The Impact of Latino Caregiver Acculturation on Treatment Engagement in Children’s Community Mental Health Services

Abstract

Ongoing treatment engagement is low in children's community mental health. Although concerns are more pronounced for racial/ethnic minorities, findings have been mixed when comparing racial/ethnic minorities with Non-Hispanic Whites. Within-group variability, such as level of acculturation, may be a more proximal predictor of treatment engagement. The current study aimed to examine the effect of Latino caregivers' acculturation on ongoing treatment engagement indicators, specifically session attendance, premature treatment termination, and treatment satisfaction. Participants were families of youth, ages 5-15, with a Latino primary caregiver (N = 93) receiving treatment for anxiety/trauma, depression, or disruptive behavior problems in community-based mental health agencies. Caregivers were classified into low and high acculturation groups using latent class analysis based on demographic indicators, such as nativity status and primary language spoken. Groups significantly differed in terms of caregivers' nativity status, age at immigration, primary language spoken, language of study assessment completion, and language spoken in the home. Families of low acculturation caregivers no showed to significantly fewer planned treatment sessions than families of highly acculturated caregivers. Treatment satisfaction did not differ between groups. Low acculturation families also had lower odds of prematurely withdrawing from treatment. Results of this study highlight the importance of considering family characteristics such as acculturation when engaging families in treatment.

Examining Latino Family Participation in Treatment for Childhood ADHD: The Role of Parental Cultural Factors and Perceptions

“…These findings are consistent with existing literature documenting the relation between more severe child behavioral problems pretreatment and poorer treatment outcomes among children receiving mental health services (Corkum et al, 2015;Reyno & McGrath, 2006), as well as research indicating that Latino individuals more closely oriented to U.S. mainstream society demonstrate better service utilization outcomes (Keyes et al, 2012;Nandi et al, 2008). Although the research on caregiver acculturation status has presented mixed findings (e.g., Ho et al, 2007;Kim et al, 2016;McCabe, 2002a), researchers emphasize the crucial need to examine parental cultural factors in the context of PMT in order to better understand parenting behaviors and service utilization outcomes for Latino families participating in child mental health services (Barker, Cook, & Borrego, 2010;McCabe et al, 2005). It is noteworthy that the effect size for father behavioral acculturation status was larger than that for mothers, which may highlight the impact of father cultural factors in the context of Latino families participating in PMT for childhood ADHD.…”

In-Session Caregiver Behaviors during Evidence-Based Intervention Delivery for Children with ASD in Community Mental Health Services

“…Latinx cultural values may have contributed to caregivers being less likely to verbally engage in therapy. Respeto, for instance, is a traditional Latinx value of respect and obedience to authority figures (such as clinicians), whereas simpatia is the desire to avoid conflict to maintain kindness (Kim, Lau, & Chorpita, 2016). These factors were identified in focus groups with clinicians who delivered AIM HI to Latinx caregivers and were highlighted as being particularly relevant with monolingual Spanish-speaking caregivers (Chlebowski, Magana, Wright, & Brookman-Frazee, in press).…”

Parent Training and Skill Acquisition and Utilization Among Spanish- and English-Speaking Latino Families

“…Among Latino families, language preference (Spanish vs. English) seems to be highly associated with level of acculturation and higher adherence to respeto - and familismo -related parenting practices (Calzada et al 2012). Moreover, the use of language as a proxy for level of acculturation has been demonstrated to predict differences between Latino families (Berdahl and Torres Stone 2009; Ceballo and Hurd 2008; Kim et al 2015). …”