Skip to main content
Top
Published in: Community Mental Health Journal 1/2017

01-01-2017 | Original Paper

Delivering CBT to Rural Latino Children with Anxiety Disorders: A Qualitative Study

Authors: Denise A. Chavira, Cristina E. Bustos, Maritza S. Garcia, Bernardo Ng, Alvaro Camacho

Published in: Community Mental Health Journal | Issue 1/2017

Login to get access

Abstract

Qualitative methods were used to understand community perspectives about ways to deliver cognitive behavior therapy (CBT) to rural Latino youth with anxiety. First, four focus groups were conducted with 28 bilingual Latino mental health providers to examine perceptions of CBT using telephone based, therapist supported bibliotherapy, and bibliotherapy without therapist support. Second, qualitative interviews were conducted with 15 Latino parents from a rural community to better understand attitudes toward CBT, and modes of service delivery. Qualitative findings revealed that parents were mostly positive about psychotherapy, and the core elements of CBT for anxiety. However, both parents and providers emphasized the need for adaptations to address practical and perceived barriers to treatment, such as time, convenience, homework, and literacy. Many parents spoke favorably of a telephone-based approach that could address many of their perceived barriers, while providers were expressed more negative views. Such findings are important for data-driven treatment development efforts.
Literature
go back to reference Alegría, M., Canino, G., Lai, S., Ramirez, R. R., Chavez, L., Rusch, D., & Shrout, P. E. (2004). Understanding caregivers’ help-seeking for latino children’s mental health care use. Medical Care, 42(5), 447–455.CrossRefPubMed Alegría, M., Canino, G., Lai, S., Ramirez, R. R., Chavez, L., Rusch, D., & Shrout, P. E. (2004). Understanding caregivers’ help-seeking for latino children’s mental health care use. Medical Care, 42(5), 447–455.CrossRefPubMed
go back to reference Angold, A., Erkanli, A., Farmer, E. M., Fairbank, J. A., Burns, B. J., Keeler, G., & Costello, E. J. (2002). Psychiatric disorder, impairment, and service use in rural African American and white youth. Archives of General Psychiatry, 59(10), 893–901.CrossRefPubMed Angold, A., Erkanli, A., Farmer, E. M., Fairbank, J. A., Burns, B. J., Keeler, G., & Costello, E. J. (2002). Psychiatric disorder, impairment, and service use in rural African American and white youth. Archives of General Psychiatry, 59(10), 893–901.CrossRefPubMed
go back to reference Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236. doi:10.1097/00004583-199910000-00011.CrossRefPubMed Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236. doi:10.​1097/​00004583-199910000-00011.CrossRefPubMed
go back to reference Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553. doi:10.1097/00004583-199704000-00018.CrossRefPubMed Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553. doi:10.​1097/​00004583-199704000-00018.CrossRefPubMed
go back to reference Chavira, D. A., Stein, M. B., Bailey, K., & Stein, M. T. (2003). Parental opinions regarding treatment for social anxiety disorder in youth. Journal of Developmental and Behavioral Pediatrics, 24(5), 315–322.CrossRefPubMed Chavira, D. A., Stein, M. B., Bailey, K., & Stein, M. T. (2003). Parental opinions regarding treatment for social anxiety disorder in youth. Journal of Developmental and Behavioral Pediatrics, 24(5), 315–322.CrossRefPubMed
go back to reference Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine de Gryter. Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine de Gryter.
go back to reference Howell, E., & McFeeters, J. (2008). Children’s mental health care: differences by race/ethnicity in urban/rural areas. Journal of Health Care for the Poor and Underserved, 19(1), 237–247.CrossRefPubMed Howell, E., & McFeeters, J. (2008). Children’s mental health care: differences by race/ethnicity in urban/rural areas. Journal of Health Care for the Poor and Underserved, 19(1), 237–247.CrossRefPubMed
go back to reference Kataoka, S. H., Stein, B. D., Jaycox, L. H., Wong, M., Escudero, P., Tu, W., & Fink, A. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 311–318.CrossRefPubMed Kataoka, S. H., Stein, B. D., Jaycox, L. H., Wong, M., Escudero, P., Tu, W., & Fink, A. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 311–318.CrossRefPubMed
go back to reference Kazdin, A. E. (2001). Bridging the enormous gaps of theory with therapy research and practice. Journal of clinical child psychology, 30(1), 59–66.CrossRefPubMed Kazdin, A. E. (2001). Bridging the enormous gaps of theory with therapy research and practice. Journal of clinical child psychology, 30(1), 59–66.CrossRefPubMed
go back to reference Kazdin, A. E., & Wassell, G. (2000). Therapeutic changes in children, parents, and families resulting from treatment of children with conduct problems. Journal of the American Academy of Child and Adolescent Psychiatry, 39(4), 414–420. doi:10.1097/00004583-200004000-00009.CrossRefPubMed Kazdin, A. E., & Wassell, G. (2000). Therapeutic changes in children, parents, and families resulting from treatment of children with conduct problems. Journal of the American Academy of Child and Adolescent Psychiatry, 39(4), 414–420. doi:10.​1097/​00004583-200004000-00009.CrossRefPubMed
go back to reference Kendall, P. C., & Sugarman, A. (1997). Attrition in the treatment of childhood anxiety disorders. Journal of Consulting and Clinical Psychology, 65(5), 883–888.CrossRefPubMed Kendall, P. C., & Sugarman, A. (1997). Attrition in the treatment of childhood anxiety disorders. Journal of Consulting and Clinical Psychology, 65(5), 883–888.CrossRefPubMed
go back to reference Lau, A. S. (2006). Making the case for selective and directed cultural adaptations of evidence-based treatments: Examples from parent training. Clinical Psychology: Science and Practice, 13, 295–310. Lau, A. S. (2006). Making the case for selective and directed cultural adaptations of evidence-based treatments: Examples from parent training. Clinical Psychology: Science and Practice, 13, 295–310.
go back to reference Lyneham, H. J., & Rapee, R. M. (2006). Evaluation of therapist-supported parent-implemented CBT for anxiety disorders in rural children. Behaviour Research and Therapy, 44(9), 1287–1300.CrossRefPubMed Lyneham, H. J., & Rapee, R. M. (2006). Evaluation of therapist-supported parent-implemented CBT for anxiety disorders in rural children. Behaviour Research and Therapy, 44(9), 1287–1300.CrossRefPubMed
go back to reference Montero-Marin, J., Carrasco, J. M., Roca, M., Serrano-Blanco, A., Gili, M., Mayoral, F., & Garcia-Campayo, J. (2013). Expectations, experiences and attitudes of patients and primary care health professionals regarding online psychotherapeutic interventions for depression: Protocol for a qualitative study. BMC Psychiatry, 13, 64. doi:10.1186/1471-244X-13-64.CrossRefPubMedPubMedCentral Montero-Marin, J., Carrasco, J. M., Roca, M., Serrano-Blanco, A., Gili, M., Mayoral, F., & Garcia-Campayo, J. (2013). Expectations, experiences and attitudes of patients and primary care health professionals regarding online psychotherapeutic interventions for depression: Protocol for a qualitative study. BMC Psychiatry, 13, 64. doi:10.​1186/​1471-244X-13-64.CrossRefPubMedPubMedCentral
go back to reference NVivo qualitative data analysis software, Version 8. QSR International Pty Ltd (2008). NVivo qualitative data analysis software, Version 8. QSR International Pty Ltd (2008).
go back to reference Paul, L. A., Gray, M. J., Elhai, J. D., Massad, P. M., & Stamm, B. H. (2006). Promotion of evidence-based practices for child traumatic stress in rural populations: Identification of barriers and promising solutions. Trauma, Violence & Abuse, 7(4), 260–273.CrossRef Paul, L. A., Gray, M. J., Elhai, J. D., Massad, P. M., & Stamm, B. H. (2006). Promotion of evidence-based practices for child traumatic stress in rural populations: Identification of barriers and promising solutions. Trauma, Violence & Abuse, 7(4), 260–273.CrossRef
go back to reference Pescosolido, B. A., Perry, B. L., Martin, J. K., McLeod, J. D., & Jensen, P. S. (2007). Stigmatizing attitudes and beliefs about treatment and psychiatric medications for children with mental illness. Psychiatric Services, 58(5), 613–618. doi:10.1176/appi.ps.58.5.613.CrossRefPubMed Pescosolido, B. A., Perry, B. L., Martin, J. K., McLeod, J. D., & Jensen, P. S. (2007). Stigmatizing attitudes and beliefs about treatment and psychiatric medications for children with mental illness. Psychiatric Services, 58(5), 613–618. doi:10.​1176/​appi.​ps.​58.​5.​613.CrossRefPubMed
go back to reference Pina, A. A., Silverman, W. K., Weems, C. F., Kurtines, W. M., & Goldman, M. L. (2003). A comparison of completers and noncompleters of exposure-based cognitive and behavioral treatment for phobic and anxiety disorders in youth. Journal of Consulting and Clinical Psychology, 71(4), 701–705.CrossRefPubMed Pina, A. A., Silverman, W. K., Weems, C. F., Kurtines, W. M., & Goldman, M. L. (2003). A comparison of completers and noncompleters of exposure-based cognitive and behavioral treatment for phobic and anxiety disorders in youth. Journal of Consulting and Clinical Psychology, 71(4), 701–705.CrossRefPubMed
go back to reference Pina, A. A., Zerr, A. A., Villalta, I. K., & Gonzales, N. A. (2012). Indicated prevention and early intervention for childhood anxiety: A randomized trial with Caucasian and Hispanic/Latino youth. Journal of Consulting and Clinical Psychology, 80(5), 940–946. doi:10.1037/a0029460.CrossRefPubMedPubMedCentral Pina, A. A., Zerr, A. A., Villalta, I. K., & Gonzales, N. A. (2012). Indicated prevention and early intervention for childhood anxiety: A randomized trial with Caucasian and Hispanic/Latino youth. Journal of Consulting and Clinical Psychology, 80(5), 940–946. doi:10.​1037/​a0029460.CrossRefPubMedPubMedCentral
go back to reference Plain Action Language Network. (2011, March, 2011). Improving communication from the federal government to the public. In Federal plain language guidelines. Retrieved November, 2014. Plain Action Language Network. (2011, March, 2011). Improving communication from the federal government to the public. In Federal plain language guidelines. Retrieved November, 2014.
go back to reference Silverman, W. K., Pina, A. A., & Viswesvaran, C. (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 37(1), 105–130. doi:10.1080/15374410701817907.CrossRefPubMed Silverman, W. K., Pina, A. A., & Viswesvaran, C. (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 37(1), 105–130. doi:10.​1080/​1537441070181790​7.CrossRefPubMed
go back to reference U.S. Congress, Office of Technology Assessment. (1990). Health care in rural America OTA-H-434. Washington, DC. U.S. Congress, Office of Technology Assessment. (1990). Health care in rural America OTA-H-434. Washington, DC.
go back to reference Whitfield, G., & Williams, C. (2004). If the evidence is so good, why doesn’t anybody use them? A national survey of the use of computerize cognitive behaviour therapy. Behavioural and Cognitive Psychotherapy, 32(01), 57–65.CrossRef Whitfield, G., & Williams, C. (2004). If the evidence is so good, why doesn’t anybody use them? A national survey of the use of computerize cognitive behaviour therapy. Behavioural and Cognitive Psychotherapy, 32(01), 57–65.CrossRef
go back to reference Willms, D. G., Johnson, N. A., & White, N. F. (1992). A qualitative study of family practice physician health promotion activities. Thousand Oaks, CA: Sage Publications. Willms, D. G., Johnson, N. A., & White, N. F. (1992). A qualitative study of family practice physician health promotion activities. Thousand Oaks, CA: Sage Publications.
Metadata
Title
Delivering CBT to Rural Latino Children with Anxiety Disorders: A Qualitative Study
Authors
Denise A. Chavira
Cristina E. Bustos
Maritza S. Garcia
Bernardo Ng
Alvaro Camacho
Publication date
01-01-2017
Publisher
Springer US
Published in
Community Mental Health Journal / Issue 1/2017
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-015-9903-3

Other articles of this Issue 1/2017

Community Mental Health Journal 1/2017 Go to the issue