Clients using interpreters wait longer and have poorer outcomes in Talking Therapies for Anxiety and Depression - a retrospective cohort study on waiting times and treatment outcomes

Kunorubwe, T., Meek, N. and Pye, R. ORCID: https://orcid.org/0000-0002-1395-7763 (2026) Clients using interpreters wait longer and have poorer outcomes in Talking Therapies for Anxiety and Depression - a retrospective cohort study on waiting times and treatment outcomes. The Cognitive Behaviour Therapist. ISSN 1754-470X (In Press)

Abstract/Summary

NHS Talking Therapies for Anxiety and Depression (TTad) offers evidence-based psychological interventions for individuals with depression and anxiety disorders across England. Despite substantial progress in improving access to therapy, disparities remain, particularly for clients from diverse backgrounds. Given the increasing linguistic diversity across England and the reported preference among clients to engage in therapy in their first language, it is not yet known whether requiring or requesting an interpreter affects access to timely and appropriate therapy, or whether such needs contribute to disparities in treatment outcomes. This study, therefore, examined waiting times and outcomes for interpreter-mediated CBT within TTad. The sample consisted of 177,340 clients who accessed TTad services for the year 2022 to 2023 and received Step 3 CBT. Clients using an interpreter were significantly more likely to wait longer for treatment compared to those not using an interpreter. Treatment outcomes differed significantly, only 58.5% of clients using an interpreter showed reliable improvement, compared to 69.2% of those not using an interpreter. Similarly, reliable recovery was lower in the interpreter group (32.5%) versus the non-interpreter group (44.5%). Among those requiring an interpreter, the lowest reliable recovery was seen in clients using professional interpreters (28.8%). These findings highlight the need for targeted strategies to reduce delays and improve outcomes for interpreter-mediated therapy, ensuring more equitable access and effectiveness of psychological interventions within TTad. Further research is needed to explore the underlying factors contributing to these disparities and to identify best practices for delivering effective, culturally and linguistically appropriate therapy.