Evidence-Based Psychosocial Treatments for Ethnic Minority Youth

Abstract

This article reviews research on evidence-based treatments (EBTs) for ethnic minority youth using criteria from Chambless et al. (1998), Chambless et al. (1996), and Chambless and Hollon (1998). Although no well-established treatments were identified, probably efficacious or possibly efficacious treatments were found for ethnic minority youth with anxiety-related problems, attention-deficit/hyperactivity disorder, depression, conduct problems, substance use problems, trauma-related syndromes, and other clinical problems. In addition, all studies met either Nathan and Gorman's (2002) Type 1 or Type 2 methodological criteria. A brief meta-analysis showed overall treatment effects of medium magnitude (d = .44). Effects were larger when EBTs were compared to no treatment (d = .58) or psychological placebos (d = .51) versus treatment as usual (d = .22). Youth ethnicity (African American, Latino, mixed/other minority), problem type, clinical severity, diagnostic status, and culture-responsive treatment status did not moderate treatment outcome. Most studies had low statistical power and poor representation of less acculturated youth. Few tests of cultural adaptation effects have been conducted in the literature and culturally validated outcome measures are mostly lacking. Recommendations for clinical practice and future research directions are provided.

Toward Dynamic Adaptation of Psychological Interventions for Child and Adolescent Development and Mental Health

“…It will also be important to disentangle the current inconsistencies and pose questions regarding the need to adapt interventions when transporting them to different countries and settings. As Berry (2015) recently pointed out, this increased awareness of intercultural validity will be necessary not only for intervention research but for psychological research in general (see also Huey & Polo, 2008). On the training level, the ability to adapt interventions to better meet developmental and contextual needs requires a core clinical and developmental skill set, such as a sound knowledge of cognitive-behavioral treatment principles and an understanding of normative developmental pathways.…”

“…Future research is required to investigate the potential and limitations of program adaptation and transportability more closely. As recommended by Huey and Polo (2008), more research with culturally sensitive conceptual models, sound research designs, and appropriate sample sizes is warranted to disentangle ambiguous findings.…”

“…Research indicates that culturally and contextually sensitive intervention, as well as an awareness of diversity, is a matter of intervention content, administration, and conduct (see Huey & Polo, 2008). Naturally, interventions should be tailored to known risk and protective factors in a specific (cultural) context (see American Psychological Association, 2003).…”

“…This latter term refers to the discussion around core principles of interventions and adaptive features, such as flexibility around the decision of which evidence-based curricula to choose for a specific behavioral issue, the use of modular designs to therapeutic interventions (e.g., Chorpita, Daleiden, & Weisz, 2005;Weisz et al, 2012), or the adaptation of scripts and activities to train core features (e.g., Rotheram-Borus, Swendeman, & Becker, 2014). Dynamic adaptation of mental health prevention and developmental intervention approaches thus refers to a process of flexible decision making regarding the selection, implementation, and evaluation of evidence-based practices and approaches to enhance child mental health and development so that it is tailored to a given context, population, and need (see Aarons et al, 2012;Huey & Polo, 2008). Similarly, creativity and openness to integrate new efforts into existing institutional structures, service agencies, and communities are needed (for examples of initiatives to build collaborative systems and improve performance and effective large-scale dissemination, see Chorpita & Daleiden, 2014).…”

Methodological challenges in treatment outcome research with ethnic minorities.

“…Moreover, such analyses cannot address the question of differential efficacy because they do not examine whether effect sizes differ from each other (Kraemer, Frank, & Kupfer, 2006). Unless inclusive trials are designed a priori to test ethnicity by treatment interactions (with matching, blocking, or stratification by ethnicity; Chambless et al, 1996), trials are underpowered to determine whether there is invariance or disparity in treatment response among ethnic groups (Huey & Polo, 2008). Without these design features even the largest of multisite trials are severely restricted in their inquiry.…”