The Latinx population in the United States is large and heterogeneous and a sizable segment is either bilingual and/or Spanish dominant. In the spirit of increasing health equity, the need to train future health service psychologists who are equipped to meet the challenging demands of an increasingly ethnically and linguistically diverse population is vital to our current mental health system. However, despite the established need for Spanish-language services to Latinx populations, there is a shortage of bilingual therapists and inadequate training provided to mental health professionals in training to provide effective language-specific services. This paper raises an important discussion regarding language competence and training needs of bilingual (Spanish-English) health service psychology trainees. We argue that language competence is an important and separate aspect of cultural competence that has been ignored and should be addressed separately during clinical training. This paper focuses on the importance of bilingualism in therapy, highlights three ethical areas of concern, and offers recommendations for programs currently training bilingual students. Language competency and training needs in Spanish-language therapy may have important implications for reducing health disparities and access to care among a population who already faces formidable obstacles in obtaining quality mental health care. Implications and recommendations for training and clinical supervision of bilingual trainees are discussed.