Do therapist cultural characteristics influence the outcome of substance abuse treatment for Spanish-speaking adults?

This secondary data analysis of protocol CTN-0021 (“Motivational Enhancement Treatment to Improve Treatment Engagement and Outcome for Spanish-Speaking Individuals Seeking Treatment for Substance Abuse”) examined whether the degree of birthplace and acculturation similarities between clients and therapists, as well as the therapists’ own level of acculturation and birthplace were related to the clients’ participation in treatment and level of substance use during outpatient substance use treatment. Sixteen therapists and their 235 clients from CTN-0021 were included in the analyses for this study. Results of the multilevel regression models for client participation in substance use treatment and client days of substance use, taking into account within and between therapist cultural characteristics, revealed that birthplace match and acculturation similarity between each therapist and his or her clients did not predict client outcomes. Instead, therapists’ birthplace and level of acculturation independently predicted days of substance use, but not treatment participation for monolingual Spanish-speaking clients. This investigation did not support the hypothesized effects of matching client and therapist on cultural characteristics to produce positive treatment effects. However, level of acculturation in therapists seems to be related to their Spanish-speaking clients’ substance use patterns while in treatment, possibly because clients benefitted from therapist expression of cultural nuances and values common to Hispanics. These findings are discussed in the context of the results of the main effectiveness trial and of psychotherapy research with ethnic minority populations, in particular Hispanic minorities.

Related protocols: CTN-0021