International Journal of Mental Health & PsychiatryISSN: 2471-4372

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Editorial, Int J Ment Health Psychiatry Vol: 1 Issue: 1

Bilingualism and Biculturalism in the Clinical Setting

Isaac Carreon*
School of Cultural and Family Psychology Pacific Oaks College, CA, USA
Corresponding author : Isaac Carreon
LMFT, Assistant Professor, School of Cultural and Family Psychology Pacific Oaks College, 55 Eureka Street, Pasadena, CA 91103, USA
Tel: (626) 529-8208
E-mail: [email protected]
Received: May 20, 2015 Accepted: May 22, 2015 Published: May 23, 2015
Citation: Carreon I (2015) Bilingualism and Biculturalism in the Clinical Setting. Int J Ment Health Psychiatry 1:1. doi:10.4172/2471-4372.1000e102

Abstract

It is estimated that by the year 2050, Latinos will make up half of the nation’s population. The rise of immigrants over the last decade has resulted in a greater need for bilingualism and biculturalism in the clinical setting. Medical and mental health practitioners are now in the spotlight to meet the needs of the growing clientele. As a result of the growing Latino population, psychologists can now expect more Spanish-speaking patients in their waiting rooms. Clinicians or agencies not providing therapeutic services in the patient’s primary language are violating one of the primary ethical standards: beneficence and nonmaleficence. Whether clinicians in private practice agree or not, they have an ethical and professional responsibility to abide by standards governed by the profession. However, too many clinicians in private practice, outpatient mental health clinics, large for profit and nonprofit settings, and HMOs do not abide by this standard.

Keywords: Bilingualism; Biculturalism

Editorial
It is estimated that by the year 2050, Latinos will make up half of the nation’s population. The rise of immigrants over the last decade has resulted in a greater need for bilingualism and biculturalism in the clinical setting. Medical and mental health practitioners are now in the spotlight to meet the needs of the growing clientele. As a result of the growing Latino population, psychologists can now expect more Spanish-speaking patients in their waiting rooms. Clinicians or agencies not providing therapeutic services in the patient’s primary language are violating one of the primary ethical standards: beneficence and nonmaleficence. Whether clinicians in private practice agree or not, they have an ethical and professional responsibility to abide by standards governed by the profession. However, too many clinicians in private practice, outpatient mental health clinics, large for profit and nonprofit settings, and HMOs do not abide by this standard.
Although non-fluent private practice clinicians continue to treat Spanish-speaking clients, the lack of clear communication may harm a patient's therapeutic progress. Although there are not enough bilingual psychologists to meet the demands of the Spanish-speaking community, the pairing of a monolingual psychologist with a Spanishspeaking client should be avoided at all costs. There are only an estimated one percent of psychologists who are Latino, while 50% of the world’s population is bilingual. Therefore, whenever possible, patients should be referred to a bilingual and bicultural clinician as it has been found that bilingual patients benefit from speaking their native tongue during therapy. Individuals who are bilingual can provide more detail and recall emotions and feelings in their primary language, as one patient illustrated: “I think in English and feel in Spanish.” A study in the International Journal of Bilingualism [1] found that individual words in a bilingual person's first language might have richer meaning for them than in translation.
Too many times, individuals whose primary language is other than English may not fully comprehend the psychologist; or the patients themselves are unable to find the correct words to explain their symptoms. A misinterpretation of the patient’s ailment can lead to the wrong diagnosis, treatment, and otherwise interfere with the therapeutic alliance. Surprisingly, the use of interpreters does not provide better results. In a study conducted by Aranguri, Davidson, and Ramirez [2], when doctors used an interpreter during a routine doctor’s visit, the presence of the interpreter altered the conversation resulting in inaccurate information being related from the patient to the doctor. Aranguri et al. [2] found omissions, reductions, and revisions in the communication between doctor and patient. This was attributed to the time constraints because of the use of the interpreter and the presence of the third person adding “coldness” to the patientdoctor relationship.
The Psychological Association approved the Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists in 2002. The guidelines were made possible through the diligent work of an appointed joint task force of APA divisions 17 and 45 over a period of 22 years [3]. The implementation of the code of ethics pertaining to working with diverse populations is an essential ethical standard to guide psychologists. These guidelines provide a rationale for psychologists to work with multicultural clients such as ethnic and racial minorities [3]. The multicultural guidelines provide a lens in which psychologists can work ethically with diverse populations [4].
According to the APA, it is encouraged for practitioners to develop skills and interventions that are attuned with the unique worldviews and cultural backgrounds of their clients [3]. Comas-Diaz [5] uses the term Sabiduria: Latino ethnic psychology to describe the application of ethnic traditions and practices into healing and liberation. She also stresses the importance of integration of ethnic psychology into psychotherapy when working with minorities as a way to demonstrate cultural competence.
Although Ph.D. clinical programs promote standardization in assessment and testing, Sattler [6] recommends adaptation to meet the needs of diverse populations including those with disabilities. Psychologists need to continue to learn about standardization procedures as well as multicultural assessment practices that take culture into consideration [3,7]. Forming a consciousness about cultural competence both in assessment and clinical interventions demonstrates accountability in respecting client’s values as well as having an ethical responsibility [8].
Therefore, bilingualism and biculturalism should be a priority for clinicians, health care organizations, and community mental health agencies. An absence of a bilingual practitioner is inexcusable. The profession cannot claim to be ethical if services are not delivered in the patient’s native tongue.

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