Therapy in Spanish works the same way therapy in English does: you meet with a licensed clinician, talk about what is going on, set goals together and work toward them over a series of sessions. The difference is that you can say things in the language they actually live in for you, and you can move between Spanish and English whenever you want.
Part of our guide: Which Type of Therapy Is Right for You?
For many bilingual people in Brooklyn, that freedom matters more than they expect. This guide covers what sessions are like, how language switching works, what a bilingual clinician listens for, and how to ask for care in Spanish at Mind Body Seven.
Why the language of therapy matters
Most people can describe their week in either language. Feelings are different. Many bilingual adults find that childhood memories, family arguments, prayers, nicknames and the way a parent or grandparent used to comfort them come back in Spanish, while work stress and dating come out in English. When therapy happens only in a second language, some of that material can feel flattened or harder to reach.
There is also the simple question of effort. Translating yourself in real time takes energy, and when you are anxious, grieving or exhausted, that energy is in short supply. Speaking the language that comes most easily lets you spend your attention on what you are feeling instead of on finding the right word.
Language carries culture, too. Expressions like "estoy con los nervios de punta," "hay que aguantar" or "me da pena" hold ideas about worry, endurance, shame and family duty that a literal translation can miss. A bilingual, bicultural clinician is more likely to hear the full meaning the first time, without you having to stop and explain it.
Switching between Spanish and English is welcome
You do not need to choose one language and stick to it. Many clients start a sentence in English and finish it in Spanish, or use Spanish for anything involving family and English for everything else. A bilingual therapist follows your lead. Some people find it useful to notice which language a topic comes out in, because the switch itself can point to something that matters.
If your Spanish feels rusty, or you grew up hearing it more than speaking it, you are in good company among people raised in New York. You can still use it in therapy, even for single words or phrases that have no good English match. No one is grading your grammar, and you can always fall back on English when that is easier.
What the first few sessions look like
The first appointment is mostly about getting to know you. Your clinician will usually ask about:
- What brings you in now, and how long it has been going on
- How you are sleeping, eating, working and getting along with the people around you
- Your family, where you grew up and, if it applies, your or your family's migration story
- Past therapy or psychiatric care, and what helped or didn't
- Which language feels most natural for different parts of your life
- What you hope will be different after therapy
You can share as much or as little as you are ready for. Over the next few sessions you and your therapist will agree on goals and an approach, and you can revisit both as things change. Our general guide to what to expect in your first therapy session covers the basics that apply in any language.
Culture, family and the topics people worry about bringing up
Some clients worry that a therapist will judge their family, their faith or their culture's way of handling problems. A culturally responsive clinician treats those things as part of your story, sometimes as a source of strength and sometimes as a source of strain. You can talk about the pressure of being the one who translates for your parents, about mixed feelings toward family expectations, or about the stigma some families attach to "ir al psicólogo," without having to explain the background first.
Themes that often come up in Spanish-language therapy include:
- Stress from immigration, separation from family or uncertainty about the future
- Being the bridge between generations, languages and cultures
- Grief for people and places left behind
- Anxiety, low mood and trouble sleeping
- Painful or frightening experiences, including ones before, during or after migration
- Conflict between parents and children who see the world differently
What you say in therapy is confidential, with legal exceptions your clinician will explain at the start (for example, a serious risk of harm to you or someone else). Your therapist can walk you through those limits in Spanish so nothing is left unclear.
Therapy approaches work in either language
Bilingual clinicians use the same evidence-based approaches used in English, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), trauma-focused work, psychodynamic therapy and, for young children, play therapy. Skills, notes and practice between sessions can be done in whichever language you will actually use at home, which makes them easier to keep up.
If you also see a psychiatric prescriber, it helps when everyone on your care team understands how you describe your symptoms. A psychiatric prescriber can discuss whether medication fits your situation, and that conversation can happen in Spanish too.
How to ask for care in Spanish
When you request an appointment, say that you would like to work in Spanish or in both languages. It also helps to mention:
- Who the care is for: you, your child, a parent or the whole family
- Whether other family members prefer a different language
- What you would like help with, in a sentence or two
Nothing needs to be perfectly organized before you reach out. A short note in either language is enough to start.
If you are having thoughts of suicide or self-harm, or you are worried about someone's immediate safety, call or text 988 (Suicide & Crisis Lifeline, which has a Spanish-language option) or go to the nearest emergency room. Mind Body Seven is an outpatient practice and is not set up for emergencies.
Getting support at Mind Body Seven
Several clinicians at Mind Body Seven provide care in both Spanish and English. You can read more on our therapy and psychiatry in Spanish page.
- Dr. Linda Perez-Puelles, PsyD is a bilingual, bicultural clinical psychologist with more than 17 years of experience with children, adolescents, adults and families, including play therapy and trauma-focused care.
- Dr. Beth Wecksell, PsyD is a bilingual supervising psychologist who provides individual and family therapy to adolescents and adults, with intensive DBT training and Level 1 IFS training.
- Dr. Lina Villegas, MD is a board-certified psychiatrist who provides psychiatric care to adults in English and Spanish, with a focus on pregnancy, postpartum, perimenopause and other life transitions.
FAQs
Do I have to speak only Spanish in therapy?
No. You can use Spanish, English or both, even in the same sentence. A bilingual therapist follows your lead, and many clients find that different topics come out more easily in different languages.
What if my Spanish is not very strong?
That is common for people who grew up in New York speaking Spanish at home and English everywhere else. You can use Spanish for the words and phrases that matter to you and English for the rest. No one is judging your grammar.
Is therapy in Spanish different from therapy in English?
The methods are the same, including CBT, DBT, trauma-focused work and play therapy for young children. What changes is that you can speak in your most natural language and work with a clinician who understands the cultural meaning behind what you say.
Can my family join some sessions?
Often, yes. If you would like a parent, partner or child to take part, mention it when you request an appointment and say which language each person prefers, so sessions can be planned around that.
Can I see a psychiatrist in Spanish too?
Yes. Dr. Lina Villegas, MD, a board-certified psychiatrist at Mind Body Seven, provides psychiatric care to adults in English and Spanish. She can discuss whether medication fits your situation and coordinate with your therapist.
