As we are working through a Psycho-Social Assessment or Diagnostic Interview with a Spanish speaking client, we are going to need the interrogative "¿Dónde?" in one main way:

1. Where something occurred

Let's use the formula of the same past tense (preterit) verbs that we used in the previous post, and ask Where? (¿Dónde?) instead of When? (¿Cuándo?) something occurred. These types of question constructions occur frequently in a Psycho-Social Assessment, and it's very helpful to be aware of, and memorize a few of them.

Simply form a question starting with "¿Dónde?" and use the preterit tense of the verb, similar to the last blog post when we were working with the question "¿Cuándo?" followed the same preterit tense of the verb. 

Here are a few examples:

1. ¿Dónde nació usted? Where were you born? We are using the interrogative "¿Dónde?" for where something happened in the past. To be born is the verb 'nacer'. If we are asking about something that happened in the past, we need the Preterit tense, which is similar to past tense absolute. It happened on a singular occasion. The correct conjugation is in the 3rd person singular of nacer: nació. 

2. ¿Dónde pasó eso? Where did that happen? Here introducing the verb 'pasar' we need the preterit tense 3rd person singular: "pasó". This is an extremely useful formula at times when you don't have immediate command of the conjugation of the verb you are needing. For example, Where did you fall? Where did that happen? Where did someone die, and/or any other action that you need to ask about. Using the generic "pasó" can really help your confidence, as you obtain the necessary information without stressing out trying to memorize numerous conjugations. It's beneficial to learn them all of course, but this technique is useful when you're not sure.
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3. ¿Dónde se casó? Where did you get married? 

4. ¿Dónde ocurrió eso? Where did that occur? As a client is delivering their narrative in the Assessment phase of therapy, they will be talking about things that happened in the past. There was a birth, a development, an education, a job, a family, some travel, conflicts, tragedies and triumphs during the experiences of that person. 

5. Other examples of using '¿Dónde?' and various verb tenses:
¿Dónde ocurrió eso? When did that occur? 
¿De dónde vinó used? Where are you from? (verb venir: to come)
¿Dónde vive usted? Where do you live (verb vivir: to live)? 
¿Dónde trabaja?  Where do you work? (verb trabajar: to work)
¿Dónde pasó eso? Where did that happen? (verb pasar: to happen)
¿Dónde sucedió eso? Where did that happen? (suceder: to happen)

In training programs, we have developed many 'formulas' such as these, to help you perform Psycho-Social Interviews and basic counseling interventions. This helps simplify and demystify the process of providing mental health services for Spanish speaking clients. 

In this post we will cover key basic vocabulary and phrases in Spanish for conducting a Psycho-Social Interview or Assessment. 

Let's again refer to our Assessment models which may require obtaining a Family History or Developmental History. We are going to ask our Spanish-speaking client a few questions about 'when' something occurred. So we need the word 'when' and the Past or Preterite tense of certain occurrences. When did something happen? Here are a few essential examples.

1. ¿Cuándo nació usted? When were you born? We are using the word 'Cuándo' for when something happened in the past. To be born is the verb 'nacer'. If we are asking about something that happened in the past, we need the Preterit tense, which is similar to past tense absolute. It happened on a singular occasion. To effectively conduct Spanish speaking therapy, you are most often going to be talking to one person. We actually need only one conjugation of the verb. So we are focusing on the verb conjugations that we actually need in a therapy office. The correct conjugation is in the 3rd person singular of nacer: nació. 

2. ¿Cuándo se casó? When did you get married? Again, inserting the word 'cuando' we will ask the client when he/she were married. 'Casarse' is to get married, so we basically memorize a few questions, in the tense we are going to need. 

3. ¿Cuándo ocurrió eso? When did that happen? As a client is delivering their narrative in the Assessment phase of therapy, they will be talking about things that happened in the past. There was a birth, a development, an education, a job, a family, some travel, conflicts, tragedies and triumphs during the experiences of that person. If the therapist is listening to the narrative and lacks command of a particular verb conjugation, we can substitute the word 'eso' or 'esto' rather than have command of the correct translation of a particular verb on the spot. The client may bring up many occurrences. If the therapist wants to know when that particular thing happened without too much effort, the correct question is ¿Cuándo ocurrió eso? When did that happen? 

4. ¿Cuándo estuvo...? This is the preterit tense of the verb 'estar', again in the third person singular, to be physically present somewhere. 

A few applicable examples of this basic construction for the Assessment phase of therapy with a Spanish-speaking client are:

¿Cuándo nació su primer hijo? When was your first child born?
¿Cuándo ocurrió el accidente? When did the accident occur?
¿Cuándo estuvo en el hospital? When were you in the hospital?
¿Cuándo estuvo en la cárcel? When were you in jail?
¿Cuándo ocurrió eso? When did that occur?
¿Cuándo vino aquí? When did you come here?
¿Cuándo se murió?  When did he/she die?
¿Cuándo se divorció?- When did you get divorced?

When psychotherapists are trained, we are exposed to many theoretical orientations that can be used to provide interventions for clients in English, Spanish or any other language we may speak. What we realize when we begin sitting in front of a client, and trying to choose and implement interventions, is that we need to 'say' many things. And we need to be prepared, know the model, and sound polished, so that trust is engendered, and good outcomes can be achieved. Years ago, as a new therapist, when I realized I was having a hard time even doing this in English, much less in Spanish, I knew some work had to be done. 

For example, with basic counseling interventions, clinicians may start with a technique such as active- reflective listening to get a counseling process started. Also at first, the therapist may have to explain a few things such as office policy, parking, payments, process of therapy, insurance, confidentiality, etc. So we need to figure out a banter that we normally use, and prepare how to say it correctly and professionally in Spanish. And practice doing that. This is how our initial program, Introduction of the Therapist to a New Client in Spanish was created... by keeping track of the language being used, making sure it was intentional and theoretically based, and preparing it in Spanish. 

In other situations, psychotherapists may start the process of treating clients by performing a psycho-social assessment. As there are many ways to conduct an assessment, we have chosen the 4 P's model, and a Multi-disciplinary Assessment model as bases for our Modules in the Assessment category. If you recall from Graduate School, the 4 P's are: Presenting Problems, Predisposing Factors, Precipitating Factors, Perpetuating Factors, and some add Protective Factors.

So what exactly do we say in English or Spanish to process these topics with a psychotherapy client? This is the rationale for our training programs.

The modules are very practical and useful for beginning to advanced therapists, as well as beginning to advanced Spanish speakers. We always want to help clinicians improve their Spanish because it is fun, it helps with employment security, and is enriching and enlightening. Feel free to reach out and ask a question about your goals. Thank you!

 Here we are presenting a list of verbs commonly used by the psychotherapist when establishing the Frame of Therapy and providing Consejos (advice & recommendations) to clients. We are highlighting the usted form of the verbs in the Present Imperative Tense, in some cases also known as the 'command' tense or subjunctive tense.

We demonstrate usage of these verbs in the usted form as that is the appropriate and professional way to address clients unless they are a child or young person. So here you will only have to memorize one form of the verb, isn't that great? It is good to memorize and practice this form so you can confidently structure the treatment and also make common therapeutic recommendations.

Unlike English, some Spanish verbs are mysteriously reflexive. So when you are saying "Siéntese por favor" you are actually saying 'sit yourself down'. To further complicate matters, some common verbs may also be stem-changing in the imperative tense and/or may require a reflexive construction.

This is something that needs to be memorized as it can't be figured out intuitively so we're showing you a few useful ones here.

We will also present the form "Le recomiendo que..." (I recommend that...). The verb that follows this clause will need to be in the imperative tense (same as subjunctive) in the third person since you don't know whether or not the action you are requesting will be performed.

Remember, it's always a good idea to keep the concepts of Respeto and Personalismo in mind by adding Por Favor and Gracias often! Usually you can add that at the beginning or end of statements.

1. Relax

Yes, it is true that clients from Latin America talk fast... and that different countries have different accents, idioms and vocabulary meanings. This can create challenging conditions for the therapist in terms of comprehension. If you get too focused in the initial sessions on asking questions or giving interpretations when you don't understand completely, this puts a great language burden on you, and you may feel stressed out and not up to it linguistically. You don't have the vocabulary and syntax ready on the tip of your tongue. It's not natural. So to make it more natural, it can be as simple a matter as rote memorization for numerous important communications. Please excuse the effrontery, no offense intended, but if you're feeling overly stressed out when communicating with Spanish-speaking clients, you are probably talking too much! You can turn the focus of the session to a person-centered and open-ended style so you are not working harder than the client. You may have to be a little more patient, but you will gather the information you need to start implementing therapeutic interventions. Meanwhile the client will have a chance to 'Desahogarse' and in doing so, truly let you know what the presenting problems are and what the client has tried so far to fix them.

Let the client talk for a long while and don't get too worried if you're at 60% comprehension. You will get the gist and the context of the problem to get started. If, after you have listened for awhile (15 mins) you're still not getting it, here is a free video, Repeat & Clarify with statements that will get the client to repeat and rephrase what they are communicating to you so you can make sure you understand the whole picture and pick up on red flags and treatment considerations. Clients are always appreciative when 'gringos' care enough to make themselves able to communicate, so you can relax in knowing that hispanic clients appreciate you, and don't judge you if you make mistakes in grammar. 

2. Know Your Numbers

It may seem boring, redundant or non-clinical to spend a lot of time studying numbers, but a strong command of numerical concepts is essential for Spanish-speaking therapists. Think of all the ways we use numbers in therapy: appointment times and dates, cost of therapy, discounts and co-pays, dates of birth and other milestones, ages, addresses, phone numbers, etc. We have prepared a module to make it easy for you to practice numbers within the context of psychotherapy.

3. Practice Vocabulary

For this part, there is no magic, you will have to memorize lists of words and conjugations of most-used verbs. To develop your own style, we recommend noticing what types of things you often say to your English speaking clients and start writing them down and translating into Spanish. Make it your intention to look up words that you frequently use with your clients in English and create a lexicon for yourself. Start to really get that vocabulary under your belt.

4. Prepare

If you study and are ready with your lexicon, you will feel prepared to handle most clinical situations. If you have your own common therapist statements ready on the tip of your tongue, you know those statements will be correct and professional because you have practiced. You will feel confident as you notice the comprehension appear in your client's countenance. You won't be fumbling around talking while observing the confused or bemused look on your client's face. Oops! When that happens you know you haven't hit the mark. You can conduct your sessions professionally in Spanish as well as English by preparing. You already know how to be a therapist and implement therapeutic interventions. To add the Spanish speaking clients, you are adding one more layer of specialty to your skills. And it's a very specific layer. Give yourself a break as you are not putting pressure on yourself to become completely bilingual, but developing proficiency as a Spanish-speaking therapist. So you do have to memorize but it's a relatively narrow focus.

5. Same But Different

It is true that Spanish-speaking clients from different countries are going to express themselves somewhat differently in terms of vocabulary, speed, slang, idiomatic expressions and cultural manifestations. This would also be true of people speaking the same language, but from a different socio-economic status, region or ethnicity within the same language group. We could make the analogy that the language differences among Spanish-speaking countries might be like the idiosyncrasies in the speech of English-speaking persons from South Carolina versus Boston, Britain vs. Belize. It's all going to be English. We are often asked about learning Spanish from a particular country. The correct Spanish is going to be the same in any Spanish speaking country whether you are in Spain or Honduras, Mexico or Chile. The differences occur in word selection, pronunciation, accent, speed, usage and sometimes verb conjugations. 

Psychotherapists, Counselors and Social Workers will be increasingly called upon to respond to the mental health needs of new waves of immigrants fleeing economic and political turmoil in countries/territories such as Venezuela, Puerto Rico and Cuba.

Take a quick look at the landscape of problems that are provoking Latin American citizens to flee their homelands and hope for better luck in other countries. Factors such as deepening economic crisis, threat of wars between neighboring countries, terrorism and narco-trafficking, fear of immigrants from other countries, food and water shortages, power outages, rampant unemployment and devaluation of currency are some of the reasons new immigrants from Latin America may appear in social service and therapy offices in English speaking countries.

Once prosperous Venezuela for example, now has its citizens standing in line for days to purchase simple necessities. In psychotherapy it is helpful for therapists to understand and appreciate the context that these clients may bring to our offices. Many are affected by a great level of stress, grief, fear and trauma and may lack the courage to talk about the reasons for their immigration.

The process of immigration itself only compounds the trauma as citizens have fled their countries and moved against their will to a foreign society where they don't speak the language or understand the norms. After working with hundreds of recent immigrants We have produced a video to help you talk to clients about sensitive immigration experiences.

Here are additional words and phrases that therapists should know:

Even though some of these problems are common in Latin America, many communities and countries enjoy peaceful lifestyles, and stable governments. So be careful to avoid over-generalizing. 

Many of our students are treating children and families in therapy, and have asked for help with vocabulary for play therapy. For this blog, we will be working with the Tú  form as that is the correct form to use with children. This is an important distinction to study, as we usually recommend and teach the Usted  form for working with adult clients. So, in this blog you will see verbs, compound tenses and reflexive constructions focusing on the Tú  form. 

Recognizing that play is a developmental process that needs exercising; using games, fantasy play, dolls and doll houses, paper crafts, "floortime" or “floor play”, are appropriate interventions developmentally to use with children of all ages.

Play therapists may find it challenging to find the right words and phrases to use during the play itself, such as introducing the play options and working with the physical aspects of the play therapy session.
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A quick message to let everyone know that some licensing boards allow Continuing Education Units for Self-Selected Study Courses. Some of our students have been obtaining CEU credits for studying clinical Spanish by using a website called CEU Cafe (link below).

SELF SELECTED COURSES WITH CEU CAFE

We are not affiliated with them other than I have used them for my own Self-Selected Courses. You can create your own Self-Selected Course for studying Spanish which includes the number of hours you spend watching our videos and studying the materials, as well as time spent in the In-Vivo training Skype sessions. 

For example, for our Three Lesson Plan Package, you can claim the number of hours you spend studying the videos and materials as well as the three hours of In Vivo training with Alfonso. So that would add up to approximately 5 or more CEU hours depending on how long you studied and practiced the materials. We can provide a certificate as requested at no additional charge with the Three Lesson Plan Package ($149).

Contact us to learn more!

When the unexpected happens, it is necessary to know how to convey to our clients what is happening. (Please use good clinical judgment when communicating personal information to clients.)

Let’s review some of the most common phrases people use in Spanish to convey excuses for missing an appointment, forgetting something, etc.:

Join our e-mail list and receive a free English Translation of this exercise, 
But first try to translate the following phrases into English yourself!

"Excusas" When You Need to Cancel or Change a Session:​

1. Se me presentó un problema fuera de mi control y no podré llegar a tiempo.
2. Tuve una emergencia y tendré que cancelar nuestra cita.
3. No se preocupe todo está bien.
4. Perdí mi agenda.
5. Mi itinerario se confundió, lo siento.
6. Me enfermé con gripe y tengo que cancelar la cita.
7. Lo siento pero tengo una emergencia y no puedo asistir a la reunión.
8. Tengo que posponer nuestra cita para otra ocasión.
9. Tengo problemas con el auto y no voy a llegar a tiempo.
10. Se me ha presentado una emergencia con un cliente en el hospital y debo cancelar nuestra reunión.
11. Amanecí enferma hoy y no voy a estar disponible para nuestra cita a las tres.
12. Se me ponchó una llanta. 
13. Lamento decirle que tengo que posponer nuestra cita de hoy.
14. ¿Cuándo puede venir a su próxima cita?
15. Puedo darle una cita para la semana próxima.

 
If you have been taking our classes or using our program, most likely, you will be able to translate these simple phrases into English. Please join our e-mail list to receive the translation.

Hopefully, you won't need to use these Excusas frequently, but of course all therapists will probably need some of them, sooner or later. So be ready just in case!
 
As always, keep practicing your Spanish daily and make sure you let your clients know of any change of plans soon enough so they can reschedule their sessions, and your problems don’t become their problems as well.
 
Take care and good luck!
Best regards, Alfonso