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 self-disclosure. 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.

Keywords:

• language switching
• ethnic minorities
• bilingual
• therapeutic engagement
• psychological therapy

Funding

This work is supported by the University of Leicester.

Notes on contributors

Dr Zahera Kapasi is a Chartered Clinical Psychologist with over 8 years' experience in the mental health sector. She has a BSc (HONS) in Psychology and an MSc in Child and Adolescent Mental Health at Northampton University and recently completed her clinical doctorate training at the University of Leicester. She has worked with individuals across the lifespan with a wide spectrum of difficulties using a range of psychological approaches for assessment, formulation, intervention and evaluation and has a special interest in working with children, young people and families with mental health difficulties and learning needs. Her research interests relate to cultural diversity and its influence on individual health beliefs and the impact of biculturalism and bilingualism on therapeutic process.

Dr Stephen Melluish is Head of Clinical Practice on the University of Leicester clinical psychology programme. He has worked for many years in adult mental health and primary care services and has an interest in community psychology and the role of culture in expressions and understandings of mental health.