Date of Award

Spring 2026

Document Type

Open Access Thesis

Department

Psychology

First Advisor

Kimberly D. Becker

Abstract

Spanish-speaking individuals face significant barriers to accessing linguistically appropriate mental health services. Language match between therapists and clients has been associated with positive impacts on the therapeutic process; however, little is known about how Spanish is used in youth therapy sessions or how therapeutic and demographic characteristics influence its use. Using 54 recorded Spanish-speaking therapy sessions from a randomized controlled trial of school-based mental health services in Los Angeles, California, this study sought to understand who participated in these sessions, how Spanish was used, and what predicted its use. To address these aims, data were drawn from electronic health records, a therapist background questionnaire, and event audio recordings. Recordings were transcribed line by line and coded to capture speakers, total words, and language used.

Findings indicated a workforce serving racially/ethnically and linguistically aligned youth, with all therapists and clients identifying as Latine/Hispanic and the majority reporting a history of speaking Spanish. Spanish was used alongside English, accounting for more than half of the words spoken in these sessions. Providers, clients, and caregivers attended sessions to varying degrees, highlighting the potential use of Spanish to serve bilingual family systems. Providers accounted for the majority of total words (58.9%) and Spanish words (54.1%), potentially underscoring their central role in shaping the linguistic environment. Bootstrapped multiple linear regressions were conducted to predict (1) the total number of Spanish words used and (2) the total number  of Spanish words spoken by therapists. Across both models, client age predicted Spanish utilization. Sessions with older youth contained a greater number of Spanish words overall (B = 154.12, 95% BCa CI [15.14, 312.92]), and providers also used more Spanish when working with older youth (B = 112.29, 95% BCa CI [18.41, 208.56]). These results may reflect that as youth get older, they may engage in greater Spanish utilization, which in turn shapes providers’ own language choices and the broader linguistic environment. This study offers one of the first session-based examinations of Spanish-speaking mental health services and provides foundational insights that can guide future research and inform linguistically responsive care for Spanish-speaking clients.

Keywords: Spanish, language match, bilingual therapy, youth therapy services, Latine/Hispanic

Rights

© 2026, Vanessa Perez

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