Acculturation, the process whereby immigrants change their behavior and attitudes toward those of the host society, is a fundamental part of migration-induced adaptations to new sociocultural environments. A rapidly expanding research literature on acculturation has accompanied the growth of international migrations. In response to the need to integrate the growing literature on acculturation and mental health status among Hispanics in the United States, and to identify points of convergence and new directions for research, 30 publications were examined. Points of convergence are identified, as are problems and limitations. The research needs new directions, proceeding from but not constricted by the assumptions and procedures in the work already done.

Three broad approaches to the development of culturally sensitive therapy programs were uncovered in the mental health literature on Hispanic populations: first, rendering traditional treatments more accessible to Hispanics; second, selecting available therapeutic modalities according to the perceived features of Hispanic culture; and third, extracting elements from Hispanic culture to modify traditional treatments or to use them as an innovative treatment tool. The conceptual order introduced into the meaning of culturally sensitive mental health services proceeds with descriptive accounts of diverse therapeutic programs within each of the three approaches. The article raises a fundamental question as to how the relationship between culture and therapy is conceived by clinical practitioners and how it ought to be conceived: Must the content of all culturally sensitive therapies stand in isomorphic, mirror-like relationship to the client's culture? Research seeking to evaluate a culturally sensitive therapy modality for children examines this question and invites more appropriate formulations relating culture to therapy.

Epidemiological studies indicate that Hispanics underutilize community mental health facilities in proportion to their needs and often fail to benefit from traditional psychotherapeutic services. This study investigated the effectiveness of a modeling therapy designed to be sensitive to Hispanic culture. In one version of the modality, cuentos (folktales) from Puerto Rican culture were used to present models of adaptive behavior and in another version folktales were tailored to bridge Puerto Ricans' bicultural conflict. High risk children (from kindergarten through third grade, N=2\0) and their mothers were randomly assigned to receive either cuento therapy, traditional therapy, or no therapy. Results indicated that cuento therapy significantly reduced children's trait anxiety relative to traditional therapy and to no intervention, and that this trend was stable over 1 year. The cuento modalities also increased Wechsler Intelligence Scale For Children-Revised (WISC-R) Comprehension subtest scores and decreased observer-rated aggression. The need to develop and evaluate culturally sensitive therapeutic modalities for Hispanics is discussed.Critics of mental health services in this country have voiced the need for Hispanics to have therapeutic services that take their culture into account (Padilla, Ruiz, & Alvarez, 1975;Rogler et al., 1983). Three approaches to the delivery of culturally sensitive services have been identified (Rogler, Blumenthal, Malgady, & Costantino, 1985). The first approach calls for increasing the accessibility of services by incorporating bilingual and bicultural staffinto mental health facilities. This is based on the assumption that Hispanics will thus experience less cultural upheaval in seeking and remaining in treatment (Acosta & Cristo, 1981;Scott & Delgado, 1979). The second approach argues that the therapy Hispanics receive should be congruent with their culture or should be modified to include cultural values (Cohen, 1972;Padilla et al., 1975). For example, while working with Cuban substance abusers, Szapocznik, Scopetta, and King (1978) developed a version of family therapy based on the familiocentric tradition of Cuban culture. This approach suggests that therapy should stand in an isomorphic relation to the client's culture or that cultural values should be mirrored

Identified the concept of acculturation as a cornerstone of immigration research, while questioning assumptions about zero-sum cultural change in acculturation scales and in procedures assessing biculturality. Involvements in the host society culture and the culture of origin should be assessed separately in order to reflect the complexities of the cultural interactions immigrants and their offspring experience. To evaluate this prescription, we convened focus groups of Puerto Rican adults to discuss their cultural experiences in Puerto Rico and in the United States. Discussions were content analyzed to develop acculturation items. Factor analysis of the responses of 403 first- and second-generation adults yielded two general factors, involvement in American culture and involvement in Puerto Rican culture, which demonstrated modest reliability, relative independence, and moderate correlations with traditional acculturation scale validators. Results of the study challenge the assumption of mutual cultural exclusivity in acculturative change; enable the measurement of degree of biculturality; and provide future directions for the assessment of acculturation in domains other than language usage. The concept of acculturation is integrated with recent formulations in community psychology which advocate a deeper and more extensive commitment to studying the implications of cultural phenomena and greater focus on the growing cultural diversity in the United States.

At the root of effective mental health care is valid psychodtagnosts, premtsed upon accurate psychometrtc technology and sound chntcal judgment The majority of clintctans, however, are monolingual and White, whtch does today (and wdl mcreasmgly) pose a problem for mental health servtce dellvery--partwularly for Htspanic pattents This arttcle examines sources of ethnw and lmgutsttc btas m evaluation of Htspamc clients It ts argued that even tf unblased assessment techmques can be developed, vahd psychodiagnosts of Hlspantc patients wdl remam dlusory to the extent that cllmctans are msensittve to the lingutsttc and cultural nuances of thetr chentele. Recommendatwns for tmprovmg chntcal practtce are offered