ECOLOGICAL AND PSYCHOCULTURAL MEDIATORS IN THE DELIVERY OF SERVICES FOR URBAN, CULTURALLY DIVERSE HISPANIC CLIENTS

Influences on underuse of mental health services by the urban, low-income Latino subgroup are analyzed through a systems-cultural framework. Results of a review of over 100 applied, empirical, and theoretical published works in the last 14-16 years strongly suggest that when social-ecological and psychocultural perspectives are used by service providers, their therapeutic relationship, techniques, and treatment plan become more clinically and culturally compatible with the presenting problems of the urban Latino client. Accuracy of assessment and effectiveness of treatment also have been found to increase. Recommendations for the overlapping domains of clinical practice, graduate training, and program and policy development are offered. By augmenting assessment and intervention models to encompass a psychocultural and socioecological view, professionals move toward a greater concordance with the life problems, phenomenology, and value orientation of urban, culturally diverse Hispanic families.