Abstract
In this chapter, we introduce readers to the Latinx population in the USA and provide suggestions for clinicians hoping to learn how to work more effectively with their Latinx clients. We begin by describing the heterogeneity of the Latinx population in the USA and discuss how historical, cultural, and adjustment experiences may be important to consider when providing treatment to Latinx clients. After describing the rich, diverse cultures that comprise the Latinx population, we provide suggestions for delivering behavioral health services to Latinx clients in an engaging and culturally informed manner. These suggestions are presented by phases of treatment, from pre-intake to termination. Although our recommendations are based on scholars who have devoted their careers to understanding the mental health needs of Latinx individuals in the USA, we caution our readers against making sweeping generalizations about Latinx clients based on cultural background alone. Instead, we encourage clinicians to consider how Latinx identity intertwines with other identities to impact each client’s lived experiences, and let this guide their approach to therapy.
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References
AlegrÃa, M., Mulvaney-Day, N., Torres, M., Polo, A., Cao, Z., & Canino, G. (2007). Prevalence of psychiatric disorders across Latinx subgroups in the United States. American Journal of Public Health, 97, 68–75. https://doi.org/10.2105/AJPH.2006.087205
Anderson, K. F., & Finch, J. K. (2017). The role of racial microaggressions, stress, and acculturation in understanding Latinx health outcomes in the USA. Race and Social Problems, 9, 218–233. https://doi.org/10.1007/s12552-017-9212-2
Añez, L. M., Silva, M. A., Paris, M., Jr., & Bedregal, L. E. (2008). Engaging Latinos through the integration of cultural values and motivational interviewing principles. Professional Psychology: Research and Practice, 39, 153–159. https://doi.org/10.1037/07357028.39.2.153
Antshel, K. M. (2002). Integrating culture as a means of improving treatment adherence in the Latinx population. Psychology, Health & Medicine, 7, 435–449. https://doi.org/10.1080/1354850021000015258
Appel, M., Weber, S., & Kronberger, N. (2015). The influence of stereotype threat on immigrants: Review and meta-analysis. Frontiers in Psychology, 6, 900. https://doi.org/10.3389/fpsyg.2015.00900
Arellano-Morales, L., Roesch, S. C., Gallo, L. C., Emory, K. T., Molina, K. M., Gonzalez, P., … Brondolo, E. (2015). Prevalence and correlates of perceived ethnic discrimination in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary study. Journal of Latina/o Psychology, 3, 160–176. https://doi.org/10.1037/lat0000040
Barrera, M., Jr., & Castro, F. G. (2006). A heuristic framework for the cultural adaptation of interventions. Clinical Psychology: Science and Practice, 13, 311–316. https://doi.org/10.1111/j.1468-2850.2006.00043.x
Benish, S. G., Quintana, S., & Wampold, B. E. (2011). Culturally adapted psychotherapy and the legitimacy of myth: A direct-comparison meta-analysis. Journal of Counseling Psychology, 58, 279–289. https://doi.org/10.1037/a0023626
Bernal, G., Bonilla, J., & Bellido, C. (1995). Ecological validity and cultural sensitivity for outcome research: Issues for the cultural adaptation and development of psychosocial treatments with Hispanics. Journal of Abnormal Child Psychology, 23, 67–82. https://doi.org/10.1007/BF01447045
Bernal, G., Jiménez-Chafey, M. I., & Domenech RodrÃguez, M. M. (2009). Cultural adaptation of treatments: A resource for considering culture in evidence-based practice. Professional Psychology: Research and Practice, 40, 361–368. https://doi.org/10.1037/a0016401
Bernal, G., & Saez-Santiago, E. (2005). Toward culturally centered and evidenced-based treatments for depressed adolescents. In W. Pinsoff & J. Lebow (Eds.), Family psychology: The art of the science (pp. 471–489). New York, NY: Oxford University Press.
Bhui, K., Rudell, K., & Priebe, S. (2006). Assessing explanatory models for common mental disorders. Journal of Clinical Psychiatry, 67, 964–971. https://doi.org/10.4088/jcp.v67n0614
Breslau, J., Aguilar-Gaxiola, S., Kendler, K. S., Su, M., Williams, D., & Kessler, R. C. (2006). Specifying race-ethnic differences in risk for psychiatric disorder in a US national sample. Psychological Medicine, 36, 57–68.
Bridges, A. J., Andrews, A. I., & Deen, T. L. (2012). Mental health needs and service utilization by Hispanic immigrants residing in midsouthern United States. Journal of Transcultural Nursing, 23, 359–368. https://doi.org/10.1177/1043659612451259
Bridges, A. J., & Lindly, E. (2008). Service utilization and case management. In Workgroup on adapting Latinx services, Adaptation guidelines for serving Latinx children and families affected by trauma (1st ed.). San Diego, CA: Chadwick Center for Children and Families.
Cabassa, L. J., Lester, R., & Zayas, L. H. (2007). It’s like being in a labyrinth’: Hispanic immigrants’ perceptions of depression and attitudes toward treatments. Journal of Immigrant and Minority Health, 9, 1–16. https://doi.org/10.1007/s1090300690101
Caldwell, L. D., Tarver, D., Iwamoto, D. K., Herzberg, S., Cerda-Lizarraga, P., & Mack, T. (2008). Defining cultural competency: From a human service provider prospective. Journal of Multicultural Counseling and Development, 36, 88–100.
Calzada, E. J., Fernandez, Y., & Cortes, D. E. (2010). Incorporating the cultural value of respeto into a framework of Latinx parenting. Cultural Diversity and Ethnic Minority Psychology, 16, 77–86. https://doi.org/10.1037/a0016071
Caplan, S. (2007). Latinos, acculturation, and acculturative stress: A dimensional concept analysis. Policy, Politics, & Nursing Practice, 8, 93–106. https://doi.org/10.1177/1527154407301751
Caplan, S., Paris, M., Whittemore, R., Desai, M., Dixon, J., Alvidrez, J., … Scahill, L. (2011). Correlates of religious, supernatural and psychosocial causal beliefs about depression among Latinx immigrants in primary care. Mental Health, Religion & Culture, 14, 589–611. https://doi.org/10.1080/13674676.2010.497810
Cavazos-Rehg, P. A., Zayas, L. H., & Spitznagel, E. L. (2007). Legal status, emotional well-being and subjective health status of Latinx immigrants. Journal of the National Medical Association, 99, 1126–1131.
Claiborn, C. D., Ward, S. R., & Strong, S. R. (1981). Effects of congruence between counselor interpretations and client beliefs. Journal of Counseling Psychology, 28, 101–109. https://doi.org/10.1037/0022-0167.28.2.101
Cooper, L. A., Gonzales, J. J., Gallo, J. J., Rost, K. M., Meredith, L. S., Rubenstein, L. V., … Ford, D. E. (2003). The acceptability of treatment for depression among African-American, Hispanic, and White primary care patients, Medical Care, 41, 479–489. https://doi.org/10.1097/01.MLR.0000053228.58042.E4
Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989, 139–167.
Da Silva, N., Dillon, F. R., Rose Verdejo, T., Sanchez, M., & De La Rosa, M. (2017). Acculturative stress, psychological distress, and religious coping among Latina young adult immigrants. The Counseling Psychologist, 45, 213–236. https://doi.org/10.1177/0011000017692111
French, S. E., Seidman, E., Allen, L., & Aber, J. L. (2006). The development of ethnic identity during adolescence. Developmental Psychology, 42, 1–10. https://doi.org/10.1037/0012-1649.42.1.1
Furman, R., Negi, N. J., Iwamoto, D. K., Rowan, D., Shukraft, A., & Gragg, J. (2009). Social work practice with Latinos: Key issues for social workers. Social Work, 54, 167–174. https://doi.org/10.1093/sw/54.2.167
Gonzales, P. M., Blanton, H., & Williams, K. J. (2002). The effects of stereotype threat and double-minority status on the test performance of Latinx women. Personality and Social Psychology Bulletin, 28, 659–670. https://doi.org/10.1177/0146167202288010
Gonzales-Ramos, G., Zayas, L. H., & Cohen, E. V. (1998). Child-rearing values of low-income, urban Puerto Rican mothers of preschool children. Professional Psychology: Research & Practice, 29, 377–382. https://doi.org/10.1037/0735-7028.29.4.377
Hays, P. A. (2009). Integrating evidence-based practice, cognitive-behavior therapy, and multicultural therapy: Ten steps for culturally competent practice. Professional Psychology: Research and Practice, 40, 354–360. https://doi.org/10.1037/a0016250
Hirai, M., Vernon, L. L., Popan, J. R., & Clum, G. A. (2015). Acculturation and enculturation, stigma toward psychological disorders, and treatment preferences in a Mexican American sample: The role of education in reducing stigma. Journal of Latina/o Psychology, 3, 88–102. https://doi.org/10.1037/lat0000035
Holmes, C. (2018, June 21). Five facts on migrants coming to the U.S. US News and World Report. Retrieved from www.usnews.com/news/best-countries/articles/2018-06-21/why-are-central-americans-coming-to-the-united-states
Ibrahim, F. A., Roysircar-Sodowsky, G. R., & Ohnishi, H. (2001). Worldview: Recent developments and needed direction. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (2nd ed., pp. 425–456). Thousand Oaks, CA: Sage.
Interian, A., Martinez, I. E., Guarnaccia, P. J., Vega, W. A., & Escobar, J. I. (2007). A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatric Services, 58, 1591–1594. https://doi.org/10.1176/appi.ps.58.12.1591
Jimenez, D. E., Bartels, S. J., Cardenas, V., Dhaliwal, S. S., & AlegrÃa, M. (2012). Cultural beliefs and mental health treatment preferences of ethnically diverse older adult consumers in primary care. American Journal of Geriatric Psychiatry, 20, 533–542. https://doi.org/10.1097/JGP.0b013e318227f876
Kleinman, A., Eisenberg, L., & Good, B. (2006). Culture, illness, and care: Clinical lessons from anthropologic and cross-cultural research. Focus, 4, 140–149. https://doi.org/10.1176/foc.4.1.140
Kouyoumdjian, H., Zamboanga, B. L., & Hansen, D. J. (2003). Barriers to community mental health services for Latinos: Treatment considerations. Clinical Psychology: Science and Practice, 10, 394–422. https://doi.org/10.1093/clipsy/bpg041
Lau, A. S. (2006). Making the case for selective and directed cultural adaptations of evidence-based treatments: Examples from parent training. Clinical Psychology: Science and Practice, 13, 295–310. https://doi.org/10.1111/j.1468-2850.2006.00042.x
Lewis-Fernandez, R., Das, A. K., Alfonso, C., Weissman, M. M., & Olfson, M. (2005). Depression in US Hispanics: Diagnostic and management considerations in family practice. Journal of the American Board of Family Medicine, 18, 282–296. https://doi.org/10.3122/jabfm.18.4.282
Long, J. R. (2001). Goal agreement and early therapeutic change. Psychotherapy: Theory, Research, Practice, Training, 38, 219–232. https://doi.org/10.1037/0033-3204.38.2.219
López, S. R., Lara, M. C., Kopelowicz, A., Solano, S., Foncerrada, H., & Aguilera, A. (2009). La CLAve to increase psychosis literacy of Spanishspeaking community residents and family caregivers. Journal of Consulting and Clinical Psychology, 77, 763–774. https://doi.org/10.1037/a0016031
Muñoz, R. F., & Mendelson, T. (2005). Toward evidence-based interventions for diverse populations: The San Francisco General Hospital prevention and treatment manuals. Journal of Consulting and Clinical Psychology, 73, 790–799. https://doi.org/10.1037/0022-006X.73.5.790
National Public Radio (NPR), Robert Wood Johnson Foundation, & Harvard T. H. Chan School of Public Health. (2017). Discrimination in America: Experiences and view of Latinos. Retrieved from https://www.hsph.harvard.edu/news/press-release/poll-Latinos-discrimination/
Neville, H. A., Spanierman, L. B., & Doan, B. (2006). Exploring the association between color-blind racial ideology and multicultural counseling competencies. Cultural Diversity and Ethnic Minority Psychology, 12, 275–290. https://doi.org/10.1037/1099-9809.12.2.275
Ortega, A. N., Rosenheck, R., AlegrÃa, M., & Desai, R. A. (2000). Acculturation and the lifetime risk of psychiatric and substance use disorders among Hispanics. Journal of Nervous and Mental Disease, 188, 728–735.
Pérez, D. J., Fortuna, L., & AlegrÃa, M. (2008). Prevalence and correlates of everyday discrimination among U.S. Latinos. Journal of Community Psychology, 36, 421–433. https://doi.org/10.1002/jcop.20221
Perreira, K. M., Chapman, M. V., & Stein, G. L. (2006). Becoming an American parent: Overcoming challenges and finding strength in a new immigrant Latinx community. Journal of Family Issues, 27, 1383–1414. https://doi.org/10.1177/0192513X06290041
Pew Research Center. (2012). Identity, pan-ethnicity and race. Retrieved from https://www.pewhispanic.org/2012/04/04/ii-identity-pan-ethnicity-and-race/
Pew Research Center. (2013). Diverse origins: The nation’s 14 largest Hispanic-origin groups. Retrieved from www.pewhispanic.org/2013/06/19/diverse-origins-the-nations-14-largest-hispanic-origin-groups/
Pew Research Center. (2017). Facts on US Latinos, 2015: Statistical portrait of Hispanics in the United States. Retrieved from www.pewhispanic.org/2017/09/18/facts-on-u-s-Latinos/#hispanic-rising-share
Phinney, J. S. (1993). A three-stage model of ethnic identity development in adolescence. In M. E. Bernal & G. P. Knight (Eds.), Ethnic identity: Formation and transmission among Hispanics and other minorities (pp. 61–79). New York, NY: State University of New York Press.
Piña, A. A., & Silverman, W. K. (2004). Clinical phenomenology, somatic symptoms, and distress in Hispanic/Latinx and European American youths with anxiety disorders. Journal of Clinical Child and Adolescent Psychology, 33, 227–236. https://doi.org/10.1207/s15374424jccp3302_3
Rastogi, M., Massey-Hastings, N., & Wieling, E. (2012). Barriers to seeking mental health services in the Latinx/a community: A qualitative analysis. Journal of Systemic Therapies, 31, 1–17. https://doi.org/10.1521/jsyt.2012.31.4.1
Rudell, K., Bhui, K., & Priebe, S. (2009). Concept, development and application of a new mixed method assessment of cultural variations in illness perceptions: Barts Explanatory Model Inventory. Journal of Health Psychology, 14, 336–347. https://doi.org/10.1177/1359105308100218
Rust, G., Kondwani, K., Martinez, R., Dansie, R., Wong, W., Fry-Johnson, Y., & Strothers, H. (2006). A CRASH-course in cultural competence. Ethnicity & Disease, 16(2, Suppl. 3), S3-29–S3-36.
Schwab, W. A. (2013). Right to dream: Immigration reform and America’s future. Fayetteville, AR: University of Arkansas Press.
Schwab, W. A. (2018). Dreams derailed: Undocumented youths in the Trump era. Fayetteville, AR: University of Arkansas Press.
Siegel, C., Haugland, G., & Chambers, E. D. (2003). Performance measures and their benchmarks for assessing organizational cultural competency in behavioral health care service delivery. Administration and Policy in Mental Health, 31, 141–170. https://doi.org/10.1023/B:APIH.0000003019.97009.15
Smith, T. B., & Silva, L. (2011). Ethnic identity and personal well-being of people of color: A meta-analysis. Journal of Counseling Psychology, 58, 42–60. https://doi.org/10.1037/a0021528
Smith, T. B., Domenech RodrÃguez, M., & Bernal, G. (2011). Culture. Journal of Clinical Psychology, 67, 166–175. https://doi.org/10.1002/jclp.20757
Snell-Johns, J., Mendez, J. L., & Smith, B. H. (2004). Evidence based solutions for overcoming access barriers, decreasing attrition, and promoting change with underserved families. Journal of Family Psychology, 18, 19–35. https://doi.org/10.1037/08933200.18.1.19
Suárez-Orozco, C., Todorova, I., & Louie, J. (2002). Making up for lost time: The experience of separation and reunification among immigrant families. Family Process, 41, 625–643. https://doi.org/10.1111/j.1545-5300.2002.00625.x
Sue, D. W. (2004). Whiteness and ethnocentric monoculturalism: Making the invisible visible. American Psychologist, 59, 761–769. https://doi.org/10.1037/0003-066X.59.8.761
Sue, S., Zane, N., Nagayama Hall, G. C., & Berger, L. K. (2009). The case for cultural competency in psychotherapeutic interventions. Annual Review of Psychology, 60, 525–548. https://doi.org/10.1146/annurev.psych.60.110707.163651
Swift, J. K., Greenberg, R. P., Whipple, J. L., & Kominiak, N. (2012). Practice recommendations for reducing premature termination in therapy. Professional Psychology: Research and Practice, 43, 379–387. https://doi.org/10.1037/a0028291
Tienda, M., & Sanchez, S. (2013). Latin American immigration to the United States. Daedalus, 142, 48–64. https://doi.org/10.1162/DAED_a_00218
Trimble, J. E., Scharrón-del-RÃo, M. R., & Hill, J. S. (2012). Ethical considerations in the application of cultural adaptation models with ethnocultural populations. In G. Bernal & M. Domenech RodrÃguez (Eds.), Cultural adaptations: Tools for evidence-based practice with diverse populations (pp. 45–67). Washington, DC: American Psychological Association. https://doi.org/10.1037/13752-003
Uebelacker, L. A., Marootian, B. A., Pirraglia, P. A., Primack, J., Tigue, P. M., Haggarty, R., & Miller, I. W. (2012). Barriers and facilitators of treatment for depression in a Latinx community: A focus group study. Community Mental Health Journal, 48, 114–126. https://doi.org/10.1007/s1059701193887
Urdaneta, M. L., Saldaña, D. H., & Winkler, A. (1995). Mexican-American perceptions of severe mental illness. Human Organization, 54, 70–77. https://doi.org/10.17730/humo.54.1.e216p6442857477q
US Census Bureau. (2016). American Community Survey: Demographic and housing estimates. Retrieved from https://factfinder.census.gov/faces/tablesservices/jsf/pages/productview.xhtml?src=CF
Varela, R., Vernberg, E. M., Sanchez-Sosa, J., Riveros, A., Mitchell, M., & Mashunkashey, J. (2004). Anxiety reporting and culturally associated interpretation biases and cognitive schemas: A comparison of Mexican, Mexican American, and European American families. Journal of Clinical Child and Adolescent Psychology, 33, 237–247. https://doi.org/10.1207/s15374424jccp3302_4
Villalobos, B. T., Bridges, A. J., Anastasia, E. A., Ojeda, C. A., Hernandez Rodriguez, J., & Gomez, D. (2016). Effects of language concordance and interpreter use on therapeutic alliance in Spanishspeaking integrated behavioral health care patients. Psychological Services, 13, 49–59. https://doi.org/10.1037/ser0000051
Wampold, B. E. (2007). Psychotherapy: The humanistic (and effective) treatment. American Psychologist, 62, 857–873. https://doi.org/10.1037/0003-066X.62.8.857
Wells, A., Lagomasino, I. T., Palinkas, L. A., Green, J. M., & Gonzalez, D. (2013). Barriers to depression treatment among lowincome, Latinx emergency department patients. Community Mental Health Journal, 49, 412–418. https://doi.org/10.1007/s1059701295475
Whaley, A. L., & Davis, K. E. (2007). Cultural competence and evidence-based practice in mental health services: A complementary perspective. American Psychologist, 62, 563–574. https://doi.org/10.1037/0003-066X.62.6.563
White, R. M. B., Roosa, M. W., Weaver, S. R., & Nair, R. L. (2009). Cultural and contextual influences on parenting in Mexican American families. Journal of Marriage and the Family, 71, 61–79.
Zsembik, B. A., & Fennell, D. (2005). Ethnic variation in health and the determinants of health among Latinos. Social Science and Medicine, 61, 53–63. https://doi.org/10.1016/j.socscimed.2004.11.040
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Bridges, A.J., Dueweke, A.R. (2020). Behavioral Health Service Delivery with Latinos. In: Benuto, L.T., Gonzalez, F.R., Singer, J. (eds) Handbook of Cultural Factors in Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-030-32229-8_12
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