Bilingual therapists may use Spanish to create trust and enhance therapeutic relationships with bilingual clients, but less is known about working with monolingual Spanish-speaking clients. This study explores clinical Spanish language skills and perceived clinical Spanish efficacy of bilingual (Spanish/English) mental health clinicians who provide services to monolingual Spanish speakers. Bilingual mental health clinicians (N = 22) completed an online self-report survey measuring their perceived level of Spanish skills, comfort, and efficacy. Results revealed that 68.2% of participating clinicians have difficulty translating therapeutic terminology into Spanish, roughly 1 to 3 times per session, with 86% stating a need for formal training in Spanish clinical terminology.