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Introduction
Additional affiliations
August 2008 - present
June 2008 - April 2016
August 1986 - present
Education
September 1972 - May 1978
University of Massachussetts at Amherst
Field of study
- Psychology
September 1968 - May 1972
Publications
Publications (184)
Major depression is a prevalent psychiatric disorder among people living with HIV (PWH). Major depression symptoms, including suicidal ideation, can hinder clinical care engagement and anti-retroviral treatment adherence. Research suggests that inquiry about major depression symptomatology and suicidal ideation should be standard practice when offe...
Mental health treatments can be more effective when they align with the culture of the client and when therapists demonstrate multicultural competence. This chapter defines cultural adaptations and therapist multicultural competencies and provides clinical examples of each. It summarizes relevant research findings in two meta-analyses. In the meta-...
This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive-behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing dep...
Latinos with bipolar disorder (BD) have a high rate of nonadherence to psychiatric medication and treatment for other medical conditions such as cardiovascular disease (CVD) risk factors than non-Latinos with BD. The aim of this study is to identify patients’ perspectives on the reasons for nonadherence to psychiatric medication and for CVD risk fa...
Mental health treatments can be more effective when they align with the culture of the client and when therapists demonstrate multicultural competence. We summarize relevant research findings in two meta‐analyses. In the meta‐analysis examining culturally adapted interventions, the average effect size across 99 studies was d = 0.50 (0.35 after acco...
There is a high incidence of anxiety disorders 1 in the latino population, and cognitive behavior therapy (CBt) has been demonstrated to be an effica-cious psychological treatment for a variety of anxiety conditions (hofmann & smits, 2008; olatunji, Cisler, & deacon, 2010; stewart & Chambless, 2009). in this chapter, we examine the available eviden...
Nos enorgullece de sobremanera presentarles este
segundo número de la Revista Puertorriqueña de
Psicología (RePS). El mismo incluye una sección
especial de un programa de investigación sobre el
tema de la cultura, la evaluación y la
neuropsicología con una trayectoria de
aproximadamente 25 años y que ha generado
interés en una nueva generación de e...
Mayor advancements have been achieved in research on the cultural adaptation of prevention and treatment interventions that are conducted with diverse ethnocultural groups. This commentary addresses conceptual, ethical, contextual, and methodological issues related to cultural adaptations. The articles in this special issue represent a major contri...
RESUMEN
La sobrevivencia se caracteriza por ser un proceso de cambio y ajuste donde se podría presentar sintomatología
psicológica relacionada a la experiencia del cáncer y reducción significativa de los niveles de actividad física. La
Activación Conductual es una intervención psicosocial estructurada que activa a la persona con el fin de mejorar s...
RESUMEN La sobrevivencia se caracteriza por ser un proceso de cambio y ajuste donde se podría presentar sintomatología psicológica relacionada a la experiencia del cáncer y reducción significativa de los niveles de actividad física. La Activación Conductual es una intervención psicosocial estructurada que activa a la persona con el fin de mejorar s...
Objective:
There is a dearth of empirical studies aimed at examining the impact of differential cultural adaptation of evidence-based clinical and prevention interventions. This prevention study consisted of a randomized controlled trial aimed at comparing the impact of 2 differentially culturally adapted versions of the evidence-based parenting i...
Evidence-Based Treatments (EBT) are modalities of psychotherapy
that are based on scientific knowledge. Criteria have been
developed to determine the efficacy of treatments for mental
disorders in specific populations. Objective: A systematic review
of psychological treatments in Puerto Rico was conducted to
identify existing studies on psychologic...
Abstract
Adolescents in Puerto Rico are at an increased risk for suicide attempts, though evidence-based treatments specifically for this group have not been tested. The current study was designed to develop and pilot test a culturally sensitive, manualized outpatient treatment for Puerto Rican adolescents who have experienced a suicidal crisis. Th...
Family therapists have a unique opportunity to contribute toward the reduction of widespread mental health disparities impacting diverse populations by developing applied lines of research focused on cultural adaptation. For example, although evidence-based prevention parent training (PT) interventions have been found to be efficacious with various...
This study evaluates how Evidence Based-Practice (EBP) knowledge, attitudes, and individual differences could predict EBP behaviors in a sample of health providers. A cross-sectional design was used to collect data using a sample of convenience of 132 mental health providers in Puerto Rico (24 – 80 years old). An evidence-based professional practic...
Psychologists have a duty to safeguard the security and well-being
of their patients. Therefore it is necessary to carry out research to
determine whether or not a psychological treatment may produce
physical or emotional adverse effects. We discuss methods such as
benchmarking, systematic reviews, and meta-analysis as strategies
to build an empiri...
We engage in a dialogue in which both Evidence-Based Treatments
(EBT) and Evidence-Based Practice in Psychology (EBPP) are
grounded in a system of intelligibility that supports the claims
of the effectiveness of psychological treatments. We establish
differences between concepts and their possible merits. These
approaches are fundamental for the de...
We address the questions posed Padilla-Martinez on teaching,
supervision and training of Evidence Based (EBT) in Puerto Rico.
Information is limited on the topic, which calls attention to the
pressing need for effective methods for teaching EBTs and on
how supervision and training are provided. We examine several
doctoral programs to explore the de...
It is necessary to carry out research on the efficacy and effectiveness
of the psychotherapeutic models practiced in Puerto Rico. Research
needs to take place at all levels, health institutions, academic
institutions, by its faculty and by graduate students. We explore
different proposals to the randomized control trial (RCT), such
as studies that...
This paper addresses the comments by Talavera-Valentin and
Reyes-Estrada (2015) on research to establish treatment efficacy, the
use of alternative methods, and the integration of new technologies.
We point out the difference between the science to determine the
efficacy of treatments and implementation and dissemination
science. We affirm the impo...
Certain subgroups of youth are at high risk for depression and elevated depressive symptoms, and experience limited access to quality mental health care. Examples are socioeconomically disadvantaged, racial/ ethnic minority, and sexual minority youth. Research shows that there are efficacious interventions to prevent youth depression and depressive...
Aim:
To develop a culturally sensitive occupation-based health promotion intervention for older Hispanic adults who live alone.
Methods:
We used a mixed method design for the content validation of the intervention and the Ecological Validity Model (EVM) to culturally center the intervention. In the quantitative phase, aging experts as well as co...
177 ARTICULOS El desarrollo de la psicología en Cuba en la obra del Dr. Alfonso Bernal del Riesgo Resumen Los hitos relevantes en el desarrollo de la Psicología en Cuba se vinculan a la obra del psicólogo cubano Dr. Alfonso Bernal del Riesgo. Método. Construcción de una cronología basada en la investigación histórica, la revisión documental y las e...
This article examines the history of clinical psychology in Puerto Rico since its beginnings in 1946, summarizing the events that led to the field's emergence and looking closely at the sixty years of its subsequent development. The information presented is based on a review of publications, theses and dissertations, and interviews with professiona...
13 de Junio del 2012 | Aceptado: 20 de Agosto del 2012 JULIO SANTANA MARIÑO1; GUILLERMO BERNAL2; LYDIA RODRIGUEZ2; KEISHALEE GÓMEZ2; JENNIFER MORALES2 (UNIVERSIDAD DE PUERTO RICO Recinto Río Piedras, San Juan, Puerto Rico). RESUMEN La hipnosis ha formado parte de intervenciones psicológicas para atender los efectos de múltiples condiciones oncológi...
In this chapter, we write from the colonized position and in support of strategies that can move the field of multicultural psychology toward decolonization of both research methods and key concepts. Indeed, we believe that what is often understood as multicultural psychology needs to be decolonized as well. To the extent that the multicultural mov...
Certain subgroups of youth are at high risk for
depression and elevated depressive symptoms, and experience
limited access to quality mental health care. Examples are
socioeconomically disadvantaged, racial/ ethnic minority,
and sexual minority youth. Research shows that there are
efficacious interventions to prevent youth depression and
depressive...
El cáncer constituye una de las condiciones más serias que enfrenta el sector de la salud pública en países desarrollados, particularmente en los Estados Unidos de América (EUA), donde actualmente una de cada cuatro muertes se debe a esa enfermedad (Jemal et al., 2009). El Centro Nacional de Cáncer de ese país estimó que en el 2009 se diagnosticaro...
The Caribbean Regional Conference of Psychology was held in Nassau, The Bahamas, from 15 to 18 November 2011, under the auspices of the International Association of Applied Psychology (IAAP), the International Union of Psychological Science (IUPsyS), and the International Association for Cross-Cultural Psychology (IACCP). The conference was hosted...
The research relevant milestones on the development of psychology in Cuba are linked to the work of Cuban psychologist Dr. Alfonso Bernal del Riesgo. Method. The method consisted in the construction of a time line, review of historical documents, and conducting interviews. Results. Three periods were identified: 1) The theoretical basis of Psycholo...
Background:
The transition from adolescence to adulthood is associated with stressful adaptation experiences that may increase symptoms of depression. We explored the prevalence and sex differences of depressive symptoms and suicidal ideation in freshmen Latino college students in Puerto Rico, and identified stressful life events that could contri...
Hypnosis is one of a number of psychological interventions which can be used to address the effects of multiple oncological conditions and treatments thereof. In this paper we review existing research results regarding the use of hypnosis in patients with breast cancer. In the first part we discuss conceptual and methodological issues. In the secon...
This multiauthored work brings together the scholarly and the clinical in its analysis of two separate yet inextricably linked endeavors in psychology: the cultural adaptation of existing interventions and the movement toward evidence-based practice (EBP).
The unifying theoretical framework of this volume promotes culturally adapted EBPs as product...
Latinos constitute the largest ethnic minority group in the United States. However, the cultural adaptation and dissemination of evidence-based parenting interventions among Latino populations continues to be scarce despite extensive research that demonstrates the long-term positive effects of these interventions. The purpose of this article is thr...
RESUMEN La hipnosis ha formado parte de intervenciones psicológicas para atender los efectos de múltiples condiciones oncológicas y sus tratamientos. En este trabajo revisamos los principales resultados de la investigación existente en donde se utiliza la hipnosis en pacientes con cáncer de mama. En la primera parte se discuten asuntos conceptuales...
The current concept and measures of self-efficacy for depression in adolescents do not consider developmental and cultural aspects essential to understand and assess this construct in Latino youth. We examined the factor structure of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA), a Spanish instrument designed to assess this co...
The present study examined the role of dissociation as a mediator in the relationship between self-reported childhood abusive experiences and adult posttraumatic symptomatology in a nonclinical, Spanish-speaking Latino sample. Participants were 208 (144 female, 64 male) students at the University of Puerto Rico. It was hypothesized that dissociatio...
This article summarizes the definitions, means, and research of adapting psychotherapy to clients' cultural backgrounds. We begin by reviewing the prevailing definitions of cultural adaptation and providing a clinical example. We present an original meta-analysis of 65 experimental and quasi-experimental studies involving 8,620 participants. The om...
This research was conducted to assess the Spanish-language Trauma Symptom Inventory's (Briere, 1995) suitability for use with a Puerto Rican sample. Minor revisions were made to the original instrument following a comprehensive appraisal involving a bilingual committee and pilot focus group. The present study outlines the review and adaptation proc...
En Puerto Rico existe una alta prevalencia de depresión e ideación suicida (IS) en adolescentes. Este estudio examinó la respuesta a una terapia cognitivo-conductual para la depresión con un protocolo para el manejo del riesgo suicida incorporado. Participaron 115 adolescentes con depresión mayor. Se realizaron análisis descriptivos, pruebas t de m...
This article presents two case studies of adolescents receiving cognitive-behavioral therapy (CBT) for depression to illustrate how family patterns, particularly mother-daughter interactions, contribute to the perpetuation of depressive symptoms and to treatment response. Participants were two adolescent girls selected for this case study from a la...
In Puerto Rico a high prevalence of depression and suicidal ideation (SI) exists among adolescents. This study examined treatment response to a cognitive-behavioral therapy (CBT) for depression that integrated a protocol for the management of suicide risk. One hundred fifteen adolescents with Major Depressive Disorder participated. Descriptive anal...
Evidence based-practice (EBP) is now being integrated into many systems of health care. To date, little research has been conducted in Puerto Rico regarding EBP. A brief measure of health provider for Evidence Based Professional Practice-Scale (EBPP-S) was developed to measure attitudes, behaviors and knowledge.
The study consisted in two phases. I...
The article described and illustrated how a culturally adapted cognitive-behavioral therapy (CBT) can maintain fidelity to a treatment protocol while allowing for considerable flexibility to address a patient's values, preferences, and context. A manual-based CBT was used with a gay Latino adolescent regarding his sexual identity, family values, an...
The authors of this study aimed to evaluate 2-factor structures for the Center for Epidemiologic Studies Depression Scale (CES-D) reported in the literature to determine which one proves to be a better fit with the data on low-income Puerto Ricans living on the island.
The sample consisted of 3,504 civilian noninstitutionalized Puerto Ricans, rangi...
This study aims to evaluate the predictive validity of the Children’s Depression Inventory items for major depression disorder (MDD) in an outpatient clinic sample of Puerto Rican adolescents. The sample consisted of 130 adolescents, 13 to 18 years old. The five most frequent symptoms of the Children’s Depression Inventory that best predict the pre...
This chapter describes important considerations related to ethical decision making for research on depression with women from ethnocultural populations. Using real-life examples, the authors present evidence of the connections between irresponsible research and cultural incompetence. The chapter focuses on epistemological, ethical, and methodologic...
There is a growing interest in whether and how to adapt psychotherapies to take into account the cultural, linguistic, and socioeconomic context of diverse ethnocultural groups. At the root of the debate is the issue of whether evidence-based treatments (EBTs) developed within a particular linguistic and cultural context are appropriate for ethnocu...
Se examinó la prevalencia de experiencias atípicas psicóticas y cuasi-psicóticas y se identificaron factores asociados a éstas en 162 jóvenes puertorriqueños/as entre 13 y 17.5 años. Se evaluó la sintomatología depresiva, la ideación suicida, así como la presencia o historia de experiencias atípicas, eventos traumáticos y maltrato o abuso. Las expe...
The stark contrast between frequent calls for research and practice that are applicable across a broad spectrum of cultural and ethnically diverse groups and the dearth of empirical knowledge about Latino families provided the impetus for this special issue on advances in Latino family research. A focus on empirically based practice frames the issu...
This study evaluates the initial efficacy of the Parent-Child Interaction Therapy (PCIT) for Puerto Rican preschool children aged 4-6 years with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), combined or predominantly hyperactive type, and significant behavior problems. Thirty-two families were randomly assigned to PCIT (n = 20) or...
Substantive barriers to research, such as cultural, language, and methodological variables, exist in Hispanic-serving institutions. Historical and contextual variables account for the differences between academic settings with research-intensive centers and those with limited infrastructure for competitive research.
We provide a case example to ser...
Background:
There is ample evidence of the efficacy of cognitive-behavioral therapy (CBT) for depression in adolescents, including Puerto Rican adolescents. However, there is still a high percentage of adolescents who do not respond to a standard "dose" of 12 sessions of CBT. This clinical case study explores the characteristics associated with tr...
or her context must be a central consid-eration in the clinical approach when working with Latino/a children and families. The opening quotation from the Spanish philosopher, "I am myself and my circumstance, and if I do not save it, I do not save myself " (Ortega y Gasset, 1914/1970, p. 30; translation ours) reflects the dialectic between person a...
The prevalence of psychotic and quasi-psychotic atypical experiences was estimated and its correlates were identified in 162 Puerto Rican adolescents (13 to 17.5 years old). Depressive symptoms, suicidal ideation, as well as the presence or history of atypical experiences, traumatic events and maltreatment or abuse were evaluated. Atypical experien...
oOur journey began in 1990, when we became aware of the high number of depression cases, as well as the increasing rates of youth suicide, we were seeing at the University Center for Psychological Service and Research. At that time, we had no idea as to what the treatment of choice was for our children and adolescents, as there had been virtually n...
Los instrumentos que miden autoeficacia en jóvenes son mayormente escalas para adultos adaptadas
para evaluar adolescentes o escalas de autoeficacia general. El propósito de este estudio fue desarrollar
y evaluar las propiedades psicométricas de la Escala de Autoeficacia para la Depresión en Adolescentes
(EADA). Además, administramos la versión en...
This study compared individual (I) to group (G) formats of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for the treatment of depression in adolescents. One hundred and 12 Puerto Rican adolescents were randomized to four conditions (CBT-I, CBT-G, IPT-I, IPT-G). Participants were assessed at pretreatment and posttreatment...
Self-efficacy questionnaires used with adolescents are mostly youth-adapted adult measures or scales developed to assess general perceived self-efficacy. The purpose of this study was to develop and assess the psychometric properties of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA). Additionally, the Emotional Self-efficacy su...
Evidence Based Psychological Practice (EBPP) presupposes an evaluation of psychotherapeutic change. This article describes different ways of understanding and measuring therapeutic change and places it under the EBPP movement. After presenting the basic elements of EBPP, statistical procedures and the recommended methods to measure therapeutic chan...