Achieving Competency in Treating the Latino Population

Latinos and Alcohol Use/Abuse Revisited: Advances and Challenges for Prevention and Treatment Programs

Melvin Delgado, PhD, editor; The Haworth Press, Inc., Binghamton, N.Y., (800) 429-6784; 2005; ISBN: 978-0-7890-2926-3; softcover; 221 pages; $24.95.

According to a 2003 Pew Hispanic Center report, the Latino population in the United States will increase from 35.3 million in 2000 to 60.4 million in 2020, making up 18% of U.S. residents. Much of this growing population is young. In 2000, 35.7% of the Latino population was younger than age 18, compared with 23.5% of non-Hispanic whites being under 18. In view of these numbers, Melvin Delgado's look at challenges in serving this population functions as a timely guide for addiction treatment and prevention professionals interested in developing culturally competent programs for Latino youth.

Dr. Delgado, a professor of social work at Boston University, is establishing a center for research training in urban communities of color, and he has gathered research and current opinions covering the spectrum of issues concerning alcohol and drug abuse treatment professionals' work with the Latino population. The book consists of three sections, looking at setting the context for Latinos and alcohol, exploring prevention and treatment considerations, and summarizing prevention and treatment strategies for professionals. Twelve chapters address the needs of various subgroups, including Puerto Ricans, Dominican-Americans, gang members, rural grandparents raising children of substance-abusing parents, and incarcerated Latinas.

Justice focus

Of particular interest is a chapter on the need for culturally specific programs for juvenile offenders. Edward Pabon, PhD, assistant professor of social work at Marywood University in Scranton, Pennsylvania, writes that Latino youths are disproportionately represented in the juvenile justice system and receive “harsh and disparate treatment at all stages of the justice system,” from arrest to the courtroom experience to sentencing. This situation will not change by itself, Dr. Pabon writes. And service programs designed with the white population in mind will not serve to prevent more Latino youths from entering the justice system, he adds.

Dr. Pabon maintains that if the culturally specific needs of this group are not ad-dressed, Latino youths with substance use problems who enter the juvenile justice system are likely to wind up in adult correctional systems. He highlights the use of Circulos del Cuidado (Circles of Care) as a vehicle for delivering culturally relevant services. Dr. Pabon writes that these talking circles, traditionally used in Native American cultures, constitute a partnership arrangement among government officials, family members, and members of the community, in which the family unit's integrity is respected and the focus is on strengthening family and community supports.

Participation in these circles is voluntary, with the emphasis on group members having the ability to design their own curriculum for addressing problems they are experiencing as a family. These circles create, Dr. Pabon says, opportunities for parents and members of the extended family to feel responsible for their children.

Dr. Pabon writes:

The core idea of the [Circles of Care] service approach is a meeting of all family members, juvenile justice officials, other persons involved with the family and the youngster, and interested community neighbors to plan for the care and protection of Latino youngsters at risk for deeper penetration into the juvenile justice system in terms of prevention and intervention…. While building on the perspective that ser-vices directed to the Latino community require attention not only to the importance of the family, the concept also involves the inclusion of other extended family members and institutions. Thus it involves the use of the natural supports seen as preference in Latino help-seeking behavior patterns.

Alcohol and drug treatment professionals involved in developing culturally competent treatment and prevention ser-vices are likely to find this book to be an informative guide.

Other resources

Assessment of Addictive Behaviors (second edition)

Dennis M. Donovan and G. Alan Marlatt (eds.); Guilford Publications, (212) 431-9800; $55

This book is designed to illustrate to practitioners and students how assessment can be worked into all aspects of the treatment continuum, from initial screening through posttreatment monitoring. Chapters present an overview of assessment challenges associated with a particular substance. New chapters in the second edition cover areas such as club drugs, gambling problems, and risky sexual behaviors.

The Addiction Counselor's Desk Reference

Robert Holman Coombs and William A. Howatt; John Wiley and Sons, (201) 748-6358; $35

This quick-reference tool includes definitions of addiction-related terms, information on addictive disorders, descriptions of treatment techniques, and lists of resources for the field, including treatment centers. The publication is designed to serve as a daily reference for professionals. Coombs is a professor of biobehavioral sciences at the University of California at Los Angeles School of Medicine; Howatt is on the faculty of the Nova Scotia Community College School of Human Services.

Behind the Eight Ball: Sex for Crack Cocaine Exchange and Poor Black Women

Tanya Telfair Sharpe, PhD; The Haworth Press, (800) 429-6784; $24.95

Using the powerful words of many African-American women, this book illustrates the extent to which individuals addicted to crack will risk illness, injury, and pregnancy to support their addiction. Dr. Sharpe is a research behavioral scientist with the Centers for Disease Control and Prevention's HIV/AIDS division. The book presents sex-for-crack barter as evidence of social exclusion and systemic racism that have destroyed the self-image of low-income African-American women.

12 Steps for Those Afflicted with Chronic Pain: A Guide to Recovery from Emotional and Spiritual Suffering

Stephen Colameco, MD, MEd; BookSurge Publishing, (866) 308-6235; $12.99

Dr. Colameco, an addiction specialist who also treats patients with chronic pain, says he has found that individuals with chronic pain are in as much need of recovery as those with addictions are. He presents a behavioral approach to pain management, saying that medical treatments for chronic pain have generally fallen short. Yet he sees his approach as complementing medical care, not replacing it.

Clinical Manual of Addiction Psychopharmacology

Henry R. Kranzler, MD, and Domenic A. Ciraulo, MD (eds.); American Psychiatric Publishing, Inc., (800) 368-5777; $52

This book combines detailed pharmacologic descriptions of drugs of abuse and the medications used to treat abuse/dependence with clinical guidance on the optimal use of pharmacotherapies. The review of major categories of drugs of abuse includes a look at hallucinogens, club drugs, and inhalants. The book's final chapter examines psychotherapies in the treatment of substance use disorders and looks at the interaction of psychotherapy and pharmacotherapy. Therapeutic topics explored in this chapter include brief interventions, cognitive-behavioral therapies, behavioral couples therapy, and 12-Step approaches.

The Treatment of Opioid Dependence

Eric C. Strain, MD, and Maxine L. Stitzer, PhD (eds.); The Johns Hopkins University Press, (800) 537-5487; $30

The successor to the co-authors' 1999 book Methadone Treatment for Opioid Dependence, this volume devotes a great deal of attention to methadone but also details the clinical use of buprenorphine. In addition, authors explore the latest research on the use of the medications naltrexone, clonidine, and lofexidine in the treatment of opioid dependence. Two chapters examine non-medication alternative treatments, including medically supervised withdrawal as stand-alone treatment. Special treatment topics that are addressed in this volume range from treatment of individuals under legal restrictions and the challenges surrounding pain management in addicted persons.

Treating Alcohol and Drug Problems in Psychotherapy Practice: Doing What Works

Arnold M. Washton and Joan E. Zweben; Guilford Publications, (212) 431-9800; $35

Focused specifically on treatment in the psychotherapy office setting, this guide offers information on assessment, diagnosis, and treatment for a variety of alcohol and drug problems. The authors focus on using a diversity of techniques based on an assessment of the client's readiness for change. The psychotherapeutic approach described in the text relies heavily on building a strong therapeutic relationship and addressing substance abuse within the larger context of clients' lives. Case vignettes and client handouts supplement the text.