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社区提供者实施循证实践的经验:治疗师种族/民族的作用。

Community providers' experiences with evidence-based practices: The role of therapist race/ethnicity.

机构信息

Department of Psychology, University of California, Los Angeles.

Department of Psychiatry, Child and Adolescent Services Research Center, University of California, San Diego.

出版信息

Cultur Divers Ethnic Minor Psychol. 2021 Jul;27(3):471-482. doi: 10.1037/cdp0000357. Epub 2020 May 11.

Abstract

OBJECTIVES

Examining therapists' experiences implementing evidence-based practices (EBPs) is fundamental to understanding how these interventions are perceived, adapted, and delivered in community settings. However, little is known about racial/ethnic variation in the experiences of therapists serving racial/ethnic minority youth and their families. Through an innovative QUAN → qual → QUAN mixed-methods approach, we examined differences in therapists' perceptions, adaptations performed, and client-engagement challenges in the largest county-operated department of mental health in the United States.

METHOD

Surveys were completed by 743 therapists (Latinx [44%], White [34%], other ethnic minority [22%]), most of whom were female (88%), master's level (85%), and unlicensed (58%). A subset of therapists (n = 60) completed semistructured interviews.

RESULTS

Latinx therapists reported more positive experiences implementing EBPs, making more adaptations to EBPs, and encountering fewer client-engagement challenges than therapists from other racial/ethnic groups. Qualitative analyses expanded on these results, revealing that Latinx therapists commonly described adapting EBPs in terms of language and culture to improve fit and promote client engagement. Informed by these qualitative themes, a refined statistical model revealed that the ability to deliver EBPs in languages other than English might have accounted for differences in therapist-reported EBP adaptations and client-engagement challenges.

CONCLUSIONS

The findings suggest that racial/ethnic minority therapists have positive experiences in implementing EBPs in community settings. In the case of Latinx therapists, bilingual/bicultural competence may facilitate adapting EBPs in ways that reduce perceptions of engagement challenges with racially/ethnically diverse clients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

摘要

目的

研究治疗师实施循证实践(EBP)的经验对于理解这些干预措施在社区环境中是如何被感知、适应和实施的至关重要。然而,对于服务于少数族裔青少年及其家庭的治疗师的种族/民族差异,我们知之甚少。通过一种创新的定量→定性→定量混合方法,我们在美国最大的县运营的心理健康部门中,研究了治疗师的看法、实施的适应以及客户参与挑战方面的差异。

方法

743 名治疗师(拉丁裔[44%]、白人[34%]、其他少数族裔[22%])完成了调查,其中大多数为女性(88%)、硕士水平(85%)和无执照(58%)。一小部分治疗师(n=60)完成了半结构化访谈。

结果

拉丁裔治疗师报告说,在实施 EBP 方面的体验更积极,对 EBP 的适应更多,与来自其他种族/民族群体的治疗师相比,遇到的客户参与挑战更少。定性分析扩展了这些结果,表明拉丁裔治疗师通常描述了以语言和文化为基础来调整 EBP,以提高适应性并促进客户参与。受这些定性主题的启发,一个经过改进的统计模型表明,用英语以外的语言提供 EBP 的能力可能解释了治疗师报告的 EBP 适应和客户参与挑战方面的差异。

结论

研究结果表明,少数族裔治疗师在社区环境中实施 EBP 方面有积极的体验。在拉丁裔治疗师的情况下,双语/双文化能力可能有助于以减少与不同种族/民族客户的参与挑战感知的方式适应 EBP。(PsycInfo 数据库记录(c)2021 APA,保留所有权利)。

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