Are Empirically Supported Treatments Valid for Ethnic Minorities? Toward an Alternative Approach for Treatment Research

Cultural Diversity and Ethnic Minority Psychology (Impact Factor: 1.36). 12/2001; 7(4):328-42. DOI: 10.1037/1099-9809.7.4.328
Source: PubMed


The psychological community has given considerable attention to the problem of establishing empirically supported treatments (ESTs). The authors argue that a scientific practice that discriminates against some approaches to knowledge undermines the EST's relevance for communities of color. They examine the EST project's contribution to knowledge of effective treatments for ethnic minorities by considering both how knowledge is constructed and the limits of research (e.g., external validity). Alternatives on how to best contribute to treatment research of clinical utility with diverse populations are articulated. An approach for treatment research, derived from an integration of the hypothesis-testing and discovery-oriented research approaches, is presented, and recommendations to advance treatment research with ethnic minority communities are offered.

Download full-text


Available from: Guillermo Bernal,
  • Source
    • "In order to develop an evidence base for mental health care for minority populations, specific ethnic and cultural issues must be taken into account [1] [2] [3] [4]. The US Surgeon General's report, " Culture, Race, and Ethnicity: A Supplement to Mental Health " and a recent white paper from the National Council of La Raza entitled " Critical Disparities in Latino Mental Health: Transforming Research into Action " [5] [6], points to the need for sub-group specific mental health research that explores the cultural variation and heterogeneity of the Latino population. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The Surgeon General's report, "Culture, Race, and Ethnicity: A Supplement to Mental Health," points to the need for subgroup specific mental health research that explores the cultural variation and heterogeneity of the Latino population. Guided by cognitive anthropological theories of culture, we utilized ethnographic interviewing techniques to explore cultural models of depression among foreign-born Mexican (n = 30), Cuban (n = 30), Columbian (n = 30), and island-born Puerto Ricans (n = 30), who represent the largest Latino groups in Florida. Results indicate that Colombian, Cuban, Mexican, and Puerto Rican immigrants showed strong intragroup consensus in their models of depression causality, symptoms, and treatment. We found more agreement than disagreement among all four groups regarding core descriptions of depression, which was largely unexpected but can potentially be explained by their common immigrant experiences. Findings expand our understanding about Latino subgroup similarities and differences in their conceptualization of depression and can be used to inform the adaptation of culturally relevant interventions in order to better serve Latino immigrant communities.
    Depression research and treatment 09/2011; 2011(4):564396. DOI:10.1155/2011/564396
  • Source
    • "Finally, most of the studies, with the exclusion of those on IPT-A, have had predominately white, middle-class samples. As such, it is not clear how effective the psychosocial treatments are for ethnic minority groups.96,97 Despite these concerns, meta-analyses suggest that evidence-based therapies are superior to usual clinical care for youth mental health problems.15 "
    [Show abstract] [Hide abstract]
    ABSTRACT: Approximately 10%-15% of adolescents will experience a major depressive episode. The risk factors associated with depression in adolescence include a family history of depression, being female, subthreshold depression, having a nonaffective disorder, negative cognitions, interpersonal conflict, low social support, and stressful life events. Despite the availability of measures to identify depressed adolescents and efficacious interventions to treat these adolescents, a large number of depressed adolescents go undetected and untreated. This review describes several screening measures that can be used to identify adolescents with elevated depression symptoms who would benefit from a comprehensive diagnostic evaluation. If an adolescent is diagnosed with a depressive disorder, there are several efficacious treatment options, including pharmacotherapy, cognitive behavior therapy, and interpersonal psychotherapy. The research supporting each of these approaches is outlined, and recommendations are made to help health professionals determine the appropriate course of treatment. Although existing treatments are effective for many depressed adolescents, approximately one-third of adolescents remain depressed following treatment. Continuing research is needed to enhance the efficacy of existing treatments for adolescent depression and to develop and study novel treatment approaches.
    Adolescent Health, Medicine and Therapeutics 08/2010; 1(1):87-95.
  • Source
    • "These studies have predominately been conducted using non-minority samples or have neglected the effectiveness of such interventions among racial and ethnic minority populations. One criticism of empirically supported treatments including brief alcohol interventions is the inadequate representation of ethnic/racial minorities (Atkinson et al., 2001; Bernal & Scharron-del-Rio, 2001; Chambless et al., 1996; Hall, 2001; Hohmann & Parron, 1996; Miranda et al., 2005; Munoz & Mendelson, 2005; Vera et al., 2003). Moreover, interventions found to be effective in one population cannot be assumed to be equally effective among ethnic minorities (Marin et al., 1995). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Evaluating the effectiveness of treatments such as brief alcohol interventions among Hispanics is essential to effectively addressing their treatment needs. Clinicians of the same ethnicity as the client may be more likely to understand the culture-specific values, norms, and attitudes and, therefore, the intervention may be more effective. Thus, in cases in which Hispanic patients were provided intervention by a Hispanic clinician improved drinking outcomes were expected. Patients were recruited from an urban Level I Trauma following screening for an alcohol-related injury or alcohol problems. Five hundred thirty-seven Hispanics were randomly assigned to brief intervention or treatment as usual. Hierarchical linear modeling was used to determine the effects of ethnic match on drinking outcomes including volume per week, maximum amount, and frequency of 5 or more drinks per occasion. Analyses controlled for level of acculturation and immigration status. For Hispanics who received brief motivational intervention, an ethnic match between patient and provider resulted in a significant reduction in drinking outcomes at 12-month follow-up. In addition, there was a tendency for ethnic match to be most beneficial to foreign-born Hispanics and less acculturated Hispanics. As hypothesized, an ethnic match between patient and provider significantly enhanced the effectiveness of brief intervention among Hispanics. Ethnic concordance between patient and provider may have impacted the effectiveness of the intervention through several mechanisms including cultural scripts, ethnic-specific perceptions pertaining to substance abuse, and ethnic-specific preferred channels of communication.
    Alcoholism Clinical and Experimental Research 11/2009; 34(2):262-71. DOI:10.1111/j.1530-0277.2009.01089.x · 3.21 Impact Factor
Show more