Bilingual Counseling

Bilingual counseling is defined as therapeutic discourse that accommodates the client’s linguistic characteristics and incorporates bilingual or multilingual factors as vital components of psychological and contextual functioning. Because language and culture are closely embedded, attention to language diversity responds to competent multicultural counseling that includes self-awareness of the counselor, knowledge of bilingual processes, and skills in bilingual interventions. The discussion that follows applies not only to bilingual individuals but also to multilingual individuals, who may exhibit a more complex language presentation in counseling.

Foundations of Bilingual Counseling

Brief Historical Perspective

In the initial stages of psychodynamic theory, Sigmund Freud documented treatment with bilinguals, but language factors per se were not addressed as instruments of therapeutic change. In the 1930s, some psychodynamic clinicians explored bilingualism, and by the late 1940s a more definite view emerged of language choice as a defense mechanism. Case studies published in the 1950s described the impact of multiple languages on psychodynamic processes such as repression, ego functions, and transference. Further investigations in the 1970s reported differential client presentation in two languages, diagnostic errors, and unique processes and interventions. The multicultural movement that followed and contributions from psycholinguistics, cognitive and clinical psychology, psychometrics, and education have widened the understanding of relevant processes evident in bilingual counseling, which are relevant regardless of the theoretical orientation of the professional.

Academic Writing, Editing, Proofreading, And Problem Solving Services

Get 10% OFF with 24START discount code

Bilingual Processes

Bilinguals are described as having a dual sense of self that responds differently to distinct contextual stimuli. Language duality allows for the conceptualization of two worlds, communication of thoughts and emotions differently, bicultural dynamics, different organizational sets of knowledge, and multiple self-identities. Intact cognitions and emotions that are specific to each language help store memories in different language domains that can be retrieved by the most meaningful language at a particular period of time.

Bilingual language development may be sequential or simultaneous. Maintenance of the first language (L1) and the second language (L2) depends on ecological support, acculturation level, language use, and sociopolitical factors. Language development encompasses learning to label emotions and cognitions that are associated with early attachments. Thus, a bilingual individual may be prone to experience affective content in L1 or the language that endorses emotional meaning while affective detachment may be expected in L2. Similarly, a sense of logic and maturity may influence accessing L2 in decision making. When both languages are learned simultaneously and supported equally, the affective component may be accessible in both languages. Knowledge of the following bilingual concepts is necessary for competent practice.

Language switching, or code-switching, is a pattern where a word or phrase is replaced by another language within a sentence or a language shift for an extended period of time. The shift occurs from L1 to L2 as well as from L2 to L1, may be involuntary or voluntary, and may be predictable by context. A voluntary shift can be (a) a purposeful strategy to be better understood, (b) a result of lack of fluency, or (c) an avoidance response. Code-switching is associated with memory of emotional content, defense mechanisms, cognitive coping skills, spontaneity, creativity, diverse attributions and interpretations, taboo words, and word retrieval problems. Words that are concrete or overlap semantically are easier to translate than words having unique meanings or abstractions such as emotions. Language mixing integrates characteristics of two languages into one word or phrase (e.g., Spanglish).

Language dominance refers to the individual’s most fluent language. Once a level of fluency is mastered and supported by high levels of use, L2 may shift to become the base, more accessed language.

Language proficiency involves high-order verbal cognitive abilities required in reading, writing, and oral expression. An individual may be proficient in English but may be dominant in Spanish. In 1984, Jim Cummins indicated that non-English speakers require a period of 5 to 7 years to attain proficient English abilities, whereas interpersonal communication skills develop within 2 to 3 years of natural and informal exposure to a second language.

Best Practices

The establishment of the therapeutic alliance, language sensitivity, non-English language acceptance, multicultural competence, and the language match between counselor and client modulate successful bilingual interventions. Sound clinical practice with bilinguals targets the motives leading to choices in language use and phenomenological experiences associated with a dual self. Application of core counseling skills is important, particularly focusing on nonverbal messages and communicating clearly without the use of idioms or regionalisms.

The professional counselor needs to engage in self-evaluation to ascertain whether he or she has the language skills to best respond to the bilingual client. Inadvertently, the practitioner may project unintentional prejudices and power imbalances by choosing the client’s L2 as the primary therapeutic language. Parallel bilingual skills between counselor and client are the ideal match to ensure understanding, maximize the applications of bilingual interventions, and provide a natural flow in therapeutic interactions as figures of speech are difficult to translate and many regional and national variations coexist within the same language. Monolingual counselors are generally not recommended but may be effective in some situations as long as the client’s L2 level is highly profi-cient, bicultural and bilingual issues are addressed, and expression in L1 narratives is encouraged.

A bilingual practice requires availability of assessment tools and documentation in two languages. A brief telephone conversation before the face-to-face interview is valuable to assess language preference. Generally, working with two languages duplicates in-session work and case management responsibilities.

Assessment Methods

Bilingual language skills may be assessed with formal and standardized instruments as well as through interviews. Several norm-referenced tests are available to measure bilingual language dominance and language proficiency (e.g., Riverside Publishing instruments: Woodcock Language Battery-Revised Tests and the Bilingual Verbal Cognitive Abilities Tests). These instruments need to be administered by assessment specialists and may be useful for counseling goals associated with educational and vocational issues.

Comprehensive clinical interviews need to include language factors such as patterns of language use and bilingual development and history. Other areas to assess are conversational proficiency, acculturation level, language used to express emotions and cognitions, language use contexts, coping strengths associated with language use, language of prayers and dreams, general literacy skills, and ecological factors that hinder or endorse specific language usage.

Assessment also requires counselor sensitivity to the interplay of cultural, linguistic, and verbal and nonverbal communication processes. Communicating in the non-dominant language may interfere with the accurate presentation of the client. Verbal and nonverbal features may be affected by limited verbal fluency, anxiety, and emotional inhibition. Affective content may be hampered by communication in a language that lacks emotional meaning. Clients may present as distant and with dissonant affect when verbalizing emotionally laden events. Frequent translations disrupt the flow of therapeutic interactions, risking client distraction and affective disengagement as well as counselor misinterpretations and excessive focus on content instead of meaning.

Bilingual Interventions

Several counseling interventions have been useful with bilingual clients. Language switching has received the most attention in research and practice. Strategically, changing languages during counseling has been used to follow the client’s language and to intervene clinically. When applied in the first manner, code-switching facilitates rapport, connects with phenomenological expressions, clarifies conceptualizations, and enhances the client’s construction of reality. By strategically shifting into the emotional language, the counselor may access affective catharsis, memories, and insights. In contrast, redirecting the shift to L2 will generate an inhibition response, producing a more rational and controlled stance to unrestrained or painful emotions.

In systemic interventions, bilingualism adds another dimension to family and couples therapy with shifts in languages representing systemic dynamics of conflict, resistance, ethnic identity, and acculturation. Cross-cultural couples and family members that share weak skills in a common language may require the counselor to assume the role of language broker.

Counselors with weak L1 fluency may encourage clients to express events and emotions to elicit affective catharsis followed by the client’s translation. The client may benefit from the comparison of different affective perspectives evident in the original and translated narrative. Language-culture-based strategies (e.g., metaphors, proverbs, dichos, music, storytelling, poetry) may be powerful therapeutic tools, and combining two languages enhances spontaneity, disclosure, and problem-solving skills.

Language is also linked to ethnic identity, social justice, and environmental stressors. Addressing language issues (e.g., loss of first language, language acquisition problems) may reveal pertinent clinical data (e.g., pressure to communicate in L2 to avoid discrimination, loss of cultural membership, ethnic identity confusion, educational problems, family conflicts).

Open communication with the client about the counselor’s bilingual language skills may address the client’s comfort level with the counselor’s linguistic abilities as well as any foreign accent evident, which may reflect biases and communication issues.

To prevent process interference, the professional literature unfavorably supports counseling with language facilitators. Special circumstances such as low-incidence languages, emergencies, and assessment needs justify the use of a trained language facilitator. David Bradford and Abilio Munoz (1993) and Freddy Paniagua (2004) provide useful guidelines.

Future Directions

Bilingual counseling requires adequate supervision and training as well as clear delineation of the competency level of the bilingual practitioner. This emerging specialty will require substantially more empirical exploration, new training models, and innovative practice methods.


  1. Ali, R. K. (2004). Bilingualism and systemic psychotherapy: Some formulations and explorations. Journal of Family Therapy, 26, 340-357.
  2. Altarriba, J., & Santiago-Rivera, A. L. (1994). Current perspectives on using linguistic and cultural factors in counseling the Hispanic client. Professional Psychology: Research and Practice, 25, 388-397.
  3. Bradford, D. T., & Munoz, A. (1993). Translation in bilingual psychotherapy. Professional Psychology: Research and Practice, 24, 52-61.
  4. Burck, C. (2004). Living in several languages: Implications for therapy. Journal of Family Therapy, 26, 314-339.
  5. Clauss, C. S. (1998). Language: The unspoken variable in psychotherapy practice. Psychotherapy: Theory, Research, Practice, and Training, 35, 188-196.
  6. Cummins, J. (1984). Bilingualism and special education: Issues in assessment and pedagogy. Clevedon, UK: Multilingual Matters.
  7. Fabbro, F. (1999). The neurolinguistics of bilingualism. East Sussex, UK: Psychology Press.
  8. Javier, R. A. (1989). Linguistic considerations in the treatment of bilinguals. Psychoanalytic Psychology, 6, 87-96.
  9. Marcos, L. R. (1976). Bilinguals in psychotherapy: Language as an emotional barrier. American Journal of Psychotherapy, 30, 552-560.
  10. Marcos, L. R., & Urcuyo, L. (1979). Dynamic psychotherapy with the bilingual patient. American Journal of Psychotherapy, 33, 331-338.
  11. Paniagua, F. (2004). Assessing and treating culturally diverse clients: A practical guide (3rd ed.). Thousand Oaks, CA: Sage.
  12. Perez-Foster, R. P. (1998). The power of language in the clinical process: Assessing and treating the bilingual person. Northvale, NJ: Jason Aronson.
  13. Santiago-Rivera, A. L., & Altarriba, J. (2002). The role of language in therapy with the Spanish-English bilingual client. Professional Psychology: Research & Practice, 33, 30-38.

See also: