Cultural Considerations for Treating PTSD in Latinx Sexual Assault Survivors With Prolonged Exposure. Issue 2 (May 2023)

• Record Type: Journal Article
• Authors: Garcia, Natalia M.; Eiff, Agustina Colombo; Lopez-Esteban, Adriana; Zoellner, Lori
• Is Part Of: Cognitive and behavioral practice. Volume 30:Issue 2(2023)
• Page Start: 179
• Page End: 194
• Publication Date: 2023-05
• Subjects: prolonged exposure -- Latinx -- sexual assault -- culturally responsive -- PTSD; Behavior therapy -- Periodicals; Cognitive therapy -- Periodicals; Behavior Therapy -- Periodicals; Cognitive Therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.cbpra.2021.12.002
• Languages: English
• ISSNs: 1077-7229

Abstract

Highlights: Latinx sexual assault survivors can benefit from prolonged exposure. Therapists should work within cultural humility and intersectionality frameworks. Build trust early and conduct culturally informed assessment and psychoeducation. Optimize exposures by getting creative and considering cultural relevance. Problem solve culturally relevant barriers to homework engagement. Abstract: There is growing interest in the implementation of culturally responsive mental health care that balances treatment fidelity and cultural fit (Castro et al., 2004). Prolonged exposure (PE) is a first-line, evidence-based treatment for posttraumatic stress disorder (PTSD) and has been successfully implemented in low-income and ethnoracial minority samples (Feske, 2008) and with Latinx individuals specifically (Vera et al., 2011). However, cultural and systemic factors may contribute to Latinx individuals experiencing higher conditional risk for PTSD (Alcántara et al., 2013), disparities in mental health care utilization (Alves-Bradford et al., 2020), and challenges with PTSD treatment delivery (Valentine et al., 2017). Culturally responsive implementation of PE with Latinx clients involves making culturally informed but person-specific assessments of clients, with adaptations as needed. We propose several culturally responsive strategies for therapists to consider when conducting PE with Latinx sexual assault survivors, such as building trust and rapport early on, conducting culturally informed assessment, investing in psychoeducation, optimizing imaginal exposure and in vivo exposure, and problem-solving barriers to homework engagement. Therapists are encouraged to approach this work with cultural humility (Fisher-Borne et al., 2015; Tervalon & Murray-Garcia, 1998) through open listening, critical self-reflection, and consideration for the way in which Latinx identity intersects with other important identity characteristics that can impact treatment relevance and engagement.