The (In)Significance of Race and Discrimination among Latino Youth: The Case of Depressive Symptoms

Abstract

Despite the growing population of Latinos in the United States, there is little research that explores how discrimination affects the mental health of Latino youth along racial lines. In this paper we ask two closely related questions. First, do black Latino youth have higher or lower symptoms of depression than nonblack Latinos? Second, is the relationship between race and depression among Latino youth buffered by discrimination stress? Results from the Transitions Study show that black Latino youth have significantly higher symptoms of depression than nonblack Latinos. The relationship between race and depression depends on daily—but not on lifetime—experiences of discrimination. The combined effect of race and discrimination holds in the face of a wide range of measures of stress, including major lifetime events, recent life events, and chronic stressors. These findings encourage future research that considers the mental health effects of racial variation among Latinos.     

Mixing Apples and Oranges and Other Methodological Problems with a Meta-Analysis of Long Term Psychodynamic Psychotherapy

Current trends in mental health practice indicate that mental health practitioners, including clinical social workers, are tending to move away from psychodynamic approaches and are favoring short-term empirically supported approaches such as cognitive-behavioral therapy (CBT). Recently, the presumption that long-term psychodynamic psychotherapy (LTPP) approaches lack empirical support has been challenged, however, with the publication in major peer reviewed journals of meta-analyses that are claimed to demonstrate its equality to or superiority over empirically supported short-term therapies for some conditions. The present article examines the methodology employed in one particular meta-analysis which compared LTPP to short term therapies and the studies upon which the analysis was based. We found that major methodological and statistical flaws with the meta-analysis and with the individual studies preclude drawing any conclusions regarding the efficacy of LTPP.     

Exploring Dimensions of Culturally Sensitive Clinical Styles with Latinos

Abstract

This study sought to identify dimensions of culturally sensitive clinical practice by comparing the personal clinical styles of Latino and non-Latino clinicians, and their clinical decisions in respect to Latino immigrant clients. A combination of qualitative and quantitative methods were used. Sixty Latino American clinicians and 47 non-Latino (White) clinicians in Northern California completed the Achieving Styles Inventory (ASI) which yields information on direct, instrumental and relational styles. Demographic data were obtained as well as information on language proficiency and years of clinical experience. Statistical analysis included uses of t-test, ANOVA, and multiple regression analysis and revealed significant differences between the two groups in personal achieving styles within all three domains. There were no significant differences on the demographic variables. Nine clinician members of each ethnic group were interviewed in-depth through non-directive interviewing styles to assess their clinical decision making via use of a case vignette. Content analysis pointed to similarities and differences in proposed assessment and intervention strategies. The Latino group displayed more culturally relevant interpretations. The non-Latino clinicians were more directive and instrumental than the Latinos who put more emphasis on self disclosure, case management, use of Spanish with the client, and crisis intervention. This finding is consistent with both the quantitative data analysis of ASI hypotheses and the expected linguistic/cultural findings of the qualitative content analysis. Bilingual non-Latino White clinicians showed more cultural sensitivity and competence than the monolingual non-Latino clinicians. These findings suggest that linguistic/cultural match and linguistic/cultural compatibility are important in cross-cultural clinical practice.     

Culturally Competent Substance Abuse Treatment with Latinos

Abstract

The Latino population in the United States is a complex and multifaceted population. Latinos are a very dynamic and mobile cultural group. The 2000 United States Census registered Latinos in practically every state. Clinicians involved in assessing and treating Latinos must consider a complex set of environmental and systemic cultural factors that have a direct impact on their problem and potential healing. Treatment must begin by systematically assessing the cultural fit between clinicians and clients.     

Latino Adolescent Reproductive and Sexual Health Behaviors and Outcomes: Research Informed Guidance for Agency-Based Practitioners

Latinos are the largest and fastest growing minority youth group in the United States. Currently, Latino adolescents experience higher rates of teen pregnancy compared to any other racial or ethnic group and have disproportionately high levels of sexually transmitted infections and HIV. Latino teens are also affected by a number of social problems such as school dropout, poverty, depression and limited access to healthcare, which contributes to disparities in reproductive health outcomes for this population. Relatively few intervention research studies and programs have been dedicated to reducing sexual risk among Latino youth, despite their particular vulnerabilities in experiencing negative reproductive health outcomes. We provide recommendations for identifying the unique reproductive health needs of Latino youth and specific applied strategies so that agency-based social workers and other providers can develop family-based interventions that improve adolescent Latino sexual and reproductive health.     

Impact of client suicide on social workers and counselors

Recent studies on the impact of client suicide on mental health professionals focus on psychiatrists and psychologists, while,in the current mental health system in our country, most clients receive services from other clinicians. This research focuses on the impact of client suicide on social workers and counselors as well as organizational responses to client suicide/attempt. Data were collected via interviews and survey of 121 clinicians. Client suicide impacts clinicians adversely in many ways. Many participants felt their agency/practice could have done more to support them during post-suicide management. Data presented in this report have the potential to aid in the creation of needed workforce development initiatives.     

Latino Immigrants,Discrimination and Reception in Columbus,Ohio

Columbus, Ohio has witnessed rapid growth in its Latino population as immigrants settle in the city to access jobs and a generally low cost of living. Immigrants also face discrimination as they settle in Columbus and interact with the city's citizens. In this paper, we note how discrimination plays out in social and economic isolation; a lack of programmes to support the incorporation of Latinos in the city; and state laws that target immigrants. We present results of ongoing ethnographic work with the Latino community in Columbus.     

Negotiating Emotional Support: Sober Gay Latinos and Their Families

This study explores how sober gay Latino men obtain support from their families. Familial ties can be a protective health factor, yet many gay Latinos experience rejection from family members because of their sexuality. There are very few studies that examine the extent and quality of emotional support from kin for this population. Understanding family dynamics within the context of recovery and sexuality can increase our understanding of how to leverage family ties to develop alcohol abuse interventions. The study was conducted via semistructured interviews with 30 sober gay Latinos using a grounded theory approach. Analyses of the qualitative data identified the following themes: family values shaped the participants’ perception of their range of choices and emotional responses; participants reported feeling loved and supported even when sexuality was not discussed with parents; and family support for sobriety is essential. Findings suggest that familial ties shape perceptions of support and importance of disclosing sexual identity. Family support often results from agreements about sexual identity disclosure, and some families can overcome cultural and religious taboos on sexuality. Future studies should investigate families that negotiate acceptance with their gay members, and whether they exhibit heterosexual biases that may influence the psychological stress of gay Latino men who wish to be sober.     

Racial/Ethnic Disparities in Mental Health Service Use for Older Foster Youth and Foster Care Alumni

Studies have shown that foster care alumni have disproportionally high rates of poor mental health outcomes compared to the general population. The purpose of this study was to examine differences in mental health service use for Latino, African American, and White youth while in foster care and upon exit from the foster care system. Secondary data were used to identify youth 1 year prior to exiting the foster care system (N?=?934) and 1 year after exit from the foster care system (N?=?433). Racial/ethnic disparities in mental health service use upon exit from the foster care system were found, with Latino youth using the least amount of services after foster care exit. Racial/ethnic service disparities in type of services used were also found. Findings suggest that a lack of support (e.g., mandatory or voluntary) may be significant in overcoming challenges in the continuation or disruption of services.     

Barrios and burbs: residential context and health-risk behaviors among Angeleno adolescents

The increasing size of the Latino immigrant population in the United States underscores the need for a more complete understanding of the role that social context plays in influencing the health of immigrants and their children. This analysis explores the possibility that residential location influences the health-risk behaviors of Latino youth in Los Angeles County, California. The data come from the Los Angeles Family and Neighborhood Survey. We apply multivariate, multilevel Rasch models to two scales of adolescent health-risk behaviors (substance use and delinquency). The findings suggest that residence in Census tracts characterized by above-county-average levels of Latinos and above-county-average levels of poverty is associated with increased odds of health-risk behaviors for Latino adolescents, particularly for those born in the United States. The findings lend support to the contention, put forth in the segmented assimilation literature, that disadvantaged urban contexts increase the risk that U.S.-born children of immigrants will experience downward assimilation.     

Barriers and Promoters of Mental Health Services Utilization in a Latino Context: A Literature Review and Recommendations from an Ecosystems Perspective

ABSTRACT

This article focuses on the problems of disparities in mental health service utilization in the Latino population in the United States. It begins with an overview of the Latino population within the United States, an exploration of the diversity within this group, and shared cultural values and traits with a particular focus on the problems of Latino poverty. A review of the literature follows, including identified barriers to and promoters of mental health services utilization. These are contextualized in a Latino perspective using an ecosystems framework. Recommendations are made for future practice, research, and policy regarding mental health and mental health services utilization in the Latino community.     

Exposure to Client Trauma,Secondary Traumatic Stress,and the Health of Clinical Social Workers: A Mediation Analysis

While it is widely acknowledged that providing services to traumatized populations may negatively impact the mental health of clinicians, little is known about the impact of exposure to traumatized clients and secondary traumatic stress on the physical health status of clinicians. As such, the twofold purpose of this study was to: (1) document the prevalence of STS in a national (US) sample of clinical social workers, and (2) to examine the relationships between exposure to client trauma, STS, and perceived health of clinical social workers. Specifically, we sought to determine if STS mediates the relationship between exposure to client traumas and perceived health. Results indicate clinicians experience intrusion symptoms most frequently, and a significant portion report arousal and avoidance symptoms. Mediation analyses revealed that exposure to traumatized client populations indirectly influenced clinical social workers’ physical health perceptions by way of secondary traumatic stress. Findings call for increased attention toward prevention and amelioration of secondary traumatic stress symptomology among direct service providers, given both its prevalence and potential impact on physical health. Directions for future research are discussed.     

Recruitment and Retention of Latinos in Social Work Education: Building on Students’ Community Cultural Wealth

Spanish-speaking and culturally sensitive social workers are in high demand throughout the country to work with Latino clients. Latinos currently represent about 11% of active social workers, limiting the capacity of social work to effectively address the needs of the Latino population. Despite this shortage, little attention has been paid to the recruitment and retention of Latinos in social work. This article presents a case study that examines a BSW program accredited by the Council on Social Work Education, at a bilingual, private college where 90% of students self-identify as Latinos. It details how the BSW program builds on the students’ community cultural wealth to ensure continued recruitment and retention of Latino students. Implications for social work education are discussed.     

Experience of Racism as a Correlate of Developmental and Health Outcomes Among Urban Adolescent Mental Health Clients

Summary

Correlates of race/ethnicity and perceived racism among 760 urban, predominantly Hispanic/Latino and African-American, adolescent mental health clients were investigated using an exploratory, clinical data-mining approach. All racial/ethnic groups reported substantial rates of racism, ranging from 80.0% for Asian/Pacific Islanders to 32.4% for Hispanic/Latinos. Racism was associated with significantly elevated environmental risk (e.g., violence, sexual abuse or assault, exposure to drug use), behavioral risk (e.g., drug use) and worry (e.g., worry about hurting self or others, worry about doing dangerous things). Overall, racism was significantly associated with more negative health and well-being outcomes than ability to get a gun, sexual orientation, and being enrolled in school. The authors conclude that experience of racism should be routinely assessed at intake to mental health services along with traumatic experiences such as physical or sexual abuse.     

The Impact of Low Socioeconomic Status and Perceived Discrimination on Parental Perceptions of the Well-Being of Latino Children

This exploratory study examined the impact of low socioeconomic status (SES) and perceived discrimination on Latino parents’ perceptions of their children’s mental health issues. Anti-immigrant policies and negative public discourse lead to perceived discrimination among Latinos, which may impact mental health. Participants (106), surveyed in 2011, were Latino, predominantly female, had a mean of 14 years living in the United States, and less than 9 years of education. The results of multivariate ordinary-least-squares regressions indicated that participants with lower levels of SES had significantly greater (p < .05) perceptions that their children were angry, had separation anxiety from parents, were fearful, and avoided social situations. Higher levels of perceived discrimination were significantly related (p < .05) to participants’ perceptions of fear among their children. Social service providers must assess for possible mental health issues and develop culturally appropriate intervention strategies to effectively address these issues with parents and children.     

Revisiting Violence in New Destinations: Exploring the Drop in Latino Homicide Victimization in Emerging Immigrant Communities, 2000 to 2010

The turn of the twentieth century brought important demographic shifts among Latinos, including increasing settlement of both foreign-born and domestic Latinos into “new destination” regions and communities with little previous exposure to such populations. In turn, some scholars find higher rates of Latino victimization in these new destination communities, but there is little empirical research exploring whether and how these same locales fare today. Our goal is to address this gap in the literature by examining how lethal violence against Latinos in new immigrant destination communities has changed over the 2000 to 2010 decade. Using data from the National Vital Statistics System, we construct hybrid fixed- and random-effects models to examine the predictors of changes in Latino homicide victimization over time. Results suggest that (1) despite the turmoil of the Great Recession, new destinations experienced a sizable drop in Latino victimization, (2) this drop has resulted in new destinations now having lower levels of Latino victimization than other destination types, and (3) 70% of this change is attributable to changes in Latino family structure, including married and extended families, as well as changes in language use in new destinations. We conclude by discussing our findings and their implications for researchers and policymakers.     

Client retention in residential drug treatment for Latinos

Client drop out from treatment is of great concern to the substance abuse field. Completion rates across modalities vary from low to moderate, not ideal since length of stay has been positively and consistently associated with better client outcomes. The study explored whether client characteristics shown to be related to retention were associated with treatment completion and treatment duration for a sample of 164 Latino substance users who entered a culturally focused residential program. In-person client interviews were conducted within a week of program admission. Logistic regression analysis was used to examine research questions. Clients most likely to drop out had self-reported co-occurring psychiatric diagnoses; they were 81% less likely to complete the program, suggesting that clients with mental health problems have a more difficult time remaining in residential treatment. Clients using drugs in the three months prior to entry were three and a half times more likely to be in the shorter stay group, and clients who lived in institutions prior to program entry were three times more likely to be in the longer-stay group. Factors contributing to drop out for this Latino sample were similar to those identified in the literature for non-Latino samples. Methods for addressing the needs of clients with co-occurring disorders are discussed.     

Cross Cultural Perspectives in Treating the Gay Male Trauma Survivor

Summary

In recent years, there has been an increased emphasis on cultural considerations in psychotherapeutic treatment. Sound psychotherapy is ideally culturally sensitive and concerned with the context within which the client developed and exists. At the same time it is often difficult for many clinicians to navigate the cultural within the psychological framework. When both patient and clinician share more than one language in common, there are a variety of subtle issues that surface. In psychotherapy, “coordinate bilinguals,” those who learn their languages separately, during different developmental stages and contexts, tend to have greater access to their emotional experiences within their first language. When the client presents with a sexual trauma history, the language spoken during the abuse will also have an effect on the language used in the psychotherapy. The case history of Lucio, a Latino gay male, is discussed in terms of the cultural and psychological elements of his treatment by a bilingual North American therapist. This therapist's psychotherapeutic conceptualizations and treatment approaches are examined and reviewed in a written dialogue/ discussion with a Latino psychologist.     

Potential and Possibility: Psychodynamic Psychotherapy and Social Change with Incarcerated Patients

In the present paper, Pierre Bourdieu’s theory of symbolic power is used to illustrate how the practice of psychodynamic psychotherapy in a prison-based mental health treatment program constitutes both a psychological and sociological intervention, congruent with clinical needs of this particular population. The author draws from psychodynamic theory, Bourdieu’s framework and her experience as a clinical social worker with the California Department of Corrections and Rehabilitation.     

Need-service matching in substance abuse treatment: Racial/ethnic differences

This study examines the impact of ancillary health and social services matched to client needs in substance abuse treatment for African Americans, Latinos and Whites. The study uses data collected from 1992 to 1997 for the National Treatment Improvement Evaluation Study, a prospective cohort study of substance abuse treatment programs and their clients. The analytic sample consists of 3142 clients (1812 African Americans, 486 Latinos, 844 Whites) from 59 treatment facilities. Results show that racial/ethnic minorities are underserved compared to Whites in the substance abuse service system. Different racial/ethnic groups come into treatment with distinct needs and receive distinct services. Although groups respond differentially to service types, substance abuse counseling and matching services to needs is an effective strategy both for retaining clients in treatment and for reducing post-treatment substance use for African Americans and Whites. Receipt of access services was related to reduced post-treatment substance use for Latinos. Study findings are relevant to planning special services for African Americans and Latinos.