Bilingual Supervision: An Interview with Adriana Rodriguez, LMFT

An interview with Adriana Rodriguez, LMFT, about how to support bilingual, bicultural therapists. Curt and Katie talk with Adriana about her experiences as a clinician as well as her perception of the systemic concerns that bilingual/bicultural therapists face. We also dig into common work challenges for these clinicians, the ethical and competency concerns monolingual supervisors face, and specific action steps for individuals and organizations to increase the quality of supervision and training for these clinicians.

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

Transcript

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Interview with Adriana Rodriguez, LMFT (She/Her/Ella)

Adriana Rodriguez (She/Her/Ella) is a California Licensed Marriage and Family Therapist, she obtained a BA in Sociology from Sacramento State and a MA in Counseling Psychology from the University of San Francisco. Adriana is a bilingual, queer, Salvadorian immigrant woman who is passionate about destigmatizing mental health. Adriana’s lens is intersectional, she is passionate about understanding how intergenerational trauma compounded with personal trauma impacts the mental health of first-generation adult children of immigrants and QTBIPOC. Adriana works with individuals and dyads in private practice in Sacramento, CA.

In this episode we talk about bilingual supervision:

• Adriana’s story as a bilingual, bicultural therapist who immigrated from El Salvador
• Experiences of immigration, learning English, and trauma
• Criticism, bias, and navigating a different culture
• The impacts of uninformed supervision on bilingual or monolingual clients
• The requirement to build one’s own tools (i.e., translating documents)
• What is getting lost in translation – linguistic, cultural, etc.

“What is getting lost in translation? And not just the linguistic translation, but the experience, the context of the cultural information that is given by the people that are in front of us that are different and even similar to us.” — Adriana Rodriguez, LMFT⠀

• The importance of understanding context
• The power differential within the clinical supervision
• How do I level the playing field and share the power?
• Sharing knowledge (rather than seeing the supervisor as the only person who has knowledge in the relationship)
• Acknowledging and talking about differences
• Ethical concerns and supervisor responsibility
• The systemic challenges that bilingual clinicians can face in getting hired or promoted
• The need for greater diversity in leadership roles
• The idea of “first generation everything”
• The make up of the job for bilingual clinicians
• Survivor guilt – immigrating, learning English, education, and making it professionally
• The identification and desire to empower clients that remind you of yourself, your family members
• The exploitation of that desire by agencies who do not have sufficient bilingual clinicians
• How frequently bilingual clinicians have large caseloads and not sufficient compensation or matching or curating of caseloads
• The risk for burnout for these clinicians
• The complexity of translation

“One of the things that I can say about…things that we take for granted as English speaking clinicians [is] that we go to trainings and…receive all this materials, but then your clients are Spanish speakers, and who’s going to translate all that for you, who’s gonna put that all in Spanish. And so then now, you are not only the clinician, the verbal interpreter, the translator of the documents, but now you have to turn all whatever evidence based practice that was packaged really beautifully in this training, and you have the duty of also translate it in Spanish.” — Adriana Rodriguez, LMFT⠀

• The need for more research around the impacts of monolingual supervisors providing supervision on bilingual clinicians (as well as the impacts on monolingual or bilingual clients)
• The constant need for self-awareness and re-examining your bias
• Making sure to understand the differences between personality and culture
• Adjusting case conceptualization, looking at the triad of supervisor-clinician-client

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Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Cultural Humility

Find Adriana on social media (Instagram, Clubhouse, Facebook)

Instagram: AdrianaRodriguezTherapy

Facebook: Adriana Rodriguez Therapy

https://www.adrianarodrigueztherapy.com/

Relevant Episodes of MTSG Podcast:

Bridging Cultural and Communication Differences in a Bilingual Psychotherapy Practice

Getting the Supervision You Want

Giving and Getting Good Supervision

 

Who we are:

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Modern Therapist’s Survival Guide Creative Credits:

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Music by Crystal Grooms Mangano https://groomsymusic.com

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 0:15
Welcome back modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And welcome to the podcast about all of the things that impact clinicians. And one of the things that Katie and I push for is about inclusion and diversity. Not only the clients that we see in our practices, but also in the workforce that we have. And it’s been a while since I’ve started one of these episodes with a joke. So Katie, this one’s to you.

Katie Vernoy 0:43
Okay.

Curt Widhalm 0:43
The topic today is about bilingual bicultural clinicians in the workplace. So you know that bilingual means somebody who speaks two languages, trilingual would obviously be…

Katie Vernoy 0:57
Three languages.

Curt Widhalm 0:59
Do you know what it is when it’s one language? How about the dominant thing in the workplace? So bad jokes aside, we are joined by a Adriana Rodriguez, she’s an LMFT in the Sacramento area. She was one of our panelists at the Therapy Reimagined 2020 conference. And she is coming back to us for Therapy Reimagined 2021. And she is going to share with us about her experience and her interest in improving bilingual aspects of the workplace, some of the limitations that our current systems have, and it’s always so much fun to hang out with Adriana. Thank you so much for joining us.

Adriana Rodriguez 1:45
Thank you for having me. I’m excited.

Katie Vernoy 1:47
We are so excited to have you here today. So fun to have people who are friends of the show on the show. And like Curt said, it’s so much fun to hang out with you. So as you know, the first thing that we ask each of our guests is who are you? And what are you putting out into the world?

Adriana Rodriguez 2:05
This is a very fun and exciting question to be asked as an avid listener of yours, to imagine being here. So I am Adriana Rodriguez. I’m a licensed marriage and family therapist. My pronouns are she/her/hers/ella. And I am a Spanish speaking, queer, first generation everything Latinx psychotherapist, and I am passionate about the stigmatizing mental health. And I believe that conversations about mental health and therapy can and should start outside of the therapy room. I find that when folks are coming to see me, it has taken a lot of contemplating to get to this place of I am going to come in. And they have spent quite an amount of time of considering cultural implications, language implications, gender, and all of these things that can be both barriers and assets. And so for me when I’m doing my work, and what I’m putting out on the world, is idea of the importance of cultural humility. When we are working with people who are the same or different as us, the need for a view that is intersectional that the experiences of our clients are coming in to see us. So, keeping in mind things like racial identity, ethnic identity, language, immigration history, sexual orientation, the gender binary, intergenerational trauma. So, all of those things like how do they show up? How do they manifest the symptoms as we recognize them in the mental health profession? And how do they impact bipoc queer and trans adult children of immigrants and so that is kinda what I am really soaking in right now. And what I talk a lot about, so thank you for having me.

Curt Widhalm 3:51
One of the things of narrative therapy, it’s about making the personal political, and that’s something where having known Adriana, for a while now off air. We know that your personal story definitely has impacted your interest in supporting bilingual clinicians, minoritized, marginalized communities, how does your story lead to this piece of your interest here?

Adriana Rodriguez 4:19
That is also another big question. So I myself am an immigrant. I came to the United States when I was 16 years old, zero English. So one of the my first encounters and the systems of the United States very different than the country I’m from, El Salvador. War torn country that led to my family immigrated. My parents immigrating in the early 90s, due to just how unsafe El Salvador was. But that led to my sister and I staying back home with our grandmother and growing up without our parents for about nine years. And so, nine years later, my parents were able to become documented due to refugee status and just how unsafe we would be to go back home. And at that point, my family reunited again, with this huge nine year gap of, they left a two year old and a seven year old and came back to an 11 year old and like a 15 year old. And that was very complicated, very difficult. And it really ruptured a lot of this attachment that even though we had this early formative years, so some, it really impacted those relationships coming back, right. Like parents to now raise like preteens and teenagers when they left little kiddos. And so I realize now that my calling and my path in to becoming a therapist is very rooted in my own trauma around separation, around immigration, around attachment. But that has been a journey to kind of realize how those all of those factors in my life really have impacted who I am. Right. So coming here at age 16, not speaking English, having to battle this idea that because I’m a person who speaks these two languages, who has had an accent, who has an accent, to sort of justify my intelligence or justify, you know, my belonging, Learning how to express myself verbally and written in a way that sometimes doesn’t do justice to what like, I’m actually thinking, because language is such a vivid thing that I even 20 years later of living in the US, I still struggle with, you know. Even the idea of like going back to school or going to trainings or navigating, coming to a podcast, first thing that comes is like, okay, breathe, think, you know, take your time to translate words, because that’s still a need. So how does that translate into my interest of supporting bilingual clinicians? It really is, because when we as bilingual clinicians with not only another language, but we’re showing up also with this multicultural experiences and in intersectional identities, that, in varying degrees throughout the years really impact who you are, right. And so, my journey in higher ed, my journey in becoming a therapist was very critical of my culture for a long time. Because when I started becoming learning to be a therapist, and we aspire to these parents that have this great attune to their children’s needs, or that can communicate their feelings that can express boundaries, like that wasn’t happening in my family. That was happening in anybody’s family that I know. And so there was a little bit of time that it really created this sense of like, my family is not good enough. And I wonder, I wonder now, after all these years of being a clinician, how those beliefs and sort of that resentment, and that hurt because my family couldn’t compare to the families I was learning in school, also potentially impacted how I felt and viewed the families that I was working with. And not having the language or the direction to be considering these things. Right. I think about if I was working with the first families that were monolingual, that were recent immigrants that had children who had experiences similar as mine, and if I had been aware of all this implications that I now I can name I have language for what difference would have made. And so then here comes the topic for today, what difference would have made for me to have a supervisor who was able to name and point those things out, or at least ask about them, and if they were showing up or playing in my work with clients. But because my supervision and this is my, you know, anecdotally my personal story on becoming a therapist, every supervisor that I’ve had has been a white woman, and the idea that there’s other factors influencing what is happening with my bilingual monolingual recent immigrants families never really came out. And so it would make me feel that I was maybe like imagining things or that I would just give up and not even bring it up because they just wouldn’t get it. So it would just kind of like automatically make me not even consider it or push it to the side, or talk to peers, and then as peers sort of like going back and forth. Like you’re noticing that, too? Me too. Oh, let’s translate this. So all of that, right. So I think long story short in terms of my own development to get into this place, I’ve had to recognize that my own family history, my own histories of both the traumas, the gifts, the resilience of the people where I come from, impact who I am and how I show up every day with my clients in the therapy room. And so that has been a journey.

Katie Vernoy 9:42
It’s so interesting to hear your story Adriana, and I’m so glad that we get to hear it today. Thank you for sharing that. I think what I understand after a lot more information has been shared with me, I, I had the same education you did but being a white woman it was is aligned with my experience. There, I didn’t know what I didn’t know at that point. And during my my time working in South Los Angeles, there was definitely a lot of education that came forward. Once I had a bilingual supervisor, who then brought in Spanish DSMs and started having, you know, supervisees, that was supervisors that actually could speak in Spanish to discuss cases. And so it was, it was very interesting to figure out very late, because I was already a supervisor at that point, like very late on like, oh, my gosh, there’s all this that’s missing. And so to me, I’m so glad that you that this is something that you’re passionate about, because I think it’s such a need, I don’t think it’s been fixed, even though this was several years ago. And so for me as as a white supervisor, there were things that I was able to take in and even in listening to your story, and the the separation during childhood, and the the need to learn specific, you know, kind of learning English or figuring out, you know, kind of what level of acculturation or whatever there was going to happen, the relationship with parents, you know, all of those things, like, your story is both unique and not uncommon. And so what do you think that white supervisors, so like the supervisors that you had, what do you think is most important for white supervisors to know, when they’re supporting bilingual clinicians, clinicians with marginalized identities, that that you think that they’re often getting wrong?

Adriana Rodriguez 11:37
I would like to answer that question with a question.

Katie Vernoy 11:40
Okay.

Adriana Rodriguez 11:40
What is getting lost in translation? Right, and not just the linguistic translation, but the experience, the context of the cultural information that is given by the people that are in front of us who are different and even similar to us, because I think even there is a gap that can happen when we’re thinking about cultural competency, which I just don’t abide by, I like to think more about the perspective of cultural humility, right? We may sometimes think that because somebody shares an identity with us or share some experience with us, that then these issues are no longer relevant, right? So this concept of what is lost in translation, or this question that I kind of pose for myself, is beyond just like the language interpreting, you know. This was said, and then this is how it’s said in English. But what is the context of the the history of this person and where they’re coming from? Who are they getting their ideas from? How are they thinking about their problems? What kind of barriers are coming up for them? Right? So when we have this position where a supervisor, right, and this is for early career clinicians thinking about power dynamics, right? There is this idea of when I go into supervision, the supervisor has power, has the ability to fire me, write me up, correct my work. So there’s power, right. And so when we’re thinking about what can supervisor, clinical supervisor, who doesn’t share the identities of the person who they’re supervising, and then even further removed from the clients that this clinician is serving, we have to ask ourself, that, you know, I would like for those the people to ask and including myself, what am I missing here? Like to start with that question with curiosity. Second, how do I level the playing field and share the power in this realm? Because I think that it is sort of like an outdated way of thinking about supervision, and that there is only one person with knowledge or with experience that is worth sharing in the room, right? And so why would it happen? Especially when there’s clear differences around race, gender, cultural identities, that, you know, that the supervisor initiated with saying, How can we share knowledge because you have knowledge that I don’t have, plain and simple, like, let’s even call it out, right? We’re different. And so how do we leverage those differences to actually serve as points of information and entryways for learning together and for co-creating and for thinking about everything that’s happening with the clients that you’re seeing in a more holistic way? Right. And so the idea of acknowledging that there’s something going to be missing when you’re translating, it’s impossible. It’s a task that is tiring. I remember, you know, seeing my monolingual clients who were speaking in Spanish, then, you know, perhaps advocating for them and trying to think or being in a meeting translating and like, and I’m closing my eyes as I’m describing this, because sometimes it requires this like brain switch, right? And so then I would go into supervision and try to explain, I did this and I did that and I did this and I did that. And then another part of supervision, it tends to be highly administrative driven, especially if you’re working in community mental health, your paperwork. So you’re having to rush through your one hour that you get of supervision and then you’re having to share space, if you have group supervision, where a lot of decisions are just not being addressed at all, right? So a beginning place would be to just talk about it, acknowledge that the differences are there, that there is power dynamics that are happening, whether you are a kind, loving, you know, supervisor, a super woke and super attuned, you’re still in power. So how do I now reshift that space and and make us co-creators to think in the benefit of the clients who are different from the supervisor, right, and that they may be missing something?

… 13:53
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Curt Widhalm 15:49
I know that you’re coming in and sharing with us and sharing with our audience your experience in this but I want to go one step further. I don’t think that that’s enough. I think that there’s almost an ethical concern when it comes to supervisors in this position. That there has to be a supervisory responsibility to say, am I actually competent enough to be supervising bilingual clinicians? I think that that is the first step that you know if I can supersede you here for a moment, but that it has to be something where the supervisor has to be able to set the tone, have have an agency wide tone, or practice wide tones, that there is a question here that cannot be answered solely with the supervisor on high, but it has to be something where the approach is first recognized, as does the supervisor A: have this knowledge and B: going beyond just cultural competency or cultural awareness or cultural humility and actually being able to do this in supervision. We wouldn’t have any qualms about this, if it was, you know, do I have the competency to do therapy with a bilingual client? I don’t think that the conversation is far enough yet that we say that this could happen with supervision.

Adriana Rodriguez 17:11
So I’m going to take it even one step further.

Curt Widhalm 17:14
Yes.

Adriana Rodriguez 17:14
And I’m gonna talk about the institutional and systemic challenges of why our supervisors who are monolingual or cisgender, or the only one, quote unquote, available to supervise these clinicians, because I’m going to tell you a secret: bilingual clinicians, we’re here, we exist and we are highly capable and sometimes we have a really hard time getting hired or promoted into positions where this is being accounted for, for all the reasons, right. And so institutionally, systemically, we need to begin with is our faculties at universities that the training programs, are they diverse enough, right? Is, are the people at CAMFT diverse enough? Are the people at the BBS diverse enough? Are, you know, systemically, we have to really take this conversation even further back. Because otherwise, what we end up doing is kind of like spinning this hamster wheel of defeat where: Well, I don’t feel qualified, I don’t feel that this is within the scope to supervise. So what do I do? You know, maybe the answer is not that you go do a training, but that you go find those clinicians who are quality, and that you make space for them in your agencies, that you are hiring them in your faculty, as faculty in your programs, that you’re giving the opportunity for these voices to be heard. Because this is another like, issue about being like part of that first gen everything. That’s what we internally call ourselves is that the power dynamics are playing and the lack of role models of people putting a hand out to say I’m gonna lift you up is real. We have to figure this out all on our own. And we’re playing around, we know as peers talking to each other. Now I belong to several Facebook groups. So Latinx therapists, where people are asking questions, how do you translate this? How do you talk about this? Back in the day, 10 years ago, when I was in my beginning, there was no such thing as this connectivity, this like peer support network. You had who you had or your agency, right? So thinking about Yes, like the scope, just like we would question the scope of practice as a therapist is my is it within my scope to supervise bilingual bicultural clinicians? What are our agencies, what are our systems, what are our education institutions doing to support bringing in diverse voices, not just for the sake of tokenizing or just to say we have diversity or we have like this one multicultural class that is being taught by xy person with this xy identity. But how are we really embodying cultural humility and cultural awareness systemically? We have to start there.

Katie Vernoy 20:00
I think it’s something where it’s so interesting, my experience has been a little bit different because I know for me, I was in Los Angeles, and there’s bilingual clinicians, bilingual Spanish clinicians are sometimes the only clinicians who are being hired and, and what’s interesting about that is that there’s still a crappy job that waits for them. And so it’s still and so then I’ve got clinicians who are monolingual English, that are complaining that they’re not bilingual, so they’re not getting hired. And so it becomes this weird dynamic around this Us/Them thing that really is about I like how you said it in the beginning this, you know, a hurdle or a benefit. I think you said it much more more eloquently than I just did. But, but the idea that the fact that you were bilingual is a hindrance pisses me off, because it is actually such a beautiful skill that you’re bringing to people who need therapy, who need support. And so being able to figure out how to fix this systemically would be awesome. I think that’s beyond the scope of our practice. But I think about even just the job, and I think this is both important for, you know, our audience members who are bilingual, who are seeking jobs, who are and also our all of our audience that potentially are looking at supervision. But I know what I saw, so but I’m gonna let you speak to your experience as a bilingual clinician in community mental health. What is the job look like, compared to monolingual English therapists?

Adriana Rodriguez 21:39
So here, one of the factors that kind of is an umbrella factor to answer this question is the survivor’s guilt. And this is something that I’ve explored extensively in my own work around how does my survivor quote unquote, and I use survivor as in relation to I am the one first person in my family that successfully not only immigrated to United States, but learned English, successfully navigated all these institutions, has a career that is in front of a computer versus doing physical work, or, you know, like having all these things. So there’s this sort of like, and maybe there’s a better term for it, but the way that I, it kind of comes up for me, it’s the survivor’s guilt, right? Of I’ve made it and I am willing and wanting to bring everybody along with me. So how does that happen when you’re in community mental health? Every client that comes across, looks, feels, talks, reminds you of your mom, your auntie, your uncle, your dad, your cousin, yourself. So they empowerment or the boundary that you could perhaps say like, I got 25 clients already, I’m drowning in paperwork. That means that you’re saying no to somebody who is so close to your identities, that it becomes really hard. Right? So as I understand the personal part. So what does it look like to…

Katie Vernoy 22:58
Can I say something really quick to that? Because I recognize that is also exploited. Because if there are not a sufficient number of bilingual clinicians, then it’s well take one more, take one more, take one more without like, can you just squeeze somebody else in?

Adriana Rodriguez 23:12
Yep.

Katie Vernoy 23:12
We really need a bilingual clinician. And so that’s exploited. So I just…

Adriana Rodriguez 23:16
Yeah, so exactly that. So because of the power dynamics that we just talked about before, right, like that is, that becomes the perfect scenario for people being overworked, overtired, under supervised, under supported, and leads to burnout. That’s why I left the field for a few years. Because it just did not seem like a sustainable way to function. That every Spanish speaking client that came in, I had to balance my personal values and guilt about saying no, and the idea that this person would go without services, because there was nobody else in my agency that could take it, right. And so and then you add productivity, and then you add all of that stuff, right. So I know that myself and other clinicians who were at our agency had some of the higher case loads had to drive further out. I was in San Francisco County when I was doing my hours as a trainee, as an intern, which now will be an associate and San Francisco County foster homes would you know, there’s San Francisco is a very small city. So our clients would get placed in San Jose, Visalia, Vallejo, you know, everywhere. And so on top of having this incredibly huge caseload, you also had to be traveling to all these places. And, you know, so it was a recipe for burnout. I burned out really quickly. I knew I was focused, I needed to get my hours and I work, work work and once I was done with my hours, I just didn’t even think I wanted to be a therapist anymore. And it took several years of, you know, I finished my hours, I took my exams, I got licensed, took a deep breath and said I need a break from this, I don’t even think that this is my and I was I’ve been in education the last eight years, seven years of my my career, because of that reason, because I felt overworked and under supported. And a lot of it now, recognizing it and kind of putting pieces together had to do with how frustrating it was to not to those circumstances for bilingual clinicians who carry this really big case load. That was not being considered, you know, and, and to an earlier point that we made, it’s like, we weren’t getting paid enough. We were not getting paid enough in comparison to folks who had smaller case loads, and who were getting getting paid around the same same amount as we were right with this, like incentives that were bilingual that just truthfully, are just not enough.

Katie Vernoy 25:48
And it’s interesting, because I, as I’m thinking back, there, there was definitely the higher case loads. But the only qualifier was, is the case a monolingual Spanish case? Or is there a monolingual Spanish parent? There’s there was not a matching with clinicians at all. And also not necessarily the same calibration related to how many were in high level of crisis versus how many were a little bit further along. Because it would be something where well, clearly when a family is in crisis, they need someone who can speak the same language. And so I would imagine the caseload was less attuned to who you were as a clinician as well as much higher acuity.

Adriana Rodriguez 26:32
Yes, definitely the acuity and the helping, the other part is that, you know, navigating systems, like for example, my case was the foster care system, navigating systems is already hard for families, regardless of who they are. But then you add the component of social justice issues, right. Differences between the caseworkers at DHS and the family, and this work that you’re doing with them and having to be the main interpreter translator person that is like in charge of doing all this connecting while also supporting the family, right? It is, it is a load, it is a load that is really big. And that I don’t know that it was on purpose, or that it was out of my supervisors in my agency trying to be unkind. I don’t I don’t know. But it was the fact that it wasn’t being thought about or considered, every time that I got assigned somebody new, right. And it was exhausting. It was exhausting.

… 27:26
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Curt Widhalm 27:28
You’re not the first person that I’ve heard talk about this extra burden of work. Of, you know, not just the caseload stuff, but you’re not even the first person I’ve heard talk to you about how we’re burning out clinicians before they ever get licensed. And many choose not to actually go through the licensing process, because of some of these barriers. And we can speak all day long about representation. But when we reward representation with extra burden, that, you know, goes beyond even what you’ve discussed so far. And I know from some of our conversations off air, like, I’d love for you to talk about the language is around even just being able to communicate what therapy is and how that impacts clients in some of the communications, how documentation works out when you’re having to do not just the translation in sessions, but to get services funded.

Adriana Rodriguez 28:30
So one of the things that I can, I can say about that, for example, things that we take for granted as English speaking clinicians. The fact that we go to trainings and you receive all this materials, but then your clients are Spanish speakers, and who’s going to translate all that for you, who’s gonna put that all in Spanish. And so then now, you are not only the clinician, the verbal interpreter, the translator of the documents, but now you have to turn all whatever evidence based practice that was packaged really beautifully in this training, and you have the duty of also translate it in Spanish. I have my own collection of Spanish forms that I’ve created over the years that I share with peers, you know, that I’ve shared, because other people are sharing with me, we resolved, we end up having to do this peer mentoring and this networking base sharing of knowledge that should be coming from the people that are training us and the people that are employing us, right. But if the cultural considerations are not there around language in this case that we’re talking about, and you say, send me to a great, you know, I used to be a Triple P parent coach for parents, right? But all the documents were in English and so then I had to prepare in advance for my Spanish session. And the language is translated in English if there was a worksheet translating that, but then there’s a complexity of also as Latinx Hispanic people not be monolithic, right? Like the idea that the Spanish that you may speak may not necessarily translate for the other person that you have in front of you. Because there’s a language and culture implications even within the same that same in different areas, countries that people are from. So something as simple as boundaries. We don’t talk about boundaries in Spanish, like, the word is limits, right? Like that’s the word that how we express it. Like even to this day, just, you know, it’s like, you got to be okay with setting your limits, because the word boundary itself, there’s not quite a translation. There’s even a debate of whether we are therapistas or therapeutas, even what a therapist is called. That’s a debate like what where do you use. The cultural component of the power dynamic then showing up in the room between you and your client, and that they want to call you a doctor, they want to call you as psicólogas. They want to call your doctor or a psychologist? And you’re like, No, no, no, I’m a therapeuta. And like, trying to explain all those things like the language, the gap in the language of not just translating, because you put it in Google Translate, and then you’re just like reading it, but the context of the education level of the person, their own trauma history, their own potential learning disabilities, you know, different factors that are going on, that in my experience, when I first came to the United States, I compare it to when I came as an 11th grader, and they wanted to put me in back into ninth grade because I didn’t speak English. And wait, what what do you mean, just because I don’t speak English, I have to go two years back in school, right? And so we are making lots of assumptions about the people who are receiving this materials who both can have either a higher capacity to understand and probably are smarter than the clinician that is in front of them in Spanish, if you ask them, right, but that sometimes, depending on the history of that person may have low literacy levels. And if that happens, how are you bringing not only translating English psychological language into Spanish, but then bring it down to the context that meets the needs where your client is at. So, it is very, very complex, and it goes beyond just translating the worksheets, because actually, the way that it’s being delivered also has to be fine tuned. So there’s like an ongoing process of fine tuning throughout that you have to figure it out on your own, you are figuring out actively.

Katie Vernoy 32:26
For folks who are wanting to support bilingual clinicians, bicultural clinicians, what are some steps that that could be taken, whether it’s as a supervisor, as a an ally, and a colleague, like what are the things that you think would be most helpful for us to do to support these clinicians that have this extra weight to carry?

Adriana Rodriguez 32:51
I think we need more research around the impact of even in a personal sort of interest, as I’ve looked, and EBSCOHost, and the APA journals, the literature around the implications of monolingual supervision of bilingual clinicians who are working with either bilingual or monolingual clients. There’s almost no literature, right? So even even beginning there, like, we have to have more research, we have to understand what are the things that are getting in the way? And also what are the gifts that come when you are having the pleasure and the honor of supervising somebody who’s so different than you and the ability to learn from them? Right? So shifting the power dynamics, more research, we need to train our supervisors to ask that question that could ask, I’m my capable, do I have the capacity? Do I have the training? Am I the best person to supervise this clinician that is in front of me? And so promoting that self awareness, that awareness, that questioning and including the cultural humility, how are the differences in the likeness between us showing up in the room and in the triad between the supervisor, the clinician, and then the, the client, right, it’s a triad that is happening. We need to increase the knowledge of these cross-cultural skills. And in moving away from the idea that competence, that there’s this is something you will achieve. This is something you have to remain flexible, open minded and open hearted, even as a as a bipoc clinician, as a woman of color, as a queer person, that I have to constantly be re-examining my beliefs and my truth because they may or may not be rooted in white supremacy, they may or may not be rooted in colonial racist practices. That if I’m not aware of them, and I’m not questioning. So, the idea of remaining self aware and in in achieving and striving for self awareness at all times, right. And and with that, hope that the more that you’re aware, then the more that you’re going to be able to make connections and help others make connections and answer the questions that you don’t have answers for. Utilize your clinicians that are in front of you, as a as a wealth of knowledge. And at the same time, do your work because you don’t want to burden on top of everything that your connections already doing to also teach you right? But how can you share the power with each other in the room so that you also can be like open minded to these things that maybe they’re just naturally don’t come to you? And how do you make them natural? How do you make this kind of questioning natural to yourself. Thinking also about the difference between personality dynamics and cultural dynamics, that just because one of your clinicians feels this way, and they’re working with this population, your next clinician’s experience is completely nuanced, and multifaceted. And so how are you, I mean, it’s a big job, I’m not gonna say that this is not a big job. But that thinking about the individual experiences of people, you know, we need to develop skills about case conceptualizing. How are we thinking about the people that we have in front of us? Right, like, what are their histories? What are their, the nuances for their own lives? And what do they bring up in the clinician? And then what are they bring up in the supervisor. It is this triad that we’re gonna be thinking about at all times. And like, and like I said earlier, thinking about not only this, the, the change as people and as individuals, but also how are we promoting the systemic change, the institutional change in opening up opportunities to uplift the voices of these clinicians who we do exist, we are here, we’re doing work, but we sometimes may not have opportunities to to be brought up to stages. So even you know, this opportunity to have me talking about this. I’m sure that there could be a person who has actually written about this, but the fact that you’re finding value in the lived experience, along with this like acknowledge that comes with just who I am like, that is the way that we’re lifting up this voices because we are there and we’re doing the work.

Curt Widhalm 37:01
Can’t wait to see where you’re at with this conversation at the end of September for Therapy Reimagined. 2021.

Katie Vernoy 37:11
Shameless plug.

Adriana Rodriguez 37:12
This is the plug. I’ll be there. So, if you want to talk more about this, you better be there too.

Curt Widhalm 37:22
And check out Therapy Reimagined conference for tickets and being able to see all of our wonderful speakers including Adriana. In the meantime, where can people find out more about you?

Adriana Rodriguez 37:38
So I love being on social media because I’m a talker and I love talking about this and everything first gen experiences because I am passionate about expanding these voices. So you likely will find me on Facebook, on Instagram, on Clubhouse everywhere, but the main place you can go to is my Instagram, Adriana Rodriguez Therapy and Adriana Rodriguez Therapy on Instagram. And then from there, you’ll be able to kind of find everything else that I’m up to. But just lately I’ve been really active on on Clubhouse because I can just say what I’m thinking. So.

Katie Vernoy 38:11
I love it. I love it. We’ll put that in the show notes.

Curt Widhalm 38:14
And you can find our show notes at mtsgpodcast.com. And until next time, I’m Curt Widhalm with Katie Vernoy and Adriana Rodriguez.

… 38:23
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Announcer 38:23
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