The study analyzed language switching in bilingual psychotherapy and its impact on therapeutic alliance. 134 psychotherapy clients in the Netherlands participated in an online survey which included...Show moreThe study analyzed language switching in bilingual psychotherapy and its impact on therapeutic alliance. 134 psychotherapy clients in the Netherlands participated in an online survey which included the California Psychotherapy Alliance Scales - Patient Version and language-related questions. Analyses of Variances and Multiple Regression Analyses were conducted to investigate the effects. The findings indicate no significant correlation between language switching by the client and therapeutic alliance, but language switching by the therapist was associated with lower scores on the Patient Working Capacity (PWC) subscale. Discussing language switching was also negatively associated with the PWC and the Therapists' Understanding and Involvement (TUI) subscales. Language switching due to language barriers (dominant to non-dominant) and to distance oneself (non-dominant to dominant) were associated with lower alliance scores. Excluding Dutch-dominant psychotherapy clients, only the associated negative contribution of language switching to distance oneself remained significant. The findings highlight the complexity and universality of language switching and the importance of linguistic awareness among practitioners, particularly regarding the challenges of language barriers and their adverse effect on therapeutic alliance. Aiming to contribute to the evolving field of bilingual and multicultural psychotherapy, this study’s findings and limitations inspire future research on a linguistic technique yet not fully understood.Show less