With the growing demand for Spanish-speaking mental health providers in the United States comes the need to understand the experiences and the training needs of bilingual psychotherapists. Infant and early childhood mental health treatment, because of its focus on dyadic therapy with caregivers and children who may present with mixed language profiles, provides a unique window into the process of bilingual psychotherapy. This qualitative study explores the experiences of 8 Spanish—English bilingual early childhood psychotherapists through qualitative interviews. Study findings include (a) identification and documentation of the language dynamics observed by therapists when working with Spanish—English parent—child dyads, (b) exploration of how therapists select the language(s) for intervention and manage language switching in their sessions, (c) identification and documentation of the challenges bilingual therapists encounter, and (d) recommendations regarding how to improve training for bilingual psychotherapists. (PsycINFO Database Record (c) 2019 APA, all rights reserved)