Thirty-six Native American tribal leaders and members living on contiguous rural Southwest California reservations were surveyed concerning their view of the acceptability of a Motivational Interviewing (MI) intervention to youth (ages 8–18 years) who are drinking and their families The results suggest that: (1) a substantial proportion of reservation youth would be willing to accept MI for behavior change; (2) relatively few are actually ready to change; (3) most reservation youth are in the pre-contemplation stage of change; and (4) MI may be well suited as an intervention to prevent underage drinking in that population Supported by NIH

Acceptability of the use of Motivational Interviewing to Reduce Underage Drinking in a Native American Community

Culturally appropriate mental health services are essential for Indigenous people who suffer the greatest mental health disparities of any ethnic group in the U.S. However, few mental health professionals receive training to work with this population. To fill this gap, a 90-minute training was created to increase knowledge of and empathy for Indigenous people and culture and therefore, improve mental health services for Indigenous patients. This training is grounded in cultural competency, cultural humility, and decolonialism. The training is presented here for mental health professionals, agencies, and administrators to use as a guide. The training aims to increase knowledge, awareness, and skills and has been implemented in a variety of settings receiving positive feedback from participants and administrators.

Decolonizing Mental Health Services for Indigenous Clients: A Training Program for Mental Health Professionals.

TIP 59: Improving Cultural Competence

A pilot randomized trial of Motivational Interviewing compared to Psycho-Education for reducing and preventing underage drinking in American Indian adolescents.

African Americans experience unique obstacles when interfacing with mental health services. Evidence of persistent disparities in treatment engagement, utilization, and quality between African Americans and European Americans has led many to conclude that treatment must be culturally tailored for African Americans. Underlying calls for increased cultural competence are assumptions regarding the effectiveness of standard treatment approaches with African Americans and the ubiquitous benefits of cultural tailoring. In this chapter, we critically assess these assumptions and review the empirical literature on treatment outcomes with African Americans and the effects of culturally tailored interventions. Overall, we find that psychotherapy, including standard and culturally tailored treatment, is generally effective with African Americans. Additionally, we show that although cultural tailoring can enhance treatment outcomes, not all forms of tailoring are equally efficacious and some types can even attenuate outcomes. Based on the empirical evidence, we provide recommendations for tailoring treatment and improving the quality of mental health services for African Americans.

Cultural Competence in Therapy with African Americans

This study evaluated the cross-cultural transportability of motivational interviewing (MI), an evidence-based addiction treatment method. Free clinical training in MI was offered in separate targeted workshops for 86 African American, Native American, and Spanish-speaking addiction treatment providers. Audiotaped pre- and posttraining clinical work samples were coded for indexes of MI competence. In all 3 samples, posttraining gains in MI proficiency were at least as large as those found earlier with predominantly non-Hispanic White providers. Combined with evidence for the efficacy of MI in minority populations, these findings support the cross-cultural applicability of MI.

Ani Bisono

Papers

Cross-Cultural Training in Motivational Interviewing