Cultural issues in family interventions

In this chapter, we have outlined a number of intervention programmes for families. In each case, the interventions have been developmentally appropriate and ecologically valid. However, one of the greatest challenges to interventionists with a developmental psychopathology focus is to implement interventions that are sensitive to the diversity of families. Family interaction by necessity is embedded within a cultural context. As such, not all parenting strategies and family interventions will be effective with all cultural groups. For example, racial differences are evident in the literature linking parenting practices to child behaviour problems/2,30)

Several programmes for families have attempted to remedy this problem by providing ecologically valid and culturally sensitive interventions to ethnic minority groups in the United States. For example, the Effective Black Parenting Programmed1,3,2) integrates a cognitive-behavioural parent training programme with information of relevance to inner-city African-American families, including discussions of traditional 'black discipline' (physical punishment) versus 'modern black discipline' (internalizing standards of behaviour). Components such as helping the child deal with racism at school and positive communication about ethnicity are also included. This programme has been effective at changing parenting behaviour and child behaviour a year later.

In addition to the content of programmes targeting diverse populations, the process of maintaining families in treatment may also differ depending on the culture in which the therapist is working. For example, Szapocznik and colleagues'3 34) have developed a programme to engage Hispano-American families in family treatment, which includes less traditional forms of engagement and more of an emphasis on the ecosystems of families and the cultural context. These researchers hypothesize that resistance to change occurs during the initial stages of therapy, and that traditional forms of engagement may be inadequate for this minority population. Instead, engagement that ranges from joining and encouraging the family to participate to home visits and meetings with significant family members is employed. This type of engagement strategy has been effective in retaining families in treatment, with the final goal of reducing drug use and other problem behaviours in adolescence. Although these programmes serve as examples of specific approaches to working with populations of different cultures, intervention research is just beginning to emphasize these differences and integrate approaches to culturally diverse families into more traditional family and parent training curriculums. More work in this area is clearly necessary, both for racial and ethnic minority populations within the United States and for cultures outside the United States.

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