Examining recipient and provider perceptions of mental health treatments and written exposure therapy for posttraumatic stress disorder with a Spanish-speaking sample.

Abstract

Treatments of Posttraumatic Stress Disorder (PTSD) often evidence high rates of dropout, ranging from 25% to 40%, among English-speaking samples. Written Exposure Therapy (WET), a novel manualized treatment for PTSD, evidences lower dropout rates and noninferiority to CPT, one of the most efficacious interventions for PTSD. Spanish-speaking Latinxs often experience greater dropout and barriers to care. WET appears promising for this population, but acceptability and perceived barriers to WET have not been examined among Spanish-speaking Latinxs. The present study assessed perceptions and acceptability of a Spanish-language version of WET among Spanish-speaking Latinxs who scored greater than 45 on the Spanish-language version of the PCL-IV, indicating likely PTSD (n = 20) and providers (n = 12). Participants completed a mixed-methods interview regarding reasons they/clients would not want to receive the treatment, why they/clients would want to receive the treatment, potential solutions for any identified barriers, and reasons for not seeking mental health services generally. Providers, but not potential recipients, identified low literacy as a barrier for WET. Providers and potential recipients identified time as a barrier to WET and other mental health services, but the time reduction was perceived as a potential facilitator of WET. Results also suggest no specific cultural barriers were identified for WET (e.g., provider cultural competency) and that Spanish WET may reduce time-related barriers and is perceived as effective and acceptable among Spanish-speaking Latinxs. Additional work is needed to expand the reach of the intervention, given that mental health services were often perceived as untrustworthy. Impact StatementThis study suggests that a Spanish-language adaptation of Written Exposure Therapy, a novel manualized treatment for PTSD symptoms, may be effective in reducing some structural barriers that Spanish-speaking Latinx populations encounter when using mental health services.

Introduction to the special issue: Improving access and quality of mental health care for diverse populations.

“…This study's results expand on the existing literature by showing that objective raters appraised the quality of working alliance as higher among racial/ethnic concordant dyads that had been in treatment longer, suggesting that length of treatment might be a potential mechanism contributing to improved working alliance among racial/ethnic concordant dyads. Acosta et al (2023) adapted written exposure therapy (WET) for posttraumatic stress disorder (PTSD) for Spanish-speaking Latinx immigrants. This underserved population often experiences trauma both prior to, during, and after migration and thus, needs access to quality culturally responsive PTSD treatments.…”

“…Acosta et al (2023) adapted written exposure therapy (WET) for posttraumatic stress disorder (PTSD) for Spanish-speaking Latinx immigrants. This underserved population often experiences trauma both prior to, during, and after migration and thus, needs access to quality culturally responsive PTSD treatments.…”