Negotiating the language(s) for psychotherapy talk: A mixed methods study from the perspective of multilingual clients

Abstract

Abstract Background Multilingual clients can benefit from expressing themselves in more than one language in psychotherapy. Yet, research suggests that language switching is typically instigated by clients, although some do not feel empowered to negotiate the language(s). Methods This paper addresses how language options, from the main therapy language(s) to language switching, were negotiated between client and therapist, as reported by 109 multilingual clients. All participants completed a web survey and five participated in follow‐on interviews. In addition, we reflect on the advantages of the mixed methods approach—particularly with regard to ethics and the explanatory sequential design. Analyses combine descriptive statistics and thematic analysis to elaborate on the trends identified in this international sample. Key Results Whereas some multilingual clients did not feel inhibited about using languages other than the main therapy language, for others the therapist played an important role in promoting multilingualism in the therapy room. Indeed, a lack of discussion surrounding language use—beyond such technical aspects as agreeing the main therapy language—was found to lead to assumptions about therapists' proficiency or the (non‐)acceptability of multilingual language practices. By contrast, metalinguistic discussions which explored process and meaning were welcomed by clients and typically opened up ways to use languages; the study itself was a catalyst for self‐reflection and productive discussions for one interviewee. Conclusions & Inferences Thus, the research provides further evidence, from clients, that developing therapists' metalinguistic awareness and competence and empowering multilingual clients to share their insights has therapeutic benefits.

Topics & Concepts