Therapy in English with a Non-Native Therapist: Anna’s Honest Take

A Scottish client shares her honest experience of therapy with a non-native therapist—misunderstandings, connection, and what really matters.

Many psychologists offering sessions in English worry about how they'll be perceived by their clients, especially when those clients are native speakers.

Their doubts often spiral into worst-case scenarios.

“If I make a mistake, they’ll think I’m incompetent”

“I can’t hesitate or use the second-best word that comes to mind… otherwise, I won’t sound prepared”

It’s a little like worrying about the monster under the bed. If you could just see how scaly or ugly or hairy it is, it loses part of its power.

There’s nothing worse than being left guessing.

That’s why I wanted to ask a native English speaker directly. What’s it actually like to be in therapy with someone who speaks English as a second language?

In this interview, I speak with Anna*, a Scottish teacher living in Spain, who has been working with a Spanish therapist, Marta, for several years.

This is just her story, of course (and every client is different), but I hope it helps put some of those fears into perspective.

Both Anna's and Marta’s names have been changed to protect their privacy.

S: My first question is, how did you find your therapist, Marta*?

A: She was a recommendation from a friend. We both had similar doubts about previous therapists that we had been with, and actually those previous therapists were both native speakers… just the style of therapy wasn't for me or my friend. And then she said she had great success with Marta, and she mentioned EMDR, which I was quite sceptical of. I didn't know anything about it, but given that it was a recommendation, and that she spoke English, I was willing to give it a go.

And, so that was it!

S: Why might a native speaker of English choose to work with a therapist who speaks English as a second language? A lot of my clients ask themselves this.

A: You know, I think that's not the thing you're worried about as a client. I think that you shouldn't leave going to therapy until panic stations, but I think a lot of times when I've gone to therapy, it's been like, OK! I need to throw money at this NOW! So my big problem is whatever my problem is. I mean, yeah, you have to be confident. Obviously, there's a minimum there. But I want to do it in English, my mother tongue.

I know a lot of people who do it in their second language, and I did have one experience of that. I got some free therapy when I had cancer. And that was quite good. But at the same time, it just felt a bit easier in English. It’s already hard to open up.

It really wouldn't be a priority for me to have a native speaker. I do caveat that with I work in the world of language teaching, so I know about that kind of fallacy, so I can't say that's everybody.

S: So, in your experience, at least, you’re not so focused on the therapist, you're focused on, well, I have this problem and I need help.

A: Exactly. But I know there are a lot of myths out there about what a native speaker brings to the table.

S: Did it cross your mind that you might have difficulties communicating with Marta before your first session? Did you even ask yourself the question, “How is this going to go from a language perspective?”

A: I don't think I did. I can't say I remember it that well. I guess there were some messages back and forth that might not have been perfect English, but it wouldn’t have been enough to worry me at that point. And my friend is a US citizen. It was fine for them, so I guess it didn't really cross my mind.

I think you're trying to evaluate everything in that first session. You're like, “Are we going to connect? Will I trust this person? Is it a useful method for me?”  So, yeah, maybe part of me was evaluating her English at the same time, but it wasn't conscious.

S: How would you describe the way Marta communicated in English with you?

A: Not perfectly! It sounds bad to start on a negative, but I don't mean it as a negative. And I think that's the key point, that “not perfectly”. I am very attuned to listening out for language mistakes because of my job, so obviously, I hear them, but I also speak Spanish, so we could switch for a bit or whatever. None of her mistakes were significant enough to make me doubt her abilities or her ability in English.

And also, if we did have blocks in communication, which occasionally happened, you just go back again and explain it a different way, which I think happens between native speakers as well. So you replay the conversation. “No, I didn't get what you mean….” That happens between me and my sister, for example. That's life!

S: I feel like I'm hearing two different things. On the one hand, it sounds like you separated her skills in terms of speaking accuracy and her skills as a therapist. For you, those were two distinct things.

A: Absolutely, yeah.

S: And the other thing was that a misunderstanding does not necessarily reflect language speaking abilities or language level.

A: Absolutely! We make mistakes in our own language all the time. You know, we do that constantly. I think a learner just assumes that all the mistakes they're making are due to their language, but it's life!

S: I'm smiling because this is something I write about on my blog all the time! OK, so when language difficulties, misunderstandings came up, basically, you just backtracked and tried to explain it another way and moved on.

A: Yeah, exactly. And sometimes I felt, or I feel, that it's my own lack of clarity. It’s like, oh, I said that in a weird way … It's good for me to go back and say “Oh, I didn't mean it like that, this is what I wanted to say” Explaining your feelings is tricky.

S: It is tricky! It’s very, very hard. And so sometimes it's valuable to question the way that you express something and to think about it a bit more and say, “Is that really how I feel?” Or “how can I best express this?”

A: Yeah, yeah.

S: How did you and your therapist build a strong therapeutic alliance or relationship despite potential language barriers or issues?

A: I think just my therapist’s empathy and listening skills and her absolute willingness to help me move forward… like that humanity of it. And also perhaps being, I don't know, being non-British. It's a personality thing, but being non-British, like she hugged me! She often hugged me! I never had that in Britain.

Again, it depends on the individual, but you know, so that's bringing in value of not being the typical sort of British straight-laced therapist, which, again, is a generalisation, but…

S:  Yeah, yeah, because there are so many safeguarding concerns.

A: Yeah, much more so, over there.

S: Yeah, it's interesting because some of the things that she did are skills that you're trained in as a therapist, but it seems like it goes beyond that, and it's her being a human towards you.

A: Absolutely, yeah, for sure.

S: Therapists are often scared of showing their humanity to clients, as though they might seem less professional. But…

A: No! And she, I mean, she has got upset occasionally, and I appreciate that, to be honest. I do feel seen on a human level, like she commented to me a few weeks ago, “Ah, I forgot how much I love your presence,” And I would imagine that's almost a no-go for therapists, but there's a real relationship there!

S: Aw, that's so lovely! I asked someone else that question as well, and he said that it was like the tiny interactions they had before and after the session, talking about the music they liked, which, again, is not the therapist’s job.

A: Yeah, yeah. It's true, though! Like, yeah, she recommended a series to me this week.

S: So, it's not… just a blank wall or a poker face. If only we could be more imperfect and human in our sessions, you know? That's what people want.

Apart from this human-ness, what qualities in your therapist stood out and made you feel understood and supported?

A: Also, I think the initial setup was quite professional, so explaining what the plan was, what EMDR was, and homework after that first session… That felt like I was being taken seriously. I think we all worry about the money we spend on therapy, making sure, like OK, she's really wanting to dig in! That was an important part at the beginning. You know, like your first class with anyone.  You did the first class really well to set the standard there.

S: It felt like she knew where she was headed, and she was taking you seriously. Her professionalism showed through.

A: Oh yeah, from day one.

S: Apart from the hugging, did you notice any cultural differences, and did they affect your experience in any way?

A: I think it's something that comes up a lot, mainly because my therapist has an Irish partner, so they are aware of differences, and that can be something we talk about in therapy. Therefore, I think she does bring a lot of cultural understanding to the table, despite not being British herself. And I know not all your clients will have that, but I do think that it's good she has spent time in Ireland. I'm not saying Irish culture and Scottish culture are identical, either, but there's a real knowledge of where I'm coming from in that sense.

S: Cultural awareness helps, for sure. It's not just the fact that her culture was different, but it's the fact that she could understand your own.

A: Yeah. And also, I think we can overstate it! I'm just thinking off the top of my head, like about that therapist before her who didn't really work out. We were from the same country, but we were very different in some ways. She didn't reveal very much about herself. But also just some of the things she said, it was like, we're not actually from the same culture in a lot of ways! So that's interesting too.

S: It really is, sometimes we tend to exaggerate intercultural differences, and we minimise intracultural differences.

A: Yeah, completely different, the opposite sides of the tracks at times.

S: Absolutely. What would you say to someone, a friend of yours, perhaps, who might be hesitant to work with a therapist whose first language isn't English?

A: I think I would highlight it from my stance as an English teacher and ask them what kind of proficiency they are thinking of. I mean, perhaps they're worried that this person has an  A2 level of English, which would be unmanageable. We do have to admit there's a limit!

But try to get it out of them what their real doubts are, and sort of counter that with arguments I know from English language teaching… and also,  really, you're looking for a therapist you connect with!

And you might go to a first session, not like it, and it has nothing to do with their English. You just don't connect with them. And the therapist also shouldn't assume it's because of their English that someone decides not to continue. I think it's like chemistry, like English classes. I'm not the right teacher for every student. And I'm sure the same is much more true for therapists. So yeah, you just try and reason with them, because it's more important that you give it a go, and then you decide.

S: Yeah, like you said, it's not purely rational, is it? It's about clicking and feeling comfortable. I have a student who chooses therapists based on their pictures.

A: Yeah, that makes sense. I remember, I've had various therapists throughout my life, and ones I had in Scotland, they were kind of like an auntie figure. Like, you could totally be one of my aunties in my family!

S: Well, you are an English teacher, so how do you think language proficiency or your language skills impact therapy? Because it's talk therapy!

A:  Yeah, exactly …  I do think you have to just push through your impostor syndrome. You have to push through any errors or whatever you're making. The only way you will improve is by giving it a go.

By all means, keep studying, keep improving, but by exploring the English that you will need in the therapy session, which might be different compared to different types of methods, then, just kind of give it a go, really!

 You do need a minimum, you know that. But after that, it's then about honing your skills and maybe think, oh, I need more vocabulary to talk about the intricacies of emotion, or the background of certain things, make sure you're on top of those things that you know are going to come up a lot, and everything else, I think you just see how it goes.

Maybe that's not the best answer…

S: No, no, it is! It is. That's why we role-play a lot, because we identify gaps in people’s knowledge and things that they have to keep working on, but they won't know until we do it.

A:  So, it's great that they can get that practice with you, so it's not the very first time they're doing it.

And, you know your patients. Perhaps for some of them, it will be a dealbreaker, but that's for them to move on. It's not personal. I do think it's almost racism at that point, I have to say. It can be.

S: Yeah, some, some of my students live in an English-speaking country, and then it's a bit more difficult in those circumstances, because some people will be really open to working with someone from a different country, but someone from, like, a small town, might not be as receptive.

A: Yeah, possibly not because of racism, but native speakerism at least.

S: Yes, or a lack of knowledge of what it's like to be from a different country, or just feeling more comfortable working with someone from your own culture, which is fine.

A: It’s how much experience you’ve got with therapy as well. Because if it's your very first time, then I can understand the reticence, really, because it’s already a big deal trying to make that first appointment. So, if you see “oh, this person's from where my mum came from”, that can make things easier.

S: Things like that, for sure, and that's okay… but expecting that you're not going to be to everyone's liking, and being okay with trying nonetheless.

A: I think as teachers, we need to be like that, and therapists, they need to be like that. A lot of the time, when I've contacted therapists, the line they come out with is, let's have a first session to see if we're a good fit or see if I can help you. And I think that's them saying that not everyone is a fit. And so that works both ways.

S: Yeah, absolutely, absolutely. How would you describe your experience with Marta on the whole, looking back?

A: Fantastic! She's the best, most effective therapist I've ever had, I would say…one of the most, and has been very practical, very, very realistic. Not promising the moon when that's not possible. And, yeah, amazing, amazing. I would recommend her to anybody.

S: Oh, great. And very human as well.

A: Very extremely human, yeah, extremely human and extremely professional in her area of EMDR, etc…

S: Very knowledgeable, very experienced…

A: And very willing to also improve. That's also evident, and I respect that in any profession where there's a sort of acknowledgement that you never know everything. So let's keep growing.

And she was open recently, we were talking about something that came up, and she said, yeah, I used to approach this in a different way, and now I do it like this, and that's just interesting. You know, there's a flexibility there as well.

S: Yeah, yeah, being willing to change things up and to grow, see how it goes.

So, what would you say to a therapist who speaks English as a second language and might be hesitant to offer a therapy session, someone who is an advanced speaker, but they're a bit nervous?

A: I would say, as I say to all my students, what is the level at which you think you'll be ready? Yeah, C3? Because it's this imaginary, imaginary, impossible goal, forever moving back and back. And it's like you have to just say, stop at a certain point.

You will never be perfect, I promise you that. And so why not start today? It's kind of as simple as that. And you'll muck it up for all sorts of reasons! I just say, take on one client, see how it goes.

S: Yeah, volunteer, if you want to.

A: Practice with a friend, whatever. But just get started. You know, it's this…. women we’re incredibly guilty of it. I just need to know a bit more … No! It's okay not to know everything!  

S: And those therapists I work with are mostly women.

A: Yeah (laughs), and it makes me, it actually makes me quite emotional thinking that we've built this kind of English language system that people are feeling so insecure. It's horrible. You're C1, you're B2. Whatever it is, it means you’re competent in work situations, there you go! The CEFR level says you're ready, you know.

S: So, do you think the ESL industry (Teaching English as a Second Language) is guilty of making people feel like they're not good enough, or making them even more insecure in some ways?

A: Yeah, yeah, I do.  Well, the fact that the lionisation of native speakers as being the only teachers rather than someone who has studied much more English than I ever have …  It starts there. I'm sure that it's an awful effect on the teaching side of things, but it must have a washback effect also on the students, you know, and I can only speak of Spain in that there's something in the culture that tells them they're shit at English, I don't know. More than much more than other places.

And you know, I'm saying all this, and I'm very embarrassed about my Spanish, and I'm probably B2-C1, you know.

S: Hmm, easier said than done. I think we also have to recognise that it's normal to feel this way, but letting that feeling prevent you from doing what you want is another thing.

A: Yeah, yeah, just keep moving forward, I guess.

S: Little by little, don't expect yourself to be perfect…

A: Exactly, yeah!

At the end of our conversation, I could almost feel both of us exhale.

Ultimately, it’s not about erasing the worry before working with your first English-speaking client.

What matters is that despite it, you prepare, are willing to keep learning and growing, and focus on what’s most important: connecting with the person in the chair opposite yours.

If you’re a therapist offering sessions in English as a second language, I hope Anna’s words offered some reassurance and maybe even a gentle push forward.

You don’t need to sound like a native therapist to do meaningful work.
What you need is a solid foundation, a clear framework, and the courage to get started.

That’s exactly what we focus on inside Talk Therapy II: Branch Out, my 12-week program designed to help mental health professionals build the skills and confidence to offer sessions in English. We practise real-life conversations, role-play tough moments, and explore those fears too.

Because, as Anna put it:

“You will never be perfect, I promise you that. So why not start today?”