This page contains information on cultural competency with regard to serving families of various cultural backgrounds. These articles discuss a broad range of issues such as mental and behavioral health and prevention intervention. Please click on links below for access to full text PDFs.

Articles from the Field:

Children’s and Adolescents’ Use of Mental Health Care Is a Family Matter

This article discusses the influence of family structure on children’s use of mental health services and explores whether a family’s dependency on government assistance compensates for the effect of family income on children’s use of services.

Intentional Families: Fictive Kin Ties Between Cross-Gender, Different Sexual Orientation Friends

This study explores the nature of intentional family relationships between friends of different genders and different sexual orientations. Drawing on in-depth interviews with 46 members of 23 friendship dyads, I first make the case that the friends considered one another family and I specify the criteria they use for making such designations. I then focus on the ways in which gender and sexual orientation influenced relationships between lesbians and straight men and between gay men and straight women. The data provided evidence that the dyad members identified one another as family and served the functions of family for each other. The findings also suggest that various gender issues affect cross-gender, different sexual orientation relationships. Exploring the meaning and functioning of these intentional family ties documents their existence and illuminates their meaning and maintenance.

Family Therapy with East Indian Immigrant Parents Rearing Children in the United States: Parental Concerns, Therapeutic Issues, and Recommendations (PDF)

This article addresses concerns specific to parenting children in the US, and presents therapeutic issues relevant to East Indian immigrant parents and families.

Key Strategies for Violence and Substance Abuse Prevention I: Working with Children and Families

Children are influenced by their families, their schools, their neighborhoods, and popular culture – especially the media. Efforts to prevent substance abuse and violence are more effective when they incorporate strategies targeting all these influences. This publication highlights key prevention strategies that target children and their families. Two other publications in this series discuss key strategies that complement and reinforce those described below. The role of classroom and school environments in prevention are the focus of Key Strategies for Violence and Substance Abuse Prevention II: Working with the Classroom and the School Environment. Key Strategies for Violence and Substance Abuse Prevention III: Working in the Community explores ways in which community-based strategies can contribute to the prevention of school violence and substance abuse.

Drug and Alcohol Abuse Prevention (Family-based)

Family-based drug and alcohol prevention programs are programs that seek to prevent and reduce the use of drugs and alcohol among children and youth. They are different from school-based prevention programs in that they focus on family risk factors and involve parents and guardians as much as (if not more than) the youth themselves. Several family-based prevention programs have been found to be effective (Foxcroft, & Tsertsvadze, 2011). Effective family-based drug and alcohol prevention approaches include: 1) Teaching parents how to set clear expectations and rules against the use of drugs and alcohol, reinforce positive behavior, engage in effective family management practices, and nurture a close and caring relationship with their children (Winters, 2007).  2) Using active and varied teaching methods and offer families opportunities to practice new skills in role plays and in activities with their children (Small & Huser, in press). 3) Using program staff, teaching strategies, and materials that are sensitive and relevant to the culture, race/ethnicity, language, income-level, family structure, and race/ethnicity of the participants is critically important (Castro, et al, 2006; St. Pierre, 1998). Ignoring participant characteristics by using a one-size-fits-all approach to service delivery is likely to result in a mismatch between the program and the participants that is likely to result in lower levels of participant engagement, satisfaction, and knowledge/skill acquisition.

Evaluation of a Tobacco and Alcohol Use Prevention Program for Hispanic Migrant Adolescents: Promoting the Protective Factor of Parent-Child Communication

Background. Interventions designed to prevent tobacco and alcohol use targeting high-risk adolescents are limited. In addition, few studies have attempted to improve parent–child communication skills as a way of improving and maintaining healthy youth decision-making.  Methods. A total of 660 Hispanic migrant families participated in a randomized pre–post control group study that was utilized to determine the impact of the intervention on parent–child communication. Both treatment and attention-control groups of youth were exposed to an eight-session culturally sensitive program presented by bilingual/bicultural college students. Parents jointly attended three of the eight sessions and participated in helping their child complete homework assignments supporting the content of each session. The content of the treatment intervention included (1) information about tobacco and alcohol effects, (2) social skills training (i.e., refusal skills), and (3) the specific development of parent–child communication skills to support healthy youth decisions. Results. Significant intervention by household size interactions for both parent and youth perceptions of communication were found indicating that the treatment was effective in increasing communication in families with fewer children. Based on the effect size and the previously established relationship between communication and susceptibility to tobacco and alcohol use, it was determined that the intervention effect could be translated into a future 5 to 10% decrease in susceptibility for these smaller families.                                                 Conclusions. A culturally sensitive family-based intervention for migrant Hispanic youth was found to be effective in increasing perceived parent–child communication in families with fewer children. It is expected that increases in this important protective factor will lead to later observed decreases in tobacco and alcohol use.

Cultural Considerations in Family-Based Primary Prevention Programs in Drug Abuse

America has been seen as a place where people from distinct ethnic and cultural groups are synthesized into one composite American culture that both includes and reflects the values, norms and mores of everyone. However, the evolution of a consensus model of ethnic and cultural fusion has failed to materialize; with many groups tenaciously adhering to their value, belief, and behavior systems of origin. Because of the degree of tenacity to which these differences have been retained, it is imperative that sufficient effort be exerted toward a clarification and an appreciation of the function of race, ethnicity, and culture in problem occurrence, prevention, and treatment. However, this clarification has not proven itself to be an easy task. Too often, the concepts of race, culture, and ethnicity are not treated as distinct in the literature, which can be confusing and problematic in determining the most appropriate methodological and analytical approach to the research. This article will discuss some of the etiological and methodological issues associated with planning, conducting, and the dissemination of family-based, drug abuse prevention programs with ethnic minorities.

Integrating Cultural Variables into Drug Abuse Prevention and Treatment with Racial/Ethnic Minorities

A set of variables, identified as “cultural variables,” is introduced as important descriptors of the life experiences of people from the major ethnic/racial minority groups in the United States. It is stated that most contemporary models for prevention and treatment of substance abuse are “culturally blind” to the effects of these cultural variables on the risk of substance abuse among racial/ethnic minority people. Accordingly, a viable strategy for culturally relevant research and program design is to integrate these cultural variables into extant models to create culturally rich models for research as well as for the development of prevention and treatment programs. The use of “model programs” is discussed in regard to the competing aims of maintaining program fidelity while also making cultural adaptations to these model programs to make them more culturally relevant. Strategies and recommendations are presented for integrating cultural variables into prevention and treatment programs that purport to serve racial/ethnic minority people.

Cultural Sensitivity and Adaptation in Family-Based Prevention Interventions

Because of the substantial impact of families on the developmental trajectories of children, family interventions should be a critical ingredient in comprehensive prevention programs. Very few family interventions have been adapted to be culturally sensitive for different ethnic groups. This paper examines the research literature on whether culturally adapting family interventions improves retention and outcome effectiveness. Because of limited research on the topic, the prevention research field is divided on the issue. Factors to consider for cultural adaptations of family-focused prevention are presented. Five research studies testing the effectiveness of the generic version of the Strengthening Families Program (SFP) compared to culturally-adapted versions for African Americans, Hispanic, Asian/Pacific Islander, and American Indian families suggest that cultural adaptations made by practitioners that reduce dosage or eliminate critical core content can increase retention by up to 40%, but reduce positive outcomes. Recommendations include the need for additional research on culturally-sensitive family interventions.

A careful balance: Multinational perspectives on culture, gender, and power in marriage and family therapy practice

Abstract: In this study, we examined how marriage and family therapists from various countries and diverse cultural backgrounds address the intersection of gender, power, and culture in therapy. Twenty participants from 15 countries responded to an Internet survey that included several hypothetical, clinical vignettes not associated with any one particular culture or nationality. Participants selected a vignette based on its similarity to clinical situations they face in practice within their cultural contexts, and provided information about their conceptualizations of gender, culture, and power, along with treatment recommendations. We analyzed data using analytic induction and constant comparison methods. Results indicate the careful balance with which the participants work to engage clients in therapy, respect cultural values and practices, and promote equitable gender relationships.

Substance Abuse Prevention in Multicultural Families

Abstract: [Forthcoming]

Links to Resources on the Web:

National Clearinghouse on Families and Youth: http://ncfy.acf.hhs.gov/publications/positive-youth-development-practice/resources

From the site: NCFY links you to the information you need to serve youth and families in new and effective ways. Topics we cover: [direct links to topics, below]

Trauma-informed care
Runaway and homeless youth
Pregnant and parenting youth
Lesbian, gay, bisexual, transgender and questioning youth
Adolescent pregnancy prevention and abstinence education
Positive Youth Development, or PYD
Relationship violence
Commercial sexual exploitation and trafficking of youth
More topics

What is Substance Abuse Treatment? A Booklet for Families. 

A free digital booklet for distributing to those struggling with abuse, or their families. Contains resources and basic information outlining treatment options.


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