DescriptionIn recent decades the number of persons in the US with limited English proficiency (LEP) has significantly increased. Research shows that persons with LEP experience higher rates of psychological distress and that LEP poses a significant barrier to accessing mental health treatment. As such, there is a growing need for psychotherapists to integrate foreign language interpreters into treatment. However, research is extremely limited on the use of interpreters in psychotherapy. Existing research focuses on challenges in treatment related to interpreter factors. Therapist factors and their effect on interpreter-facilitated treatment remain relatively unexamined. This study was undertaken to investigate how integrating interpreters into psychotherapy shifts the therapeutic process, with particular attention to therapist factors. A qualitative research design combining ethnographic and grounded theory was used. Eleven semi-structured interviews were conducted with psychologists experienced at conducting interpreter-facilitated therapy. Five major research questions were addressed: (1) How do therapists conceptualize interpreter-facilitated therapy in terms of the interpreter’s role, their relationship with the interpreter, and the interpreter’s relationship with the patient? (2) To what extent do therapists acknowledge and engage with interpreters’ presence in interpreter-facilitated psychotherapy? (3) What emotions do therapists experience in reaction to working with interpreters and to what extent do they reflect on and process these reactions? (4) According to therapists, what should therapist training on interpreter-facilitated therapy entail? (5) Aside from interpreter factors, what challenges arise in interpreter-facilitated psychotherapy? The following qualitative themes emerged: the importance of on-going positive relationships between all therapy participants, clearly establishing the frame of therapy and defining roles, having regular pre-sessions and post-sessions, and therapist flexibility. Other themes included: therapists’ conceptualizations of the interpreter’s role; therapists’ emotional reactions to working with interpreters; systemic barriers and limitations; the myth of interpreter neutrality; and the need for therapist training in interpreter-facilitated therapy. The findings of this study suggest important implications for therapist training and practice, namely: the importance of being flexible; building collaborative relationships with interpreters; regularly communicating expectations and feedback with interpreters; and understanding the potential benefits of engaging the personhood of interpreters in the therapy process.