Respond to at least two of your colleagues who made a different recommendation than you did. Elaborate on their cultural adaptation with the group they identified. For example, you might discuss a merit or limitation of the cultural adaptation that your colleague proposed, or you might suggest an alternative application.Respond to at least two of your colleagues who made a different recommendation than you did. Elaborate on their cultural adaptation with the group they identified. For example, you might discuss a merit or limitation of the cultural adaptation that your colleague proposed, or you might suggest an alternative application.
Colleague 1 Maribel :
Participant quote
“Before, I was just living in [a shelter] wondering if I have a room if I didn’t make it back here by 5:30 [registration for beds], how to answer questions about what I’m doing, where I’m going. Whereas now [living in “social assisted housing”] it’s like I got to set goals. I just get up. I work part-time. [I’m] looking for full-time, but my current few hours are my own judgment. I get home when I want to get home, I leave when I want to leave. It’s like, it’s a better situation for me and as far as the drugs and the alcohol and like the cards and the gambling. (100)” (Matheson, 2022)
Provide an interpretation
The client’s fundamental and psychological requirements have been fulfilled. Maslow’s theory (1943, 1954) posited that human needs were structured hierarchically, with basic physiological needs for survival situated at the foundation and higher-level self-actualization needs, which are more innovative and intellectually oriented, at the top (Mcleod, 2020). According to Maslow’s hierarchy of needs, obtaining basic physiological needs and safety needs is a prerequisite for the individual to satisfy higher-level needs. As McLeod (2020) noted, fulfilling needs corresponding to a particular stage becomes increasingly challenging as one ascends the hierarchy due to interpersonal and environmental obstacles that tend to impede our progress.
The fundamental human requirement is preserving our physical existence, which is the primary impetus for our actions. Once the lower-level needs are satisfied, individuals are driven by the higher-level needs, and this process continues. The human organism can only operate at its maximum potential if these requirements are met. According to Maslow, if you do not care for your basic physiological demands, everything else merely matters (Mcleod, 2020). After an individual’s physiological requirements have been met, the desire for security and safety becomes prominent (Mcleod, 2020).
Intervention recommendation
The dimensions of cognitive-behavioral therapy (CBT) align with the customary cultural attributes and social encounters of Latino/a/x patients. The didactic focus of Cognitive Behavioral Therapy (CBT) is beneficial in guiding Latino/a/x clients towards therapy by providing them with knowledge about the conceptualization of disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders and the treatment approach of CBT. Implementing an educational approach in psychotherapy aims to elucidate the therapy process and aligns with the preparation of the role. This preparation aids clients who are unfamiliar with therapy to comprehend what they can anticipate and what is expected of them, thereby augmenting treatment compliance and thwarting premature termination (Organista, 2006).
The understanding of the social context of an individual is crucial to comprehending the factors that contribute to the development of someone’s fundamental values and schemas, despite CBT being a micro-theory of clinical practice. However, the primary objective of Cognitive Behavioral Therapy (CBT) is to assist individuals in restoring a state of healthy functioning by facilitating cognitive and behavioral modifications that result in more logical decision-making and increased levels of self-esteem and interpersonal regard. (González-Prendes & Brisebois, 2012).
Adapt the practice recommendation to be culturally sensitive and relevant for Latino/a/x immigrants
The case of a Latino/a/x client with a traditional orientation who meets the diagnostic criteria for depression but characterizes their symptoms as nervios (nerves) is worth considering. Nervios is a culture-specific term that describes a psychological response to highly stressful situations, such as grief, danger, or familial discord. This response is characterized by a sense of unease and a variety of physical symptoms. Cognitive-behavioral therapy (CBT) has the potential to provide a viable framework for clients to understand their issues and receive treatment without invalidating their personal experiences and perspectives on the problem and potential remedies. According to Organista (2006), cognitive behavioral therapy (CBT) is comparatively less abstract than other therapeutic approaches, making it more comprehensible for clients.
Incorporating the culturally relevant value of personalismo into the relationship-building protocol can enhance the initial step toward successful engagement in therapy with Latino/a/x clients. The term “Personalismo” pertains to recognizing and considering the personal aspect of relationships, encompassing professional relationships oriented towards specific tasks, such as psychotherapy. The conventional approach of prioritizing the presenting issue during therapy may come across as needing a more personal touch to Latino patients, notably when it disregards the essential social bonding required to establish confianza or trust. As personalism is a concept that does not equate to informality, presenting oneself in an excessively casual or overly amicable manner would be erroneous. The responsibility of the culturally sensitive psychotherapist is to strike a balance between the formal approach focused on tasks and the personalized approach that provides courteous attention to the client. In order to attain equilibrium, it is often imperative for therapists who are attending to Latino clients to participate in much small talk, also known as platica, that incorporates prudent self-revelation (Organista, 2006).
Colleague 2 Justin:
Main Theme and Interpretation of Participant’s Quote
“When somebody’s out there trying to motivate you and help you in ways that you cannot waste your time but take time. I found that [my GACW] is extremely, extremely helpful one-on-one (115)” (Matheson et al., 2022, p. 7). The main theme of this quote is the participant’s appreciation for the help they were receiving from the Gambling Addiction Case Worker (GACW). It appears there was a rapport built between the GACW and the participant because they wanted to take their time and get the most out of the treatment. The participant was actively engaged in the sessions, which seemed to be due to feeling valued by the GACW.
Micro Intervention Informed Recommendation
Focusing on the quote, the participant felt the one-on-one help from the GACW was beneficial. An evidence-based micro-intervention that may be useful in practice is Motivational Interviewing (MI). This directive approach empowers the individual to identify and effectively solve their inconsistency in changing their behavior. Studies have shown MI is associated with reducing gambling behavior frequency and severity, and these changes remain during the follow-up period (Menchon et al., 2018).
Culturally Adapted Motivational Interviewing for Hispanics
Cultural competence is one of the most vital social work skills that require continual examination. It is essential that the interventions introduced and employed within a social work practice are culturally appropriate for the patient. While unadapted MI addresses an individual’s culture by promoting their autonomy and freedom, culturally adapted MI focuses more on the social contextual themes relevant to the Hispanic culture and their condition/behavior seen in previous qualitative research. For Hispanic patients, cultural values and priorities can be discussed and identified as potential reasons to enhance intrinsic motivation to change (Lee et al., 2013).
Applying Strategies for Surface Structure Adaption
Fennig (2021) discussed using the patient’s preferred language when in practice is a significant aspect of culturally competent care. This surface structure adaptation allows a Hispanic patient with limited English proficiency (LEP) to be engaged and involved with their care. One strategy to promote this adaptation is to provide forms and instructions/education material in the patient’s preferred language. Furthermore, the translated material should be simplified due to the risk of limited literacy in Western healthcare constructs (Andrulis & Brach, 2016). A second strategy is offering interpreter services in practice. Technological advancements make it more accessible, timely, and cost-effective to utilize a telehealth interpreter service such as Martti by UpHealth. Martti is a language accessibility communicator that connects, communicates, and provides excellent care to limited English proficient, Deaf, and hard-of-hearing individuals. This service can access interpreters 24/7 in over 250 languages through their app, which can be used on any telephone, smart device, or computer. Each session is fully compliant, meeting HIPAA and accessibility guidelines (UpHealth, 2023). I have experience using Martti, and it effectively allowed the patient to feel heard and involved with their care plan.