Therapy for New and Veteran Olim

For olim (immigrants to Israel), families on relocation, and anyone whose mother tongue is not Hebrew, a therapist who speaks their language saves them the constant effort of “translating themselves.” It leaves more room for the raw feelings they are living with. This matters especially now: in recent years, aliyah (immigration to Israel) from North America and other English-speaking countries has been growing.

Why does language matter in therapy?

Your mother tongue is the language in which you first felt love, fear, shame and comfort. A 2012 review of research on bilingual people found that for most people, emotional words in their first language are processed more automatically and are felt more in the body, while in a language learned later, emotional reactions tend to be milder and more distant.^[1] Put simply, “I’m so sorry” can touch a different place than the Hebrew “slicha” (סליחה), even for someone who speaks fluent Hebrew.

Language is tied to memory, too. In a classic 2000 study of people who speak both Russian and English, participants recalled more memories from a certain period of their lives when the conversation was in the language they spoke at that time.^[2] A woman who made aliyah from New Jersey may find that her childhood stories come alive in English, even though she lives her daily life in Hebrew.

The paradox of therapy in a second language

In 1976, the psychiatrist Luis Marcos described an “emotional detachment effect” in patients who spoke in therapy in a language that was not their mother tongue.^[3] This distance is not necessarily a bad thing. On the one hand, therapy held entirely in a “distant” language can stay in the head and never reach the heart. On the other hand, a certain amount of distance can work like a guardrail, making it possible to talk about trauma, sexuality or shame without being flooded.

A study published in 2024 under the title “My recovery is in English” came to one clear conclusion: there is no single, fixed link between language and emotion. For some patients, a second language gave exactly the distance they needed to talk about past trauma. Others felt it was not enough to fully express themselves.^[4] So the right question is not “Which language should therapy be in?” but “In which language are you least busy searching for words, and most free to feel?”

Does my therapist need to speak my language?

Not necessarily. As usual, the answer is complicated. A 2021 review of 38 studies on language matching between patients and health care providers found a mixed picture: in some studies, a shared language was linked to better outcomes, and in others no link was found.^[5] Part of the reason may be the paradox described above. Sometimes the distance created by a different language or culture actually makes it easier to open up.

Assessment and diagnosis are different. There, precise words and cultural understanding matter a great deal. So when you need an evaluation, it is more important that the psychologist or psychiatrist doing it knows your mother tongue well. A 2010 review of 26 studies in psychiatry found that an evaluation done in a language that is not the patient’s main language can be incomplete or distorted.^[6]

Why do aliyah and relocation shake even strong people?

Acculturative stress is the mental strain of having to learn the unwritten rules of a new culture and live by them, while still holding on to who you were.

This stress adds up from small things: a call with a clerk at Bituach Leumi (National Insurance), a parent-teacher meeting where you miss the jokes, Israeli directness that can feel rude at first. Moving to another country also brings losses that are hard to name: your support network, your professional standing, a sense of humor that worked in another language, and the confidence of knowing “how things work.”

A 2014 Israeli study of olim from North America found that their work situation was usually below what they had in their home countries. Even so, their life satisfaction was relatively high, and most did not think about leaving.^[7] Crisis and opportunity can live side by side. You can be at peace with your decision and still grieve what you left behind. In a way, this is even necessary. It does not help to push away the crisis and the grief just to feel better about the decision to move. It is possible, and worth trying, to hold both feelings at once: joy about the change, the new country and the new possibilities opening up, together with grief for what you left behind and for how complicated it is to start a new life in a different language and culture.

In situations like these, therapy that focuses on relocation can make a real difference. It helps you separate practical problems from emotional pain, work through homesickness and guilt toward parents who stayed abroad, and notice changes in your relationship, for example when one partner speaks Hebrew well and the other depends on them. In Israel, sirens, war and a heated public mood come on top of all this, and they reach olim before they have built a support network here.

What do people work on in relocation therapy?

• Before the move and in the first months: expectations, fears and decisions, including the gap between what you imagined and what is actually happening.
• Grief for what you left behind: home, friends, aging parents and language, even when moving was completely your choice.
• Relationships and parenting: shifting roles, depending on the partner who knows the country, and arguments that come from overload.
• Identity and belonging: Who am I here? What is left of who I used to be? And how do I deal with thoughts of going back?

Are there normal stages of adjustment, and when is it more than that?

The familiar model describes a “honeymoon” at the start of the move, then a crisis, then gradual adjustment. But when researchers followed people over time, the picture was much more varied. A 2015 study that followed 2,480 teenagers in student exchange programs in more than 50 countries found five different patterns of stress, and only about 5% of them went through the classic curve of excitement, a fall and recovery. Most had mild stress (41%) or minor relief (47%).^[8] The study looked at temporary stays, not immigration, but the message holds: there is no single right path.

That is why it helps to think of adjustment as a cycle, not a ladder (Figure 1). You can move ahead at work and feel stuck socially, or feel settled and then be thrown off again around a holiday, a birth, a war or a visit “home.”

When should you reach out for help?

You do not need to wait for a diagnosis. Consider getting help when:

• Sadness, anxiety, anger or homesickness go on for weeks and make your life smaller.
• Your sleep, appetite or energy changes a lot.
• You pull away from people, have panic attacks, or drink or use drugs more than before.
• Arguments at home keep coming back and getting worse.
• A child or teen avoids school, friends or activities they used to love.

In an emergency, such as suicidal thoughts or immediate danger, do not wait for an appointment. Go to the emergency room,^[9] call Magen David Adom (MDA), Israel’s ambulance service, at 101, or call ERAN, Israel’s emotional first aid line, at 1201. It is good to know that ERAN also runs an English-language helpline for olim: *3201, Sunday to Thursday until 9 pm.^[10]

What do children and teens go through after the move?

Children pick up Hebrew fast, so it can look as if they are “doing fine.” But how quickly a child learns the language is not necessarily a sign of emotional adjustment. Children lose friends, their place in the social group and a shared language with the teacher, and sometimes they feel that even their parents do not know how the system works. Teenagers make the move in exactly the years when belonging and identity are being built anyway, and some of them end up translating and handling things for their parents. This shift, from the place of a child to something closer to the place of a parent who helps the family find its way in a new country, has complex effects on the emotional life of both parent and child, and on the whole family. It is very important to talk about it and work through it.

Sometimes the best first step for a child is parent guidance, or therapy for the parent. And when it comes to which language to use in a child’s therapy, ask the child. Many children of olim speak English at home and Hebrew in class, and the language in which they are comfortable talking about feelings is not always the one they speak best.

What is different about the Israeli context?

Aliyah from North America has grown in recent years. According to Nefesh B’Nefesh, the organization that helps North Americans make aliyah, 3,900 olim arrived in 2022, 3,020 in 2023, 3,706 in 2024 and 4,150 in 2025, a 12% rise in the last year (Figure 2).^[11] And according to Israel’s Ministry of Aliyah and Integration, of about 21,900 olim in 2025, about 3,500 came from the United States and about 840 from the UK. Together, that is almost one in every five.^[12]

These numbers are only part of the picture. English speakers in Israel also include returning residents (Israelis coming back after years abroad), spouses who did not make aliyah, students, lone soldiers (soldiers serving without family in Israel) and families on relocation. And there is a familiar paradox here: you can feel at home in your values or your community, and at the same time feel like a complete outsider at a parent-teacher meeting or in a doctor’s office.

How do you find an English-speaking therapist in Israel?

There are three main routes, and you can combine them:

• Your kupat holim (health fund). Since July 2015, Israel’s health funds have been responsible for mental health services,^[13] and treatment through them is free or costs a low quarterly fee.^[9] Ask directly for a therapist who works in English, and ask about independent therapists who work with your health fund.
• Private therapy. This gives you a wider choice of language, approach, hours and experience with olim, but it costs more. Some supplementary health fund plans and private insurance policies pay back part of the cost, so check in advance.
• Online therapy. This greatly widens your options, especially outside central Israel. Make sure the therapist is licensed to work in Israel, and ask how your privacy is protected and what happens in an emergency.

Whatever route you choose, check the therapist’s credentials. Licensed psychologists are listed in the Ministry of Health’s register of psychologists, which you can search on the ministry’s website.^[14] Tipul Chacham also has a page of therapists who work in English, which you can filter by region, age group and online sessions.

What should you ask a therapist before you start?

A short first call by phone or video is a chance to check the fit. Questions worth asking:

1. Are you comfortable doing therapy fully in English, including talking about painful and emotional topics?
2. What experience do you have with olim, relocation, cross-cultural couples or bilingual children?
3. Can we switch between English and Hebrew during a session?
4. What is your training and license, and what approach do you use?
5. Do you work with my health fund or insurance, and what is your cancellation policy?
6. For online therapy: what do we do if there is an emergency?

Pay attention to how the conversation feels, too. Do you keep having to explain the culture you come from? Can you talk about regret, anger at Israel or doubts without fearing judgment?

Frequently asked questions

This guide offers general information. It is not a diagnosis, and it does not replace professional care.

Sources

1. Pavlenko, A. (2012). Affective processing in bilingual speakers: Disembodied cognition? International Journal of Psychology, 47(6), 405-428. doi.org/10.1080/00207594.2012.743665
2. Marian, V., & Neisser, U. (2000). Language-dependent recall of autobiographical memories. Journal of Experimental Psychology: General, 129(3), 361-368. doi.org/10.1037/0096-3445.129.3.361
3. Marcos, L. R. (1976). Bilinguals in psychotherapy: Language as an emotional barrier. American Journal of Psychotherapy, 30(4), 552-560. doi.org/10.1176/appi.psychotherapy.1976.30.4.552
4. Verkerk, L., Fuller, J. M., Huiskes, M., & Schüppert, A. (2024). 'My recovery is in English': Clients' language choices in multilingual psychotherapy. Counselling and Psychotherapy Research, 24(3), 949-961. doi.org/10.1002/capr.12769
5. Hsueh, L., Hirsh, A. T., Maupomé, G., & Stewart, J. C. (2021). Patient-provider language concordance and health outcomes: A systematic review, evidence map, and research agenda. Medical Care Research and Review, 78(1), 3-23. doi.org/10.1177/1077558719860708
6. Bauer, A. M., & Alegría, M. (2010). Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: A systematic review. Psychiatric Services, 61(8), 765-773. doi.org/10.1176/ps.2010.61.8.765
7. Amit, K., & Riss, I. (2014). The subjective well-being of immigrants: Pre- and post-migration. Social Indicators Research, 119(1), 247-264. ideas.repec.org/a/spr/soinre/v119y2014i1p247-264.html
8. Demes, K. A., & Geeraert, N. (2015). The highs and lows of a cultural transition: A longitudinal analysis of sojourner stress and adaptation across 50 countries. Journal of Personality and Social Psychology, 109(2), 316-337. pmc.ncbi.nlm.nih.gov/articles/PMC4507515/
9. Israel Ministry of Health. Mental health therapy services (through the health funds, and what to do in a crisis). me.health.gov.il/en/mental-health/therapy-rehabilitation/public-care/community-treatment/treatment-services/
10. ERAN, Emotional First Aid. English helpline for olim. www.eran.org.il/eran-for-the-community/olim/english-helpline/
11. Nefesh B'Nefesh year-end aliyah figures, as reported by Israel National News (December 28, 2022), The Jewish Link (January 4, 2024) and JNS (December 30, 2025, "North American aliyah tops 4,100 in 2025, highest level in four years"). www.jns.org/israel-news/north-american-aliyah-tops-4100-in-2025-highest-level-in-four-years
12. Israel Ministry of Aliyah and Integration, 2025 figures, as reported by ynet (Hebrew). www.ynet.co.il/judaism/article/hkhnuzgn11x
13. Aviram, U., & Azary-Viesel, S. (2015). Mental health reform in Israel: Challenge and opportunity. Taub Center for Social Policy Studies in Israel, Policy Paper 2015.02. www.taubcenter.org.il/wp-content/uploads/2020/12/mentalhealthreformenglish2015.pdf
14. Israel Ministry of Health. Register of licensed psychologists (Hebrew). registries.health.gov.il/Practitioners/27
15. Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340. doi.org/10.1037/pst0000172