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J Consult Clin Psychol. 2014 Jun;82(3):392-403. doi: 10.1037/a0036365. Epub 2014 Mar 24.

Treatment engagement and response to CBT among Latinos with anxiety disorders in primary care.

Author information

1
Department of Psychology, University of California-Los Angeles.
2
RAND Corporation.
3
Department of Psychiatry, University of California-San Diego.
4
Department of Psychiatry, University of Arkansas for Medical Sciences.
5
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California-Los Angeles.
6
Veterans Affairs San Diego Health Care System Center of Excellence for Stress and Mental Health.
7
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine.
8
Los Angeles County Department of Mental Health.

Abstract

OBJECTIVE:

In the current study, we compared measures of treatment outcome and engagement for Latino and non-Latino White patients receiving a cognitive behavioral therapy (CBT) program delivered in primary care.

METHOD:

Participants were 18-65 years old and recruited from 17 clinics at 4 different sites to participate in a randomized controlled trial for anxiety disorders, which compared the Coordinated Anxiety Learning and Management (CALM) intervention (consisting of CBT, medication, or both) with usual care. Of those participants who were randomized to the intervention arm and selected CBT (either alone or in combination with medication), 85 were Latino and 251 were non-Latino White; the majority of the Latino participants received the CBT intervention in English (n = 77). Blinded assessments of clinical improvement and functioning were administered at baseline and at 6, 12, and 18 months after baseline. Measures of engagement, including attendance, homework adherence, understanding of CBT principles, and commitment to treatment, were assessed weekly during the CBT intervention.

RESULTS:

Findings from propensity-weighted linear and logistic regression models revealed no statistically significant differences between Latinos and non-Latino Whites on symptom measures of clinical improvement and functioning at almost all time points. There were significant differences on 2 of 7 engagement outcomes, namely, number of sessions attended and patients' understanding of CBT principles.

CONCLUSIONS:

These findings suggest that CBT can be an effective treatment approach for Latinos who are primarily English speaking and likely more acculturated, although continued attention should be directed toward engaging Latinos in such interventions.

PMID:
24660674
PMCID:
PMC4303048
DOI:
10.1037/a0036365
[Indexed for MEDLINE]
Free PMC Article
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