Psychotherapy involves talk, regardless of theoretical foundations. Therapist and client(s) engage in verbal, non-verbal, and paraverbal exchanges to communicate about their experiences and co-create meanings of the experiences. The exchanges between two or more people can be so powerful that they can facilitate clients’ desired changes. The beauty and science of the therapeutic conversation has captivated me and simultaneously challenged me.
Almost forty new international therapist trainees enter the field of Counseling Psychology each year (Forrest, 2010). Among international trainees, those who are not fully fluent in English, like me, tend to face unique challenges associated with their language proficiency, particularly during the beginning stage of their professional development. Garrison et al. (2022) identified difficulties in therapeutic communications and language-related anxiety and distress. For international trainees with linguistic minority identities, understanding nuanced meanings of client statements and appropriately using therapeutic language may be challenging (Garrison et al., 2022). Since therapist trainees in general are likely to struggle with a lack of sense of self-efficacy and competence (Skovholt & Rønnestad, 2003), the addition of the language challenge may place a double burden on language minority international trainees (Georgiadou, 2014; Liu, 2013).
Research has provided helpful supervisory strategies for international trainees dealing with linguistic difficulties. For example, exploration of trainees’ language experiences, validation and strength affirmation, clinical communication facilitation, and de-emphasis on language use have been suggested (Garrison et al., 2022; Nilsson & Wang, 2008). Although prior studies have offered insight, how to implement the suggestions in supervision practice is still unclear. Therefore, in this article, I highlight some of my own supervisory experiences as an international trainee with linguistic challenges, which I believe helped me better manage my language anxiety and further grow as a therapist. By illustrating the helpful supervisory moments, I hope to contextualize suggestions for supervision.
It should be noted that my reflections cannot capture all international trainees’ lived experiences. As a person bound to my own culture, I can only provide the context of my own experiences: I am a fourth-year Ph.D. student in a Counseling Psychology program in the U.S. who was born and raised in South Korea. Before coming to the U.S. for my doctoral study, I had no prior experience living in a different country or speaking a second language. I earned a master’s degree in Counseling and Clinical Psychology in South Korea and had two years of clinical training before beginning practicum in the U.S. in my second language. Regarding language proficiency, I experienced difficulty expressing myself clearly and understanding others in English, particularly for the first two years. I am still not fully comfortable communicating in English compared to my mother tongue.
My reflections are not to say we need to focus more on linguistic aspects of international trainee experiences than other aspects of training. Certainly, not all international trainees deal with language anxiety; that is, there are significant individual differences in international trainees’ experiences and needs. The purpose of my reflections is to discuss possible needs of some international trainees whose language minority identities are salient to them and who might need help with their language challenges.
Curiosity and Understanding in Linguistic Identity Exploration
Existing literature has suggested it is important to explore international trainees’ linguistic identity (Garrison et al., 2022) in addition to their other cultural identities, such as international status, cultural differences, and acculturation. I resonate with the importance of linguistic identity exploration and will illustrate how my supervisor’s genuine curiosity about and understanding of my linguistic identity likely facilitated the exploration process.
In my first meeting with one of my supervisors, he said he was aware of the language issue that I had, and that we could discuss it together when things came up. Part of me felt relieved that he already recognized my struggle and expressed his willingness to navigate language issues with me. However, the other part of me was thinking, “…What issues might he perceive? And what if my issues were even worse than what he’d thought?” I did not really want to have to discuss my language issue with him. I decided I would try my best to avoid making language-related mistakes in supervision and therapy. One day, my supervisor asked how I felt about communicating with my clients in English. Unlike the first event, I felt comfortable sharing my language anxiety and real difficulties in therapy. He did not criticize or minimize my struggles, but conveyed his understanding of them through his attuned non-verbal responses. My supervisor then asked when I started to learn to speak English.
Because I sensed his genuine interest in my own story of language development, I felt safe to share that I seldom spoke in English before my doctoral study, and that was why it had taken me so long to embrace my desire to study therapy in the U.S. My supervisor showed surprise, and I joked, “Yeah, I was too brave.” We laughed together. My supervisor said he was glad I decided to come to the U.S. because he believes I would grow as a therapist despite linguistic challenges. After this second event, I came to feel he understood my linguistic identity, and I became less worried about making language-related mistakes (which actually helped me make fewer mistakes!).
It is intriguing that the two supervision events regarding my linguistic identity elicited different reactions from me. Looking back, my supervisor was non-judgmental about my language skills, so he was willing to discuss my linguistic challenges. However, I worried that my supervisor would not be okay with my language struggles, due to my internalized shame about my language proficiency. That is, I was afraid of being judged, and fearful that my supervisor would not be understanding. So how did the second supervisory event help me feel safe enough to embrace my fears? I believe it was my supervisor’s genuine curiosity and willingness to understand what I felt at that moment. My supervisor’s open questions about my subjective linguistic identity conveyed his non-judgmental intentions rather than presumptions. Additionally, our supervision alliance grew more over time, so I was likely to experience his genuine curiosity and understanding. Thus, his genuine curiosity enabled me to better manage my shame and fear of judgment.
Considering the heterogeneity of the language identity of international trainees, supervisor curiosity about international trainees’ linguistic identity seems crucial. Some international trainees are fully bilingual, while others have not been thoroughly exposed to their second language. In addition, some might still experience language-related anxiety and distress regardless of their language proficiency, while others might not. Therefore, it may be helpful to provide international trainees with opportunities to share their perspectives on language identity rather than presume.
Collaborating on Clinical Communication
Since linguistic difficulties affect international trainees’ sense of self-efficacy and competence, supervisors should help these supervisees` improve their clinical communication (Garrison et al., 2022). For instance, providing sample or alternative verbal statements that can be used in sessions or clinical notes is helpful. My supervisors’ linguistic feedback and modeling has helped me better communicate my intent and content to my clients and supervisors (Garrison et al., 2022), and I believe the sense of agency I felt in the collaborative process was crucial in bringing a positive effect.
One of my supervisors used to correct my linguistic mistakes that hindered my communication with clients. I found it very helpful because it would be difficult for me to learn them alone. However, at the same time, I felt embarrassed and judged because I was dealing with shame about my language identity. One day, my supervisor noticed I looked upset after he corrected what I said and asked me if I felt hurt to hear his corrections. I said, “It is not hurtful because I know you have a good intention. I can feel it genuinely. But it is painful to see my errors. I am frustrated to see them…” I got tearful, and my supervisor nodded as an expression of his empathy for my pain. My supervisor then explained that he wanted to help me learn a better way of communication because he thought it would help my therapeutic work. He then asked if I wanted him to correct my linguistic mistakes, saying, “It is totally up to you. I will not correct it if you don’t want me to.” I could sense his genuineness in his nonverbal expressions. I knew I needed linguistic learning, so I asked him to correct my mistakes. After the conversation, I no longer felt embarrassed by his corrections; instead, I was truly grateful and relieved that I could improve my therapeutic communication with his help.
Before this event, I tended to pretend that I understood everything my supervisor said, even if I did not. However, after agreeing to improve my clinical communication, I became more active in asking for clarifications and repetitions. Ironically, I also began to spend more time practicing speaking in English in my daily life. Consequently, my language anxiety decreased.
My supervisors have acknowledged my agency by offering me the opportunity to decide how I would like to be helped. They asked me:“Would you [a trainee] want to do a role play?” “You can disclose your international identity in your first session and let clients know there might be times you ask them to repeat what they said if you think that would be helpful. If you don’t want to do so, you don’t have to.” “If you want me to share my notes from my own practice after de-identifying it, I am happy to do so.” I felt empowered when my supervisors invited my perspective on the helpfulness of the possible instructional techniques.
Many practical suggestions to help international trainees improve their clinical communication (Garrison et al., 2022) seem contradictory. While some suggest supervisors should provide feedback on international trainees’ English performance, others advise that they refrain from doing that due to the risk of over-correction and perceived judgment. Just as agreement on the goals and tasks of supervision is crucial to the effectiveness of supervision in general (Ladany, 2013), it seems important for supervisors and international trainees to agree on the approach that would most benefit the trainee’s clinical communication.
Validating Linguistic Challenges and De-Emphasizing Performance
Prior investigations of helpful supervisory behaviors have suggested de-emphasizing the role of English language use (Garrison et al., 2022). Given that some international trainees experience high anxiety, and therapy is semiotic rather than just semantic, placing less emphasis on language performance makes sense. However, this approach might minimize trainee struggles, because in reality, therapy is a conversational process requiring linguistic ability. Trainees might feel relieved by the deemphasis on language issues initially but later realize that talking is not a small part of therapy practice. Using my own supervisory experience, I would like to suggest supervisors be careful not to accidentally minimize how hard it is to be doing therapy in a non-native language. One way to do that is to first acknowledge international trainees’ linguistic challenges and validate their emotional experiences.
During the first supervision meeting with one of supervisors in my practicum, I brought up my language issues and anxiety. My supervisor said, “I can’t even imagine how challenging it would be to do therapy in a second language because I have a privilege in that aspect. But I believe therapy is not all about language, and you have a good clinical intuition.” This statement has stayed with me for so long. By being humble and recognizing her privilege, my supervisor acknowledged my challenges before de-emphasizing the importance of language use. With my supervisor’s acknowledging her unearned benefits in the linguistic aspect, I felt my linguistic disadvantage was recognized by my ally. I then could take the courage to give less emphasis on my linguistic performance and appreciate my clinical strengths more.
Clearly, international trainees are heterogenous, and some of them are dealing with linguistic difficulties. To help their professional development, supervisors’ understanding of and responsiveness to their linguistic challenges are considered important. In my experience, what makes a difference in the helpfulness of language-related supervision interventions are general helpful supervision components, such as curiosity, understanding, collaboration, validation, cultural humility, etc. It is my hope that practitioners and researchers continue to discuss how to effectively provide them to diverse international students in supervision practice.
Cite This Article
An, M. (2022). The Supervision Experience for an International Therapist Trainee Working in Her Second Language. Psychotherapy Bulletin, 57(4), 11-15.
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