Although researchers have identified a multitude of factors that contribute to family participation in mental health services, few studies have examined them specifically for Latino youth and their families in the U.S., a population that continues to experience significant disparities related to the availability, accessibility, and quality of mental health services. Latino youth and their families are at greater risk of dropping out of treatment prematurely and demonstrating poor treatment engagement, both of which have subsequent negative effects on treatment response outcomes. In order to help to guide efforts to improve the accessibility and quality of mental health services for Latino youth and their families, the current paper integrates modern conceptualization of family participation in youth mental health services and provides a summary of contextual factors within an ecological framework (Bronfenbrenner in The ecology of human development: experiments by nature and design, Harvard University Press, Cambridge, 1979). The current review aims to integrate empirical research on the impact of various contextual factors across multiple levels (i.e., culture, community, mental health system, family, parent/caregiver, and child/adolescent) on Latino family participation in youth mental health services, including treatment retention, engagement, and response. Clinical implications will be discussed, and an integrated, conceptual model will be presented. Not only does this model help to demonstrate the way in which existing literature is conceptually linked, but it also helps to highlight factors and underlying processes that health care providers, administrators, and policy makers must consider in working to improve mental health services for Latino youth and their families living in the U.S.

Focus group data from Latino parents, research examining Latino cultural values, and recommendations from mental health providers working with Latino families were used to culturally adapt, an evidence-based parent training program for Latino youth with attention-deficit/hyperactivity disorder (ADHD). Session-specific, cultural adaptations were made to 5 sessions, and 2 sessions were completely replaced with newly developed, more culturally congruent sessions. The adapted treatment also resulted in global adaptations to all treatment sessions, cultural adaptations to the assessment and feedback phase, as well as adaptations targeting practical barriers to treatment. Initial treatment outcomes from a small pilot demonstrated that 100% of families successfully completed the culturally adapted parent training program and reported being very satisfied with treatment. Eighty percent of children demonstrated reliable improvement in parent-reported ADHD symptomatology, and 40% of parents reported reliable improvement in both parental and family functioning.

The current study sought to examine the impact of family functioning (i.e., balanced cohesion and balanced flexibility) and individual factors (i.e., familism and global self-worth) on the incidence of mental health problems in a sample of Latino early adolescents. Additionally, the current study examined the way in which individual factors mediated the effects of family functioning on mental health problems in Latino youth. Eighty Latino parent-adolescent dyads participated in the current study, including 66 mothers and 14 fathers, as well as 42 female early adolescents and 38 male early adolescents. Parents and youth completed questionnaires assessing the incidence of mental health problems in youth, and adolescents completed additional questionnaires assessing acculturation, family functioning, familism, and global self-worth. Results indicated that adolescent acculturation was not significantly related to mental health outcomes in youth. However, adolescents' reports of increased family functioning predicted decreased externalizing problems in youth, as well as increased levels of familism and global self-worth in youth. Increased levels of familism predicted decreased externalizing problems in youth, and increased levels of global self-worth predicted decreased internalizing and externalizing problems in youth. Mediation results indicated that individual factors mediated the effects of family functioning on externalizing problems in youth. These results highlight the associations between family functioning, familism, global self-worth and the incidence of mental health problems and provide valuable information on the way in which individual variables mediate the effects of family functioning on mental health problems in Latino early adolescents.

Objective: To advance our knowledge about the most effective way to treat Latino youth with ADHD, the current feasibility and pilot study compared a culturally adapted evidence-based treatment (CAT) for ADHD to standard evidence-based treatment (EBT).Method: Following a comprehensive ADHD assessment, 61 Latino families of school-aged children (mean age of 8 years) were randomly assigned to either CAT or standard EBT (i.e., parent management training).Results: CAT outperformed standard EBT when examining homework completion and mother-reported treatment satisfaction. Apart from two trends favoring CAT, CAT and EBT both resulted in significant improvements in parent-and teacher-reported ADHD symptoms and functional impairment, as well as motherand father-reported parental functioning.Conclusion: CAT outperformed standard EBT when examining several engagement and acceptability outcomes. CAT and EBT were equally effective when examining traditional treatment outcomes, which is impressive considering the robustness of standard EBT, especially when delivered by culturally competent staff.

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