Abstract

In recent years psychologists have increased awareness and concern regarding the quality of mental health services provided to people of color. For several reasons clients of color often find traditional mental health services foreign or unhelpful. To help diminish obstacles faced by clients of color, several authors have advocated traditional mental health treatments be modified to better match clients' cultural contexts. Researchers have also begun investigating outcomes associated with culturally modified mental health treatments, often contrasting them with traditional mental health services. Recently numerous studies containing empirical data have been published. To date there has been no attempt to review this rapidly growing body of literature. Due to the sheer number of studies analyzing the efficacy of culturally modified treatment, the literature has become large and unwieldy. The present study used meta-analytic methodology to gather and organize quantitative data obtained from such studies. Across 80 studies that met criteria to be included in this meta-analysis, the resulting random effects weighted average effect size was d = .44, indicating a moderately strong benefit of culturally adapted treatments relative to traditional treatments. To further examine whether the association of treatment outcome and culturally modified treatments varied as a function of various sociodemographic variables, a series of categorical (and where appropriate, continuous) moderator analyses were conducted. Moderation effects were ascertained only for participant age and for Hispanic populations, with studies consisting of participants of higher chronological age and higher percentages of Hispanic participants having effect sizes of greater magnitude than studies with participants of younger ages or with few Hispanic participants. These results may indirectly provide evidence for the importance of client acculturation, given that older populations tend to be less acculturated (and therefore more in need of cultural modifications) than younger populations and that Hispanic populations are more likely to speak Spanish, necessitating adaptation of therapy to be conducted in their native language. Other variables, such as participant gender, did not moderate the results. Overall, the findings provide evidence for the benefit of modifying psychotherapy to match the cultural context of the client. Recommendations for future research on the topic are provided.

Degree

PhD

College and Department

David O. McKay School of Education; Counseling Psychology and Special Education

Rights

http://lib.byu.edu/about/copyright/

Date Submitted

2007-03-26

Document Type

Dissertation

Handle

http://hdl.lib.byu.edu/1877/etd1796

Keywords

culturally adapted, mental health treatment, culturally modified, meta-analysis, counseling, psychotherapy

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