Cross-lingual competence: Conceptualization, measurement, and relevance to mental health practitioners

Abstract

In multicultural and multilingual Australia, mental health practitioners (MHPs) are increasingly attending to the psychological needs of culturally and linguistically diverse (CALD) people. Most clinical interactions occur in English, which is the CALD clients’ non-native language, making it a challenging task for clients and practitioners. Language is the main vehicle of assessment, diagnosis, and treatment in most Western models of mental health care. Even so, minimal attention has been paid in policy, research, and practice to MHPs’ language diversity related competence to work effectively with CALD clients. To address this gap, this research aimed to conceptualise, define, and operationalise the novel construct of cross-lingual competence and to develop a reliable and valid psychometric instrument to measure it - the Cross-lingual Competence Scale (CLCS). This research was conceptually and theoretically grounded on Sue et al.’s (1996; 1982) metatheory of multicultural therapy and counselling and their tripartite model, and on research findings from the fields of multicultural psychotherapy and psycholinguistic. On these bases, the domains of awareness, knowledge and skills were argued to be central to the cross-lingual competence construct. Study 1 generated the initial set of items for the CLCS and explored its factor structure through exploratory factor analysis (EFA). Data was collected from in-training and fully registered MHPs (n = 155) in Australia through an online survey containing 61 items and additional measures of MHPs’ multicultural and general competence. Exploratory Factor Analysis did not support the hypothesised structure based on the tripartite conceptualisation; instead, a novel factorial structure representing three distinct concepts emerged: a. MHPs’ Self-perceptions of Competence (SPC); b. MHPs’ Knowledge of Barriers for Clients (KBC); and c. MHPs’ Knowledge of Barriers for MHPs (KBP). The emergent factor structure of the CLCS provided evidence of a new and strong organising concept for self-assessments of competence: self-perceptions of competence and factual knowledge. Importantly, the KBC and KBP subscales were positively associated to one another but unrelated to the SPC subscale, suggesting that the two overarching domains (perceptions and factual knowledge) are unrelated. Thus MHPs’ estimates of their own cross-lingual competence to effectively work with CALD clients were discrepant from their demonstrable knowledge necessary for competent work. The initial assessment of validity further highlighted this discrepancy showing that the SPC subscale converged with all criterion measures of competence reporting MHPs’ self-perceptions, while the KBC and KBP subscales did not. Study 2 aimed to confirm the factor structure of the CLCS and further assess its reliability and convergent validity in a new sample of Australian MHPs (n = 257). Through CFA competing models were tested. The findings from Study 2 closely replicated those of Study 1, supporting the hypothesis that the 3-factor structure would be the best fit for the data. This outcome lent support to the overarching distinction between self-perceptions and factual knowledge. The final version of the CLCS had 23 items and each subscale had good reliability and validity. Study 3 sought to identify predictors of MHPs’ cross-lingual competence as measured by the three subscales of the CLCS exploring the following individual characteristics: ethnic status, language status, professional status, exposure to work with CALD clients, and multicultural training. Based on the combined samples from studies 1 and 2 (n = 412) data was analysed through t-tests and hierarchical multiple regression. Study 3 results showed that MHPs who belonged to an ethnic minority, were bilingual, worked with CALD clients frequently, were fully registered, and had multicultural training reported higher levels of self-perceived competence than their counterparts. When analysed collectively, all these individual characteristics except for ethnic status, predicted MHPs’ self-perceptions of competence. On the other hand, knowledge of barriers for clients was only predicted by engagement with CALD clients, while knowledge of barriers for MHPs was predicted by engagement with CALD clients and language status. Indeed, engagement with CALD clients was the only significant predictor across all three subscales. Overall this research contributes to theory, research and practice of multicultural psychotherapy in several ways. First, it has contributed an innovative construct to the field of cross--cultural psychotherapy, cross--lingual competence. Second, it has developed a reliable and valid measure of MHPs’ cross-lingual competence composed of three subscales each one with good psychometric properties to be used for various purposes. Third, it has established cross-lingual competence as a construct that is related but distinct from multicultural competence requiring specific attention and assessment. Finally, it has shed light into individual characteristics that predict cross-lingual competence and potential means to promote cross-lingual competence among CALD and non-CALD MHPs. Theoretical and practical implications for future research into development and assessment of cross-lingual competence are discussed.