By the time the young Mexican-American mother turned to Selia Servín-López and her team for help, she was in despair. Speaking in Spanish, she spilled out her tale. Having suffered sexual abuse as a child, she couldn't bring herself to touch her own children. A television show had convinced her that victims of abuse almost invariably abuse their own children, and she was determined to break the cycle. She even sat in on her children's classes to make sure they were safe.
During the session, Servín-López and her team noticed that even the woman's dichos, or sayings, focused on the importance of family. At session's end, they asked the woman to imagine how her children would feel about their relationship decades hence. Less than an hour later, the woman called back to report that she had bathed her baby and kissed her children.
For Servín-López, the story points to the importance of being fluent in both the Spanish language and Latino culture when providing services to Spanish-speaking clients. Had the woman met with a therapist lacking these skills, Servín-López believes, she probably would have ended up on medication and in long-term therapy to address her sexual abuse, overprotectiveness and the resulting marital problems.
"The fact that I was able to address this client in her own language and pick up on all the little nuances of her language helped me tap into what she was most concerned about," says Servín-López, a student in the PsyD program at Our Lady of the Lake University in San Antonio. "It created enough of a shift in her so that she could do something that felt comfortable for her. As a result, she didn't need to be in therapy forever."
Stories like this are just what her professors like to hear. Servín-López and several other students in her program are earning a special certificate in psychological services for Spanish-speaking populations. This unique training experience, launched in 1997, features a comprehensive curriculum that has already spawned an exchange program with a Mexican university and a summer institute offering an intensive version of the program.
"Monolingual psychologists don't understand the complexity of bilingualism," explains psychology professor Joan L. Biever, PhD, dean of graduate studies at the university. "Most people assume that if you speak Spanish at home, you're competent to speak it at work. We feel that's definitely not true."
The certificate program grew out of students' concerns. Although a third of the program's doctoral students and more than half of its master's degree students speak Spanish with friends and family, many felt they lacked the skills to use their language in professional settings. Even the most fluent students confessed to thinking in English and then translating their thoughts into Spanish during therapy sessions, a process that shifted their attention from what they were saying to how they were saying it.
A 1996 survey the department conducted revealed that students weren't the only ones with that problem. Of the 300 bilingual licensed psychologists in San Antonio, only 11 actually offered services in Spanish. Of these, the nine who responded to the survey all felt that they had received inadequate graduate school training in providing services in Spanish.
"What was happening was that students were going out and getting jobs where they would be the only Spanish-speaking person," says Biever. "All of a sudden they would be providing Spanish-language services they had never been trained to provide. But if they didn't provide those services, the clients would go without."
The result was the certificate program, which Biever believes is one-of-a-kind. The curriculum features 21 semester hours of courses, which includes Latino psychology, theories of multicultural counse ling and a rigorous professional/technical Spanish class designed to teach students how to think theoretically in Spanish. Students must also spend at least eight hours a week at a bilingual practicum site for three consecutive semesters and spend a semester supervising others at a bilingual site. Most students fulfill these requirements at the university's own clinic, which is located in the heart of San Antonio's barrio.
Students also have the option of honing their skills farther afield. In the summer of 1999, Biever initiated an exchange program with the Universidad de las Américas by taking five students to Mexico City for a month. The students got practicum experience via a private practice the university had connections with, allowing them to sit in on therapy sessions and serve as co-therapists with Mexican psychologists. Since then, several Mexican students have come to San Antonio to take classes and observe sessions in the university's clinic.
Thanks to an agreement with the Universidad del Mayab, Our Lady of the Lake also offers what Biever calls a "mini-immersion experience" in language and culture. Each May, students spend two weeks taking language classes, visiting a psychiatric hospital and other sites and soaking up culture in the town of Mérida in the Yucatán Peninsula.
This summer the department will debut a Summer Institute for Bilingual Psychologists. The goal of the four-week-long program is to give students at other graduate programs a chance to experience a condensed version of the certificate program.
A marketable skill
Although the certificate program is still too new to have produced any PsyD graduates, local employers have already started asking job applicants if they've taken certificate courses. That's because the certificate program prepares students much better than programs that simply teach them how to translate psychological jargon into Spanish, says Servín-López, who supervises student therapists at the university clinic.
Students learn about the importance of family and religion in Latino culture, for example. They learn how to handle situations such as family therapy sessions in which some family members speak Spanish while others prefer English. And they learn how to give case presentations, translate diagnostic terms and tackle other professional duties in Spanish.
Such training is especially important for the non-Latino students in the certificate program. Take Christie Sprowls, for instance. As the daughter of a diplomat, Sprowls became fluent in Spanish as a child living in Peru, El Salvador and Colombia. She has had to learn how to handle the gifts of food her clients bring her and find ways to keep appointments on track with clients for whom personal relationships are more important than time constraints. She's even had to cope with clients who mistake her for Latina and discuss their distrust of white people.
"When I'm speaking Spanish, I feel like a different person," says Sprowls. "It's a real gift to feel confident and comfortable moving between the white and Latino cultures."
Training like this is critical, says Carol Williams, a PsyD candidate at the university and the associate executive director of the American Psychological Association of Graduate Students at APA.
"Psychology is getting better in terms of diversity, but it's nowhere close to matching the demographics of the nation," she points out. "I'm not one who believes you have to be just like your clients to be able to help them, but we have to do something to close that gap. Tailored programs like this one help accomplish that goal."
Servín-López agrees. For her, the certificate program prepares students to be truly competent and ethical providers. She recalls one student who told her that she had learned how to communicate with Spanish-speaking clients even though she couldn't speak Spanish very well herself: Whenever she didn't understand what her clients were saying, she would simply ask them to draw a picture.
"I don't want to hear about another family that has to draw a picture to explain a feeling or bring in a janitor to translate things to a therapist who can't understand them," says Servín-López. "That shouldn't be happening anymore."
Rebecca A. Clay is a writer in Washington, D.C.