This case study describes the integration of cultural values into the cognitive-behavioral therapy (CBT) of a Latino with depression to illustrate culture-based modifications in the use of CBT treatment with this client. Cultural values of familismo, personalismo, respeto, and machismo are defined and weaved into the case conceptualization and treatment process, to build a culturally competent treatment approach. The article describes challenges in the treatment of the individual and provides culture-specific strategies to modify the traditional CBT approach and increase the prospects of successful treatment outcomes. It acknowledges the heterogeneity of the Latino population and cautions against broad generalizations. Treatment implications; limitations relative to gender, education, and socioeconomic status; and recommendations for practice and research are also included. The article further provides a discussion on the status of intervention research with racial and ethnic minority groups and Latinos in particular.

Traditional machismo in Mexican American culture has been considered detrimental to marital satisfaction (MS). Contrary to this notion, contemporary views of machismo suggest that masculinity in Mexican American couples is contextual and fluid along a continuum of positive and negative dimensions. In this study, the dyadic effects of positive and negative machismo on MS in Mexican American couples were explored using actor-partner interdependence model (APIM) analyses. A sample of 112 Mexican American couples completed bilingual self-report questionnaires assessing endorsement of machismo beliefs and MS. Adjustments were made for income, acculturation, and number of children. Results showed an actor effect of overall machismo on MS for husbands among low-acculturated but not high-acculturated couples. Furthermore, we found that wives’ endorsement of positive machismo beliefs was associated with higher levels of their own MS, whereas moderate levels of positive machismo were associated with higher levels of MS for husbands. In contrast, wives’ endorsement of negative machismo was associated with lower levels of their husbands’ MS (a partner effect). Additional analyses revealed that among low-acculturated couples, husbands’ positive machismo was positively associated with their own MS, but not among high-acculturated couples. Among wives, we found the opposite pattern: wives in low-acculturated couples showed no association between positive machismo and MS, but among high-acculturated couples, wives’ endorsement of positive machismo was positively associated with their own MS. These findings call for a more nuanced understanding of positive and negative machismo and challenge stereotypical notions of machismo still prevalent in popular culture and research as intrinsically pathological.

Thus, the TACER-3 was more effective at selectively identifying women drinking at fetal risk levels than the original T-ACE. The TACER-3 allows for more efficient use of healthcare provider time in directing targeted clinical interventions with pregnant women identified as drinking at fetal risk levels.