Methods: This study utilized a heuristic qualitative approach (Moustakas, 1990). Ten bilingual psychotherapists of diverse racial and ethnic backgrounds were interviewed using in- depth, semi-structured interviews. The transcripts of these interviews were coded for line-by –line for concepts and themes (Padgett, 2004) by both researchers using the qualitative analysis software in Vivo.
Results:Analysis indicated consensus among interviewees that the role of language in therapy with bilingual clients is central to organizing experiences, emotion and memories. It was reported that bilingual clients tend to switch between languages when they struggle to identify feelings and particularly when dealing with highly charged material. It was reported that clients often present with different values, identity and sense of self when shifting languages. When clients recall trauma in their mother tongue they were able to remember more vivid memories, and sensations. The interviews revealed significant insights on transference and counter -transference. Language was reported to be a factor that influenced the therapeutic alliance, as it triggered issues of trust, idealization, and hostility towards the psychotherapist. Two major streams of counter transference themes emerged. Monocultural bilingual therapists tended to engage more intellectually and were more concerned with boundaries, whereas bicultural bilingual therapists tended to engaged more relationally and were more concerned with self-awareness.
Conclusions and Implications The study provides valuable information for social workers who are treating bilingual clients. It highlights that dynamics of therapy are always shaped by language. The expression of painful memories or trauma can be accessed predominately in a native tongue. Being able to narrate a story in their mother tongue may help clients gain access to material that may not simply be translatable. Therapists should track shifts from language to language as they are of significant clinical importance (e.g. indications of resistance and defenses).Bicultural clients may experience themselves differently through each linguistic system. Finally, this study points out that clinicians need to be very attentive to transference and counter-transference dynamics as their own ethnic identities cultures, values, as their conceptions of self and other are often played out in the treatment process. Understanding the role of language in therapy has far reaching implications. Bilingualism should not only be considered simply a skill but rather an expertise that allows clinicians to conduct more in depth quality treatment and make agencies more welcoming to diverse populations.