Clinical 

Guillermo Bernal, Ph.D., University of Puerto Rico, Rio Piedras

Monday, January 11, 2010, 10:30 am – 10:30 pm
4448 East Hall
Sponsored By: Race, Ethnicity, Culture and Psychopathology (RECAP Speaker Series)

Event Information

 

Evidence-based treatment (EBT) is grounded on randomized clinical trials (RCT) considered the standard for mental health care. Evidence Based Psychological Practice (EBPP) is an alternative proposal that integrates the best available research with clinical expertise and patient characteristics, culture and preferences and it is now APA policy. EBPP is broader and more inclusive than EBT by expanding the rules of evidence beyond RCTs, incorporating the expertise of clinicians, and the preferences and characteristics of the patient including cultural values. Yet both approaches are limited with regard to their consideration of culture. The former essentially ignores culture and the latter reduces culture to a variable for consideration, among many other variables. This presentation will examine the similarities and differences between EBT and EBPP and will argue for an evidence based treatment and practice that is born and shaped within a cultural context and embedded in a changing context that is increasingly multicultural. Psychotherapy is viewed as unique cultural phenomenon. The critiques of EBT and EBPP from a multicultural perspective will be reviewed. A central issue is whether to adapt EBTs in such a way as to take into account the cultural, linguistic and socio-economic context of diverse ethno-cultural groups. A contextual approach is presented to frame both EBT and EBPP within its ecology and draw from the notion of embedded contexts to inform interventions. Examples of cultural embedded processes will be drawn from a program of research on the efficacy of psychological treatments for adolescent depression in Puerto Rico: framing the research question, use of mixed methods, translation of instruments, cultural adaptation of treatments, recruitment of participants, interpretation of results, and context of the study. We conclude with recommendations for future work in planning and conducting culturally embedded research and practice.