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Interpreters for Therapy and Mental Health

In therapy the conversation is the treatment, and a psychiatric evaluation depends on how a person speaks as much as on what they say. Here is who is responsible for the interpreter, what mental health work asks of one, and how clinicians, clinics and attorneys book one with us.

If the clinic receives federal health funding, it provides the interpreter

Mental health services are health programs under the Section 1557 rule, which applies to any health program or activity that receives federal financial assistance from HHS (45 CFR 92.2). A covered clinic, hospital unit or practice must offer a qualified interpreter when one is needed, free of charge, and may not require the client to bring or pay for their own (45 CFR 92.201(b), (c)(1), (e)(1)). The rule's definition of a qualified interpreter fits this setting closely: accurate and impartial, using specialized terms without changes, omissions or additions, preserving the tone, sentiment and emotional level of the original, and bound by confidentiality (92.4).

Family members are restricted for the same reasons as in medicine, and more so here. A covered provider may not rely on a minor child except as a temporary emergency measure, and may rely on an adult companion only in an emergency or when the client asks for it privately, with a qualified interpreter present, and the request is documented (92.201(e)(2)–(3)). In therapy the relative is often part of what the client needs to talk about.

So a client of a community mental health center or a clinic that takes federal health funding should ask the clinic for the interpreter. Who books us: therapists and psychiatrists in private practice that receive no federal financial assistance — the federal rule does not reach them, though state law may — and who would rather see the client than refer them away; covered clinics for a language or an in-person session their usual service cannot fill; psychologists conducting evaluations for immigration cases, and the attorneys who commission them; and clients paying privately for a therapist they chose. If a payer or program requires a specific interpreter credential, tell us when you request; we confirm whether we can staff it before you book.

What therapy asks of an interpreter

The interpreter works in the first person, consecutively, in short segments, and renders how something is said along with what is said: the hesitation before an answer, a flat "fine", swearing, crying, a joke. A clinician reading affect through an interpreter is relying on the interpreter not to smooth it out. A cleaned-up rendering of a distressed client sounds calmer than the client is.

In a psychiatric evaluation this is the whole point. Tangential answers, words that do not exist, sentences that break off, pressured or very slow speech — the interpreter renders them as they come, and tells the clinician when something is also disordered or unclear in the original language. That lets the clinician separate a symptom from a translation problem. The interpreter does not interpret the client's meaning for them or offer a diagnosis of their own.

Expressions of distress vary by language and culture, and some sound alarming or trivial when rendered literally. When an expression carries a cultural meaning the clinician may miss, the interpreter says so openly in the session, so that both the clinician and the client hear it. Risk questions — about self-harm, suicide, harm to others — are rendered exactly as the clinician worded them. Standardized questionnaires and tests are a further question: interpreting an item changes it, and the clinician decides which instruments can be used through an interpreter and how to document that.

Continuity, confidentiality and the third person in the room

• The same interpreter across sessions helps the relationship. Ask for it when you book a series; we tell you whether that interpreter is available for the schedule.
• Small language communities mean the client may know the interpreter, or fear being known. Give the client the interpreter's name before the first session and let them say if there is a problem.
• Five minutes before and after. A short pre-session briefing (what today is about, anything difficult coming) and a debrief help. They fall within the booked time; schedule the hour to include them.
• The interpreter has no role outside the session: no rides, no phone calls with the client, no side conversations in the waiting room.
• Trauma work is heavy for the interpreter too. For a series of trauma-focused sessions, say so when you book.
• Couples, family and group sessions need one speaker at a time, and a group with several languages needs one interpreter per language.

Seating, video and phone

In person, the interpreter usually sits beside and slightly behind the clinician, so the client looks at the clinician and the conversation stays between them. By video, the interpreter joins the clinician's platform as a third participant; a covered provider using video remote interpreting must ensure real-time video without lags or blurred images, both faces visible, and clear audio (92.201(f)). Phone works for a scheduling check-in, but it loses the face and the body, which are much of what a mental status examination observes.

Booking sessions and evaluations

By video it is $80 per interpreter per hour from the scheduled start, one-hour minimum: a weekly 50-minute session is $80, four sessions a month $320. In person it is $110 an hour with a two-hour minimum, so a single in-person session costs at least $220 plus travel at $0.70 per mile from the interpreter's location — so weekly therapy costs less by video, and in person makes most sense for evaluations or back-to-back clients. A three-hour psychological evaluation in person is $330 plus travel; by video, $240.

Send the type of session (individual, couples, family, group, psychiatric or psychological evaluation), the standing day and time for a series, the platform or address, the client's language and country, and whether questionnaires or tests will be administered through the interpreter. Evaluation reports that need to exist in another language are a separate written service at $24.95 per page certified.

By video, by phone or in person

Virtual interpreting runs on Zoom, Google Meet or Microsoft Teams, or over the telephone. It is quicker to arrange, costs less and carries no travel charge, and it suits appointments, calls and most meetings.

In person is what venues with their own rules tend to expect, and the right choice when documents are being signed or several people are speaking at once. Tell us the platform, or the city and the venue, when you send the request.

Languages

The standard-availability languages are: Spanish, Portuguese, French, Mandarin, Cantonese, Arabic, Russian, Korean, Vietnamese, Haitian Creole, Polish, Italian, German, Japanese, Hindi, Urdu, Persian, Turkish, Ukrainian, Tagalog, Bengali, Punjabi, Gujarati, Tamil, Armenian, Greek, Hebrew, Romanian, Serbian, Bosnian, Somali and Nepali. Every other language we offer carries the 25–30% limited-availability rate. If a language is not on that list it is not because we cannot do it — it is because the pool of qualified interpreters in the United States is small enough that we will not promise a date without checking.

Each language has its own page on what to watch for — dialects, names, dates, who the speakers usually are: see interpreters by language.

What it costs

Rates are per interpreter, per hour, and billed from the scheduled start time rather than from when everyone actually arrives.

• Virtual — $80 per hour, one-hour minimum. Zoom, Google Meet, Teams or telephone.
• In person — $110 per hour, two-hour minimum.
• Limited-availability languages — add 25–30%. Which languages those are is listed below rather than left vague.
• Travel for in-person work — $0.70 per mile from the interpreter's location.

How the travel charge works out

Travel is charged at $0.70 per mile from the interpreter's location, which means you can work it out rather than wait for a quote: a 20-mile round trip is $14, a 60-mile round trip is $42, a 150-mile round trip is $105. There is no separate call-out fee on top.

We will not pretend to know in advance where the interpreter will be coming from — that depends on the language, the date and the venue. What we do is confirm the interpreter and the exact travel figure before you book, so it is never a surprise on the invoice. Virtual assignments carry no travel charge at all, which is one reason most of what we do is virtual.

How booking an interpreter works

• You send the request with the form below: the language, the setting, the format, the date and how long it should last.
• We confirm before you commit: the interpreter, the exact price and the travel figure if there is one. We reply the same business day, and no payment is taken at this stage.
• You confirm, and the interpreter is booked for your date.

What to have ready

The more of this comes in the first message, the fewer exchanges before you have a price:

• The language, the date, the start time and how long it should run.
• Virtual or in person: the platform, or the city and the venue.
• The setting and the subject matter.
• How many people need interpreting for.
• Any credential the venue requires of the interpreter.

Request an interpreter

Tell us the date, the language and the setting and we will come back with the interpreter, the exact price and the travel figure if there is one — before you commit to anything.

Sources

What this page says about the rules was checked against these official sources on October 21, 2026. Rules change; the source is always the authority.

• 45 CFR 92.201 — Section 1557: Meaningful access for individuals with limited English proficiency (eCFR; rule of May 6, 2024)
• 45 CFR 92.4 — Section 1557 definitions: qualified interpreter for an individual with limited English proficiency (eCFR)
• 45 CFR 92.2 — Section 1557: Application to health programs receiving HHS financial assistance (eCFR)

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