Substance Abuse/Addiction Among Hispanic-Latina/o Americans

The 2015 National Survey of Drug Use and Health determined that only 2.2 million people with a substance abuse disorder, or about 1 in 10, received any type of treatment in 2014. About 3 million of those in need who did not receive treatment were Hispanic or Latino ². Increasing access to addiction services for those of Latino descent may require specific accommodations such as bilingual treatment resources ¹, family oriented treatment services, Hispanic-Latina/o cultural competence, and an awareness of barriers that may prevent Latina/os from seeking services, including a lack of permanent residency or an absence of benefits programs offered through their workplace.

During the period of Sept. 15-Oct. 15, we commemorate National Hispanic-Latino Heritage Month. This month, the Ethnicity and Health in America Series will be raising public awareness about substance abuse and addiction among Hispanic-Latino Americans. We are featuring the work of José Szapocznik, a clinical psychologist and one of the nation's leading family therapists specializing in Hispanic families.

¹ "Behavioral Health Equity: Hispanic or Latino."  SAMHSA. Substance Abuse and Mental Health Services Administration, 1 June 2015. Web. 01 Sept. 2017.

² U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016.

Brief Strategic Family Therapy: Twenty-Five Years of Interplay Among Theory, Research and Practice in Adolescent Behavior Problems and Drug Abuse

2000 
José Szapocznik 
Robert A. Williams  

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Abstract

This article describes a systematic program of research that focuses on Brief Strategic Family Therapy (BSFT) and the adaptations that were developed based on BSFT principles. The culture-specific origins of BSFT are reviewed, as well as its broader applications to the field of family therapy. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Programmatic work is described that challenges basic principles of family therapy by expanding BSFT to a One Person modality and a strategic engagement procedure. Both of these novel approaches are intended to add tools to therapists' repertoire in working with difficult-to-engage families. A preview discussion of results is presented from a randomized clinical trial that is an application of an ecosystemic prevention version of BSFT. The implications of the work of the Center for Family Studies are discussed in the context of the broader service system. Ultimately, this article articulates a way of thinking about adolescent problem behavior, its social interactional determinants, and a range of theoretically consistent family-centered strategies that attempt to change social ecological processes that impact adolescent developmental trajectories.

Citation: Szapocznik, J., & Williams, R. A. (2000). Brief Strategic Family Therapy: Twenty-Five Years of Interplay among Theory, Research and Practice in Adolescent Behavior Problems and Drug Abuse.  Clinical Child and Family Psychology Review ,  3 (2), 117-134.

José Szapocznik, PhD, is a Cuban-born clinical psychologist of Polish -Jewish ancestry , and one of the nation's leading family therapy developers and researchers specializing in Hispanic families. He is the developer of Brief Strategic Family Therapy® and director of Brief Strategic Family Therapy Institute. Szapocznik is also the director of the Center for Family Studies, the chair emeritus at the Department of Public Health Sciences and the Founding and Honorary Director of the Miami Clinical Translational Science Institute, all at the University of Miami. The latter Institute was the only NIH/NCATS designated institute (out of 60) co-funded by the National Institutes of Health (NIH)/National Institute on Minority Health and Health Disparities because of its focus on minority populations and culturalized health sciences.

Szapocznik has been a member of the American Psychological Association since 1977. He is a founding member of the Board on Minority Affairs and a Div. 43 Fellow on Family Psychology and Div. 50 Fellow on Addictions. In 1991, he was recognized by the APA Board of Professional Affairs with the Award for Distinguished Professional Contributions to Public Service and in 1996 by the Division of Family Psychology with the Carolyn Attneave Award for Diversity in Family Psychology for his advocacy of families affected by HIV.

Szapocznik has received over $125 million in NIH funding; has published over 270 scholarly articles; has held a number of policy advisory roles including membership in the National Advisory Councils for the National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Institute on Minority Health and Health Disparities, NIH AIDS and Center for Substance Abuse Prevention/Substance Abuse and Mental Health Services Administration (SAMHSA); served on the search committees for the directors of the Food and Drug Administration, NIMH, NIDA (three times), and both SAMSHA Centers for Substance Abuse Treatment and Prevention; and has mentored a large cadre of minority graduate students and junior faculty who are now in academic leadership positions.

Szapocznik's research has spanned four important areas. First, as principal investigator for the last 18 years of one of 13 NIDA-funded Nodes of the National Drug Abuse Treatment Clinical Trials Network, Szapocznik has been a leader in the national initiative to translate effective drug abuse treatments into clinical practice by engaging community-based drug abuse specialty treatment programs and medical sites in conducting randomized clinical trials. Second, Szapocznik paved the national effort to prevent and treat adolescent drug abuse and behavioral problems in Hispanic youth by developing and testing family-based, evidence-based approaches. He published the first ever randomized trial of family therapy for the treatment of adolescent drug use; developed and tested a number of culturally specific adaptations, and has had an ongoing program of research since the 1970s on the development, efficacy, effectiveness and implementation of the Brief Strategic Family Therapy approach for the care of drug using, behavior problem children and adolescents. Third, Szapocznik published the first psychometrically rigorous scales for the measurement of acculturation and bicultural involvement, in a vigorous program of research that continuous to date, and fourth, his interest in context — early on the roles of culture and family in their impact on Hispanic youth and their families — later was expanded to encompass the larger physical environment. He pioneered research on the impact of the physical built environment on Hispanic population's behavioral and physical health, demonstrating that mixed use environments were more likely to lead to better Hispanic children and adolescent's adjustment in school; and that walkable environments prevented the onset of risks for chronic diseases among Cuban immigrants.

Source:

https://www.bsft.org/about/who-we-are/jose-szapocznik-ph.d1opens in new window

https://phydatabase.med.miami.edu/documents/cv/Szapocznik.Jos%C3%A9_133681_cv.pdfopens in new window

https://www.drugabuse.gov/jose-szapocznikopens in new window