1. Cultural Competence with Latino and Hispanic Communities

2. Latino Americans Cuban Mexican Puerto Rican Brazilian Salvadorans Dominicans Central American Other

3. Outreach and Enrollment Strategies Adapt materials  Use tx approaches that can be culturally adapted Provide a personal approach  No “one-size-fits-all” approach  Solution-Focused  Strengths-Based  Cognitive Behavioral Therapy (CBT)  Motivational Interviewing  Skill building Use BH Peer Model Use Familiar Language

4. Outreach and Enrollment Strategies Engage Community Members on Their Own Terms Communicate Directly with Community Members Use Media as a Resource  Talk Radio  Television Channels  Church Newsletters  Community Magazines

5. Outreach and Enrollment Strategies Address Barriers  Access to Education  Mental Health Disparities  Immigration Reform Initiatives  Human Trafficking  Homelessness  Childcare Challenges  Lack of Transportation  Comprehension level  May need English translator or require bilingual services  Inflexible Work Sch edules

6. Culturally Competent Practices Recognize heterogeneity within the population  Differences in migration  Reception in the U.S.  How and why they came to the U.S.  Acculturation processes began in their countries of origin due to effects of neocolonialism and globalization  Most often reasons for migration shape the reception and settlement in the U.S. Immigrants are acting on a right to improve their lives and may make life threatening decisions as to how to accomplish this. Once in the U.S. they can be easy targets for exploitation and poor living conditions. Important not to demean, devalue, or project negative values or attitudes. Do not use the term “illegal alien” or even alien itself.  Nondocumented (preferred term) versus illegal alien  Using the term “illegal alien” promotes dehumanization of immigrants by seeing them as less moral.

7. Engage, Evaluate, Assess, and Intervene To be effective, workers must pay attention to bicultural identification and language preference Often, language is an indicator of acculturation and is associated with health outcomes Important not to demean, devalue, or project negative values or attitudes May see help through health professionals first Skill development is premised on cultural attunement with attention to language, cultural values, and contextual stressors Planning can include a process stage, orientation, contact, problem identification, assessment, intervention, and termination

8. Family The value of family is a central theme, a collective sense of self within the world. Tradition of honoring the elderly  Can appear to be enmeshment, from an individualistic, western philosophy.  Grandmother is often viewed as the wise “protector,” allowing strong intergenerational ties. Family systems approach (Salvador Minuchin) came out of this importance of family. Engaging fathers and their expertise will be important. The value of collective and “high context” communication, that which is personal and face-to-face. Role of the father as patriarch, and the role reversal of women being able to find employment, often resulting in family stress, substance abuse, and domestic violence. The role of the traditional values of the adults versus those assimilated by the youth. This can cause family discord.

9. Religion Cannot assume that the religion will be Catholic, yet it may be prominent. Cultural history has been eradicated in the past by theology. Pentecostal denominations are growing rapidly within the Americas.

10. Practice Skills Relationship Protocols: The development of trust is important. Style: Must be personable, patient, and formal. Respect for authority, and seeking permission from the patriarch or senior family member before initiating any intervention, as well as displaying humility, will all go a long way. Problem Identification: Praise and recognition of strength to seek out assistance. Advocacy for self-help organizations and autonomy within the community.

11. References Weaver, 2007. Cultural Competence with Latino Americans, in Culturally Competent Practice, A Framework for Understanding Diverse Groups and Justice Issues, 2007. Doman Lum, Editor, Thomson, Brooks and Cole, Belmont, Ca. Substance Abuse and Mental Health Services Administration. (Rockville). Strategies for Behavioral Health Organizations to Promote New Health Insurance Opportunities in Latino and Hispanic Communities. 2014: Substance Abuse and Mental Health Services Administration.