Culturally sensitive intervention with children and families

This paper presents the thesis that cultural sensitivity is a special form of interpersonal sensitivity and an indispensable ingredient in successful intervention with members of other cultures. Examples from clinical work, attachment research, case management and professional consultation are provided to illustrate the different settings where this approach can be applied.This paper is a revised version of a presentation at the Training Institute of the National Center for Clinical Infant Programs, Washington, D.C., December 1987.     

Culturally sensitive treatment of African Americans with substance-related disorders

1. Recent data indicate African Americans are the largest ethnic/racial population in the United States, and psychiatric nurses are in pivotal positions to develop culturally sensitive mental health care. 2. Spirituality, religion, families, and communities play key roles for African Americans with substance-related disorders. 3. Barriers to culturally sensitive mental health care include diagnostic bias and mistrust, stigma, and cost.     

The power of poetry: Validating ethnic identity through a bibliotherapeutic intervention with a Puerto Rican adolescent

The use of a Puerto Rican poem in ego-supportive work with a sixteen-year-old adolescent is described. His positive response to reading poetry of his own people indicated that his ethnic identity, a core element of ego identity, was validated by the experience. The possible relationship between the bibliotherapeutic intervention and the course of the client's treatment is discussed, as are implications for the use of ethnically sensitive bibliotherapy in practice.     

Puerto Rican injection drug users: Prevention implications in Massachusetts and Puerto Rico

This study examines whether place of residence is a factor associated with reporting a positive HIV/AIDS, Hepatitis C (HCV), or Sexually Transmitted Disease (STD) status in a sample of 400 injection drug users (IDUs) residing on the Island of Puerto Rico (N=139) and in western Massachusetts (N=261). Logistic regression models revealed that IDUs residing in western Massachusetts were 66% less likely to be HIV positive compared to IDUs residing in Puerto Rico (p<.000) while IDUs residing in western Massachusetts were about 67% less likely to have a positive STD status than those residing in Puerto Rico (p<.000). Place of residence was not significantly associated with HCV status. Results indicate the need to develop prevention programs tailored to the unique socio-cultural context of Puerto Rican IDUs residing on the Island of Puerto Rico whose circumstances differ from those in the mainland US. To reduce drug use, HIV/AIDS, HCV, and STDs among Puerto Ricans in both locales, the Capacity Enhancement Model is proposed in order to develop more effective prevention programs.     

Disclosures of Sexual Abuse by Puerto Rican Children

Psychotherapists who have experience working with Puerto Ricans on issues of child sexual abuse, and Puerto Rican women who were abused sexually as children were interviewed in this exploratory study about disclosure. Certain cultural norms and factors related to Puerto Ricans' status as an oppressed minority in the United States were identified as making the disclosure of sexual abuse especially difficult for Puerto Rican children.     

Puerto Rican migration and occupational selectivity, 1982-1988

"This study examines whether or not the likelihood of Puerto Rican workers choosing to migrate to the United States depends on their occupations or skills. The study determined that the occupational composition among those migrating from the island to the United States generally corresponds to the occupational distribution in Puerto Rico. The exception is that, after controlling for labor market conditions in Puerto Rico and in the United States and for other characteristics of the migrants, farm workers, laborers, and craft and kindred workers are overrepresented in the flow of migrants. The two most important factors contributing to the occupational distribution of migrants are whether or not they already have job offers in the United States and whether they are currently employed in Puerto Rico."     

Childhood Sexual Abuse and Drug Use Among Low-Income Urban Puerto Rican Women

SUMMARY

This study examines the relationship between childhood sexual abuse and adult drug use among low-income urban Puerto Rican women. Interviews were conducted with 718 women, 408 involved in drug use and a comparison group of 310 non drug-users. Results demonstrate a strong association between childhood sexual abuse and adult drug use. The impact of childhood sexual abuse was greater for women reporting greater abuse severity, abuse by a family member, and increased abuse duration. Findings support a direct effects model of childhood sexual abuse on adult drug use. The increased rates of drug use among victims of childhood sexual abuse did not appear to be mediated by other childhood maltreatment or family background factors. Implications for practice and research are discussed.     

Puerto Rican Abusive and Non-Abusive Mothers' Beliefs About Appropriate and Inappropriate Child Discipline

Abstract

Qualitative findings from face-to-face interviews of a subset of participants in a large quantitative study are used to explore the perspectives of 10 professional Black women (PBW) regarding their definitions of spirituality and their experiences using this resource to cope with work-related stress. Findings include that many PBW do not differentiate between spirituality and religion and that they utilize spirituality-particularly prayer, meditation, and inspirational readings-to gain personal strength, inner peace, and guidance and to reflect on and reappraise stressful situations in the workplace. Further, many PBW view spirituality as a problem-focused, rather than an emotion-focused, coping strategy. Implications for social work practice and future research are offered.     

The circular migration of Puerto Rican women: towards a gendered explanation

"The purpose of this paper has been to outline a theoretical framework for the explanation of the circulation of Puerto Rican women that brings gender relations to the fore, but frames the island-mainland pattern of mobility in the context of core-periphery capitalist relations. We have argued that gender relations in the home and workplace are vitally important for understanding women's moves to the [United States] and return trips to Puerto Rico. Specifically, we posited that most Puerto Rican women move as tied-migrants or because of their obligation or desire to meet gender responsibilities. In addition, we also viewed migration as an action with the potential to modify gender relations and alter future migration decision-making, as women gain experience in the labour market and exposure to new social and cultural environments." (SUMMARY IN FRE AND SPA)     

Changes in the characteristics of Puerto Rican migrants from 1955 to 1980

"This article tests the assumption that recent cohorts of migrants from Puerto Rico to the United States are a more select portion of the population, i.e., more educated and professional, than earlier cohorts. In this analysis, the demographic and socioeconomic characteristics of three cohorts of Puerto Rican migrants over the last 30 years are compared utilizing data from the 1960, 1970, and 1980 censuses."     

Reintegration of circulating families in southwestern Puerto Rico

Puerto Rican migration to the US has been a more or less continuous process since 1917. The perspective of viewing return migration as a circulation process suggests that there are entries, exits, and reintergration into the metropolitan labor market. This study explores the circulatory movements of Puerto Rican families, events that influence the adaptation process when returning to Puerto Rico, and cultural identity aspects. Data collected by means of 2 research instruments that were administered to the respondents simultaneously were used: 1) a life history matrix and 2) an open-ended questionnaire. These interviews outlined the principal problems of adaptation as mentioned by the circulating migrants. The most difficult problems to adjust to were economic and employment (58%), followed by social acceptance (23%), education (17%), and language (15%). Transportation, medical services, and recreational facilities were also problems mentioned as being significant. It is expected that a great majority of migrant laborers will go to live in immigrant residential locations in large US cities. It is also expected that these migrants will meet with certain value conflicts by living in urban ghettos. These families will have serious difficulties finding economic stability and will possibly consider migrating once again as an alternative to their social reality. This study illustrates that: 1) the migrants return in family groups; 2) they face discriminatory problems in employment agencies and schools; 3) they look forward to a formal education as a means of social mobility; 4) they identify themselves with values, habits, and Puerto Rican traditions; and 5) they value the quality of life in Puerto Rico.     

Culturally sensitive adaptation of PREPARE with Japanese premarital couples

In this study, we attempted to achieve a culturally sensitive adaptation of the PREmarital Personal And Relationship Evaluation (PREPARE) Inventory with Japanese premarital couples (n = 849). A translation, back-translation, and construct modification process was initiated by a group of U.S. and Japanese researchers to ensure a culturally sensitive and applicable adaptation of PREPARE. Alpha reliability analyses revealed good internal consistency among Japanese PREPARE scales. A Japanese premarital couple typology was developed using cluster analyses. Several unique features of the Japanese premarital types are identified and discussed. Suggestions are provided for continued enhancement in adaptation process of PREPARE with Japanese premarital couples.     

Long-term treatment of emotionally disturberd adoptees and their families

A review of literature on outpatient treatment of emotionally disturbed adoptees is presented. Key issues in adoption therapy are discussed. A model featuring long-term support for adoptive children and their families is described with a menu of accompanying clinical strategies. Applications in mental health settings and directions for research are reviewed.     

The needs of adolescent girls who self-harm

People who self-harm are typically intelligent, adolescent or young adult, middle to upper class girls, who do so to feel something or, paradoxically, to stop feeling and calm down. Girls who self-harm need to feel understood, listened to non-judgmentally, and responded to in relation to the unspoken suffering behind the self-harm behavior. The aim of treatment of girls who self-harm is to facilitate understanding of the act and provide alternative, healthier coping strategies.     

Migration, social support and perinatal health: an origin-destination analysis of Puerto Rican women

Using pooled origin-destination data from the Puerto Rican Maternal and Infant Health Study, we investigate linkages between migration, social support, and perinatal health. We document differences in social support between three groups of Puerto Rican women: non-migrant women in Puerto Rico, first-generation migrants to the U.S. mainland, and mainland-born women. The role of social support in producing differences in perinatal health outcomes between the groups is assessed. The analysis shows striking differences in social support between island and mainland women, but little systematic variation among mainland women by generation of U.S. residence. The lower level of social support available to mainland women is not reflected in the health outcomes examined, which do not generally worsen with migration to the United States (with the exception of maternal smoking). Nonetheless, we show that social support has important implications for stress, which in turn increases the risk of poor health behavior and compromised infant health.     

Substance Abuse Among Puerto Rican and Dominican Gang Members in a Small City Setting

SUMMARY

Joining a gang increases an adolescent's risk for substance abuse. To better understand the contextual development of drug use behavior, this retrospective ethnographic study describes a sample of 76 young small-city mainland Puerto-Rican and Dominican males who joined gangs when they were younger. Data is presented and discussed on the drug abuse behavior including their drug using progression and the context in which such use occurs. The young average age of onset 11.2 (sd = 2.6) combined with the rapid progression to more dangerous drugs, which generally occurs within six years, demonstrates the elevated risk associated with small city gang membership. Differences in the patterns of drug use were also found between the English and Spanish speaking groups. The authors discuss the implications of the study findings on the development of interventions. Recommendations address future research possibilities on drug abuse within Latino gangs.     

Predictors of Health Information Needs among U.S. Mainland and Puerto Rican Caregivers

Stroke caregivers often do not have the information necessary to adequately manage the stroke recovery process at home. We explore how the educational needs of stroke caregivers vary by race, ethnicity, and place, and their association with caregiver characteristics. We surveyed 276 stroke caregivers living on the U.S. Mainland and in Puerto Rico to assess their educational needs related to stroke recovery. Caregivers report a high overall need for educational materials with Puerto Rican stroke caregivers having greater needs compared to whites and African Americans on the Mainland. Increased caregiver educational needs are associated with greater desire to institutionalize, less positive appraisals of caregiving, greater use of coping strategies, and greater burden. All caregivers can benefit from educational materials, but special attention to island-dwelling Puerto Rican caregivers may provide additional benefit. Future research and interventions should focus on tailoring educational materials for race, culture, and other caregiver characteristics.