Seeking Models and Methods for Cultural Adaptation of Interventions: Commentary on the Special Section.
Seeking Models and Methods for Cultural Adaptation of Interventions: Commentary on the Special Section.
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寻求干预措施文化适应的模式和方法：专题评论。
DOI：
10.1016/j.cbpra.2010.01.006
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发表时间：
2010
影响因子：
2.9
通讯作者：
Zayas,LuisH
中科院分区：
文献类型：
--
作者：
Zayas,LuisH
Rogler、Malgady、Costantino和Blumenthal（1987）在早期关于为西班牙裔群体发展和适应社会心理干预的文献中提出了三种方法。第一个是让拉美裔更容易接受传统治疗。另一种方法是根据他们与西班牙文化的接近程度选择可用的治疗方法，并将其应用于这一人群。第三是从西班牙文化中提取元素来修改传统的治疗方法。这些方法并不相互排斥。事实上，在为拉丁美洲人选择和使用经验支持的治疗方法方面，他们可能会非常有效地合作。毕竟，针对美国不同地区和不同年龄段的拉丁裔群体，有越来越多的文献介绍了适应和定制治疗方法。在文化适应研究中的集体努力是为了提高拉丁美洲人测试干预措施的可及性，并使用关键的西班牙文化元素来提高这些治疗的效用。在许多方面，Rogler等人的方法分类在今天可能比论文刚发表时更有意义。作为一个刚进入心理健康领域的人，当时几乎没有人关注种族和民族——而且，当种族和民族被包括在内时，种族和民族往往被视为病理的来源，而不是力量的来源——我对我们在将文化置于确保治疗使用和成功的适当位置上所取得的进展印象深刻。但我充分意识到，我们还有很长的路要走，要将源于共同种族的文化因素纳入其中，使干预措施与西班牙裔相关并有效。由于缺乏对反映西班牙文化的具体特征的经验证实，我们的进展可能受到限制。许多与拉丁美洲人有关的文化概念，如尊重、家庭主义、婚姻主义和人格主义，已经出现在文献中（并在本节的论文中再次出现），它们现在已经成为研究拉丁美洲人的研究人员和临床医生的常用词汇。一般的操作假设是，如果我们在设计和实施干预措施时观察到这些文化特征，拉美裔人将更好地参与和服务。然而，这一假设并没有经受住严格的审查。在最近对拉丁文化价值文献的回顾中，梅勒妮·多梅内克·罗德里格斯、安娜·鲍曼、奥黛丽·施瓦茨和我发现，围绕文化价值，有一些定义上的共识正在逐渐凝聚。尽管如此，这些概念中的许多还没有被操作化或操作化得足够统一，以至于我们可以放心地说它们可以或已经被用于干预适应研究。例如，Dumka， Lopez和Carter（2002）在他们对21个拉丁裔家庭的养育干预措施的回顾中发现，大多数研究确定了一个或多个泛拉丁价值观，但很少有引用或其他信息被提出“来证实这些价值观的有效性”（第61页）。215)。这当然是一个令人担忧的问题，我们应该下定决心，更好地处理这一问题
Early in the literature on developing and adapting psychosocial interventions for Hispanic groups, Rogler, Malgady, Costantino, and Blumenthal (1987) suggested three approaches. The first one was to make traditional treatments more accessible to Hispanics. Another was to select available therapies according to their proximity to Hispanic cultures and apply them to this population group. And a third was to extract elements from Hispanic culture to modify traditional treatments. These approaches are not mutually exclusive. In fact, they may work together very effectively in the selection and use of empirically supported therapies for Latinos. After all, there is a growing literature on adapting and tailoring therapies to diverse Latino groups in different parts of the US and across the life span. The collective efforts in cultural-adaptation research have been to improve accessibility of tested interventions for Latinos and use critical Hispanic cultural elements to enhance the utility of these treatments. In many ways, Rogler et al.'s classification of approaches is perhaps more relevant today than when the paper first appeared. As someone who began in the mental health field when little if any attention was paid to race and ethnicity—and, when included, race and ethnicity were often framed as sources of pathology rather than as sources of strengths—I am impressed by the progress we have made in placing culture at its rightful place for ensuring treatment use and success. But I am fully aware that we still have a good distance to go to incorporate cultural factors stemming from a common ethnicity to make interventions relevant and effective with Hispanics. Our progress may have been limited by the lack of empirical substantiation of the specific features that reflect Hispanic cultures. Many cultural concepts that are associated with Latinos, such as respeto, familismo, marianismo, and personalismo, have appeared in the literature (and reappeared as they do in the papers in this section) with such regularity that they are now found in the common lexicon of researchers and clinicians working with Latinos. The general operating assumption has been that Latinos will be better engaged and served if we observe these cultural features when we design and implement our interventions.This assumption, however, has not stood up to critical scrutiny. In a recent review of the literature on Latino cultural values, Melanie Domenech Rodriguez, Ana Baumann, Audrey Schwartz, and I are finding that there is some definitional consensus that has gradually coalesced around the cultural values. Still, many of these concepts have not been operationalized or operationalized with sufficient uniformity that we can comfortably say they can be or have been used in intervention-adaptation research. Dumka, Lopez, and Carter (2002), for example, found in their review of 21 parenting interventions for Latino families that most studies identified one or more pan-Latino values but few citations or other information were presented “to substantiate the validity of these values”(p. 215). This is certainly a cause of concern and should steel our determination to get a better handle on