Author ORCID Identifier

http://orcid.org/0000-0003-1209-3892 : Keren Escobar

Document Type

Article

Publication Date

2018

Publication Title

Social Work in Mental Health

Volume

16

First Page

743

Last Page

755

DOI

10.1080/15332985.2018.1476284

Keywords

Cognitive behavioral therapy, culturally adapted interventions, depression, Hispanic, Latina/o, meta-analysis, social work interventions

Abstract

Depressive disorders are common among Hispanic people. Evidence-informed guidelines indicate cognitive behavioral interventions (CBI), but they were developed primarily with non-Hispanic White people. Narrative studies of clients and workers along systematic review evidence suggested that well-defines cultural adaptations of CBIs would likely improve outcomes among Hispanics people with diverse mental health problems. We advanced the meta-analytic hypothesis that CBIs incorporating so-called “deep structure” cultural adaptations will be more effective than otherwise similar, but more superficially, “surface structure” or non-adapted interventions with depressed Hispanic people. This meta-analysis synthesized evidence from nine typically randomized trials in the United States with one subsample from the Commonwealth of Puerto Rico. Most clients were young women, living in poverty and suffering a reactive depressive episode. We found statistical and practical support for our hypothesis. In most practice contexts, CBI success rates were between 15% and 30% better than those typically observed with other usual practices. Moreover, these effects were maintained at 6- to 12-month follow-up. Given the size and growth of the Hispanic American population, their prevalent experience of depression, and the size of the intervention effects, these synthesized findings seem of potentially great human, clinical, and policy significance.

Funding Reference Number

This work was supported by the Ontario Graduate Scholarship.

Available for download on Saturday, April 01, 2119

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