Incorporating culture into substance abuse treatment: The associations among acculturation and acculturative stress and treatment outcomes for Latino adolescents

Substance use disorders are prevalent among adolescents and there is a need to develop and test empirically supported interventions that target these disorders specifically. However, to date, much of the empirically supported intervention research in this arena has neglected the needs of ethnic minority youth. Recent research efforts support the notion of cultural adaptation/accommodation (modifying interventions to increase cultural congruence) of standard interventions to better serve ethnic minority clients. However, few studies have examined the efficacy of cultural adaptations in direct comparison studies. Direct comparisons studies would allow for an examination of relative efficacy as well as moderating effects. These types of studies will help researchers determine when a cultural adaptation is likely to be most helpful for a particular client.;This study aimed to understand the associations between acculturation and acculturative stress and treatment outcomes for Latino adolescents participating in a substance abuse treatment program. A total of 70 Latino adolescents participated in a randomized-controlled trial designed to directly compare an empirically supported, standard cognitive behavioral group-based intervention with a culturally accommodated cognitive behavioral intervention. Adolescents participated in 12 weeks of active treatment as well as pre- and posttreatment assessments. Results provided evidence for relative efficacy of the culturally accommodated intervention, as adolescents in both treatment conditions reported significant decreases in their substance use. There were no significant differences between the two treatment conditions. In addition to examining relative efficacy, this study also examined for the presence of interaction effects between cultural variables and treatment outcomes. It was hypothesized that adolescents who were matched to the most appropriate intervention (i.e., less acculturated adolescent matched to accommodated intervention) would report the largest reduction in substance use. Results did not reveal any significant three-way interactions, indicating the specific cultural variables did not moderate treatment outcomes by treatment condition. Despite these null findings, future studies should continue to exam the role of cultural variables on treatment outcomes.