Psychometric characteristics of a Spanish version of the DAST-10 and the RAGS.

Although Hispanics/Latinos constitute the largest ethnic minority group in the United States, there are few culturally and linguistically valid Spanish language clinical assessment instruments. This shortage is even more critical in the addictions field. This article presents the psychometric characteristics of two drug abuse screening instruments; the Drug Abuse Screening Test (DAST-10), and the Reduce Annoyed Guilty Start (RAGS) test that were translated into Spanish. Participants included 60 drug abusers, 35 alcohol abusers, and 127 individuals with no alcohol and/or drug problem. Results indicated that the Spanish versions of the two drug abuse screening instruments were reliable and unidimensional and differentiated drug abusers from non-substance abusers and from alcohol abusers.

The Recovery Knowledge Inventory: assessment of mental health staff knowledge and attitudes about recovery.

In order to assess knowledge of and attitudes toward recovery-oriented practices among providers of mental health and substance abuse treatment and rehabilitation services throughout the state of Connecticut, an instrument named the Recovery Knowledge Inventory (RKI) was developed and administered. The items that comprise the instrument are based on the emerging literature on recovery in psychiatric and substance use disorders, and assess four different domains of understanding, namely: 1) roles and responsibilities in recovery, 2) non-linearity of the recovery process, 3) the roles of self-definition and peers in recovery, and 4) expectations regarding recovery. This paper describes the instrument and its preliminary psychometric properties, and provides an example of its utility in assessing the training needs of staff who increasingly are being expected to deliver recovery-oriented care.

The Connecticut Latino Behavioral Health System: A culturally informed community-academic collaboration.

The Connecticut Latino Behavioral Health System (LBHS) represents a culturally informed community-academic collaboration that includes agencies focused on mental health, addictions, behavioral health within community health centers, and social rehabilitation; the Yale University Department of Psychiatry; and the Connecticut Department of Mental Health and Addiction Services. The core mission of the LBHS is to expand and enhance the provision of recovery-oriented, and culturally and linguistically appropriate, services to the monolingual Spanish-speaking community in parts of South Central Connecticut. This article outlines the rationale and need for such a collaboration to meet the needs of an underrepresented and underserved ethnic minority group. The process by which these entities came together to develop and successfully implement systemic strategies is described in the context of 2 overarching priorities: (a) workforce development, and (b) access to services. The authors also highlight lessons learned that have informed the decision-making process since the inception of the LBHS, and future directions to ensure that it is prepared to meet changing consumer needs and systemic priorities. (PsycINFO Database Record

Application of cultural constructs in the care of first generation Latino clients in a community mental health setting.

As the Latino population in the United States grows, it is imperative to attend to the appropriateness of the mental health care that is being provided to its members. Latinos experience many of the same behavioral health disorders as other ethnic and cultural groups in the United States, but underutilize services relative to many other groups. Such underutilization may be related to issues such as stigma, language, and acculturation level, all of which often create barriers to treatment. First generation Latinos (i.e., individuals born outside the United States) are especially vulnerable to adverse experiences when seeking and receiving treatment. This may be due in part to acculturation and language issues which may further contribute to future underutilization of services. A well established therapeutic alliance developed through the appropriate use of cultural constructs may help mitigate some of the barriers faced by some Latino groups, especially those who are first generation. This paper reviews several cultural constructs that have been highlighted in the Hispanic behavioral health literature and discusses their potential implications for clinical care. This paper offers a number of practical clinical guidelines for mental health professionals who work with Latino groups. These clinical recommendations are based on a synthesis of selected cultural constructs and the clinical experiences of the authors' work in a large community-based Hispanic mental health clinic.

Therapeutic alliance: satisfaction and attrition of patients from a mental health clinic in Ayacucho, Peru.

This study examines the role of the patient-provider relationship (alliance) and patient satisfaction in early patient withdrawal from mental health therapy in rural Peru. A prospective comparison of 60 patients demonstrated that early withdrawal was associated with the clinician's, but not the patient's, evaluation of the patient-provider alliance. This suggests that the satisfaction and alliance questionnaires typically used in high-income countries may not be effective in evaluating patient attitudes in this population, but may be useful for clinician evaluations of the alliance. Clinicians can use the Working Alliance Inventory to indicate the need for early intervention to prevent patient drop-out in middle- and low-income countries.