Addiction Treatment – When English Is a Second Language (ESL)
When English is not a person’s first language, it can be difficult to navigate some elements of day-to-day life in the US. This can be particularly apparent in healthcare settings. As described in an article from The Boston Globe, people who speak English as their second language – ESL speakers – may have trouble fully understanding a doctor’s instructions, let alone the complexities of modern healthcare.
The same is true for addiction treatment. A person who speaks English but may not grasp all of its nuances, who also needs rehab, may have trouble understanding everything that is happening in the treatment program. The language barrier can constitute a major barrier to treatment, making it more difficult to bring about positive treatment outcomes and achieve recovery for these populations.
English as a Second Language in Addiction Treatment
The US is home to people whose families have immigrated from all over the world. As a result, there are many people in this country for whom English is not their first language. In addition, the states that border Mexico or along the southern coastline may have higher populations of native Spanish speakers who learned English while living here.
Substance abuse is a universal issue, no matter the place of origin. While plenty of the people with substance use disorders in the US speak English as a first language, immigrants or children of immigrants who are ESL speakers sometimes have addiction issues as well, and need treatment to recover and return to a more productive, abstinent life. For example, while most Latino/Hispanic people in the US are born here, some are immigrants or children of immigrants who are ESL speakers, and those who become acculturated by living in the US are more likely to use illicit drugs, based on information in a Treatment Improvement Protocolfrom the Substance Abuse and Mental Health Services Administration.
This creates a need for treatment that can support those for whom English is not a first language. To create this type of treatment, it is important to understand what barriers exist for ESL speakers.
The Language Barrier and its Effects
There are many issues that can occur in therapy because of the language barrier. For an ESL speaker, the barrier often results from a few factors:
- Delay in self-translation from English into original language
- Not understanding certain idioms
- Lack of full English vocabulary
- Inability to translate some complex concepts
As described in another one of SAMHSA’s Treatment Improvement Protocols, the delay in self-translation can lead to the person responding to conversation more slowly. If this occurs, the person may feel left out of discussion if the conversation is moving along quickly and the language barrier makes it difficult to keep up.
In addition, when discussion is heated or emotional, the lack of nuance or full vocabulary can make it difficult for the individual to find the words to express feelings or ideas that need to be discussed. This can result in limited ability to offer or receive information that might be valuable in creating the atmosphere needed for recovery.
Options for Treatment for ESL Speakers
- Providing listening exercises such as those offered through ESL-Lab can improve comprehension for ESL speakers in treatment programs. In addition, providing them with treatment materials that use simplified language can eliminate some of the translation issues.
- During group therapy, where comprehension during interaction is a key element of the process, ESL speakers are more likely to succeed if there is a translator who can communicate some key concepts in the speaker’s original language, improving comprehension. It is important that these translators be experienced with and trained in substance abuse treatment concepts to make sure that comprehension is as high as it can be.
- According to SAMHSA’s Treatment Improvement Protocols, a leader or counselor who provides attentive listening and allows for silence when new ideas are introduced can help an individual with a delay in comprehension to absorb and understand a concept before responding. This can aid not only in comprehension, but also in the person’s level of comfort with participating in the session.
- Even better, a leader or counselor who is bilingual in the individual’s language can provide a higher level of comprehension. Programs that are designed for ESL speakers in certain languages can provide this benefit, boosting comprehension, involvement, and motivation, and making sure the individual has the fullest possible ability to achieve recovery.
It may even be possible in some cases to find programs that are available for the language in question. In particular, treatment programs in Spanish are available in various locations around the country.
Finding Treatment for ESL Speakers
When it comes to finding the kind of help that is most likely to benefit ESL speakers, it’s important to consult with the treatment professionals – particularly the intake specialist – to discuss the options available to support these individuals in receiving treatment that will best fit their needs. Ask about bilingual programs, availability of translators, and materials that meet the needs of ESL speakers before selecting the treatment program.
Local government and municipal mental health departments often have resources that can inform individuals and their families about the programs available in their area to treat ESL needs. In addition, SAMHSA has resources in Spanish that can help both the service providers and those seeking help who speak Spanish as their first language to get the support they need.
There are programs available for those who speak English as a second language. Making the effort to find them is worth it in order to give the individual seeking treatment the highest chances of engagement in treatment.