This article presents a conceptual model of organizational cultural competence for use in mental health services that resulted from a comprehensive review of the research literature. The model identifies four factors associated with cultural competence in mental health services (community context, cultural characteristics of local populations, organizational infrastructure, and direct service support) and redefines cultural competence as the degree of compatibility among these factors. A strength of this model of organizational cultural competence is that it facilitates future research and practice in psychiatric services settings and links culturally competent practices to service parity.

This article presents a conceptual model of organizational cultural competence for use in mental health services that resulted from a comprehensive review of the research literature. The model identifies four factors associated with cultural competence in mental health services (community context, cultural characteristics of local populations, organizational infrastructure, and direct service support) and redefines cultural competence as the degree of compatibility among these factors. A strength of this model of organizational cultural competence is that it facilitates future research and practice in psychiatric services settings and links culturally competent practices to service parity.

In recent years, there has been increased interest in the science of child development, particularly relative to early childhood (i.e., birth to 5 years) and children with challenging behavior. A broad interest in brain-behavior relationships and prevention services for young children has led to a renewed interest in the developmental significance of early life experiences (National Research Council & Institute of Medicine, 2000). Armed with an increasingly large body of neuroscience research, researchers have begun to examine the efficacy of prevention services and supports for young children and families, particularly those with challenging behavior (i.e., behaviors that interfere with optimal learning or engagement in prosocial interactions with peers and adults; Powell, Fixsen, & Dunlap, 2003). In light of such a research agenda, the voices of parents are often left unheard, despite widespread acknowledgment that "parents are the child's first and most important teacher" (Ferrell, 1985). A sizable body of interdisciplinary research has evolved in support of a system of care designed to both improve children's growth and development and to prevent occurrences of challenging behavior in young children. While qualitative studies in early intervention and early childhood special education are presently lacking (Sandall, Smith, McLean, & Ramsey, 2002), local efforts have begun to investigate the impact of services vi for young children with special needs in Hillsborough County, Florida (Raffaele Mendez & Hess, 2003). However, detailed reports of parent experiences were not possible, nor did the study focus on challenging behavior. Consequently, the purpose of this qualitative study was to obtain detailed parent reports of experiences raising young children with challenging behavior. Analyzed within an ecological framework relative to emergent themes and reported patterns of risk and protective factors, participating parents were afforded an opportunity to share their stories and provide illustrations of experiences raising young children with challenging behavior. Results indicated that parents not only shared many similar experiences (e.g., difficulties obtaining accurate information, obtaining services and supports, financial stress, stress within the family, and community isolation), but also reported comparable ecological risk and protective factors impacting their child's behavior. Implications for research and practice are discussed.

This study evaluated whether a self-administered stress management training (SSMT) could improve quality of life (QOL) and reduce distress among Hispanics receiving chemotherapy across multiple community clinical settings. Participants were randomized to receive SSMT (n = 106) or usual care (UCO) (n = 113). The primary outcome-QOL (SF-36) and secondary outcomes depression (CES-D), and anxiety (STAI) were assessed longitudinally over four chemotherapy cycles. Acculturation (BAS) and patients' intervention adherence were assessed. About 63% of participants reported distress after the initial chemotherapy cycle. Hispanics with lower acculturation reported greater STAI-Trait scores (p = .003). No significant treatment effects on outcomes measures were observed for participants receiving SSMT. SSMT intervention techniques were reported useful and improved mental health scores were observed with patients on a psychotropic agent (p = .04). Hispanics experience an elevated level of distress, yet SSMT did not significantly improve primary outcomes. SSMT may be potentially effective when combined with a psychotropic agent. SSMT enhancing strategies are discussed.

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The dropout of Latino adolescents from public schools has been linked to behavioral health issues such as delinquency and family conflict. Greater understanding is needed about the interplay of cultural, social, and developmental factors in this process. This article reports the findings of 14 group interviews conducted using a participatory approach with Latinos in a large school district in the southeastern USA. Findings support the need for comprehensive school-based interventions along the continuum from early intervention to intensive treatment for Latino adolescents who are at risk of dropping out. Participatory research is recommended for identifying strategies that integrate culturally and developmentally appropriate adaptations into existing behavioral health and dropout prevention services.

Using a case example of one of the mental health agencies in Florida, we demonstrate the utility of concept mapping for developing a program logic model and articulating a program theory for program assessment. The results of the concept mapping procedure enabled identification of 100 program services as described in statements by staff. Moreover, results revealed four major categories of those services and the main strategies used. This information was used to develop the first three components of a logic model. Concept maps were also used to reveal underlying assumptions built into the agency's theoretical approach.

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