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Treatment - CBT

Analyzing the Impact of Language Barriers on CBT Experience for Pediatric Anxiety in Spanish- Speaking Families

(PS3-64) Analyzing the Impact of Language Barriers on CBT Experience for Pediatric Anxiety in Spanish- speaking Families

Friday, November 15, 2024

11:30 AM – 12:30 PM EST

Location: Franklin Hall, Level 4, Marriott Downtown

Author(s)

Vivian Tapia, M.A.

Therapist and Research Coordinator
Children's Hospital Los Angeles
Hacienda Heights, California, United States
Amy E. West, ABPP, Ph.D.

Professor of Clinical Pediatrics, Psychology, and Psychiatry & the Behavioral Sciences
Children's Hospital Los Angeles/University of Southern California
Los Angeles, California, United States

Abstract Text: Cognitive-behavioral therapy is an effective treatment for pediatric anxiety (Howes Vallis, Zwicker, Uher, & Pavlova, 2020). However, the implementation of CBT in culturally and linguistically diverse populations is not well understood. The Sequential Multiple Assignment Randomized Trial (SMART) for Pediatric Anxiety is a large randomized clinical trial designed to assess treatment optimization and effectiveness in a predominantly Latinx youth population and caregivers in Los Angeles County. (Peterson et al., 2021). Many caregivers enrolled in the trial are monolingual Spanish speakers, thus, a critical component of implementing exposure-based CBT has examined language and translation barriers. The SMART Study involves N=272 patients with pediatric anxiety assessed for symptoms and psychosocial functioning domains at baselines and randomly assigned to receive medication (Prozac) or CBT (Coping Cat). After 12 weeks, if not fully remitted, youth are re-randomized to either (1) optimize current condition (medication or CBT) or (2) optimize current condition and add other condition. After 24 weeks of treatment, families and clinicians participate in a qualitative interview to assess: treatment satisfaction, barriers, facilitators, adherence, symptom reduction, coping skills and rapport. The current proposal interviews a subgroup of monolingual Spanish speaker caregivers and clinicians. Using qualitative data analysis methods in the larger qualitative study, we conducted thematic analyses utilizing NVivo and examined themes related to challenges for therapists, caregivers, and patients when language and translation issues arise. Challenges related to language include difficulty understanding translation and principles of CBT treatment and materials, as has been documented in other studies (Chavira, D. A., et al., 2014). Due to implementation of CBT designed and manualized in English, traditional barriers may arise for monolingual Spanish speaking patients i.e., stigma, therapeutic alliance, and cultural differences. The previously unreported disparity lies in the lesser comprehension of Cognitive Behavioral Therapy (CBT) principles among Latinos. This difference could potentially stem from language barriers affecting either the understanding of translated CBT materials or the patients' conveyance of their comprehension to the anxiety clinical specialist. (Chavira, D.A., et al., 2014). Ultimately, this research examines monolingual Spanish speaking families experience to implement practical strategies and cultural responsiveness for therapeutic outcomes in CBT when navigating pediatric anxiety disorders. “Vera et. al (2022), Several constraints in the interpretation of our data warrant consideration. Substantial evidence supports the notion that the mental health care needs of Latinos remain largely unmet.” This study aims to unveil the lived experiences, perspectives and challenged faced by both therapists and families when language and translation issues arise.