse-quences of the demand-control balance, consider theexperience of progressing through successively moredifficult stages of a familiar video game. At the begin-ning, you have considerable resources at your disposal(your experience with the game, your knowledge of thefew dangers awaiting you on the early levels, several“lives” in storage, a full cache of weapons or otherassets needed for the challenge) and in these ways, youare in great control of the situation, though perhapsnot very entertained. However, as you proceed tohigher levels of the game, the dangers and difficultylevel, the demands, increase steadily while your re-sources and abilities to respond to these increasingchallenges, your control, steadily diminishes. Beforelong, the demand-control dynamics have shifted yourexperience from the leisurely, confident environmentportrayed in quadrant IV of Figure 1, to the ineffective,overwhelmed experience portrayed in quadrant II. Butyou keep playing the game because there is an exhila-rating period when there is a balance between demandand control that is high enough (quadrant I) for youto find the experience pleasurably challenging and thatstimulates growth of your knowledge and skill at thegame.

Control and the Interpreting Profession

As noted, the positive or negative outcomes of a givenoccupational situation are not dictated by job demandsalone but by the relation between demands and control.Karasek and Theorell’s concept of control includes theskills and other resources a worker has to cope with thedemands presented to him and especially his degree ofauthority and freedom to exercise decisions about whichskills and resources to employ and how to do so. Kara-sek and others have shown that providing workers withincreased job control decreases rates of illness and ab-senteeism (Karasek, 1990, 1992). The two componentsof job control, skills/resources and decision authority,are combined in the concept of decision latitude, whichKarasek and Theorell use as a synonym for control.

In many work settings, decision latitude is deter-mined by the responsibilities and resources assigned toa particular job position (e.g., regional manager for


sales in New England with a certain budget and stafffor the year) and by policies and procedures set by one’ssupervisor or other elements of the organizationalstructure. In a profession, however, decision latitude islargely determined by one’s education and experience,the freedoms attributed to that professional role by so-ciety, and by the profession’s code of ethics and stan-dards of conduct. The decision latitude that can be ex-ercised by a physician or attorney is related more toeducation and professional standards than workplaceper se. Hospitals allow doctors to practice within theirarea of competence and according to the ethical and be-havioral standards of the American Medical Associa-tion. Most professionals enjoy wide decision latitude inresponding to the demands of their work. That is whyprofessional occupations are typically experienced aspleasurable and stimulating, even though demands areoften high, since the corresponding high degree of de-cision latitude (quadrant I of Figure 1) leads to the ac-tive type of job experience Karasek and Theorell citeas the most preferred and the one associated with lesspsychophysiological risk. Yet the profession of sign lan-guage interpreting is unique in that it has codified andotherwise incorporated in professional education andpractice the importance of not exercising decision lati-tude, apart from that pertaining to the linguistic de-mands of translation work.

The code of ethics of the RID, the primary nationalassociation of sign language interpreters, contains pro-visions that can be viewed as directly or indirectly re-stricting decision latitude. The code of ethics containseight tenets, one of which states that interpreters “shallnot counsel, advise or interject personal opinions”(RID, 1994, p. 13). Another states that interpreters“shall keep all assignment-related information strictlyconfidential” (p. 12). Until recently, the code also in-cluded a set of explanatory guidelines following eachtenet. Although the RID voted in 1995 (B. Hall, per-sonal communication, April 10, 2000) to discontinuepublication of the guidelines (leaving just the tenets ofthe code), their influence is still significant in the inter-preting profession, as evidenced by the guidelines’ con-tinued appearance in important interpreting texts (e.g.,Metzger, 1999). The most recent RID publications(Cartwright, 1999; RID, 1999) continue to portray theinterpreter’s decision latitude as severely restricted,

a coherent translation. Instead, she guesses at what thepatient might have meant and eventually withdrawsfrom the situation, since she cannot “counsel, advise orinterject personal opinions” even though she could, ifshe felt it were proper, explain in detail to the clinicianhow the patient’s language was distorted from typicalASL and even how it differed from her prior experi-ences with that patient, but that, too, would be prohib-ited by the need to “keep all [previous] assignment-related information strictly confidential.” Instead, theclinician is left ignorant of this vital information, whichcould hold direct bearing on diagnosis and treatmentplanning. Another interpreter works diligently to fulfillhis “only function . . . to facilitate communication”between two parties when he spots a bee in a cornerof the room. This distracting environmental demandreduces the quality of his translation work (Gerver,1974). Moreover, since the interpreter is allergic to beestings, a disruptive intrapersonal demand is engen-dered, as the interpreter’s growing concern for his ownsafety further distracts him from the translation task athand. A physician and patient agree that a prescriptionis needed for a certain ailment but, distracted by laterconversation, no one but the interpreter recalls that theprescription has not been written by the time the ap-pointment is over. She decides not to speak up, be-lieving that would be out of role. A deaf consumer, at-tending a convention, asks the hotel concierge fordirections to a certain restaurant. The interpreter onduty, familiar with the area, knows that the directionsgiven are incorrect. But, based on her training, sheconveys the inaccurate information rather than step outof role. A deaf psychiatric patient becomes increasinglyvolatile in a confrontive therapy session, scaring the in-terpreter, and even directs an angry outburst towardher as a function of his own psychological issues. Theinterpreter does not feel able to debrief or obtain sup-port from anyone following this stressful assignment,for fear of violating her confidentiality oath. This pro-hibition was recently reiterated in a RID publicationon mental health interpreting (RID, 1999).

Our intention in conveying these examples is not tocritique the RID code of ethics or professional guide-lines per se but to emphasize how the real or perceivedlack of decision latitude in interpreting assignmentscan lead to significant stress in light of the four demand


even in complex, professional, personal, and ethicallychallenging situations.

The confidentiality guideline states that “evenseemingly unimportant information could be damag-ing in the wrong hands. Therefore, to avoid this possi-bility, [interpreters] must not say anything about anyassignment” (RID, 1994, p. 12). Although confidenti-ality is an ethical tenet common to many professions,no specific provision is made in the RID code or itsguidelines for discussion of one’s professional perfor-mance and work experiences in a confidential supervi-sory relationship, unlike the code of ethics and conductfor psychologists, for example (American PsychologicalAssociation, 1992). Fritsch Rudser (1986) and Heller etal. (1986), have called for the interpreting professionto establish a confidential supervision mechanism andrecommend that it specifically be described as permis-sible in the guidelines of the code of ethics. The formerRID guidelines also advised that an interpreter’s “onlyfunction is to facilitate communication” (p. 13), that “if[one’s] feelings interfere with rendering the messageaccurately, he/she will withdraw from the situation”(p. 13), and that interpreters “are not editors and musttransmit everything that is said in exactly the same wayit was intended” (p. 13). How might these restrictionsin decision latitude affect the occupational experiencesof sign language interpreters, considering all four de-mand categories with which they must contend?

A speaker at a lecture cannot operate the slide pro-jector correctly, presenting a problematic environmen-tal demand. The interpreter, who is familiar with theequipment and could rectify the problem easily, recallsthat her “only function is to facilitate communication”and does not offer to assist. The speaker abandons theprojector and, frustrated and dislodged from his pre-sentation plan, begins speaking in a faster and less or-ganized manner, increasing the linguistic demand forthe interpreter. An interpreter in a psychiatric emer-gency room is asked to translate for a deaf patientbrought in under mental health arrest. The patient isacutely psychotic and his normally fluent sign languageis grossly distorted just as hearing persons’ languagecan be distorted by mental illness (Pollard, 1998a,1998b). But the interpreter, believing that she “musttransmit everything that is said in exactly the same wayit was intended” is unable to provide the clinician with

categories we described. The decision latitude con-veyed by the RID guidelines seems to leave interpreterswith few options for responding to many of the de-mands presented in their occupation, especially thosethat arise from environmental, interpersonal, and in-trapersonal factors. Traditionally, interpreters havebeen taught that thoughts, information, commentary,and feelings are to be suppressed, as well as all behaviornot directly related to responding to the linguistic de-mands of the translation task. If this is not possible,then withdrawal from the situation is the only option.Even the opportunity to evaluate and perhaps improveone’s ability to cope with these demands is curtailedby the apparent restriction on supervision and peerconsultation, if such supervision risks disclosure ofassignment-related information. Although divergencefrom these highly restrictive views is openly discussedat interpreter workshops and in some training pro-grams, such views are still widespread in the interpret-ing profession (Cartwright, 1999; Heller et al., 1986;Metzger, 1999) and are further reflected in the lan-guage of the RID code of ethics, which has not beenrevised since 1980. In contrast, the code of ethics of theAmerican Psychological Association (an organizationover 100 years old) is still periodically revised in lightof changing societal and professional trends, most re-cently, in 1979, 1982, and 1992.

It is no surprise that the aforementioned literatureon occupational stress in the interpreting profession al-ludes to decision latitude restrictions as prominentcauses of stress and burnout. Heller et al. (1986) spe-cifically portray the restrictive nature of the interpreterrole as stress-inducing. The lack of opportunity (deci-sion latitude) to deal with the emotional impact ofsome interpreting assignments was also blamed ascausing stress by Heller et al., as Harvey and Gunther(1994) also note. These and other studies of interpreterstress (Branam, 1991; Neville, 1992; Swartz, 1999; Wat-son, 1987) emphasize how current interpreter trainingand professional practice standards do not adequatelyaddress the actual challenges (demands) of the inter-preting occupation or the negative consequences ofinterpreter isolation after formal training has ended.Interpreter training and professional developmentactivities must address all four of the demand catego-ries described here and reconsider the consequences of


such a restrictive view of decision latitude that appearsto be prominent in the interpreting profession.

Demand, Control, and Interpreter Education

Theorell and Karasek (1996), in a review of the litera-ture on demand-control theory and related occupa-tional stress research, emphasize the long-term em-ployment consequences of balanced versus unbalanceddemand-control job dynamics. They conclude that“the active job situation, over a significant period oftime, is associated with the development of a feelingof mastery that in turn inhibits the perception of jobstrain during periods of overload—thus reducing thepsychophysiological impact of stressful situations atwork . . . on the contrary, daily residual strain arisingfrom a stressful work situation gives rise to accumu-lated feelings of exhaustion, which may inhibit learningattempts by leading to withdrawal from the learningchallenges presented on the job” (p. 11). There are di-rect implications here pertaining to the national short-age of interpreters and the need for retention of skilled,experienced interpreting professionals. The presentlack of decision latitude perceived by many interpretersand still codified in the RID code of ethics, and the lackof other control resources, including a formally sanc-tioned, confidential supervision mechanism and ad-vanced practice training, is likely contributing to ill-ness, injury (including CTD), high turnover, andburnout rates in the interpreting profession and, con-sequently, the national interpreter shortage (Jackman,1999; Matthews, 1994; Sanderson, 1987). “Skilledinterpreters seem to leave the field faster than [inter-preter training programs] can train new ones” (Wat-son, 1987, p. 79). In a career as demanding as interpret-ing, a singular focus on recruiting new students,without addressing the educational, supervisory, andprofessional development needs of working interpret-ers, is like continually adding more water to a leakingbucket instead of attending to the broader aspect ofthe problem.

The acquisition of classroom-based interpretingknowledge and the ability to translate between sign lan-guage and spoken English does not complete the edu-cation of a sign language interpreter. Interpreters mustintegrate theory and basic translation skills with the

tion and advanced training and supervision. “Higherjob satisfaction is positively correlated to more training. . . as well as effective supervision that includes inter-action with colleagues and . . . supervisors. . . . [These]findings beg for . . . a much higher degree of supportwhile on the job” (D. B. Swartz, personal communica-tion, October 21, 1999).

Similar conclusions can be drawn from a surveyconducted by the first author in 1999, of working inter-preters in the Rochester, New York, area. They wereasked to evaluate the adequacy of the training pro-grams from which they graduated in light of their post-graduate occupational experiences. Nineteen of the 48respondents graduated from “certificate” programs of6 to 10 weeks’ duration (for fluent signers); the other29 attended 2-year associate’s degree programs. In 15out of 17 skill areas assessed,1 drawn from all four de-mand categories, the interpreters from nondegree pro-grams reported they were “insufficiently prepared” or“not at all prepared” by their programs. Interpretersfrom degree-granting programs reported they were“insufficiently prepared” in 5 of the 17 skill areas at thetime of graduation. None of the 48 reported being“very well prepared” in any of the 17 skill areas. Onaverage, respondents “strongly agreed” (4 on a scale of5) with the statements “I would have preferred moresupervised training before graduating” and “Greaterskill development would occur if course work and ex-periential opportunities were more integrated andoffered earlier.” It would not be correct to assume thatthe respondents simply needed or wanted more practi-cum experience. Even though practica were rated asthe “most helpful” (4 on a scale of 5) portion of theireducations, these working interpreters rated the per-centage of skills they now possessed as acquired 18%or less from practica. Table 2 provides supporting data.Respondents provided estimates of the percentage ofeach skill listed that they learned during their trainingprogram (including any practica) versus the percentagelearned after graduation. The average estimate of thepercentage of skills learned after their training hadended was over 66%.

We believe these data document a problem with in-terpreter training, not necessarily in the nature andlength of school-based programs, but in the lack of apostgraduate training period of supervised interpreting


many challenges of professional practice includingthose arising from environmental, interpersonal, andintrapersonal demands. They must develop uniqueknowledge bases and other skills (beyond those per-taining to language per se) regarding the varied servicesettings where interpreters work and, most impor-tantly, expand and hone their professional judgmentskills. This is particularly important and challenging inservices settings such as health care, mental health, thecourts, and other complex environments where inter-preters are increasingly in demand due to the accessi-bility mandates of the Americans with Disabilities Act(ADA; Cokely, 1982; DeMatteo, Veltri, & Lee, 1986;Hall, 1999; Harmer, 1999; Harvey, 1997; Pollard, 1996,1998a, 1998b; Pollard & Smith, in press; Putsch, 1985;Shaw, 1996; Stansfield & Veltri, 1987; Veltri, 1993;Yafee, 1999; Young, 1985). Roy (1993) notes that inter-preter training programs do not address the full rangeof interpreting demands but tend to focus on the “su-perficial aspects of the communication event which re-inforce the notion that the interpreter’s task is largelymechanical and that the interpreter’s role in the eventis passive” (p. 146).

The knowledge base and professional judgmentskills needed to function effectively as a sign languageinterpreter, especially in these complex settings, are notso much taught as they are developed. Allowing thesecritical interpreter competencies to develop haphaz-ardly, on-the-job, without supervision or mentorship, isan error of oversight that distinguishes the interpretingprofession from many others that require extended in-ternship periods. This oversight not only holds seriousconsequences for deaf and hearing consumers of inter-preting services, it endangers the size and stability ofthe already insufficient interpreter resource pool byfailing to attend to the retention and early professionaldevelopment of graduates.

Observations and emerging research data suggestthat most working interpreters hunger for supervisionand professional development, often prioritizing thesethings higher than salary in a new job offer (Swartz,1999). Theorell and Karasek (1996; Karasek &Theorell, 1990) have confirmed that such supports atwork decrease occupational health risks. Swartz’s studyis one of the few empirical investigations that touchesupon the relationship between interpreter job satisfac-

practice. It is frightening that these interpreters judgedthat the majority of their education occurred after theirformal training (and practica) had ended, while theywere on the job, serving consumers, with no formal supervi-sion.Other professions (e.g., medicine, law enforcement)are associated with continued supervised learning afterthe classroom-based period of education has ended.Unlike interpreters, these newly graduated profession-als are rarely the only individuals in the work environ-ment with the specialized knowledge needed to conductthe work and they rarely perform their duties unsuper-vised, especially during the early years of practice.

Given the desire for and scarcity of advanced train-ing and supervision, it is not surprising that Heller etal. (1986), Swartz (1999), and Watson (1987) attributeinterpreter burnout and early departure from the pro-fession directly to stress. If interpreters had guidancein advanced skills application, and supervision andmentorship during the professional seasoning periodthat follows graduation, more might survive this pe-riod, when their commitment to the field is initiallychallenged. Other professions, such as medicine, men-tal health, teaching, and law enforcement, all havelearned the value of an extended period of practice-based instruction and supervision. It is no coincidencethat these professions, which are highly demandingand which value independent judgment and the reten-tion of skilled veterans, all require extended supervisedtraining periods. The field of sign language interpret-


ing has not followed suit and continues to address theinterpreter shortage through a singular focus on estab-lishing more training programs. It can be argued thatthe lack of attention to early professional developmentand retention of recent graduates is an equal or greatercause of the national interpreter shortage than a limita-tion in the number of college-based interpreter train-ing programs.

Despite the proliferation of interpreter trainingprograms, now numbering over 130 in the UnitedStates and Canada, Frisherg’s (1986) criticism thatthere exists “no universally accepted standard of whatconstitutes an adequate instructional program” (p. 88)remains largely true today. Sign language interpretingprogram graduates may hold only a “certificate” or anassociate’s, a bachelor’s, or a master’s degree. McIntireet al. (1991) have stated that “the education of sign lan-guage interpreters is insufficient and inadequate . . .[with] tremendous diversity in program philosophy,quality, structure and goals. The result is lack of con-sistency in the linguistic skills, knowledge, and atti-tudes of program graduates” (p. 2).

Efforts toward improvement are taking place. TheConference of Interpreter Trainers (CIT) and the RIDhave adopted standards for interpreter education pro-grams (CIT, 1995). Yet this document seems to suggestvariable definitions of interpreter competencies as wellas educational standards unlikely to result in the degreeof competency desired. The document first notes that

Table 2 Percentage of skills learned in versus outside of interpreter training programs

Skill or demand % Learned % Learned(ling., envir., inter- and intrapersonal) during training after training

Knowledge of ASL linguistic features 39 61Knowledge of sign vocabulary 42 58Making appropriate word choices during voicing 45 55Making voicing sound fluid and natural 41 59Assessing the language of deaf consumers 31 69Helping hearing people utilize interpreter services 32 68Building rapport with deaf and hearing consumers 21 79Knowledge base for medical environments 36 64Knowledge base for mental health environments 36 64Knowledge base for business environments 21 79Knowledge base for K–12 educational environments 45 55Knowledge base for postsecondary environments 32 68Skills to advocate for yourself and your needs 22 78Ability to identify and deal with “inner noise” 25 75Average percentage 33.4 66.6

after graduation, through unsupervised, on-the-jobexperience.

As the CIT progresses toward implementing inter-preter education standards through a training programaccreditation system (C. Cogen, personal communica-tion, April 8, 1999), other entities have begun their ownprocesses of defining and recognizing interpreter com-petencies. The Missouri Department of Mental Health(1998) has proposed minimum standards for sign lan-guage interpreters who work in their programs. Prac-tice standards for interpreters in health care settingsalso have been proposed (Massachusetts Medical Inter-preters Association & Education Development Center,Inc., no date). The New York State Department of Ed-ucation has funded the National Technical Institute forthe Deaf in Rochester, New York, to lead developmentof a certification process for interpreters who work inK–12 educational settings (Livadis, 1997, 1998). Theseefforts reflect growing concerns with how best to ad-dress the variability of interpreter skills and readinessfor employment that has become evident in the wake ofthe ADA, which spawned a tremendous increase in thedemand for interpreter services.

Although the ADA mandates that sign language in-terpreters be “qualified,” the definition of qualified hasbeen left unspecified. Hall (1999) notes that “withoutthe tools or mechanisms to identify who has attainedsome level of competency, hiring entities are at a losson how to satisfy the mandates of ADA in locating/providing ‘qualified’ interpreter services” (p. 1). Hallproposes model legislation that might be used for suchpurposes. A few states have enacted interpreter licens-ing laws; however, the status quo in most of the countryis tremendous variability in interpreter competency.Not only do formal training programs vary in length,breadth, and quality (McIntire et al., 1991), the pre-vailing lack of regulations regarding interpreter quali-fications allows persons with no formal training what-soever to be hired into some interpreter positions.Persons with sign language fluency but no formaltraining, and even persons with limited sign languagefluency and no formal training, are regularly hired insome settings out of employers’ sheer desperation tomeet access demands and/or failure to appreciate theskills and experience level qualified interpreters need.

Interpreter licensing legislation and practice stan-


an interpreter must be able to serve “a diverse popula-tion in a variety of settings across a broad range offields, [requiring] professional interpreters to possess abreadth of knowledge and depth of knowledge.” Laterin the CIT document, this ideal seems to be loweredto a “breadth of knowledge allowing interpretation ofgeneral discourse within several fields [and] sufficientspecialized knowledge of one or two disciplines al-lowing interpretation of more specialized discoursewithin these disciplines.” Is the former “breadth anddepth of knowledge” now applied only to two specialtyfields? How could a freelance interpreter, especially oneeducated in a certificate or associate’s degree program,be expected to develop a “breadth of knowledge anddepth of knowledge” sufficient to work competently ina college, health care, legal, and mental health setting,all of which she might be called into on a given day?

Perhaps the more significant question is where willthis specialty content and judgment knowledge comefrom? It is not likely to be presented in the classroomenvironment of most interpreter training programs,especially those below the master’s level. This leavespracticum training opportunities. Yet the CIT stan-dards on practica state only that students should workwith a qualified supervisor, observe other interpreters,be exposed to varying experiences and a variety of deafconsumers, and have opportunities to apply classroomknowledge to their work (CIT, 1995). There is no req-uisite number of hours specified for completion of thisexperiential component of the interpreter’s education.In reality, the average practicum requirement for mostinterpreter training programs is about 200 hours. Thistime can be spent in observation of other interpreters,providing direct interpreting services, practicing inter-preting skills with videotapes, in supervision with amentor, and other activities related to the Deaf or inter-preter communities. Students in many programs cancomplete these required practica hours in two semes-ters. Moreover, practicum opportunities for students toobserve working interpreters and provide direct ser-vices are often limited to locations where interpreterswork on a full-time basis, primarily educational set-tings (Frishberg, 1986). Usually, opportunities for inter-preters to become familiar with the content, dynamics,and other occupational demands of environments suchas legal, health care, college, and mental heath, occur

dards typically are written with an emphasis on thelength and nature of the interpreter’s education and, insome cases, supervised practice experience. This ap-proach is similar to that taken in developing license orcertification standards for other high demand, highcontrol professions, such as medicine, teaching, andlaw. In these professions, too, concerns periodicallyarise regarding quality assurance, educational methodsand standards, and protection of the consumers beingserved. These professions also consider extended peri-ods of supervised clinical practice (e.g., internships) anessential component of the training process followingthe classroom-based educational period. Another pro-fessional education trend in these fields, worthy of con-sideration for interpreter education, is the evolution ofproblem-based learning approaches.

Education scholars increasingly recommend thattraining in the practice professions involve hands-onservice experience as early as possible. Problem-basedlearning emphasizes early student exposure to practicechallenges with real consumers and, through this con-textual approach, merges the acquisition of knowledgeper se with evolution of professional practice and judg-ment skills, which are modeled and nurtured by sea-soned teachers or mentors. Problem-based learning hasbeen shown to trigger prior knowledge, motivate learn-ers, and stimulate classroom discussion. It is being usedin an increasing number and variety of professionalschools (e.g., medical and nursing schools), and is a re-action against traditional education approaches thatyield graduates insufficiently able to apply classroomknowledge to daily professional practice (Frost, 1996;Saarinen-Rahiika & Binkley, 1998). This educationaltrend also could be construed as the emerging prefer-ence in how to teach and hone decision latitude skillsin high demand occupations. Witter-Merithew (1992)recommends a similar competency-based education ap-proach for interpreter education, one which requires“that knowledge be demonstrated in ‘real-world set-tings’ over a period of time.” Such programs would in-clude “a strong experiential and application compo-nent” with “frequent self, peer and instructor feedback. . . and an immediate opportunity to integrate feed-back into their work.” Interpreter training programsalso should provide students with “support and en-couragement for this critical portion of the learning ex-perience” (pp. 2, 5).


Conclusions

Sign language interpreting is a high demand occupa-tion, one where the demands are numerous, dynamic,and interactive and arise from complex linguistic, envi-ronmental, interpersonal, and intrapersonal factors.Interpreting is also a profession that appears to presentsevere restrictions in decision latitude, especially interms of responding to demands other than linguisticones. This combination of high demand and low deci-sion latitude puts interpreters at high risk for stress-related illness, injury (including CTD), and burnout,according to demand-control theory and related occu-pational stress research. The available empirical dataregarding stress in the interpreting field support thisperception, suggesting that the national shortage ofsign language interpreters, in part, may arise fromstress-related or stress-aggravated CTD disabilitiesand early career burnout. Although the high demandnature of the interpreting occupation cannot readily bealtered, changes can be made in the area of decisionlatitude that may hold promise for reduction of thenegative consequences of stress and subsequent im-provement in the size and health of the professional in-terpreter resource pool. As with other professional ser-vice occupations, the nature of one’s education, earlyprofessional development, and the behavioral stan-dards of one’s profession hold considerable importancein the development of decision latitude resources andskills.

Daniel Burch, former president of the RID, hasnoted that the trend in interpreter education is towardthe proliferation of 4-year training programs (personalcommunication, April 9, 2000). Yet Dean’s survey data,presented herein, suggest that the increase in educa-tional time between a “certificate” program and a 2-year associate’s degree program did not result in iden-tifiable differences in graduates’ views of their pre-paredness for interpreting work when asked to reflectupon their education. Will shifting from 2-year to 4-year training programs offer a benefit that was not ap-parent when comparing 6-week to 2-year programs?Roy (1993) states that 2-year programs are inadequatefor training interpreters to meet the multiple and com-plex demands of the occupation, while Young (1985)questions the ability to provide adequate training in 4or even 6 years of traditional instruction.

Cartwright, B. (1999). Encounters with reality: 1,001 interpret-ing scenarios. Silver Spring, MD: Registry of Interpreters ofthe Deaf.

Cokely, D. (1982). The interpreted medical interview: It losessomething in the translation. Reflector, 3, 5–10.

Conference of Interpreter Trainers. (1995, March). National in-terpreter education standards. Northridge, CA: Author.Available through the Internet at www.cit-asl.org/standard.html.

DeCaro, J., Feurerstein, M., & Hurwitz, T. A. (1992). Cumula-tive trauma disorders among educational interpreters: Con-tributing factors and intervention. American Annals of theDeaf, 137(3), 288–292.

DeMatteo, A. J., Veltri, D., & Lee, S. M. (1986). The role of asign language interpreter in psychotherapy. In M. L. McInt-ire (Ed.), Interpreting: The art of cross-cultural mediation (pp.135–153). Silver Spring, MD: Registry of Interpreters ofthe Deaf.

Frishberg, N. (1986). Interpreting: An introduction. Silver Spring,MD: Registry of Interpreters for the Deaf (RID) Press.

Fritsch Rudser, S. (1996). The RID code of ethics, confidential-ity and supervision. Journal of Interpretation, 3, 47–51.

Frost, M. (1996). An analysis of the scope and value of problem-based learning in the education of health care professionals.[Review]. Journal of Advanced Nursing, 24(5), 1047–53.

Gerver, D. (1974). The effects of noise on the performance ofsimultaneous interpreters: Accuracy of performance. ActaPsychologica, 28, 159–167.

Hall, B. (1999). State regulation of interpreters: Critical issuesand model legislation, a policy paper. Available through RIDfax on demand service, www.rid.org/fax.html.

Harmer, L. M. (1999). Healthcare delivery and deaf people: Areview of the literature and recommendations for change.Journal of Deaf Studies and Deaf Education, 4(2), 73–110.

Harvey, M. (1997). The evolving relationship between inter-preter and family therapist. Journal of Interpretation, 7,63–76.

Harvey, M., & Gunther, P. (1994). Negative emotional fallout ofinterpreting for deaf persons. Proceedings of Breakout III:New Traditions. Psychosocial rehabilitation for persons who aredeaf and mentally ill (pp. 23–28). DeKalb, IL: Northern Illi-nois University.

Heller, B. Stansfield, M., Stark, G., & Langholtz, D. (1986). Signlanguage interpreter stress: An exploratory study. In Pro-ceedings of the 1985 Convention of the American Deafness andRehabilitation Association. Little Rock, AK: ADARA.

Jackman, T. (1999, July). At colleges, lack of interpreters for deaf.Registry of Interpreters for the Deaf (RID) Views, 16, 1, 7.

Karasek, R. A. (1979). Job demands, job decision latitude, andmental strain: Implications for job redesign. AdministrativeScience Quarterly, 24, 285–307.

Karasek, R. A. (1990). Lower health risk with increased job con-trol among white collar workers. Journal of OrganizationalBehavior, 11(3), 171–185.

Karasek, R. A. (1992). Stress prevention through work reorgani-zation: A summary of 19 international case studies. Condi-tions of Work Digest, 11, 23–41.

Karasek, R., & Theorell, T. (1990). Healthy work: Stress, produc-tivity, and the reconstructing of work life. New York: BasicBooks.


Perhaps the length of time in an interpreter train-ing program is not so much the issue, as the nature ofthe training activities one is engaged in. We believethere is a need for an extended period of supervisedpractice for sign language interpreters, of a length andnature similar to internships common in other profes-sional occupations that have high degrees of demand.We also believe that interpreter education prior to theinternship level should include instruction regardingthe full range of demands of the profession, includingthose that arise from environmental, interpersonal, andintrapersonal factors, and should prepare students toappreciate and respond to those demands in ways thatfit the profession’s ethical principles and behavioralguidelines. However, the current restrictions or disclar-ity in what those behavioral guidelines are must be ad-dressed by interpreters and interpreter educators. It isour hope that demand-control theory and its applica-tion to the interpreting profession can inform that un-dertaking.

Received April 10, 2000; revisions received July 17, 2000; ac-cepted July 19, 2000

Note

1. The 17 skill areas listed in the survey were as follows. Lin-guistic Demand: expressive ASL skills (voice to sign), expressivetransliterating skills (voice to sign), voicing for ASL signers (signto voice), voicing for English-oriented signers (sign to voice); En-vironmental Demand: preparedness to work in medical settings,preparedness to work in mental health settings, preparedness towork in general business settings, preparedness to work in K–12educational settings, preparedness to work in postsecondary edu-cational settings; Interpersonal Demand: assessing language modeof deaf consumer, ability to adapt to range of consumer commu-nication modes, assessing hearing consumers’ understanding ofinterpreting process, ability to adapt to hearing consumers’ levelof understanding of interpreting process, ability to educate deaf/hearing consumers about roles/duties/limitations of interpret-ing; Intrapersonal Demand: assertiveness skills to advocate foryourself and your needs, ability to identify one’s “inner noise”and deal with it appropriately.

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Documents

Application of Demand-Control Theory to Sign Language Interpreting: Implications for Stress and Interpreter Training