WHAT IS IT LIKE FOR LATINO ADOLESCENTS TO BE IN GROUP THERAPY FOR SUBSTANCE USE?

Transcription

1 WHAT IS IT LIKE FOR LATINO ADOLESCENTS TO BE IN GROUP THERAPY FOR SUBSTANCE USE? Xavier Rubio, Edgar Guerrero, Cyntia Rodriguez, Stephanie Hoover, Ph.D. This research was supported by the National Institute on Drug Abuse (Jason Burrow-Sanchez, K23DA019914)

2 Substance Use with Latino Adolescents Latino youth, in particular, are at higher risk for substance use disorders (14%) compared to their White (12.7%) or African American (7%) counterparts (see CASA, 2011). As a group, adolescents with substance use issues are underserved, with an estimated 8% of those who need services actually receiving them (SAMSHA, 2010). Among treatment seeking youth, ⅔ - ¾ of Latino adolescents were court-referred, but only ½ of Whites (Shillington & Clapp, 2003). Latino adolescents are less likely to access and complete treatment, compared to Whites (Saloner, Carson, & LeCook, 2013).

3 What is Culturally Tailored CBT Culturally tailored CBT for Latino adolescents includes three main focuses acculturation, familism, and ethnic identity. These three focuses are the pivoting point between culturally tailored CBT and standard CBT.

4 Cultural Accommodation Model

5 Stages 1 & 2 Stage 1 focuses on gather cultural information to include in the intervention program from four different sources. Stage 2 focuses on integrating the cultural variables from stage 1 into the treatment.

6 Stages 3 & 4 The last two stages focus on testing the new accommodated treatment vs the standard treatment. These stages are geared toward evaluating the recruitment process, participant engagement, satisfaction and the efficacy of the intervention.

7 Research question: What do Latino adolescents disclose in the final group session of substance abuse treatment?

8 RCT Treatment Conditions Session Standard CBT Culturally-accommodated CBT 1 Intro and Engagement Intro and Engagement 2 Problem Solving Problem Solving 3 Decision Making Chains Decision Making Chains 4 Problem Solving Maps Problem Solving Maps 5 Coping with Cravings/Urges Coping with Craving/Urges 6 Communication Skills Ethnic Identity & Adjustment 7 Drug Refusal Skills Communication Skills 8 Relapse Prevention Drug Education and Refusal 9 Anger Management Relapse Prevention 10 Mood Management Anger Management 11 Social Support Mood Management

9 Sample Demographics Participant Variables Age Gender Language (home): Spanish English Both Birthplace: US Mexico Other S-CBT Therapy Group Data 88.9=male 58% 28% 14% 69% 28% 3% Participant Variables Age Gender Language (home): Spanish English Both Birthplace: US Mexico Other A-CBT Therapy Group Data 91.2% =male 85% 9% 6% 53% 44% 3%

10 Consensual Qualitative Research Design Why consensual qualitative research design? (CQR; Hill et al., 2005; Hill, 2012) Rigor in consensus building Multiple perspectives Address biases

11 Consensual Qualitative Research Analysis Steps 1. Data immersion 2. Coding/Core Ideas Individual tasks and then reach group consensus 3. Domains Individual tasks and then reach group consensus Placed codes into domains & revise 4. Categories Individual tasks and then reach group consensus Placed codes into categories & revise

12 Preliminary Results The following are preliminary domains that help identify what the Latino adolescents learned from being in therapy this may include, Relationships and support within group Relationships and support outside of group Problem solving techniques Group feedback and skills learned

13 Relationships and support within of group Therapist: So any ideas you guys have as far as group things you liked, didn t like, we ll take them. So whoever wants to start. And you can have more than one of either, so don t feel like you just have to be limited to one. (Mark): like how in this group you can say something and you know that when we go out [leave group] you won t say nothing about it. Like another program you tell your counselor, oh yeah, I smoked some weed the other day, and he ll tell your probation officer, like have this big meeting about it, and then like here, I can tell you like yo I smoked some weed last weekend, I know you won't tell my probation officer.

14 Relationships and Support Outside of Group (Chris): If I didn t bring my homework back she'd call me and she'd be like, you need to get your head in the game. Therapist: Your PO would? (Chris): Yeah. Or you're going to get locked up again.

15 Problem solving techniques Therapist: So then what we want to do here [instead of using drugs] is we want to think about what can I do instead? (Harold): Have to stay home Therapist: Stay home, and video games? (Harold): Play some MW3. I got Red Box next door.

16 Group feedback and skills learned Therapist: Take a minute to think. What things stuck with you, what things do you remember about the different sessions that we talked about? (James): I learned about my triggers. Therapist: Triggers, okay. So what about your triggers? (James): I learned about like what situations that I am in make me want to use.

17 Conclusion Culturally accommodated CBT was modified in order to increase cultural relevance regarding culture, language, and problems related to Latino adolescents, this allowed for further conversation of stressors Latino adolescents faced on a daily basis. Ultimately the analysis will compare the two forms of CBT.

18 References Berry, J. W. (1980). Acculturation as varieties of adaptation. In A. Padilla (Ed.), Acculturation: Theory, models and some new findings(pp. 9 25). Boulder, CO: Westview. Burrow-Sánchez, J. J., Minami, T., & Hops, H. (2015). Cultural Accommodation of Group Substance Abuse Treatment for Latino Adolescents: Results of an RCT. Cultural Diversity and Ethnic Minority Psychology, doi: /cdp Chen, P. D., Rizzo, P.D. (2010). Racial and ethnic disparities in use of psychotherapy: evidence from U.S. national survey data. Psychiatric Services, 61, doi: /ps Hill, C. E., Thompson, B. J., Hess, S. A., Knox, S., Nutt Williams, E., & Ladany, N. (2005). Consensual qualitative research: An update. Journal of Counseling Psychology, 52, doi: / Hill, C. E. (2012). Consensual qualitative research: A practical resource for investigating social science phenomena. Washington, DC: American Psychological Association Huey, S. J., Tilley, J. L., Jones, E. O., & Smith, C. A. (2014). The contribution of cultural competence to evidence-based care for ethnically diverse populations. Annual Review of Clinical Psychology, 10, doi: /annurev-clinpsy

19 Acknowledgements Gelso Psychotherapy Grant, Society for the Advancement of Psychotherapy, Stephanie Hoover K23DA019914, NIDA, Jason Burrow-Sanchez