Therapists in a Foreign Land: Acculturation, Language Proficiency and Counseling Self-Efficacy among Foreign-Born Therapists Practicing in the United States



Immigration and acculturation can have profound effects on counselors’ sense of self and interactions with others. Yet the influence of being an immigrant on a therapist’s use of self during actual clinical encounters has received very little empirical attention, even though the number of foreign-born counselors is steadily increasing in the U.S. In order to fill this gap we conducted a web-based survey study to examine the associations between acculturation, language proficiency, and clinician’s self-efficacy in a sample of 258 foreign-born counselors and providers currently practicing in the U.S. Results suggest that perceived prejudice and not the level of acculturation is significantly associated with levels of clinical self-efficacy, suggesting that the attitudes and behaviors of the host community play a much bigger role in the acculturation of immigrant therapists than previously assumed.


Acculturation Counseling self-efficacy Foreign-born counselors Immigration 


  1. Akhtar, S. (1999). Immigration and identity: turmoil, treatment and transformation. Northvale: Jason Aronson Inc.Google Scholar
  2. Baggerly, J., & Osborn, D. (2006). School counselors’ career satisfaction and commitments: correlates and predictors. Professional School Counseling, 9, 197–205.Google Scholar
  3. Bandura, A. (1997). Self-efficacy: the exercise of control. New York: Freeman.Google Scholar
  4. Berry, J. W. (1980). Acculturation as varieties of adaptation. In A. Padilla (Ed.), Acculturation theory, models and some new findings. Boulder: Westview.Google Scholar
  5. Berry, J. W. (1983). Acculturation: a comparative analysis of alternative forms. In R. J. Samuda & S. L. Woods (Eds.), Perspectives in immigrant and minority education (pp. 65–78). Lanham: University Press.Google Scholar
  6. Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology: An International Review, 46, 5–98.Google Scholar
  7. Berry, J. W. (2006). Contexts of acculturation. In D. L. Sam & J. W. Berry (Eds.), The Cambridge handbook of acculturation (pp. 27–42). New York: Cambridge University Press.CrossRefGoogle Scholar
  8. Berry, J. W., Kim, U., Minde, T., & Mok, D. (1987). Comparative studies of acculturative stress. International Migration Review, 21, 491–511.Google Scholar
  9. Birman, D. (1994). Acculturation and human diversity in multicultural society. In E. J. Trickett, R. J. Watts, & D. Birman (Eds.), Human diversity: perspectives on people in context (pp. 261–284). San-Francisco: Jossey-Bass.Google Scholar
  10. Blow, A. J., Sprenkle, D. H., & Davis, S. D. (2007). Is who delivers the treatment more important than the treatment itself?: The role of the therapist in common factors. Journal of Marital and Family Therapy, 33, 298–317.PubMedCrossRefGoogle Scholar
  11. Bouhris, R. Y., Moise, L. C., Perreault, S., & Senecal, S. (1997). Towards an interactive acculturation model: a social psychological approach. International Journal of Psychology, 32, 369–386.CrossRefGoogle Scholar
  12. Brown, L. S. (1994). Subversive dialogues: theory in feminist therapy. New York: Basic Books.Google Scholar
  13. Bula, J. F. (2000). Use of the multicultural self for effective practice. In M. Baldwin (Ed.), The use of self in therapy (pp. 167–189). New York: The Hartford Press.Google Scholar
  14. Castaño, M. T., Biever, J. L., Gonzalez, C. G., & Anderson, K. B. (2007). Challenges of providing mental health services in Spanish. Professional Psychology: Research and Practice, 38, 667–673.CrossRefGoogle Scholar
  15. Clauss, C. S. (1998). Language: the unspoken variable in psychotherapy practice. Psychotherapy, 35, 188–196.CrossRefGoogle Scholar
  16. Clement, R. (1986). Second language proficiency and acculturation: an investigation of the effects of language status and individual characteristics. Journal of Language and Social Psychology, 5, 271–290.CrossRefGoogle Scholar
  17. Duncan, B. L., &, Lambert, M. J. (2010). On becoming a better therapist. American Psychology Association.Google Scholar
  18. Frey, L. L., & Roysircar, G. (2004). Effects of acculturation and worldview for White American, South American, South Asian, and South East Asian students. International Journal for the Advancement of Counseling, 26, 229–248.CrossRefGoogle Scholar
  19. Fukuyama, M. A. (1994). Critical incidents in multicultural counseling supervision: a phenomenological approach to supervision research. Counselor Education and Supervision, 34, 142–151.Google Scholar
  20. Garcia, M., & Lega, L. I. (1979). Development of a Cuban ethnic identity questionnaire. Hispanic Journal of Behavioral Sciences, 13, 247–261.Google Scholar
  21. Garza-Guerrero, A. C. (1974). Culture shock: its mourning and the vicissitudes of identity. Journal of the American Psychoanalytic Association, 22, 408–429.PubMedCrossRefGoogle Scholar
  22. Gutierrez, F. J. (1982). Working with minority counselor education students. Counselor Education and Supervision, 3, 218–226.CrossRefGoogle Scholar
  23. Hardy, K. V. (1990). The theoretical myth of sameness: a critical issue in family therapy training and treatment. In G. W. Saba, B. M. Karrer, & K. V. Hardy (Eds.), Minorities and family therapy (pp. 17–22). New York: Howarth Press.Google Scholar
  24. Hartman, H. (1950). Comments on the psychoanalytic theory of the ego. In H. Hartman (Ed.), Essays on ego psychology (pp.113–141). New York: International University Press.Google Scholar
  25. Henley, N. M. (1995). Ethnicity and gender issues in language. In H. Landrine (Ed.), Bringing cultural diversity to feminist psychology (pp. 361–395). Washington D.C: American Psychological Association.CrossRefGoogle Scholar
  26. Horenczyk, G. (2000). Conflicted identities: acculturation attitudes and immigrants’ construction of their social world. In E. Olshtain & G. Horenczyk (Eds.), Language, identity and immigration (pp. 13–30). Jerusalem, Israel: Hebrew University Magnes Press.Google Scholar
  27. Isaacson, E. (2002). The effect of evolving cultural identities on the experience of immigrant therapist. Dissertation Abstracts International: Section B: The Sciences and Engineering, 63(5-B), 2586.Google Scholar
  28. Jacob, E. J., & Greggo, J. W. (2001). Using counselor training and collaborative programming strategies in working with international students. Journal of Multicultural counseling and Development, 29, 73–88.CrossRefGoogle Scholar
  29. Kim, Y. Y. (1988). Communication and cross-cultural adaptation: an interdisciplinary theory. Clevedon: Multilingual-Matters-Limited.Google Scholar
  30. Kline, F., Acosta, F. X., Austin, W., & Johnson, R. G. (1980). The misunderstood Spanish speaking patient. American Journal of Psychotherapy, 33, 331–338.Google Scholar
  31. Lacina, J. G. (2002). Preparing international students for a successful social experience in higher education. New Directions for Higher Education, 117, 21–28.CrossRefGoogle Scholar
  32. Larson, L. M., & Daniels, J. A. (1998). A review of the counselor self-efficacy literature. The Counseling Psychology, 26, 179–218.CrossRefGoogle Scholar
  33. Larson, L. M., Suzuki, L. A., Gillespie, K. N., Potenza, M. T., Bechtel, M. A., & Toulouse, A. (1992). Development and validation of the counseling self-estimate inventory. Journal of Counseling Psychology, 39, 105–120.CrossRefGoogle Scholar
  34. Lent, R. W., Hill, C. E., & Hoffman, M. A. (2003). Development and validation of the counselor activity self-efficacy scales. Journal of Counseling Psychology, 50, 97–108.CrossRefGoogle Scholar
  35. Mana, A., Orr, E., & Mana, Y. (2009). An integrated acculturation model of immigrants’ social identity. The Journal of Social Psychology, 149, 450–473.PubMedCrossRefGoogle Scholar
  36. Mehta, S. (1998). Relationship between acculturation and mental health for Asian Indian immigrants in the United States. Genetic, Social, and General Psychology Monographs, 121, 61–78.Google Scholar
  37. Miranda, A. O., & Umhoefer, D. L. (1998). Acculturation, language use, and demographic variables as predictors of the career self-efficacy of Latino career counseling clients. Journal of Multicultural Counseling & Development, 26, 39–52.CrossRefGoogle Scholar
  38. Mittal, M., & Wieling, A. (2006). Training experiences of international doctoral students in marriage and family therapy. Journal of Marriage and Family Therapy, 32, 369–383.CrossRefGoogle Scholar
  39. Mori, Y., Inman, A. G., & Caskie, G. L. (2009). Supervising international students: relationship between acculturation, supervisor multicultural competence, cultural discussions, and supervision satisfaction. Training and Education in Professional Psychology, 3, 10–18.CrossRefGoogle Scholar
  40. Morris, J., & Lee, Y. (2004). Issues of language and culture in family therapy training. Contemporary Family Therapy, 26, 307–318.CrossRefGoogle Scholar
  41. Ng, K., & Smith, S. D. (2009). Perceptions and experiences of international trainees in counseling and related programs. International Journal for the Advancement of Counselling, 31, 57–70.CrossRefGoogle Scholar
  42. Ng, K., & Smith, S. D. (2012). Training level, acculturation, role ambiguity and multicultural discussions in training and supervising international counseling students in the United States. International Journal for the Advancement of Counselling, 34, 72–86.CrossRefGoogle Scholar
  43. Nilsson, J. E. (2000). A comparison of international and United States students in APA-accredited programs: acculturation, counseling self-efficacy and role difficulties in supervision. Dissertation Abstracts International Section A: Humanities and Social Sciences, 60(11-A), 3919.Google Scholar
  44. Nilsson, J. E., & Anderson, M. Z. (2004). Supervising international students: The role of acculturation, role ambiguity, and multicultural discussions. Professional Psychology: Research and Practice, 35, 306–312.CrossRefGoogle Scholar
  45. Nilsson, J. E., & Dodds, A. K. (2006). A pilot study in the development of the international student supervision scale. Multicultural Counseling and Development, 34, 50–62.CrossRefGoogle Scholar
  46. Noels, K. A., Gordon, P., & Clement, R. (1996). Language, identity, and adjustment: the role of linguistic self-confidence in the acculturation process. Journal of Language and Social Psychology, 15, 246–264.CrossRefGoogle Scholar
  47. Phinney, J. S. (1998). Ethnic identity in adolescents and adults. In P. B. Organista, K. M. Chun, & G. Marin (Eds.), Readings in ethnic psychology (pp. 73–99). New York: Routledge.Google Scholar
  48. Phinney, J. S., Horenczyk, G., Liebkind, K., & Vedder, P. (2001). Ethnic identity, immigration, and well-being: an interactional perspective. Journal of Social Issues, 57, 493–510.CrossRefGoogle Scholar
  49. Rahman, O., & Rollock, D. (2004). Acculturation, competence, and mental health among South Asian students in the United States. Journal of Multicultural Counseling and Development, 32, 130–142.CrossRefGoogle Scholar
  50. Rastogi, M., & Woolford-Hunt, C. (2005). Academic sojourners in the United States of America: color in the ivory tower. In M. Rastogi & E. Wieling (Eds.), Voices of color. First- person accounts of ethnic minority therapists (pp. 211–228). Thousand Oaks: Sage.CrossRefGoogle Scholar
  51. Redfield, R., Linton, R., & Herskovits, M. J. (1936). Memorandum for the study of acculturation. American Anthropologist, 38, 149–152.CrossRefGoogle Scholar
  52. Redmond, M. V., & Bunyi, J. M. (1993). The relationship of intercultural communication competence with stress and the handling of stress as reported by international students. International Journal of Intercultural Relations, 17, 235–254.CrossRefGoogle Scholar
  53. Ryder, A. G., Alden, L. E., & Paulhus, D. L. (2000). Is acculturation unidimensional or bidimensional? A head-to-head comparison in the prediction of personality, self-identity, and adjustment. Journal of Personality and Social Psychology, 79, 49–65.PubMedCrossRefGoogle Scholar
  54. Sella, E. (2007). Countertransference and empathy: the perceptions and experiences of polyglot immigrant clinicians, who, working with monolingual or bilingual immigrant children, are practicing in a language that is not their mother tongue. Dissertation Abstracts International Section A: Humanities and Social Sciences, 67(8-A), 3167–3502.Google Scholar
  55. Sodowsky, G. R., & Lai, E. M. (1997). Asian immigrant variables and structural models of cross-cultural distress. In A. Booth, A. C. Crouter, & N. Landale (Eds.), Immigration and family: research and policy on U.S. Immigrants (pp. 211–234). Mahwah: Erlbaum.Google Scholar
  56. Sodowsky, G. R., & Plake, B. S. (1991). Psychometric properties of the American International Relations Scale. Educational and Psychological Measurement, 51, 207–216.CrossRefGoogle Scholar
  57. Sodowsky, G. R., & Plake, B. S. (1992). A study of acculturation differences among international people and suggestions for sensitivity to within-group differences. Journal of Counseling and Development, 71, 53–59.CrossRefGoogle Scholar
  58. Sodowsky, G. R., Lai, E. W. M., & Plake, B. S. (1991). Moderating effects of sociocultural variables on acculturation attitudes of Hispanic and Asian Americans. Journal of Counseling and Development, 70, 194–204.CrossRefGoogle Scholar
  59. Sprenkle, D. H., Davis, S. D., & Lebow, J. L. (2009). Common factors in couple and family therapy. The overlooked foundation for effective practice. New York: Guilford.Google Scholar
  60. United States Census Bureau (2010). Retrieved from
  61. United States Department of Homeland Security (2009). Retrieved from
  62. Verdinelli, S., & Biever, J. L. (2009). Experiences of Spanish/English bilingual supervisees. Psychotherapy Theory, Research, Practice, Training, 46, 158–170.CrossRefGoogle Scholar
  63. Wieling, E., & Marshall, J. P. (1999). Cross-cultural supervision in marriage and family therapy. Contemporary Family Therapy, 21, 317–329.CrossRefGoogle Scholar
  64. Winkelman, M. (1994). Cultural shock and adaptation. Journal of Counseling and Development, 73, 121–126.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Couple and Family Therapy DepartmentDrexel UniversityPhiladelphiaUSA
  2. 2.Department of Public HealthTemple UniversityPhiladelphiaUSA

Personalised recommendations