Table of Contents
Executive Summary
This report is commisioned to offer an analysis and assessment on the cultural responsiveness of the Aggression Replacement Training among youths in the Latino community. The method of analysis entails incorporation of Samuels, Schudrich and Altschul advice to identify the elements of cultural unresponsiveness in the Aggression Replacement and therefore offer recommendations to modify the evidence-based practice. Results from the analysis indicated the current system of ART in the United States is grounded on a philosophy that contradicts with the values and culture of the Latino youth. Consequently, the lack of cultural responsiveness in the ART programs leads to negative implications on the service delivery besides enumerating barriers to seeking care among youths in this community. Therefore it is necessary to modify ART programs towards eliminating the disparities and enhancing culturally responsive practices. It is recommended to involve families as the Latino youth culture is family centric.
Problem Statement:
“The systemic barriers in the current ART programs in addition to racism, discrimination, language barriers, and cultural incompetencies hinders Latino youths from utilizing the current treatments.” Culturally responsive intervention practice with Latino youth is critical to facilitate adequate access for the utilization and treatment dispensing to the youths with acting out behavior in this population. Familism is an important cultural value in the Latino youth community. Familism values are “a set of normative beliefs espoused by Latino populations that emphasize the centrality of the family unit and stress the obligations and support that family members owe to both nuclear and extended kin.”
Discussion Statement
Challenges in Aggression Replacement Therapy
It is critical to have a better understanding of the different impacts of culture on the psychological health services as it enables providers to establish ART programs which are more responsive culturally responsive. “Youths in the Latino community have a less likelihood of seeking specialized treatment for the aggressive behaviors but instead, tend to rely on the primary care clinic and informal support programs.” The main reasons for the underutilization of the ART services are due to the unavailability of culturally competent healthcare providers as well as the language barrier. “Also, the stigma that is commonly linked to psychological health concerns lowers their utilization of the ART since they believe that the practitioner will judge them unfairly.” The current EBP in the US puts more emphasis on individualism and personal responsibilities in the healing process and fails to address the role of family relationship in the recovery path. The Latino community values family relationships which are referred to as familism and believes that families play a significant role in offering social support when is experiencing a psychological condition. Religious beliefs, and the perception of the mental illnesses by the Latino community members prevents them from seeking the ART interventions. “For instance, the mental illnesses are linked with sins (Pecados) and evil eyes (curanderos) which they believe that it requires confinement.” The family members might experience shame because they perceive the aggressive condition as an indicator of individual weakness thereby hindering them from seeking specialized care. As a result, the youths prefer to seek help from traditional healers, priests, and family members such as curanderos, compadre, santeros, and espiritistas. Therefore, it is important to include family in the treatment setting as well as including religious leaders, traditional healers, and priests in delivering of the interventions. Without modifying ART programs to address these can lead to underutilization of the ART services as well as misdiagnosis and contradiction in the treatment options.
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Literature Review
In their research to assess the available alternatives to modify the evidence-based treatments, The ART programs should be amended to match the culture of the population. “According to these authors, the Latino youths are more likely to seek the services of the ART programs if they are aligned with their cultural values.” “Similarly, in their investigation to determine the factors to consider when modifying an Evidence-Based Practice approach, the authors postulate that recognizing family connectedness among the Latinos is crucial as it encourages the youths to seek specialized care offered in the ART system.” Furthermore, the studies revealed that the modification process should center on aspects such as lifestyle, social position, religious beliefs, linguistic as well as the Latinos’ perception of the mental illnesses. In both studies, the investigators integrated empirical survey and concluded that the ART programs should involve the whole community during the process of adaptation to ensure that they provide an enhanced prognosis for dispensing services among Latino’s youths with chronic aggressive behavior. The findings from the analysis are of relevance since they offer more insight into the importance of culturally responsive programs in providing effective services to individuals in this population.
Methods of Assessing ART
“The preliminary phase of assessing whether an ART program is culturally responsive entails the assessment of the targeted group to identify the lack of cultural unresponsive.” The assessment method involves evaluating the Latino culture to ensure that the ART program is in alignment with their culture. During the assessment process, the Latino youths, family members, and the community are interviewed to determine the relevance of the treatment model. Mainly individuals are interviewed about their experiences with the intervention based on their beliefs, values lifestyles, linguistic and practices to determine if they are culturally competent. Also, literature is analyzed to obtain secondary information on the culture, population-specific risk as well as the protective elements on the effect of the ART system. “The theoretical underpinnings of the ART intervention are evaluated to ascertain whether they agree with the culture and norms of Latinos.” Finally, the outcome of the assessment process will be critically evaluated to detect a possible mismatch of the therapy and therefore work with the families and the community to correct the incompetencies. During the assessment process, it was found that the there are significant barriers: language, core familism/familsmo values, religious beliefs, perception of mental illness, stigma, are among the cultural incompetencies that prevent youths from the Latino community from utilizing the current intervention programs.
Conclusions and Recommendations:
Eliminating the barriers to ART care and enhanced access to effective intervention increases the utilization of the EBP therapy as well as the prognosis among youths in the Latino community. “Modification of the ART program should capitalize on the Latino’s strengths and the guiding philosophy to make the intervention more relevant to the community.” Another aspect to consider is subject position. “The theory of subject position postulates that individuals perceive their identity by positioning themselves within culturally based discourses and narratives.” The concept is of relevance in the ART intervention since it forms the methodological and theoretical foundation upon which the approach of self-construction is premised. In this context, it is critical to assess the Latino culture to acquire understanding of the various cultural opinions, norms, and taboos that might impact the process of therapy. For instance, aggressive actions are considered as personal weaknesses as a result of sin or evil eyes from supernatural forces, and as a result, the youth faces stigma which prevents them from seeking the services of the ART programs. Therefore, the subject position of ART providers is of relevance in diagnosing and treating the aggressive behavior to ensure that they are aligned with the beliefs of Latino culture. Having ART providers from the Latino community is one method to remedy this. The program should focus on improving language access to the Latino community members in need of the services by either incorporating a local interpreter or hiring bilingual health care providers. “Also, given that the Latino community puts more value on the family, the program should be family and religion-oriented to include the services of close family members and priests. Stigma, disparities, and discrimination associated with the current ART system can be addressed by creating awareness of the significance of the program in treating psychological illnesses.” “The adopted ART program should implement collective learning since the Latino community believe that collectivism and communal orientation plays a major role in mitigating psychological disorders.”
