Hogg Foundation for Mental Health

Cultural Adaptation Grantees Trained in Evidence-Based Practices

December 1, 2006

This fall, grantee organizations in the Cultural Adaptation Initiative began working with expert consultants to master an evidence-based psychotherapy.

Three of the organizations are focusing on learning cognitive-behavioral therapy, a psychotherapy approach that involves teaching people with mental health problems, like depression and anxiety, ways to change problematic thought and behavior patterns that contribute to their distress.

Cognitive-behavioral therapy is considered an evidence-based practice because a large body of research has demonstrated its ability to improve mental health problems.

Participants in the multi-day trainings included therapists from Tropical Texas Center for Mental Health and Mental Retardation in Edinburg, Family Service of El Paso, and Community Family Centers (Centros Familiares de la Comunidad) in Houston.

Drs. Monica Basco and Kevin Stark conducted the trainings.

Monica Basco, Ph.D., is a clinical associate professor in psychiatry at The University of Texas Southwestern Medical Center in Dallas. She has lectured and published extensively on cognitive-behavioral therapy for adults. Basco has also trained therapists throughout the state in the treatment.

Professor of school psychology at The University of Texas at Austin, Kevin Stark, Ph.D., is an expert in cognitive-behavioral therapy for children and adolescents. He has written manuals guiding therapists through the treatment, and has conducted numerous trainings for therapists around the country.

While the principles of cognitive-behavioral therapy are relatively simple to learn, becoming proficient in the treatment takes ongoing support. For this reason, consultants will provide ongoing support to the newly trained psychotherapists.

Once the grantee organizations master the treatment, they will begin adapting it to fit their clients' cultural backgrounds. An evaluation of the grant program will look at the grantees' process of creating the cultural adaptations and how they impact client outcomes.

A Closer Look at the Cultural Adaptation Initiative Grantees

In July 2006, the Hogg Foundation announced awards totaling more than $2.9 million over three years to five organizations around Texas. The organizations have been funded to adapt the delivery of evidence-based practices (EBPs) to be compatible with the cultures of their populations of color.

Over the next three years, the foundation will regularly inform its stakeholders about the Cultural Adaptation grantees' work. In future newsletters, on the foundation's website, and through other means, the organizations' efforts to implement and culturally adapt an EBP will be described. The foundation shares this information as a resource to other service organizations around the state.

Located in Houston, Community Family Centers (Centros Familiares de la Comunidad) was awarded $607,107 to culturally adapt cognitive-behavioral therapy for Latino adolescents diagnosed with depressive disorders. Cognitive-behavioral therapy is a treatment approach in which problematic thoughts and behaviors are seen as contributing to a person's distress. The therapy focuses on modifying those thoughts and behaviors to lift the person's symptoms.

Community Family Centers is a nonprofit community-based organization that has provided educational and social services to low-income Latinos in Houston's East End for over 30 years. Its services are designed with the goals of "strengthening families and enriching the quality of life in the community and providing a safe and nurturing environment for children to excel."

DePelchin Children's Center in Houston received a grant of $919,515 over three years to modify their delivery of trauma-focused cognitive-behavioral therapy to reflect the culture of Latino children and their parents. In trauma-focused cognitive-behavioral therapy, the basic principles of cognitive-behavioral therapy are applied to the unique experience of people who have been traumatized. The treatment brings the parents into the therapy, providing them with psychoeducation about trauma and the therapy process.

For over 100 years, DePelchin has provided services for Harris County children and families to "strengthen the lives of children and their families in our community by providing a continuum of services to prevent and resolve social and emotional crises." The organization has a multicultural client base, with Latinos representing the largest segment of clients served. The majority of the organization 's clients are on Medicaid.

A grant of $384,441 over three years was awarded to Family Service of El Paso (FSEP) to adapt the provision of cognitive-behavioral therapy for depression in adults to fit the culture of its Latino service population. A few studies have shown that cognitive-behavioral therapy can help Latino adults with depression. However, this grant will provide FSEP the opportunity to explore and develop cultural adaptations to ensure its effectiveness.

This private nonprofit organization was founded in 1893, with the mission of improving the quality of individual, family, and community life in El Paso. It provides mental health services to the community regardless of the ability to pay. FSEP primarily serves El Paso County, but also provides services to people from the areas surrounding Juarez, Mexico, and Las Cruces, New Mexico. The majority of its clients are Latino, most of whom speak Spanish as their primary language, and low-income.

Lena Pope Home, Inc., in Fort Worth received a grant of $536,695 over three years to adapt the Defiant Child model for treating children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. The organization will culturally adapt the model for African American children. The Defiant Child model was developed by leading ADHD authority Dr. Russell A. Barkley. It is a structured treatment approach in which parents are trained to manage their children's behaviors appropriately.

For the initiative, this private nonprofit organization will collaborate with the Fort Worth Independent School District, The City of Fort Worth Public Health Department, and The University of Texas at Arlington. Lena Pope Home provides a range of programs designed to meet the behavioral health care needs of children, families, and adults. The majority of its services are provided to children and families, most of whom are African American or Latino, and uninsured.

Based in Edinburg, Tropical Texas Center for Mental Health and Mental Retardation received a grant of $526,855 over three years to modify the delivery of behavior and exposure therapies for the treatment of anxiety disorders in Latino children and adults. In behavior therapy, clients are taught techniques such as relaxation for managing their distress. Exposure therapy consists of strategically exposing clients to phobic subjects or traumatic memories in order to reduce their associated distress.

Tropical Texas will partner with area agencies, such as the Texas Health and Human Services Commission's Office of Border Affairs, for this initiative.

Tropical Texas was the first community mental health center established in Texas. Located in the Rio Grande Valley, the organization provides services to the residents of Hidalgo, Willacy, and Cameron Counties. It serves a population that is predominantly Latino, low-income, and uninsured.