Providing Evidence-Based Practice to Ethnically Diverse Youths: Examples From the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) Program

Abstract

At first glance, implementing evidence-based treatments for ethnically diverse youths may seem to raise some concerns. Do manual-based treatments work for the diverse youths whom we see in our communities? Should clinicians only use culturally specific treatments? Unfortunately, the literature is not definitive. Several studies have found that tailoring interventions for specific populations can increase their effectiveness 1 Bernal G Intervention development and cultural adaptation research with diverse families. Fam Process. 2006; 45: 143-151 Crossref PubMed Scopus (92) Google Scholar , 2 Botvin GJ Baker E Dusenbury L Botvin EM Diaz T Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. JAMA. 1995; 273: 1106-1112 Crossref PubMed Scopus (714) Google Scholar , 3 Hirachi TW Catalano RF Hawkins JD Effective recruitment for parenting programs within ethnic minority communities. Child Adalesc Soc Work J. 1997; 14: 23-29 Crossref Scopus (91) Google Scholar , 4 Szapocznik J Kurtines WM Foote FH Perez-Vidal A Hervis OE Conjoint versus one-person family therapy: further evidence for the effectiveness of conducting family therapy through one person with drug-abusing adolescents. J Consult Clin Psychol. 1986; 54: 395-397 Crossref PubMed Scopus (127) Google Scholar , 5 Rossello J Bernal G The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents. J Consult Clin Psychol. 1999; 67: 734-745 Crossref PubMed Scopus (398) Google Scholar , whereas others have found that cultural adaptations of an intervention may actually dilute the effectiveness of the original treatment even though retention is improved. 6 Kumpfer KL Alvarado R Tait C Turner C Effectiveness of school-based family and children's skills training for substance abuse prevention among 6-8-year-old rural children. Psychol Addict Behav. 2002; 16: S65-S71 Crossref PubMed Google Scholar What seems to be important is to strike a balance between fidelity to evidence-based treatment and culturally informed care.