Multilingual Clients’ Experience of Psychotherapy

Abstract

The present study focuses on the experiences of 182 multilingual clients who had been exposed to various therapeutic approaches in various countries. An on-line questionnaire was used to collect quantitative and qualitative data. The analysis of feedback from clients with multilingual therapists showed that clients use or initiate significantly more code-switching (CS) than their therapists, and that it typically occurs when the emotional tone is raised. Gender was unrelated to CS frequency. CS is used strategically when discussing episodes of trauma and shame, creating proximity or distance. CS allows clients to express themselves more fully to the therapist, adding depth and nuance to the therapy. The therapist's multilingualism promotes empathy and clients' own multilingualism constitutes an important aspect of their sense of self. Multilingual clients benefit from a therapeutic environment where multilingualism is appreciated, and where they can use CS.

The talking cure—building the core skills and the confidence of counsellors and psychotherapists to work effectively with multilingual patients through training and supervision

“…Dewaele and Costa () recruited 182 multilingual clients to their research project via nonclinical routes. They used a combination of questionnaires, which employed Likert scales and Open Boxes, and face‐to face interviews.…”

“…One multilingual research participant reminded us: “The mother tongue, i.e. the language your mother spoke to you in, is highly significant in the transference” (C126, Guajarati, English, French, Spanish) (Dewaele & Costa, , p. 44).…”

“…Childhood memories were found to be richer and more emotionally charged when recounted in the first language. Dewaele and Costa () reported that 61% (of a total of 109 participants) of the multilingual therapy patients who participated in their research agreed that their language‐switching was linked to a raised emotional tone, as illustrated by this quotation:

My therapist did not understand my (first language) L1, however she asked me to talk about my childhood which seemed irrelevant in the therapy in English; however, when I mixed in some words from my L1s, it started to make more sense talking about my childhood. As if English language did not let my memories come back efficiently enough, and I just needed some key words in L1 to bring memories back.

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“…It seems to be crucial for a therapist to keep an open mind and to tolerate ambiguity when working with multilingual clients. Although the third overarching theme, which emerged from Dewaele and Costa (), was the fact that the multilingualism of the therapist promotes greater empathic understanding, it is the core skills of all therapists with regard to clients’ multilingualism, which is appreciated by one research participant:

It doesn't matter whether the therapist understands the actual language spoken: there comes a point where I as a patient I am invited to hear and listen to myself. This is very helpful, in the presence of another benevolent being.

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

“…Indeed, minority ethnic individuals often report a dual sense of self (Marcos & Urcuyo, 1979), which explains why some personal characteristics may be linguistically represented in one language but not in another (Espin, 2013;Kanno, 2003;Kokaliari et al, 2013;Sciarra & Ponterotto, 1991). In therapy, this can have a significant impact on the therapeutic process and the extent to which clinicians understand their client's position, depending on the language used (Clauss, 1998;Dewaele & Costa, 2013;Kokaliari et al, 2013). If clients are only able to share their experiences in one language, clinicians may misunderstand the difficulties being presented, potentially impacting on the therapeutic alliance, the engagement and the outcome of therapy (Kai & Hedges, 1999;McKenzie, 2008;Williams, Turpin, & Hardy, 2006).…”