Context and Culture: The Initial Clinical Interview with the Latina/o Client

Measuring the Elusive Construct of Personalismo among Mexican American, Puerto Rican, and Cuban American Adults

Personalismo may have a broad influence on the well-being of U.S. Latinos by shaping social networks, and, in turn, access to information and resources. However, research on personalismo is currently constrained by the lack of a psychometrically sound measure of this cultural construct. This research used a mixed methods approach to develop a personalismo scale across three studies: a cognitive interviewing study with Mexican American adults (n=33); a cognitive interviewing study with non-Latino white, Mexican American, Puerto Rican, and Cuban American adults (n=61); and a psychometric telephone survey with Mexican American, Puerto Rican, and Cuban American adults (n=1,296). The final, 12-item scale had high internal consistency reliability and appears to be appropriate for use with Mexican American, Puerto Rican, and Cuban American adults. Significant differences emerged across Latino subgroups, with higher personalismo observed among Cuban Americans and female respondents, providing empirical evidence of cultural heterogeneity among U.S. Latino populations.

Addressing Acculturative Stress in Psychotherapy: A Case Study of a Latino Man Overcoming Cultural Conflicts and Stress Related to Language Use

To foster engagement in treatment and improve therapeutic outcomes for immigrant clients, it is important for therapists to integrate cultural values and to recognize the psychological stressors faced as immigrants learn to adapt and assimilate changes associated with moving to a new country. This case study describes the integration of cultural values when working with immigrant Latino clients who are at an increased risk of experiencing acculturative stress as a result of moving to the United States and having limited English knowledge. The integration of cultural values of familismo and personalismo are also discussed as it related to case conceptualization and treatment process. Finally, the current case provides information about conducting therapy in two languages and transitioning from Spanish to English as part of acculturation process while also addressing multifaceted aspects involved when working with Latino clients.

Providing mental healthcare to immigrants: current challenges and new strategies

PURPOSE OF REVIEW

The article reviews recent evidence on improving access to mental healthcare for immigrants and best practice of care provision.

RECENT FINDINGS

Language barriers, different beliefs and explanatory models of illness, confidentiality concerns, stigma, reluctance to seek psychological help outside families, and social deprivation may prevent immigrants from accessing mental healthcare. Pathways are influenced by families, primary care practitioners, voluntary organizations, and social services. Interpreting services are often not available, and data documentation on immigrants' use of services is inconsistent. Nonmedical specific services for immigrants can be effective in outreach activities. Cultural training of staff can improve clinicians' attitudes and patients' satisfaction with care. Integrative approaches between primary and mental healthcare, psychoeducational programs, and technological innovations have been developed to improve access to care.

SUMMARY

Immigrants can face significant barriers in accessing mental healthcare. Strategies to overcome these barriers are as follows: increased coordination and communication between voluntary organizations, social services and mental health services; training of staff on cross-cultural issues; integration of mental healthcare with primary care; psychoeducational initiatives focused on families and broader social groups; and technology-based interventions.