Cultural considerations

Those seeking to identify common cultural values across Latinos with diverse backgrounds face a difficult task, says Elizabeth Fraga, PhD, a full-time lecturer at Columbia University Teachers College and a practitioner specializing in Latino clients.

A Mexican migrant worker in California, for example, may have very little in common with a Puerto Rican physician in New York, she says. Given this diversity, therapists would benefit from a familiarity with core Latino values coupled with sensitivity to each Latino client's personal experiences, notes Fraga. When dealing with Latino clients, Fraga suggests therapists draw on the cultural research of psychologists like Patricia Arredondo, EdD, a psychology professor at Arizona State University, and consider how strongly their clients value:

• Familismo. Many Latinos come from tightly knit families and feel disloyal discussing family problems with outsiders. However, a family's built-in support system can be employed by psychologists to help Latino clients cope with mental illness or other behavioral health problems.

• Simpatia. Unlike mainstream American culture, which often expects individuals to assertively voice their concerns, Latino cultures tend to place greater value on interpersonal harmony. Given this tendency, a psychologist who suggests a client bring up a problem to her husband might be mindful about the stress such a confrontation could provoke.

• Respeto. Latino cultures tend to give greater deference and respect to individuals in positions of authority than mainstream American culture does. Accordingly, Latino clients may give great weight to psychologists' in-session suggestions--perhaps more than a practitioner expects.

• Personalismo. The detached professional relationship that many therapists cultivate with their clients may seem alien to those Latinos that adhere to the value of close interpersonal relationships. Therapists might consider sharing some minor details of their lives with these clients, to make the clients feel more comfortable and welcome, Fraga says. Adds Stephen Behnke, JD, PhD, director of APA's Ethics Office: "Here a self-disclosure would have a well-defined role in the treatment, so done thoughtfully and with the client's needs in mind, it would be ethically appropriate."

--S. DINGFELDER