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Unformatted text preview: 154 Recent writing and research on Latino mental health concerns have assisted in sharpening issues re- garding Latino mental health needs and in identifying service delivery features that enhance effectiveness of services. What was once framed as underutilization of services is now conceptualized as disparities in ser- vice delivery (Acosta, 1979; Barrera, 1978; Padilla & Ruiz, 1973; Sue, Fujino, Hu, Takeuchi, & Zane, 1991). This shift has broadened inquiry on improving services to include appraisal of institutional and orga- nizational factors that may affect the relevance and fit of services for Latinos (U.S. Department of Health and Human Services, 2001, p. 143). There is evidence that Latinos are at higher risk for some major mental illnesses (Moscicki, Rae, Regier, & Locke, 1987; Rogler, Malgady, & Rodriguez, 1989), but not others (Canino, Hector, Shrout, & Rubio-Stipec, 1987). When such elevated risk is present, there is a strong suggestion that it is associated with duration of time in the United States (Hough, Landsverk, Karno, & Burnam, 1987; Ortega, Rosenheck, Alegria, & Desai, 2000; Vega, Kolody, Aguilar-Gaxiola, & Alderete, 1998) and that primary care providers are the point of access to mental health care for many Mexican Americans (Karno, Ross, & Caper, 1969; R. F. Munoz & Ying, 1993; Vega et al., 1998). The exces- sively high dropout rate of Latinos receiving mental health services suggests significant efforts are needed in making mental health services more relevant to this Clinical Algorithms as a Tool for Psychotherapy With Latino Clients Peter Manoleas, LCSW Betty Garcia, PhD University of California at Berkeley California State University, Fresno and Oakland, California Clinical algorithms have the advantage of being able to integrate clinical, cultural, and environ- mental factors into a unified method of planning and implementing treatment. A model for practice is proposed that uses 3 algorithms as guides for conducting psychotherapy with Latino clients, the uses of which are illustrated in a single, ongoing case vignette. The algorithm format has the additional advantage of easily adapting itself for data gathering for research purposes. diverse population. Research with a focus on multiple factors such as help-seeking behavior, the effective- ness of specific interventions, acculturation levels, and service models will be most helpful in informing the development of future services. The dual mandates of managed care and cultural competence have prompted many clinicians to ponder what contributes to effective practice with Latinos. This article focuses on the individual clinical en- counter in the mental health outpatient setting and proposes a model for practice using decision tree for- mats known as algorithms as guides for conducting psychotherapy with Latino clients. Algorithms deal- ing with engagement, assessment–formulation, and treatment–intervention are presented. Factors rele- vant to assessment and intervention decision making...
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This note was uploaded on 09/08/2010 for the course SCWK 280 at San Jose State University .