Culturally Relevant Treatment Often Engages the Family First

Family involvement increasingly is being appreciated as a pivotal component of effective substance use treatment. In working with the Hispanic/Latino community, however, a clinical director suggests to Addiction Professional that this realization has been there for some time, as a must-have in order to carry any hope for success.

Where the American family is about individuation, says Ana Moreno, MS, LMHC, of Miami-based Family Recovery Specialists, the Hispanic culture of the family emphasizes being part of the collective (“until the day you drop dead,” she quips). Without effective communication with the patient's family, numerous risks for derailing treatment progress will surface.

For example, “If you tell family members that they need to kick their loved one out of the house, they will run out of your office, or look at you like you're absolutely crazy,” says Moreno, Family Recovery Specialists' co-founder and clinical director.

The outpatient detox and rehabilitation organization, which operates fully bilingual and culturally relevant services for the Hispanic population, is part of the Delphi Behavioral Health Group.

Addressing resistance

Moreno says family members in the Hispanic culture will ultimately tend to become very engaged in their loved one's treatment process. But taking the first steps toward pursuing treatment often poses a challenge.

“There is still quite a bit of stigma for recovery services,” she says. “Substance use disorders are still seen as bad parenting, a reflection on the family.”

Opportunities to educate abound, then. Offering family members information about the neurobiology of addiction can make a major difference in diminishing shame, Moreno says. Resistance toward asking for help tends to be especially pronounced among Hispanic males, she says.

It also might become important to address misconceptions about alcohol's risks head-on. “There is difficulty seeing alcohol causing as much interference as it really is,” Moreno says. “Family members talk about people from their country starting to use alcohol at 14. There's more justifying and rationalizing.”

Facilities serving the Hispanic/Latino population also should be mindful of the important influences of religion and spirituality in these individuals' countries of origin, Moreno suggests.

Programs also need to remain aware of nuances in the cultural norms of people from different Hispanic cultures, she adds. Family involvement generally remains a common thread, however, which could mean a larger-than-typical attendance at an intervention, or perhaps an expansive approach where the patient or family wants a priest or family doctor actively engaged as well. “I will add whoever they want to add,” Moreno says.