The need for cultural competence and the need for evidence-based practice in mental health services are major issues in contemporary discourse, especially in the psychological treatment of people of color. Although these 2 paradigms are complementary in nature, there is little cross-fertilization in the psychological literature. The present article illustrates the complementary nature of these 2 paradigms. A main point of convergence is related to the development of culturally adapted interventions in the move from efficacy research to effectiveness studies. The implications of cultural adaptations of empirically supported treatments for mental health services in terms of research and practice with ethnic/racial minority populations are discussed.
The underutilization of mental health services by African Americans may be due, in part, to their cultural mistrust. The purpose of this article is twofold: (a) to conduct a meta-analysis of the correlations between cultural mistrust in African Americans and their attitudes and behaviors related to mental health services use, comparing them to the correlations between cultural mistrust and measures relevant to other psychosocial domains, and (b) to test some methodological hypotheses about the Cultural Mistrust Inventory, the most popular measure of cultural mistrust. The meta-analysis suggests that the negative effects of Blacks’ cultural mistrust in interracial situations are not unique to counseling and psychotherapy but represent a broader perspective. The meta-analysis also suggests that development of the Cultural Mistrust Inventory with a male-only college sample did not compromise its external validity. The implications of these results for the provision of mental health services to African Americans are discussed.
Although clinicians are encouraged to be more sensitive to cultural factors in the diagnosis and treatment of mental disorders, as evidenced by the significant changes in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994), little information is provided to help them determine which aspects of culture are important to the mental health of African Americans. This article discusses the importance of cultural mistrust as a psychological construct in the lives of African Americans. The origins of the construct, the research it has generated over the past 2 decades, and implications for improving interventions with Black clients seeking mental health care are discussed.
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