Skip to main content
SpringerLink
Log in

Treatment Considerations and Tools for Treating Latino Children with Anxiety

  • Chapter
  • First Online:
Toolkit for Counseling Spanish-Speaking Clients

Abstract

Anxiety disorders are among the most prevalent disorders for children and adolescents and are associated with significant short- and long-term consequences (Costello, Egger, & Agnold, 2005). Some data suggest that Latinos report higher levels of anxiety symptoms than other groups (Pina & Silverman, 2004). Research comparing non-Latino White and Latino youth who participate in evidence-based treatments for anxiety highlights similar outcomes between groups; however, Latinos continue to underutilize mental health services when compared to non-Latino populations (e.g., Ojeda & McGuire, 2006; Pina, Silverman, Fuentes, Kurtines, & Weems, 2003). While research expands in the realm of anxiety treatment for Latino youth, a gap remains with regard to accessible and applicable materials to use while working with Spanish-speaking populations. This chapter provides practical information for clinicians working with Spanish-speaking Latino children and families. The following information and resources are provided:

  • Brief overview of current research on evidence-based practices with Latino populations

  • Cultural considerations to help the provider modify current treatment practices

  • Session plan and Spanish language worksheets with culturally relevant examples

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Alegría, M., Canino, G., Shrout, P., Woo, M., Duan, N., Vila, D., & Meng, X. (2008). Prevalence of mental illness in immigrant and non-immigrant U.S. Latino groups. American Journal of Psychiatry, 165(3), 359–369.

    Article  PubMed  PubMed Central  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Book  Google Scholar 

  • Andrés-Hyman, R. C., Ortiz, J., Añez, L. M., Paris, M., & Davidson, L. (2006). Culture and clinical practice: Recommendations for working with Puerto Ricans and other Latinas (os) in the United States. Professional Psychology: Research and Practice, 37(6), 694–701.

    Article  Google Scholar 

  • 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(2), 153–159.

    Article  Google Scholar 

  • Arcia, E., Castillo, H., & Fernández, M. C. (2004). Maternal cognitions about distress and anxiety in young Latino children with disruptive behaviors. Transcultural Psychiatry, 41(1), 99–119.

    Article  PubMed  Google Scholar 

  • Bacallao, M. L., & Smokowski, P. R. (2013). Obstacles to getting ahead: How assimilation mechanisms impact undocumented Mexican immigrant families. Social Work in Public Health, 28(1), 1–20.

    Article  PubMed  Google Scholar 

  • Berry, J. W. (1980). Acculturation as varieties of adaptation. In A. Padilla (Ed.), Acculturation: Theory, models and findings (pp. 9–25). Boulder, CO: Westview.

    Google Scholar 

  • Cabassa, L. J., Zayas, L. H., & Hansen, M. C. (2006). Latino adults’ access to mental health care: A review of epidemiological studies. Administration and Policy in Mental Health, 33(3), 316–330.

    Article  PubMed  PubMed Central  Google Scholar 

  • Calzada, E. J., Huang, K. Y., Anicama, C., Fernandez, Y., & Brotman, L. M. (2012). Test of a cultural framework of parenting with Latino families of young children. Cultural Diversity and Ethnic Minority Psychology, 18(3), 285–296.

    Article  PubMed  PubMed Central  Google Scholar 

  • Canino, G., Shrout, P. E., Rubio-Stipec, M., Bird, H. R., Bravo, M., Ramirez, R., & Martinez-Taboas, A. (2004). The DSM-IV rates of child and adolescent disorders in Puerto Rico: Prevalence, correlates, service use, and the effects of impairment. Archives of General Psychiatry, 61(1), 85–93.

    Article  PubMed  Google Scholar 

  • Canino, I. A., Rubio-Stipec, M., Canino, G., & Escobar, J. I. (1992). Functional somatic symptoms: A cross-ethnic comparison. American Journal of Orthopsychiatry, 62(4), 605–612.

    Article  PubMed  Google Scholar 

  • Cartwright-Hatton, S., Roberts, C., Chitsabesan, P., Fothergill, C., & Harrington, R. (2004). Systematic review of the efficacy of cognitive behaviour therapies for childhood and adolescent anxiety disorders. British Journal of Clinical Psychology, 43, 421–436.

    Article  PubMed  Google Scholar 

  • Chavira, D. A., Bustos, C. E., Garcia, M. S., Ng, B., & Camacho, A. (2015). Delivering CBT to rural Latino children with anxiety disorders: A qualitative study. Community Mental Health Journal, 53(1), 1–9.

    Google Scholar 

  • Comas-Diaz, L. (2006). Latino healing: The integration of ethnic psychology into psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 43(4), 436–453.

    Article  Google Scholar 

  • Constantino, G., Malgady, R. G., & Rogler, L. H. (1986). Folktales as culturally sensitive psychotherapy for Hispanic children. Journal of Consulting and Clinical Psychology, 54(5), 639–645.

    Article  Google Scholar 

  • Costello, J. E., Egger, H. L., & Angold, A. (2005). The developmental epidemiology of anxiety disorders: Phenomenology, prevalence and comorbidity. Child and Adolescent Psychiatric Clinics of North America, 14(4), 631–648.

    Article  PubMed  Google Scholar 

  • Feldman, J. M., Ortega, A. N., Koinis-Mitchell, D., Kuo, A. A., & Canino, G. (2010). Child and family psychiatric and psychological factors associated with child physical health problems: Results from the Boricua youth study. Journal of Nervous and Mental Disease, 198(4), 272–279.

    Article  PubMed  PubMed Central  Google Scholar 

  • Finch, B. F., & Vega, W. A. (2003). Acculturation stress, social support and self-rated health among Latinos in California. Journal of Immigrant Health, 5(3), 109–117.

    Article  PubMed  Google Scholar 

  • Gaines, S. O., Marelich, W. D., Bledsoe, K. L., Steers, W. N., Henderson, M. C., Granrose, C. S., … Page, M. S. (1997). Links between race/ethnicity and cultural values as mediated by racial/ethnic identity and moderated by gender. Journal of Personality and Social Psychology, 72(6), 1460–1476.

    Article  PubMed  Google Scholar 

  • Ginsburg, G. S., & Schlossberg, M. C. (2002). Family-based treatment of childhood anxiety disorders. International Review of Psychiatry, 14(2), 143–154.

    Article  Google Scholar 

  • Ginsburg, G. S., & Silverman, W. K. (1996). Phobic and anxiety disorders in Hispanic and Caucasian youth. Journal of Anxiety Disorders, 10(6), 517–528.

    Article  Google Scholar 

  • Grant, B. F., Stinson, F. S., Hasin, D. S., Dawson, D. A., Chou, S. P., & Anderson, K. (2004). Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican American and non-Hispanic whites in the United States: Results from the National Epidemiologic Survey on alcohol and related conditions. Archives of General Psychiatry, 61(12), 1226–1233.

    Article  PubMed  Google Scholar 

  • Guarnaccia, P. J., Martinez, I., Ramirez, R., & Canino, G. (2005). Are ataques de nervios in Puerto Rican children associated with psychiatric disorder? Journal of the American Academy of Child & Adolescent Psychiatry, 44(11), 1184–1192.

    Article  Google Scholar 

  • Gudiño, O. G., Lau, A. S., Yeh, M., McCabe, K. M., & Hough, R. L. (2009). Understanding racial/ethnic disparities in youth mental health services: Do disparities vary by problem type? Journal of Emotional and Behavioral Disorders, 17(1), 3–16.

    Article  Google Scholar 

  • Hale, W. W., Raaijmakers, Q., Muris, P., van Hoof, A., & Meeus, W. (2008). Developmental trajectories of adolescent anxiety disorder symptoms: A 5-year prospective community study. Journal of the American Academy of Child & Adolescent Psychiatry, 47(5), 556–564.

    Article  Google Scholar 

  • Halgunseth, L. C., Ispa, J. M., & Rudy, D. (2006). Parental control in Latino families: An integrated review of the literature. Child Development, 77(5), 1282–1297.

    Article  PubMed  Google Scholar 

  • Hofstede, G. (1984). Culture’s consequences: International differences in work-related values. Newbury Park, CA: Sage.

    Google Scholar 

  • Hovey, J. D., & King, C. A. (1996). Acculturative stress, depression, and suicidal ideation among immigrant and second-generation Latino adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 35(9), 1183–1192.

    Article  Google Scholar 

  • Huey, S. J., Jr., & Polo, A. J. (2008). Evidence-based psychosocial treatments for ethnic minority youth. Journal of Clinical Child and Adolescent Psychology, 37(1), 262–301.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jenkins, J. H. (1988). Ethnopsychiatric interpretations of schizophrenic illness: The problem of nervios within Mexican-American families. Culture, Medicine and Psychiatry, 12(3), 301–329.

    Article  PubMed  Google Scholar 

  • Kendall, P. C. (1994). Treating anxiety disorders in children: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 62(1), 100–110.

    Article  PubMed  Google Scholar 

  • Kirmayer, L., & Young, A. (1998). Culture and somatization: Clinical, epidemiological, and ethnographic perspectives. Psychosomatic Medicine, 60(4), 420–430.

    Article  PubMed  Google Scholar 

  • 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(4), 295–310.

    Google Scholar 

  • Lopez, I., Rivera, F., Ramirez, R., Guarnaccia, P. J., Canino, G., & Bird, H. R. (2009). Ataques de nervios and their psychiatric correlates in Puerto Rican children from two different contexts. The Journal of Nervous and Mental Disease, 197(12), 923–929.

    Article  PubMed  Google Scholar 

  • Lopez, S. R., & Guarnaccia, P. J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51, 571–598.

    Article  PubMed  Google Scholar 

  • Lorenzo-Blanco, E. I., & Unger, J. B. (2015). Ethnic discrimination, acculturative stress, and family conflict as predictors of depressive symptoms and cigarette smoking among Latina/o youth: The mediating role of perceived stress. Journal of Youth and Adolescence, 44(10), 1984–1997.

    Article  PubMed  Google Scholar 

  • Luis, T. M., Varela, R. E., & Moore, K. W. (2008). Parenting practices and childhood anxiety reporting in Mexican, Mexican American, and European American families. Journal of Anxiety Disorders, 22(6), 1011–1020.

    Article  PubMed  Google Scholar 

  • Lyneham, H. J., Wignall, A., & Rapee, R. M. (2008). Helping your anxious child Children’s workbook. In Center for Emotional Health (2nd ed.). Sydney, Australia: Macquarie University.

    Google Scholar 

  • McCabe, K. M. (2002). Factors that predict premature termination among Mexican-American children in outpatient psychotherapy. Journal of Child and Family Studies, 11(3), 347–359.

    Article  Google Scholar 

  • McKay, M. M., & Bannon, W. M. (2004). Engaging families in child mental health services. Child and Adolescent Psychiatric Clinics of North America, 13(4), 905–921.

    Article  PubMed  Google Scholar 

  • Nadeem, E., Lange, J. M., Edge, D., Fongwa, M., Belin, T., & Miranda, J. (2007). Does stigma keep poor young immigrant and U.S. born black and Latina women from seeking mental health care? Psychiatric Services, 58(12), 1547–1554.

    Article  PubMed  Google Scholar 

  • Ojeda, V. D., & McGuire, T. G. (2006). Gender and racial/ethnic differences in use of outpatient mental health and substance use services by depressed adults. Psychiatric Quarterly, 77(3), 211–222.

    Article  PubMed  Google Scholar 

  • Pina, A. A., & Silverman, W. K. (2004). Clinical phenomenology, somatic symptoms, and distress in Hispanic/Latino and European American youths with anxiety disorders. Journal of Clinical Child and Adolescent Psychology, 33(2), 227–236.

    Article  PubMed  Google Scholar 

  • Pina, A. A., Silverman, W. K., Fuentes, R. M., Kurtines, W. M., & Weems, C. F. (2003). Exposure-based cognitive-behavioral treatment for phobic and anxiety disorders: Treatment effects and maintenance for Hispanic/Latino relative to European-American youths. Journal of the American Academy of Child & Adolescent Psychiatry, 42(10), 1179–1187.

    Article  Google Scholar 

  • Pina, A. A., Zerr, A. A., Villalta, I. K., & Gonzales, N. A. (2012). Indicated prevention and early intervention for childhood anxiety: A randomized trial with Caucasian and Hispanic/Latino youth. Journal of Consulting and Clinical Psychology, 80(5), 940–946.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rapee, R. M., & Wignall, A. (2002). Cool kids program: Family version session guide. Sydney, Australia: Macquarie University Anxiety Research Unit.

    Google Scholar 

  • Rastogi, M., Massey-Hastings, N., & Wieling, E. (2012). Barriers to seeking mental health Services in the Latino/a community: A qualitative analysis. Journal of Systemic Therapies, 31(4), 1–17.

    Article  Google Scholar 

  • Resnicow, K., Baranowski, T., Ahluwalia, J. S., & Braithwaite, R. L. (1999). Cultural sensitivity in public health: Defined and demystified. Ethnicity & Disease, 9(1), 10–21.

    Google Scholar 

  • Ryder, A. G., Alden, L. E., & Paulhus, D. L. (2000). Is acculturation unidimensional or bidimensional? A head-to-head comparison in the prediction of personality, self-identity, and adjustment. Journal of Personality and Social Psychology, 79(1), 49–65.

    Article  PubMed  Google Scholar 

  • Salgado de Snyder, V. N., Diaz-Perez, M. J., & Ojeda, V. D. (2000). The prevalence of nervios and associated symptomatology among inhabitants of Mexican rural communities. Culture, Medicine and Psychiatry, 24(4), 453–470.

    Article  PubMed  Google Scholar 

  • Salman, E., Carrasco, J. L., Liebowitz, M., Diaz Marsa, M., Prieto, R., Jusino, C., … Klein, D. (1997). Los ‘ataques de nervios’: Un estudio de caracterización diagnóstica. Actas Españolas de Psiquiatría, 25, 285–289.

    Google Scholar 

  • Sanchez, M., Dillon, F., Ruffin, B., & De La Rosa, M. (2012). The influence of religious coping on the acculturative stress of recent Latino immigrants. Journal of Ethnic & Cultural Diversity in Social Work, 21(3), 1–20.

    Article  Google Scholar 

  • Santiago-Rivera, A. L., Arrendondo, P., & Gallardo-Cooper, M. (2002). Counseling Latinos and la familia: A practical guide. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Silverman, W. K., Pina, A. A., & Viswesvaran, C. (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 37(1), 105–130.

    Article  Google Scholar 

  • Suarez-Morales, L., & Lopez, B. (2009). The impact of acculturative stress and daily hassles on pre-adolescent psychological adjustment: Examining anxiety symptoms. Journal of Primary Prevention, 30(3-4), 335–349.

    Google Scholar 

  • Sue, D. W., & Sue, D. (2003). Counseling the culturally diverse. New York, NY: John Wiley & Sons, Inc..

    Google Scholar 

  • Tarshis, T. P., Jutte, D. P., & Huffman, L. C. (2006). Provider recognition of psychosocial problems in low-income Latino children. Journal of Health Care for the Poor and Underserved, 17(2), 342–357.

    Article  PubMed  Google Scholar 

  • Task Force on Promotion and Dissemination of Psychological Procedures. (1995). Training in and dissemination of empirically validated treatments: Report and recommendations. The Clinical Psychologist, 48(1), 3–23.

    Google Scholar 

  • Umaña-Taylor, A. J., & Alfaro, E. C. (2009). Acculturative stress and adaptation. In F. A. Villarruel, G. Carlo, J. M. Grau, M. Azmitia, N. J. Cabrera, & T. J. Chahin (Eds.), Handbook of U.S. Latino psychology: Developmental and community-based perspectives (pp. 135–152). Thousand Oaks, CA: Sage Publications, Inc.

    Google Scholar 

  • U.S. Department of Health and Human Services (USDHHS). (2000). Mental health: Culture, race, and ethnicity—Supplement to mental health: A report of the surgeon general. Rockville, MD: Author.

    Google Scholar 

  • Varela, R. E., & Hensley-Maloney, L. (2009). The influence of culture on anxiety in Latino youth: A review. Clinical Child and Family Psychology Review, 12(3), 217–233.

    Article  PubMed  Google Scholar 

  • Varela, R. E., Sanchez-Sosa, J., Biggs, B. K., & Luis, T. M. (2009). Parenting strategies and socio-cultural influences in childhood anxiety: Mexican, Latin American descent, and European American families. Journal of Anxiety Disorders, 23(5), 609–616.

    Article  PubMed  Google Scholar 

  • Varela, R. E., Vernberg, E. M., Sanchez-Sosa, J. 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(2), 237–224.

    Article  PubMed  Google Scholar 

  • Weems, C. F., Hayward, C., Killen, J., & Taylor, C. B. (2002). A longitudinal investigation of anxiety sensitivity in adolescence. Journal of Abnormal Psychology, 111(3), 471–477.

    Article  PubMed  Google Scholar 

  • Wood, J. J., McLeod, B. D., Sigman, M., Hwang, W., & Chu, B. (2003). Parenting and childhood anxiety: Theory, empirical findings, and future directions. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 44(1), 134–151.

    Article  PubMed  Google Scholar 

  • Yeh, M., McCabe, K., Hough, R. L., Dupuis, D., & Hazen, A. (2003). Racial/ethnic differences in parental endorsement of barriers to mental health services for youth. Mental Health Services Research, 5(2), 65–77.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095-1563, USA

    Emily L. Escovar MA & Denise A. Chavira PhD

  2. Center for Anxiety & Related Disorders, Boston University, 648 Beacon St., 6th Floor, Boston, MA, 02215, USA

    Carla A. Hitchcock Robinson

Authors
  1. Emily L. Escovar MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carla A. Hitchcock Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Denise A. Chavira PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Emily L. Escovar MA or Denise A. Chavira PhD .

Editor information

Editors and Affiliations

  1. Department of Psychology, University of Nevada Reno, Reno, Nevada, USA

    Lorraine T. Benuto

Appendices

Cultura y Contexto

figure a

La Escala de Preocupación

figure b

Conecta Los Pensamientos y Sentimientos

figure c

Pensamientos Relajantes y Preocupantes

figure d

Pensamientos, Sentimientos, y Acciones

figure e

Practicando Pensamientos Relajantes

figure f

Plan Escalón por Escalón

figure g

Las Recompensas

figure h

Lucha Contra el Miedo Enfrentándote a Él

figure i

Resolviendo Problemas

figure j

Cultura y Contexto

figure k

La Escala de Preocupación

figure l

Conecta Los Pensamientos y Sentimientos

figure m

Pensamientos Relajantes y Preocupantes

figure n

Pensamientos, Sentimientos, y Acciones

figure o

Practicando Pensamientos Relajantes

figure p

Plan Escalón por Escalón

figure q

Las Recompensas

figure r

Lucha Contra el Miedo Enfrentándote a Él

figure s

Resolviendo Problemas

figure t

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Escovar, E.L., Robinson, C.A.H., Chavira, D.A. (2017). Treatment Considerations and Tools for Treating Latino Children with Anxiety. In: Benuto, L. (eds) Toolkit for Counseling Spanish-Speaking Clients. Springer, Cham. https://doi.org/10.1007/978-3-319-64880-4_19

Download citation

Publish with us

Policies and ethics

Search

Navigation