Cultural%20Elements%20in%20Treating%20Hispanic%20Populations

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Cultural Elements in Treating Hispanic Populations

• Maria del Mar Garcia, MSW, MHS
• 22nd Annual Multicultural Symposium
• June 8-9, 2006

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CBHATTC Headquarters
St. Thomas
Bayamón
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CBHATTC Mission

• Help address the drug use problem and its
  consequences by developing the workforce and
  promoting organizational change in Puerto Rico,
  US Virgin Islands and Hispanic communities in the
  United States, utilizing culturally appropriate
  activities and products.

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Objectives

• Discuss common cultural beliefs, attitudes and
  behaviors among Latinos that can help service
  providers
• Gain an understanding of how cultural change
  among Latinos can influence drug use
• Discuss helping strategies to treat Latinos drug
  users

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Introduction

• Hispanics/Latinos (H/L) now comprise the largest
  minority group in the United States (14.2)
• As a group
• They are young
• 40 are under the age of 21
• Have a disproportionately low-income level
• 23 live below the poverty line
• Have a low level of educational attainment
• More than half of H/L under the age of 25 have
  not graduated from high school

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Introduction

• Hispanics/Latinos accounted for about 50 of the
  national population growth of 2.9 million between
  July 1, 2003, and July 1, 2004.
• Hispanic growth rate of 3.6 over a year was more
  than 3 times that of total population (1).
• Over 13 million (32.7) Hispanics lack health
  insurance

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Illicit Drug Use in the Past Month and Past Year
Among Hispanics Aged 12 or Older
U.S. Dept. of Health and Human Services,
Substance Abuse and Mental Health Services
Administration, Office of Applied Studies.
NATIONAL SURVEY ON DRUG USE AND HEALTH, 1999-2003
Computer file. ICPSR version. Research Triangle
Park, NC Research Triangle Institute producer,
2004. Ann Arbor, MI Inter-university Consortium
for Political and Social Research distributor,
2004.
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Drug Use among Adolescents

• 12th grade Hispanic students reported the highest
  rate of use for some drugs
• Crack
• Heroin
• Heroin with a needle
• Methamphetamine
• Rohypnol
• 2004 Monitoring the Future

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Treatment Admissions by Hispanic Population
1992-2002Percent distribution
Office of Applied Studies, Substance Abuse and
Mental Health Services Administration, Treatment
Episode Data Set (TEDS) 3.01.04. U.S.
population US Bureau of the Census, Population
Projections of the United States by Hispanic
Origin 1995 to 2050. Population Electronic
Product45
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Distribution Map by ATTC Region
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What is culture?

• Is the conceptual system that structures the way
  we view the world
• Beliefs
• Norms
• Values

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Ethnicity

• Refers to the social identity and mutual
  belongingness that defines a group of people on
  the basis of common origins, shared beliefs and
  standards of behavior

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Ethnocentrism

• The tendency to view ones own culture as best
  and to judge the behavior and beliefs of
  culturally different people by ones own standards

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Acculturation

• Process of cultural transformation that takes
  place when two different cultures interact
  resulting in assimilation, partial or total, of
  one of the cultures by the other one
• Diccionario de la Lengua Española

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Multicultural Practices

• Key Factors
• Impacts Relationship building
• Communication among people

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Multicultural Practices

• Requires three domains
• Awareness of oneself and others
• Knowledge of self and others
• Skills-interpersonal and intervention

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Personal Dimensions of Identity

• Dimension A
• Age
• Ethnicity
• Gender
• Race
• Language
• Physical ability/disability
• Sexual orientation
• Social Class

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Personal Dimensions of Identity

• Dimension B
• Education background
• Geographical location
• Income
• Marital Status or Relationship Status
• Religion
• Work experience
• Citizenship Status
• Military experience
• Hobbies or recreational habits

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Personal Dimensions of Identity

• Dimension C
• Historical Moments
• Historical Eras

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How culture change affects Latinos and their drug
use

• Immigration
• Represents two major sources of stress
• 1-Family dislocation-fragmentation and
  reconstruction
• 2-Culture Change

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Familism in the Latino Culture

• Strong commitment to family life that values
  collective goals over individual well-being

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Indicators of Familism

• Early childbearing
• Higher average fertility levels
• Large family households, often extended to
  include grandparents, aunts

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Indicators of Familism

• Tendency to live with kin instead of unrelated
  individuals or alone
• Patriarchal structure
• Gender roles clearly defined

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Familism

• A multidimensional concept
• Structural dimension
• Behavioral dimension
• Attitudinal dimension

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How is drug use seen by the Latino Family?

• Adolescent drug use
• Shock, anger, disappointment, feel betrayed,
  embarrassed, sense of failure
• Ungrateful and failing to appreciate parents
  sacrifices

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Females addicts with children

• Experience guilt and shame about neglecting their
  children
• Parents will blame her for failing her duties as
  a good mother
• Partner may be seen by family the responsible for
  womans drug use

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Cultural Based Evaluation

• Questions that may help
• Information about life in the country of origin
• Immigration history
• Length of time in the USA
• Frequency of traveling between countries

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Cultural Based Evaluation

• View about drug use
• Experiences with loss, persecution, torture, war
  and deprivation
• What mayor changes have the client experience as
  a result of coming to this country
• Language of preference

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Barriers that keep Latino clients away from
treatment

• Language barrier
• Problems with immigration authorities
• Role identification as provider or protector
• Treatment for drug dependence is difficult to
  access
• Fear to reveal to family their use and
  consequences
• Shame, stigma
• Feeling of being out of control

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Barriers, cont.

• Lack of a continuum of care services that address
  the recovering Latinos needs
• Inability to pay for private care because lack of
  insurance
• Fear of official inquiries or action by child
  protective services

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Helping strategies in treatment

• Remedial academic work
• Vocational training
• Emphasis in values of family loyalty and
• Spirituality
• Trans-cultural/multicultural approach
• Motivational Intervention approach

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Treatment strategies

• Focus on establishing trust (confianza)
• Encourage participation in different creative
  activities
• Assess when to involve family members
• Discuss with family the use of medication in
  treatment

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What concepts from this presentation can I apply
in my agency?What concepts from this
presentation I am already applying in my agency?
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• Consider how dull life would be if we all looked
  alike, thought alike, and acted alike!!!!!!!!!!!

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References

• Vega, W.A. (2006). Cultural Elements in Treating
  Hispanic Populations. Universidad Central del
  Caribe.
• Miller, W.R., Rollnick, S. (1991) Motivational
  Interviewing Preparing People to Change
  Addictive Behaviors. New York The Guildford Press