Boston University College of Health & Rehabilitation Sciences:
Sargent College

Boston University College of Health & Rehabilitation Sciences: Sargent College

Development of a Culturally-Adapted Cognitive-Behavioral Therapy (CBT) Intervention for Spanish-Speaking Individuals with PTSD

Funding:

Gail Berg Endowed Research Fund

Dates:

2012 - 2013

Description

Trauma exposure, and its frequent outcome post-traumatic stress disorder (PTSD), has been found to be quite common among people in the U.S., as over 50% have reported exposure to at least one traumatic event, and approximately 10% of those go on to develop PTSD. Several studies have demonstrated that members of vulnerable populations are more apt to be exposed to multiple traumatic events and to develop PTSD at significantly higher rates than those in the general population. Members of ethnic racial minorities experience additive chronic stressors, including exposure to racism, extreme poverty, immigration, political violence from home countries and chronic urban community violence, all of which serve as additive risk factors in the development and maintenance of PTSD. For instance, Latino individuals are more vulnerable to developing PTSD and those with PTSD experience more severe symptoms than persons from other ethnic backgrounds. Despite the high rates of trauma and PTSD that Latinos experience, there are very few evidence-based interventions to address this disorder within the Spanish-speaking population. More consumer-friendly, culturally appropriate, and effective PTSD interventions for the Spanish-speaking population are greatly needed.

Our group (Mueser, Gottlieb, and other colleagues) has developed an effective CBT for PTSD intervention, specifically for use with vulnerable populations, and aimed for individuals with special needs and challenges (including severe PTSD symptoms, the existence of multiple traumatic events, co-occurring psychiatric symptoms, problematic substance use, cognitive difficulties, functional impairment, chaotic living environments, and poor mental health service use and adherence), similar to many of the challenges faced by the Latino population. In this study, a culturally appropriate, user-friendly, acceptable, and effective intervention, based on our original CBT for PTSD treatment, for use with the Spanish-speaking Latino adult population was developed. Via an evidence-driven process, the investigators adapted and translated the existing treatment manual, and evaluated its feasibility via a small pilot study. Spanish-speaking frontline mental health clinicians in the Boston community were trained and supervised in the competent delivery of the intervention with a small group of treatment-eligible Spanish-speaking Latino clients with PTSD. Clients’ perceptions of the acceptability of the intervention and its impact on PTSD and associated symptoms were evaluated, as were the clinicians’ experiences and satisfaction with the adapted intervention. Further appropriate revisions were made following the pilot process.

Investigators

Principal Investigator: Jennifer Gottlieb, Ph.D.
Co-Investigator: Kim Mueser, Ph.D.
Co-Investigator: Maria Restrepo-Toro, M.S.
Consultant: Melvin Delgado, Ph.D.

Contact

Inquiries related to the project should be addressed to:

Kim Mueser
mueser@bu.edu
Boston University, Center for Psychiatric Rehabilitation
940 Commonwealth Avenue West, 2nd Floor
Boston, MA 02215