Spanish-English Bilingual Therapy in Brooklyn: Why Language Matters in Care

If Spanish is the language you think, feel or argue in, therapy in Spanish can make it easier to say exactly what you mean. At Dr. Lewis's practice in Brooklyn, Dr. Beth Wecksell, PsyD, is listed as a bilingual Spanish-English psychotherapist. The research on language-concordant care, meaning care delivered in the patient's preferred language by a clinician who speaks it, mostly points toward better outcomes, though the mental health evidence specifically is thin.

This guide explains what that research does and does not show, when bilingual therapy matters most, your rights to an interpreter in New York hospitals and federally funded programs, and how to ask for Spanish-language care at this practice or elsewhere.

Why language matters in therapy

Therapy runs on words. You describe feelings, memories and relationships, and the therapist listens for nuance, tone and what is left unsaid. Many bilingual people notice that they talk about some topics more easily in one language than the other: childhood and family in Spanish, work in English, for example. For some people, emotional words learned early carry a weight that a translated equivalent does not.

A bilingual therapist allows you to move between languages as you need to, without stopping to translate. That can matter for:

• Describing emotions precisely, including expressions that do not translate well, such as "nervios" or "ataque de nervios".
• Talking about family, where relationships, roles and expectations may be tied to cultural context.
• Family sessions in which parents prefer Spanish and children prefer English.
• Recalling memories that were formed in Spanish.
• Feeling understood without having to explain your culture first.

Being bilingual is not the same as sharing a culture, and a shared language does not guarantee a good fit. It removes one barrier; the rest depends on the therapist and the relationship. Spanish speakers in Brooklyn come from many countries, with different vocabularies, accents and traditions, so it is fair to ask a therapist about their familiarity with your background as well as their fluency.

What the research on language-concordant care shows

A systematic review on this question, published in 2019 in the Journal of General Internal Medicine, looked at 33 studies comparing language-concordant care with other approaches for patients with limited English proficiency. Of those, 25 (76%) found at least one outcome better with language-concordant care, 5 (15%) found no difference and 3 (9%) found worse outcomes. The authors concluded that, in most situations, language-concordant care improves outcomes.

The limits matter just as much:

• Only 4 of the 33 studies were randomized controlled trials; most were observational.
• None of the studies used a standardized assessment of the clinician's language skills, so "bilingual" could mean very different levels of fluency.
• Only 3 studies focused on mental health, and 2 of those showed a positive outcome.
• The review was about patients with limited English proficiency. Its findings do not directly answer whether a fluent bilingual person benefits from therapy in Spanish.

In plain terms: if you prefer Spanish, the evidence supports asking for a Spanish-speaking clinician, but it does not mean therapy in English, or with a professional interpreter, cannot work well.

When bilingual therapy matters most

Your right to an interpreter in New York

Whether a clinic must provide an interpreter depends on what kind of provider it is and how it is funded. Two sets of rules are most relevant in New York.

Federally funded health programs

Under Section 1557 of the Affordable Care Act, HHS rules apply to every health program or activity that receives federal financial assistance from HHS, directly or indirectly, as well as programs HHS administers. Those programs must take reasonable steps to provide meaningful access to people with limited English proficiency, and language assistance must be free of charge, accurate and timely. When interpretation is needed, they must offer a qualified interpreter. They may not rely on an adult who is not a qualified interpreter, or on a minor child, except in limited situations such as a temporary emergency measure.

New York hospitals

New York's hospital patient-rights regulation requires hospitals to run a language assistance program. Skilled interpreters must be available to inpatients and outpatients within 20 minutes, and to emergency patients within 10 minutes, of a request. Family members, friends or non-hospital staff may interpret only if the patient agrees, free interpreter services have been offered and refused, and issues such as age, confidentiality and conflicts of interest are considered; interpreters should be 16 or older except in emergencies. The New York hospital Patients' Bill of Rights says that if you do not understand your rights or need help, the hospital must provide assistance, including an interpreter.

Private practices

A private, self-pay practice may not be covered by these specific rules, depending on its funding. Ask any practice directly how it handles language needs before you start. Either way, asking a child or relative to interpret in a therapy or psychiatric visit is a poor idea: it puts them in a difficult position and limits what you can say.

If you are thinking about suicide or are in crisis, call or text 988 (the 988 Suicide & Crisis Lifeline) or go to the nearest emergency room. To reach a Spanish-speaking 988 counselor, call 988 and press 2, or text AYUDA to 988. In a hospital emergency room, you can ask for an interpreter.

Working well with an interpreter

Sometimes the best available clinician for your situation does not speak Spanish, particularly for medication care. A professional interpreter can make that work. A few habits help:

• Ask for a trained medical interpreter, not a relative or friend. Federally funded programs must offer a qualified interpreter when one is needed, and when machine translation is used for critical or complex material, it must be reviewed by a qualified human translator under the same rules.
• Ask for the same interpreter across visits if possible, so you are not retelling your story to someone new each time.
• Speak to the clinician, not the interpreter, and pause after a few sentences so nothing gets lost.
• Tell the clinician if a word or phrase does not translate well. A short explanation of what you mean is better than an approximate word.
• Ask for medication instructions in writing in Spanish, and repeat the plan back in your own words before you leave.

Interpreted sessions take longer, and that is normal. If a visit feels rushed, say so and ask whether more time or a follow-up visit can be arranged.

A note for families

In many households, parents prefer Spanish and children prefer English. When a child or teen needs care, a bilingual therapist can speak with the parents in Spanish and the young person in whichever language they choose, without relying on the child to interpret. That protects the child from carrying adult information and lets parents ask everything they want to ask. If the therapist is not bilingual, a professional interpreter for the parent portions of a session is the safer option.

How to ask for Spanish-language care

Be direct and specific. Useful questions, at any practice:

• Is there a therapist who can conduct sessions entirely in Spanish?
• Can sessions switch between Spanish and English as needed?
• If I also need a prescriber, does anyone on the medication team speak Spanish, and if not, how are interpreters arranged?
• Are intake forms, consent forms and billing documents available in Spanish?
• Is the bilingual therapist available in person, by telehealth, or both?
• Does the therapist see children, couples or families, if that is what I need?

NIMH suggests asking any prospective therapist about their credentials and experience, whether they have experience with your age group and condition, how progress will be assessed, and whether there are limits to confidentiality. Those questions matter just as much when language is your starting point. More are in questions to ask on a discovery call.

Bilingual therapy at Dr. Lewis's practice

The practice lists Dr. Beth Wecksell, PsyD, as a bilingual Spanish-English psychotherapist, one of seven psychotherapists on the team. The team also includes psychiatrists, psychiatric nurse practitioners and a health and wellness coach, and its ongoing care includes psychotherapy such as CBT and DBT. The facts the practice publishes do not say whether any prescriber speaks Spanish, so ask on the discovery call if you will need medication care in Spanish.

A few practical points:

• The first step is a free discovery call by phone or text, where you can ask about care options, scheduling and insurance. Say at the start that you want a Spanish-speaking therapist.
• Individual clinical care starts with the Patient Interest Form; note your language preference there too.
• Dr. Lewis sees patients in person in Brooklyn and by telehealth for patients physically located in a state where she holds an active medical license, and the team confirms eligibility for your state before your first visit. Ask whether therapy sessions in Spanish can be held in person, by telehealth or both.
• All of the practice's practitioners are out of network with all insurance plans, including Medicare and Medicaid, and payment is due at the time of service. The practice provides superbills for possible out-of-network reimbursement. Fees are on the insurance and payment page. If you need care that is in network with your plan, ask the team on the discovery call about options.

This guide cannot tell you whether a specific clinician will be available when you call; ask the team. If the bilingual therapist cannot see you, ask the team about alternatives, such as a qualified interpreter, or whether they can suggest Spanish-speaking clinicians elsewhere in Brooklyn.

If the right match is not available

Language is one factor in fit, not the only one. If a Spanish-speaking therapist is not available where you are looking, you still have options:

• Start with an English-speaking therapist and a professional interpreter for sessions where precision matters.
• Look for clinicians who list Spanish in professional directories or on their own websites, and confirm their fluency directly.
• Consider telehealth with a Spanish-speaking clinician licensed in your state.
• If cost is the barrier, ask about community mental health clinics; a clinic that receives federal financial assistance from HHS is covered by the language-access rules above.

For more on how to start therapy with this team generally, see starting psychotherapy with Dr. Lewis's team. If you are helping a Spanish-speaking parent or relative get care, how to help an adult family member start psychiatric care covers consent and practical steps. For urgent needs in the city, see psychiatric emergency vs urgent care in New York City. The practice's psychotherapy page and team page describe the approach and the clinicians, and every starting point is in the Choosing Psychiatric Care guide.

Frequently asked questions

Does Dr. Lewis's practice have a Spanish-speaking therapist?

The practice lists Dr. Beth Wecksell, PsyD, as a bilingual Spanish-English psychotherapist. Ask on the discovery call about current scheduling.

Can I switch between Spanish and English in the same session?

With a bilingual therapist, many people do. Ask the therapist at the start how they prefer to work and tell them what feels natural to you.

Can my teenager interpret for me at a medical visit?

It is best not to. Federal rules for federally funded health programs restrict relying on a minor child to interpret except in temporary emergencies, and New York hospital rules say interpreters should generally be 16 or older.

Is therapy in Spanish more effective than therapy in English?

For people with limited English proficiency, most studies find better outcomes with language-concordant care, but the mental health evidence is limited. For fluent bilingual people, fit and approach may matter as much as language.

Does a hospital in New York have to give me an interpreter?

Yes. New York regulations require hospitals to run a language assistance program and to make skilled interpreters available within set time limits.

What if I need a psychiatrist who speaks Spanish?

Ask the team on the discovery call whether a Spanish-speaking prescriber is available or how interpreters are arranged for medication visits.

Sources

1. A Systematic Review of the Impact of Patient-Physician Non-English Language Concordance on Quality of Care and Outcomes. Journal of General Internal Medicine (Diamond L et al.), 2019. pmc.ncbi.nlm.nih.gov
2. 45 CFR 92.201 - Meaningful access for limited English proficient individuals. Code of Federal Regulations (via Legal Information Institute, Cornell Law School), 2026. law.cornell.edu
3. 45 CFR 92.2 - Application. Code of Federal Regulations (via Legal Information Institute, Cornell Law School), 2026. law.cornell.edu
4. Section 405.7 - Patients' rights (10 NYCRR). New York State Department of Health, 2026. regs.health.ny.gov
5. Psychotherapies. National Institute of Mental Health, 2024. nimh.nih.gov
6. What to Expect. 988 Suicide & Crisis Lifeline, 2026. 988lifeline.org

Educational information, not medical, tax or legal advice. Decisions about diagnosis, medication and treatment belong with a clinician who knows your history.