Language switching by bilingual therapists and its impact on the therapeutic alliance within psychological therapy with bilingual clients: a systematic review

Abstract

A systematic review was conducted to evaluate the empirical literature exploring the role of language switching in therapeutic engagement for bilingual therapists working with minority ethnic clients who share the same native language. The review identified three main themes of research focusing on: the training needs and professional development of bilingual therapists; the emotional aspects of language use; and the use of language switching and its perceived effects on the therapeutic process. The review indicates that language switching may be a useful therapeutic strategy for bilingual therapists when working with bilingual clients. Findings indicate how language switching may strengthen the therapeutic alliance and enhance client selfdisclosure. They also highlight gaps in the training needs of bilingual therapists. Limitations of the reviewed studies are considered, with discrepancies in recruitment processes and sampling as prominent factors that have impacted upon the generalisability of findings. Recommendations and implications for future research and practice are discussed for language switching as a tool, which may prove valuable for bilingual therapists when accessing and engaging with diverse populations in the therapeutic domain.

Using stakeholder perspectives to guide systematic adaptation of an autism mental health intervention for Latinx families: A qualitative study

“…In addition to Spanish‐speaking therapists, there is a need for bilingual and bicultural supervisors and formalized training in the delivery of mental health services in multiple languages (Castaño, Biever, González, & Anderson, ; Schwartz, Rodríguez, Santiago‐Rivera, Arredondo, & Field, ), all of which require focused efforts to prioritize bilingual and bicultural hires across multiple levels of an organization. Furthermore, as many bilingual providers cite concerns about their linguistic competence (Kapasi & Melluish, ), assessment of providers' Spanish language proficiency would help guide targeted language‐based supports needed in supervision or at the broader agency level. In particular, as our study results replicate findings from other studies in which Spanish–English bilingual providers noted difficulties in using technical terms of therapy (e.g., Verdinelli & Biever, ); it is highly likely that both consumers and bilingual providers across settings and interventions would benefit from the current study's recommendation for simplification of language used in intervention delivery.…”

Bilingualism in the real world: How proficiency, emotion, and personality in a second language impact communication in clinical and legal settings.

“…Ideally, for bilinguals with relatively high L2 proficiency, practitioners should be able to speak the same languages as patients or clients. Switching between languages as needed, during psychotherapy in particular, can increase patients’ self-disclosure and emotional expression (Ramos-Sánchez, 2007; Santiago-Rivera, Altarriba, Poll, Gonzalez-Miller, & Cragun, 2009), facilitate the therapeutic alliance (Kapasi & Melluish, 2015) and be used deliberately to the benefit of the therapy (Martinovic & Altarriba, 2013). The utility of this approach may also extend from psychotherapy to communication with professionals in other sensitive professional situations (such as a legal trial or a medical procedure).…”

Training of bilingual school psychologists in the United States: A culturally and linguistically responsive approach

“…However, encountering an emotion word in the second language (L2) does not activate as many associations as in the L1 (Altarriba, 2001). Thus, it is common to observe clients engage in code switching to represent their emotions during therapy (Altarriba & Santiago-Rivera, 1994; Basnight-Brown & Altarriba, 2007; Kapasi & Melluish, 2015; Martinovic & Altarriba, 2012). Perez-Foster (1998) suggested that language code switching is deliberate, predictable, and contextually and situationally dependent.…”

“…Beyond these characteristics, school psychologists might also consider assessing the student's level of acculturation and physical and mental health status in order to form an effective treatment/intervention plan (Esquivel, Oades-Sese, & Jarvis, 2010). On an ongoing basis, school psychologists might evaluate and refine treatment modalities to fit the needs and characteristics of CLD students (Basnight-Brown & Altarriba, 2007; Kapasi & Melluish, 2015).…”