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Aim or purpose

The purpose of this research is to address the gap in the existing literature on the multilingual aspect of language in psychotherapy with children and adolescents.

This research aims to reply to the following research questions:

• what might be the meaning for clients of being multilingual in the therapeutic process?
• how does bilingualism influence the therapeutic relationship with children and young people?
• what are the strengths and weaknesses of bilingualism in therapy with children and young people?

Design methodology

I used a systematic literature review (PRISMA guidelines, 2009) to identify, screen, and select articles based on the following criteria:

• recent qualitative, mixed and case studies on talking therapies
• participants up to 25 years old or adults referring to childhood/adolescence
• focus on bilingualism/multilingualism rather than multiculturalism
• written in English
• including a reflection about the method to extract data

I used thematic synthesis (Thomas & Harden, 2008) to extract, analyse and interpret data. The rigour of this study was enhanced by the use of auto-ethnography as a source of evidence (McLeod, 2015). The auto-ethnography documents self-reflections on the journey of research and on personal experience of being multilingual.

Results and findings

Ten studies matched the inclusion criteria. The synthesis process involved three stages: coding, construction of descriptive themes, and development of analytical themes. I organised the codes hierarchically into descriptive themes classified in purpose and use of bilingualism.

From analysis of the descriptive themes, two groups of meanings emerged:

• feeling rejected, alienated, excluded and disconnected
• feeling accepted, trusted, acknowledged and empowered.

Yolanda, a 23-year-old L1 Spanish client, felt uncomfortable, hurt and disappointed when, after disclosing a vulnerable experience in English to her therapist, she was referred to another therapist because of her accented English (P茅rez-Rojas et al., 2019, p. 249).

Elena, a 20-year-old L1 Italian speaker, preferred to use English in therapy and sought reassurance from her therapist to confirm her fluency in English (Rolland et al., 2021).

Elena S., a teenager L1 Spanish speaker preferred to use English in therapy as she didn鈥檛 know how to express her emotions in Spanish and this caused sadness in her parents (Binkley & Koslofsky, 2017).

A homosexual Latino male, Lucio, experienced sexual trauma in childhood and adolescence. He refused to use Portuguese (L1) in therapy, preferring to use English (Lx) Cassese & Mujica, 2000).

*LX: any foreign language learned after the age at which the first language, L1, was acquired (Dewaele, 2018).

Research limitations

• case studies give us an insight into the clients through the eyes of the therapist, which is different from gathering data based on participants' meanings
• studies based on a mixed sample and the use of adult participants referring to childhood/adolescence might have influenced the interpretation of findings: the meaning that an adult client gives to a multilingual experience related to childhood/adolescence might be different than that one of a child/adolescent
• publication bias
• studies written in languages other than English might contain additional concepts which have been left out of this research
• no additional reviewer

Conclusions and implications

The findings confirm previous research and theoretical elaborations on the existence of a link between multilingualism and power, privilege, agency and identity (Costa, 2020, p.5). The experience of bilingualism in therapy seems to be intertwined with the experience of attachment and trust, rupture and repair. The research suggests that the meaning a client gives to bilingualism聽 can be co-constructed within an attuned therapeutic relationship. In this co-construction journey, there is a significant opportunity for children and young people in finding their way through languages, hence reaching emancipation and affirmation in the world.