L’importance de la voix pour accompagner, accueillir et résonner avec le patient dans le travail transculturel

Abstract

The human voice is an often underestimated tool in clinical practice and psychosocial studies and research. Paradoxically, despite being a primary means of expressing emotions and sharing intimate feelings, the human voice is often neglected in clinical psychotherapeutic work. Despite its importance for psychotherapists, psychiatrists, and caregivers, a lack of theories and deeper explorations of its potential impedes its explicit utilization in the mental health care environment. This article focuses on the importance of the caregiver's voice when working with patients from different cultures and languages, particularly in transcultural clinics, such as transcultural consultations, which emphasize the therapeutic characteristics of the voice that clinicians often overlook. The authors examined the clinical intuition of experienced caregivers, including nurses, psychologists, and psychiatrists, who work with patients from diverse cultural and linguistic backgrounds. The prosody and musical elements of the spoken voice play a particularly important role in these clinical settings that transcend language barriers. Through a qualitative inductive study involving six experienced clinicians, the authors developed themes highlighting the importance of the caregiver's voice. These themes were based on the experiences and clinical anecdotes of participants specializing in transcultural therapeutic approaches, accustomed to collaborating with interpreters who bridge the language divergence between French and the patients’ native languages. The transcultural consultation constitutes a unique therapeutic approach comprising a team of co-therapists with diverse cultural backgrounds and languages, along with patients, their family members, and professionals providing administrative, medical, or psychological help. The principal therapist is responsible for setting the stage for the consultation and may invite co-therapists to share mental images or proposals while listening to the patient. In this group setting, attentiveness to the voice is crucial, as it provides the therapist with direct audible cues from the patient, and it is also what the patient receives from the caregivers. Before language is translated by an interpreter, the patient perceives the sound of the therapist's voice, its musicality, prosody, and conveyed emotions. The results of this qualitative study suggest that the therapist's voice in a transcultural clinical setting is essential in creating a positive work environment, conveying good intentions to patients, and establishing a therapeutic alliance through prosodic elements. Furthermore, the voice plays an important implicit and explicit role for the participants in this study. They note that their voice unconsciously varies, and they can use it explicitly as a therapeutic tool to create an impulse or mood. Important aspects of the patient-caregiver relationship can be exclusively transmitted by the tone of the voice and by the musicality of the linguistic content of statements made by the caregiver, who wields an important clinical tool that is often taken for granted. The study also highlighted the important contrast between the explicit role of the caregiver's voice as a conscious therapeutic tool and the implicit, unconscious influence on the caregiver's voice linked to the relationship with patients. Further interdisciplinary studies of the human voice as a tool in a clinical and psychotherapeutic context are therefore essential, and the transcultural approach could inspire future research.