Healthcare Foundation

Bridging the Gap in Bilingual/Bicultural Mental Health Services

A Conversation with Mental Health Talent Pipeline Scholarship Awardee Cesia Jovel

Cesia Jovel is in her third year in University of San Francisco’s masters program in counseling psychology. As a bilingual and bicultural resident of Sonoma County who is pursuing a career in mental health, with the intention of serving her local Latinx community, Cesia applied for and received a scholarship through Healthcare Foundation’s Mental Health Talent Pipeline Project to help support her studies and training.

With the first two years of class work now behind her, Cesia is currently spending her final practicum year working at Side By Side, the San Anselmo-based nonprofit serving young people impacted by adversity with a diverse range of programs. She is one of three mental health therapist trainees in the organization’s Santa Rosa office.

The Covid-19 pandemic has greatly exacerbated the strain on mental health and wellbeing for many young people today, and the need for therapists with the linguistic fluency and cultural competency to work with and relate to both monolingual and bilingual members of the Latinx community has never been more apparent.

We caught up with Cesia recently to ask about her work, her studies, and her perspective as someone just entering the mental health field in northern Sonoma County. The following exchange has been lightly edited for clarity.

Can you tell us a little about how your traineeship has been going and what your role at Side By Side entails?

So far it’s been pretty great. Side By Side serves children, teenagers, and young adults. We get referrals from school counselors and teachers, as well as self-referrals, and we also see people that have been referred through Medi-Cal. As a trainee I only see those who are not insured. I’ll be there for nine months, so up until I graduate. Right now, I’m providing support and therapy to young adults, addressing any depression or anxiety or intrusive thoughts. I mostly do talk therapy, either through Zoom or by phone [during the pandemic]. I can be that person that they can talk to about their week, while learning coping mechanisms. I’m teaching psycho-education, addressing stress, for example, things that can be challenging for their mental health.

Starting next week I’ll be part of Side By Side’s YouThrive program, where we go into schools and do class presentations and workshops, educating youth, mostly high school and middle school kids, about mental health in general—boundaries, stress management, a variety of different topics that include cultural diversity and trauma in a way that is age appropriate. I’ll also be seeing clients one-on-one there. For those programs we offer up to five free sessions. If I determine that a client needs more than that they would be able to receive that [additional support]. That is mainly what I will be doing, providing services in Spanish and English.

I am a bilingual and bicultural clinician so I have that flexibility of being able to also reach those clients that are monolingual in Spanish—and their parents, because part of the therapy process, especially with the younger clients, is having the parents involved as much as we can. Part of the population we serve are kids that have arrived to the U.S. very recently, so they’re still in that transition phase of learning English. Even when they do learn English, some clients might be more comfortable having therapy in Spanish. Or Spanglish if you will. So being flexible that way is important.

I understand that you yourself made a transition from El Salvador to the U.S. as a young person?

I was 13. I can definitely [relate]. I’ve had therapy before, and I think I would have felt more comfortable having it in Spanish for a lot of that process. I had a hard time finding a therapist who was bilingual. It’s not to say that my therapist wasn’t competent. It was very helpful to see her. But at some point I realized it was a little bit limiting for myself. Just because that’s how I operate, thinking in Spanish and then having it come out in English. When it comes to processing things, I think it would be better for children to have that flexibility to [engage in therapy] in the language they’re more comfortable in. That was one of the reasons that I went into this line of work. Especially here in Sonoma County, I have had a really hard time, and still am, finding a Spanish-speaking therapist, who is affordable as well.

At my agency, the population that we’re reaching out to with these services are really wanting to have that bilingual aspect to it. And bicultural as well, because it’s one thing to have the language skills and another to really understand where your client is coming from in terms of the cultural background, and being able to integrate that into the services that you’re providing. That’s part of the rapport that your build with the client and that’s one of the most important aspects of therapy: you want to build that trust with that person so that when they see you they understand where you’re coming from—that can make a difference for them in terms of opening up and being willing to even just talk about things.

Is stigma around the subject of mental health a challenge in your work?

I would say so. I can only speak to the Sonoma County Latino community, because that’s the one that I’m most familiar with, but there are some challenges in terms of the willingness to talk about mental health in general, let alone taking that step of going to therapy or being willing to use those resources. With the younger generation at least it’s changing. I think we’re a little bit more open about that. But that younger generation is still having trouble talking to their parents about it. That’s part of why Side By Side has the YouThrive program, to not only be a source of support for those high school and middle school students but to provide that education and that awareness. I’m thinking, for example, about stress responses. It’s not a coincidence that you feel a certain way when all these stressful things are happening. Your body is reacting to that. That psycho-education, going to places like schools instead of waiting for the client to come to us—saying, hey look, this is a resource, this is the information that is out there—I think that has some value. It’s also good to demonstrate that therapy is not necessarily what the movies or TV shows portray it as, it’s not such a cliché, and it’s really not just for the people that are quote-unquote crazy. Moving away from that, you see that it can be so much more.

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Joel Lewis

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