A systematic review of depression psychotherapies among Latinos

Abstract

For decades, the literature has reported persistent treatment disparities among depressed Latinos. Fortunately, treatment development and evaluation in this underserved population has expanded in recent years. This review summarizes outcomes across 36 unique depression treatment studies that reported treatment outcomes for Latinos. Results indicated that there was significant variability in the quality of RCT and type/number of cultural adaptations. The review suggested that there might a relation between cultural adaptations with treatment outcomes; future studies are warranted to confirm this association. Cognitive Behavioral Therapy was the most evaluated treatment (CBT; n = 18, 50% of all evaluations), followed by Problem Solving Therapy (PST; n = 4), Interpersonal Therapy (IPT; n = 4), and Behavioral Activation (BA; n = 3). CBT seems to fare better when compared to usual care, but not when compared to a contact-time matched control condition or active treatment. There is growing support for PST and IPT as efficacious depression interventions among Latinos. IPT shows particularly positive results for perinatal depression. BA warrants additional examination in RCT. Although scarce, telephone and in-home counseling have shown efficacy in reducing depression and increasing retention. Promotora-assisted trials require formal assessment. Limitations and future directions of the depression psychotherapy research among Latinos are discussed.

The impact of race and ethnicity on rates of return to psychotherapy for depression

“…Our findings are supported by the limited literature in this area that providers and organizational culture contribute to dropout in psychotherapy. Potential factors, although some are controversial, include lack of racial, ethnic, and language concordance between providers and patients (Collado, Lim, & MacPherson, 2016;Sripada et al, 2016), poor therapeutic alliance (Cooper et al, 2016;Johansson & Eklund, 2006), and lack of cultural competence (Imel et al, 2011). Implicit racial bias of healthcare providers, although not studied specifically in psychotherapy dropout and effectiveness, has been implicated in a number of studies on treatment outcomes in racial and ethnic minority patients (Green et al, 2007;Spoont et al, 2015).…”

Latino immigrants, depressive symptoms, and cognitive behavioral therapy: A systematic review

“…Cognitive Behavioral Therapy (CBT) remains widely used and the most evaluated treatment for depression for Latinos (Collado et al, 2016) and Latino immigrants (Antoniades et al, 2014); and thus, holds promise for Latino immigrant populations (Stacciarini et al, 2007).…”

“…The closest the literature comes to addressing this gap can be found in two systematic reviews. In the more recent study, Collado et al (2016) summarized 36 studies of depression treatment for Latinos that examined a variety of interventions: Behavioral Activation, CBT, Interpersonal Therapy, Problem-Solving Therapy, and Structural Ecosystems Therapy.…”

“…Unfortunately, because the reviewers did not distinguish between Latino immigrants and other immigrant groups (here or abroad), the effectiveness of CBT with immigrant Latinos in the U.S. remains an open question. Moreover, like the Collado et al (2016) review, the investigators did not consider how geographic characteristics might affect treatement outcomes (Antoniades et al, 2014). The current review fills this gap by examining the effectiveness of CBT with immigrant Latinos and by describing how CBT has been culturally adapted and used with Latino immigrants in both urban and new growth communities.…”

Depressive Symptoms and Relationship Between Genders: Differences in Young Adults in a Randomized Clinical Trial

“…In terms of psychotherapy, studies reveal significant improvement in depressive symptoms after intervention with brief psychotherapy (Collado, Lim, & MacPherson, 2016;Silva et al, 2016), as well as with brief psychotherapy plus medication when compared with medication alone (Bressi, Porcellana, Marinaccio, Nocito, & Magri, 2010;Hollon et al, 2005Hollon et al, , 2014. However, no differences between genders were addressed in the literature.…”