Therapy with the Hispanic population – Is it any different?

Not all therapy is the same. Differences in culture, language, and background call for different therapeutic approaches. In my experience, with therapy in the Hispanic and bilingual population, there are certain conflicts and struggles unique to Hispanics. First, for therapy to be successful with Hispanics, we have to understand the difference between “Hispanic” and “Latino” and the diversity within these groups. Second, the difference between the Latino emphasis on the family versus the American focus on the individual can lead to conflict amongst parents and children. Lastly, there are distinctly Hispanic ways of speaking about complex issues like emotions that call for careful attention.

Hispanic v. Latino: What’s the Difference?

What’s the difference between Hispanics and Latinos? The words are often used interchangeably, but describe distinct, yet overlapping, groups. “Hispanic” describes a language group—those who speak Spanish. “Latino,” while many in this group are also Hispanic, defines a geographic group—those from Central and South America.

Despite sharing a common language, the Hispanics I do therapy with at TCSI, are remarkably diverse, and this diversity has its own challenges. I am from Colombia, but I primarily work with clients and families from Central America. We have different traditions and cultures. Even for me, sometimes it is difficult to understand all of the implications of these differences.

For example, compare someone from Argentina with someone from Central America. Argentina was colonized, in part, by Italians, so there are Italian influences in Argentina. But if you go to Central America, you find that the indigenous part is much stronger than in South America. They have firm indigenous traditions. Some communities in Central America do not even speak Spanish, but have their own language! Hispanics and Latinos are not all the same; they have their own dialects and histories.

To do therapy with Hispanic families, you have to understand their country of origin and their culture. If someone is from Colombia, you have to understand Colombians have been going through a civil war for over fifty years. You have to know that people from Colombia may have trauma history, have lost a loved one because of war and conflict. Salvador had an internal war for years; when doing therapy with Salvadoran families, history of trauma and loss often create the background of their experiences.

Family v. Individual

In addition to these distinctions, familial conflict frequently centers on the differences between parents and their child. Parents may be monolingual while the client is bilingual. The client’s Spanish is often weak because they only speak the language at home and not at school, so they don’t fully develop their Spanish skills. Parents often immigrated to the United States and want to speak Spanish while the client was raised here in the United States and is more comfortable with English. These differences in language and experience lead to major problems in communication of things such as rules, emotions, and supervision.

When you work with Latinos, the concept of the family versus the individual is useful. I’ve noticed here in the U.S. that you are to appreciate who you are as an individual—your goals and values as an individual. But in Latino culture, family and community takes priority over individual goals and values. This is a real shock when families go to therapy because most therapy values are directed toward the individual.

When working on individual goal setting with a client, I always try to include the family in their goals. I would say for all the clients I have worked with, family opinions and group goals are always important. With family therapy, you have to find a balance between what the person wants and the goals of the family. This process has usually worked, but when personal values do not match with family values, then we need to work on a middle path to alleviate the conflict.

Language, Sayings, Stories

With Hispanics, expressing emotions is very different. In Hispanic culture, we tend not to express emotions very openly, especially if they are negative emotions. We seek the positive side in things. While this is a strength of the culture, we also need to acknowledge what is wrong, negative and painful. Suicidal or homicidal emotions need to be expressed and handled even if expressing such emotions is taboo.

Sayings are very important for Hispanics because we use sayings to describe the world. Spanish is so complex and elaborate while English is more straightforward. In Spanish, you elaborate and explain around the point, but when you want to make a point, you use a saying.

This way of speaking in Spanish can often be interpreted in therapy as avoidance. Bilingual people often tend to have this problem—it’s not that we’re avoiding the topic or the point. In our culture, we go around things; we give examples, we are not always straightforward. This is the way we have learned to describe the world and our feelings. That’s why we use sayings and stories, which are especially useful in therapy. You try different routes for explaining things, especially if English is not your first language. You do not usually find the words to express your emotions. For example, I can use the words in English, but it may not have the full meaning of what I want to express, and a saying may have more meaning in my native language.

In family therapy, we encourage the client to speak in Spanish to his or her family. The child will be trying to speak in Spanish, but will want to speak in English, and cannot find the words to describe their feelings in Spanish because they have come to express and know their feelings in English. Part of working with bilingual clients is helping them to cultivate their language skills to better express themselves to their family.


Working with the Hispanic population has been rewarding and challenging in many ways. I love helping parents and kids express themselves to each other in the midst of the cultural and linguistic diversity that complicates their communication. It is important both to help Hispanic children growing up in the United States to remember their mother tongue while recognizing the great benefits of being bilingual.