Cognitive Processing Therapy for Spanish-speaking Latinos: A Formative Study of a Model-Driven Cultural Adaptation of the Manual to Enhance Implementation in a Usual Care Setting

J Clin Psychol. 2017 Mar;73(3):239-256. doi: 10.1002/jclp.22337. Epub 2016 Jul 5.

Abstract

Objective: As part of a larger implementation trial for cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) in a community health center, we used formative evaluation to assess relations between iterative cultural adaption (for Spanish-speaking clients) and implementation outcomes (appropriateness and acceptability) for CPT.

Method: Qualitative data for the current study were gathered through multiple sources (providers: N = 6; clients: N = 22), including CPT therapy sessions, provider fieldnotes, weekly consultation team meetings, and researcher fieldnotes. Findings from conventional and directed content analysis of the data informed refinements to the CPT manual.

Results: Data-driven refinements included adaptations related to cultural context (i.e., language, regional variation in wording), urban context (e.g., crime/violence), and literacy level. Qualitative findings suggest improved appropriateness and acceptability of CPT for Spanish-speaking clients.

Conclusion: Our study reinforces the need for dual application of cultural adaptation and implementation science to address the PTSD treatment needs of Spanish-speaking clients.

Keywords: Latinos; cognitive processing therapy; cultural adaptation; implementation; posttraumatic stress disorder.

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / methods
  • Cognitive Behavioral Therapy / standards*
  • Culturally Competent Care / methods
  • Culturally Competent Care / standards*
  • Female
  • Hispanic or Latino / psychology*
  • Humans
  • Male
  • Manuals as Topic / standards*
  • Middle Aged
  • Qualitative Research
  • Stress Disorders, Post-Traumatic / therapy*
  • Young Adult