Therapy is twice as effective in clients' native language

Psychotherapy for ethnic-minority clients can be particularly effective if psychologists integrate clients' cultural values into treatment, according to a recent paper that provides the first survey of culturally adapted mental health interventions.

The meta-analysis of 76 published and unpublished quantitative studies found that therapy for ethnic-minority clients who received services in their native language was on average twice as effective as therapy in English. It also found that interventions designed for a particular culture are four times more effective than interventions designed for multiple minority groups.

"The evidence is now in," says study co-author and Brigham Young University professor Timothy B. Smith, PhD. "And it is in our opinion no longer justifiable to not adapt psychological interventions for clients of color."

BYU graduate student Derek Griner and Smith analyzed studies of 25,225 total participants; 31 percent were African American, 31 percent Hispanic or Latino/Latina American, 19 percent Asian American, 11 percent Native American and 8 percent European American or other comparison groups.

Among their findings:

• Participants with or without a mental health diagnosis were equally as likely to benefit from interventions.

• The ethnicity of clients generally did not affect therapy's effectiveness. However, therapy for those with low levels of acculturation was twice as effective as therapy for those with moderate acculturation. Hispanic and Latino/Latina clients with low acculturation appeared to benefit the most-perhaps because they are highly likely to speak a language other than English, be migrants and remain in a lower socioeconomic status, the authors conjecture.

• Studies with participants who were older tended to be more effective than studies with younger participants-possibly because older adults tend to be less acculturated, and therefore in greater need of adaptations to therapy.

However, the authors note more research is needed on how to evaluate whether therapists are culturally competent and how to determine what specific practices help minority clients succeed. They also call for increased foreign language training for psychology graduate students.

-D. Smith Bailey