Nicole Bagarella
Cultural Psychology Final Paper
Prof. Seeley
Multicultural Competency in Couples and Family Therapy for Latinos
Current demographic studies in the U.S. have shown an increase in the Latino population.
It is one of the fastest growing ethnic groups and is estimated to reach a population of 62 million
by the year 2020 (U.S Census Bureau, 1998). It is important that health care providers and social
services develop strategies to assist this growing ethnic minority, particularly in the field of
psychology. Marriage counselors and family therapists will be required to respond to the increase
in Latino families seeking psychological services by developing multicultural methods of
therapy. Therapists need to acknowledge that traditional white middle class models of
psychotherapy need to adapt in order to become transferable to clients with different cultural
backgrounds. Multicultural competency is essential for family therapists working with Latino
families who experience different socioeconomic and political situations. This essay attempts to
examine issues surrounding the use of multicultural guidelines in developing cultural awareness,
sensitivity and competency in marriage and family therapy for Latinos.
The APA Multicultural Guidelines are based on principles that “articulate respect and
inclusiveness for the national heritage of all groups, recognition of cultural contexts as defining
forces for individuals’ and groups’ lived experiences, and the role of external forces such as
historical, economic, and socio-political events” (APA, 2003, p.382). These guidelines remind
therapists that an individual’s culture affects their perception of life experiences. The first
guideline encourages psychologists to recognize that they may hold attitudes and beliefs which
can detrimentally influence their perception of and interactions with individuals who are
1
ethnically and racially different from themselvesi. In order to be aware of race-based stereotypes
or underlying racism that may affect the treatment, therapists should reflect on these existing
biases and their triggers, to encourage the development of cultural sensitivity when treating their
clients. Issues may arise when therapists adopt a color-blind approach and focus on universal
behaviors or values that endorse assimilation with the Caucasian majority group. This approach
deemphasizes the influence that racial and ethnic group membership has on minoritiesii.The
second guideline encourages psychologists to recognize the importance of multicultural
awareness and sensitivity in their treatment of racial or ethnically diverse individualsiii.
Acquiring knowledge about a client’s racial, ethnic or spiritual identity will help therapists
understand different worldviews and perspectives which, in turn, will improve communication
and trust between the client and therapist, and allow culturally relevant discussions to take place.
Knowledge of both Latino history and the current legislative attention facing Latinos may help
therapists understand their client’s behavior and experience within a relevant social contextiv.
The third guideline states that as educators, psychologists are encouraged to employ the
constructs of multiculturalism and diversity in psychological discussionv. Addressing
multicultural issues in psychological education is an important process in training therapists that
will find themselves treating clients from varying cultural backgrounds. Omitting the role of
culture in psychological development and theory is another form of the color-blind approach.vi
The fourth guideline encourages psychologists to recognize the importance of conducting
culture-centered and ethical psychological research among persons from different minority
backgroundsvii. As was discussed in the introduction, psychologists should perform research that
is relevant to national demographic changes. These include the rise of bilingual, non-English
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speaking and multiracial individuals (U.S Census Bureau, 2003). Research on couples and
families should be culturally relevant, and reflect the growing diversity of races and cultures
within the U.S. This could lead to research regarding variations in the expression of emotions
among individuals of differing cultures living in the U.S. Some populations (including Latinos in
the U.S.) do not experience or express emotions in the same way that Caucasian middle-class
Americans do. There are also variations between cultures with respect to family structures,
relationship structures and the definitions of emotions and standards that may affect the
functioning of relationships. The fifth guideline encourages psychologist to apply culturally
appropriate skills in clinical and other applied psychological practicesviii. Acquiring sufficient
knowledge of a client’s history, ethnic or religious membership and other relevant cultural
experiences, will facilitate the creation of culturally-adapted treatment. Psychologists can modify
traditional interventions to fit the client or create new methods of intervention by using cultural
elements and information. This may involve using holistic, religious or communal
interventionsix. It is possible that in Latino families and couples, interventions incorporating the
extended family, religion or external cultural sources are more effective than traditional methods
of psychotherapy involving almost exclusively individual counseling. The sixth guideline
suggests that psychologists use organizational change to support culturally informed policy
development and practices.x Organizational change would involve participation in local, state
and national legislative effortsxi. Adherence to these guidelines will facilitate therapists’ ability to
be culturally competent in their practice. The following case studies demonstrate the importance
and effectiveness of these guidelines when treating Latino patients in family therapy.
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Constructing Cultural Competence: Perspectives of Family Therapists Working with
Latino Families by Taylor, Gambourg, Rivera and Laureano presents issues that emerged from
nine therapists’ experiences counseling Latino families. Five major themes emerged from the
narrative interviews which include: the use of language in therapy, Latino definitions of family,
issues of immigration and culture clash, the impact of social class, gender and power between the
client and therapist and constructions of cultural competence.xii All therapists agreed that
proficiency in Spanish was an essential tool in understanding clients’ experiences and
expressions. When clients feel that they are understood in their own language, certain barriers are
removed in therapy. Therapists who grew up speaking Spanish found it easier to understand
Latino culture and thus were better able to empathize with Latino patients.xiiiHowever, Spanishspeaking therapists were careful to notice differences in the meaning of particular words when
addressed to Latino clients from varying Latin American countries: “cultural competence has
more to do with negotiating and co-constructing meanings with clients, rather than superficially
speaking the same language and assuming that clients will understand” (pg. 437). The bilingual
therapists in this article considered it important to recognize that meanings may shift depending
on the client’s national background. Allowing patients to clarify the meaning of words with their
therapists will allow psychologists to learn more from each individual Latino client.xiv
Differences were also found between American Latinos and Latin American clients. “Latinos
born in the U.S privilege issues of race over issues of social class” (pg. 437). Therapists realized
that their position of authority, their accent and their clothes allowed immigrant Latino clients to
assume that they were high class. It is important to discuss issues of power, race and social class
with minorities that have historically been subjected to racism and oppression from other
cultures. Identifying and discussing these issues will help these types of clients trust their
4
therapist. Female therapists struggled with issues of domestic violence, psychological control
and emotional abuse surrounding Latina clients. Self-awareness, self-monitoring and personal
experience with victims of abuse allowed therapists to deal with the cultural clash between Latin
American values and the American notions of equal rights and corporal punishment.xvAnother
salient topic is the culture clash that takes place between family members of different
generations. Children of Latino immigrants are usually more acculturated to mainstream U.S
culture and this can cause internal family dynamics to suffer. Using the concept of
“biculturalism”, therapists attempted to help bilingual clients preserve adaptive skills from both
their native culture and American society.xvi Other helpful interventions included obtaining
“migration narratives”, including traditional healing methods and assuring that a client’s belief
system was not devalued.xvii These techniques allow therapists to understand each family’s
cultural and migratory experiences, allowing them to customize treatments. A key component of
treatment efficiency is a therapist’s willingness to learn from their clients. Understanding Latino
family structures is also crucial in family therapy. Unity, loyalty and cooperation with members
beyond the nuclear family were some of the values related to the extended family that emerged
in these case studies: In these family systems, Latinos reported believing that they were a
problem for their families. Therapists who had previously worked with Anglos noted that they
were more likely to assign external sources as problematic. Therapists attempting to use Bowen’s
family systems theory realized that the concept of “low-differentiation and high reactivity” could
not be properly applied to cultures that have suffered from events such as discrimination, racism,
and sexual harassment. Traditional Western stage models do not take into consideration that
clients may express symptoms that are heavily influenced by their historical and cultural context.
Therapists in these case studies avoided traditional interventions and used a narrative approach:
5
“it broadens the exchange of one’s family, friends, institutions, and socio-cultural constructions.
It also values emotional experiences and relationships.”(pg.441). It is clear then, that therapists
can collaborate with Latino clients to develop alternative forms of treatment that are more
culturally relevant than traditional western methods. The next case study demonstrates how a
therapist’s creativity is part of the therapeutic process.
Culturally Creative Psychotherapy with a Latino Couple by an Anglo Therapist by
Declan Barry and Wesley Bullock describes a case study of a Chilean couple living in the
Midwest that decided to receive couples counseling. Jose and Gabriela, two Chilean immigrants
who attended a Midwestern university, are both fluent in Spanish and English and have lived in
the U.S. for four years. Both Jose and Gabriela had received individual therapy before; Jose had
gone to two psychodynamic therapists in Chile and a Jungian therapist in the U.S. while Gabriela
had seen two psychodynamic therapists in Chile and had completed a trial of cognitivebehavioral therapy in the U.S. They had also received marital therapy in Chile. Jose disliked
marital therapy stating that the therapist had reportedly not liked him and had instead favored his
wife.xviii A therapist’s bias against clinical couples, specifically against clinical husbands, has
been documented in studies (Wampler & Sun Ro, 2009) and can potentially hinder the diagnosis
and treatment of couples. If context and culture are not factors considered when examining
behavior, therapists could harm a relationship’s progress by perceiving men as aggressive, cold
and unwilling to cooperate. Gabriela and Jose’s relationship had undergone many stressful
situations, including Jose’s temporary abandonment and Gabriela’s sexual affair with their
church minister. The therapist used a multi-model approach that relied on strategic and
experiential techniques to examine the client’s roles, rules and behavioral patterns in the
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relationship.xix Based on the second APA Multicultural Guideline regarding knowledge about
ethnically and racially different individuals; the therapist explored the couple’s life before
coming to the U.S., their respective family history, their social network and their perceptions of
their ethnic group. The therapist realized that the couple was living in a marginalized world with
no friends in the host country and no contact with family members back home. In order to
discuss these issues, the therapist employed a tradition used by the couple to teach their daughter
moral lessons. This involved the use of a multiethnic doll collection through which to express the
couple’s adaptation to one another and to their new host culture.xx At the same time, the therapist
assigned the couple to watch different movies with themes related to immigration, freedom,
relationships and strong moral beliefs. Watching movies provided clients with a working
distance to explore their feelings; they paid attention to how the movie characters influenced
each other, how their relationship changed over time and how they could relate to specific
characters.xxi These methods are associated with the APA’s fifth guideline regarding culturally
appropriate skills in practice. Through these interventions, underlying themes of poverty,
prejudice towards Mexicans, ethnic ties and family heritage emerged. The therapist went as far
as to include a cultural enactment during a session, where the couple confessed their sins to each
other and asked for forgiveness. This ritual was seen as appropriate, given the couple’s Catholic
background and the frequent discussions of morality that took place during therapy. Forgiveness
and acceptance expressed in a culturally creative fashion were key factors of therapeutic change
in this case study.xxii These creative approaches to family therapy allowed the couple to
communicate more effectively with each other. The use of dolls allowed the couple to
“crystallize” their attitudes toward their native culture and American culture, eventually leading
them to seek opportunities to socialize with Latinos and Americans in their environment. The
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dolls provided a creative element to aid the couple in expanding their support system abroad.
Issues of acculturation and adaptation to host countries are recurrent with immigrant couples and
should be addressed to allow individuals to function optimally in their new environments. By
taking a couple’s traditional instructive element (the dolls) and combining it with culturally
relevant exercises and rituals, the Anglo therapist was able to help Jose and Gabriela let go of
built-up anger and guilt. Being able to relate to the client’s world is essential in a multicultural
competent practice. The following study relates to APA’s fourth guideline regarding culturally
sensitive research.
Busby and Parra-Cardona’s study Exploring Relationship Functioning in Premarital
Caucasian and Latino/a Couples: Recognizing and Valuing Cultural Differences looks at
differences in relationship functioning amongst Latino and Caucasian premarital couples. They
used an expanded version of Gottman’s Cascade Model of Relationship Dissolution and then
analyzed specific variables related to important values in Latino culture.xxiii The researchers
assumed that analyzing relationship functioning among premarital couples would be a good
indicator of a couple’s future risk of experiencing severe marital difficulties. Gottman’s model
has been able to predict couples heading for divorce with a 93 percent accuracy rate (Gottman,
1994). Hostility, instability, violence and empathy were four additional variables included in the
original four component model. Gottman expected the final outcome to be similar across
different ethnic groups (Gottman, 1999). This concept does not take into account various cultural
factors that may disprove his model and poses a color-blind approach to therapists who may use
it. The model assumes that the components of criticism, defensiveness, contempt and flooding
are elements that are experienced and expressed by different ethnic groups. As the results
8
showed, this is not the case for Latino couples. Personalismo (high level of emotional resonance
in interpersonal encounters), machismo (the expectation that a man will be honorable,
responsible and loving toward his family), marianismo (the expectation that a woman should be
submissive, self-sacrificing, religious, humble and modest), familismo (a value that highlights the
priority of family connections and participation) and armonia (building and maintaining strong
interpersonal connections) are noted by the authors as concepts that therapists should be aware
of, but which may also lead to stereotyping of Latinos from different backgrounds. This relates
to the APA’s first and second guidelines, where therapists must be aware of a group’s
worldview, perspective and values but must also be cognizant of race-based stereotypes that can
form if information is not properly categorized and understood to vary within individuals. The
Relationship Evaluation Questionnaire, a 271 item self-report instrument was used to explore
additional differences between the couples: gender roles, communication and autonomy from
family of origin.xxiv Analysis revealed that the Cascade model was not equivalent for Latinos and
Caucasians. Most paths were significant for Caucasians while there were many non-significant
paths for Latinos. The expected negative correlation between empathy and defensiveness was not
found in Latino males. Males who report higher scores of empathy did not necessarily have
lower scores on defensiveness.xxv The study also found that the greater the degree of empathy
Latina females experience for their partner, does not necessarily reduce the amount of criticism
they will express towards their partner. This suggests that the way empathy influences negative
interactions may be very different for Latino couples.xxvi The path leading from criticism to
flooding (feeling emotionally and physiological overwhelmed) was not significant for Latinos
either. It may be that flooding and empathy scales do not accurately capture the experience of
Latinos with respect to these psychological constructs. The researchers suggest that their
9
findings might indicate missing variables that influence the components of the Cascade model.
Busby and Cardona also question the components of the Cascade Model, suggesting that
flooding may be an irrelevant construct to include when studying Latinos. With regards to the
cultural values of armonia and familismo, low scores in communication and autonomy from
family were interpreted as being inconsistent with communication aspects related to armonia.
Familismo was established as a positive protective factor in Latino families, which could explain
the decrease in autonomy from family. The authors stated that perceived discrimination and
stress from cultural identity need to be included into future studies. Following the APA
guidelines, Busby and Cardona recognize that interpreting relationship functioning among
minorities without developing sensitivity to anxiety provoking influences can lead to misleading
results.xxvii Despite the study’s clear limitations, the researchers provided culturally informed
suggestions and explanations to account for their results. This type of awareness within research
is beneficial to future studies in order to collect information that will be culturally sensitive and
useful in practice. When choosing culturally appropriate treatment, is it important to recognize
the differences between cultural interventions and culturally sensitive therapies.
Len Sperry’s Culture, Personality, Health, and Family Dynamics: Cultural Competence
in the Selection of Culturally Sensitive Treatments distinguishes three different type of culturally
sensitive treatment. A “cultural intervention” relies on a method that is consistent with the
client’s belief system regarding healing and has the potential to effect a specified change. xxviii
Some examples include prayer, exorcism, healing circles and traditional healers. The previous
case study with Jose and Gabriela used a religious ritual (i.e. confession), to promote efficient
communication and forgiveness. Identifying possible cultural interventions for Latino families
10
follows the tenents of the second and fifth APA multicultural guidelines. Knowledge of a
group’s historical and religious identity can guide the therapist to recommend treatment
alternatives that are not necessarily based on traditional Western clinical approaches. Focusing
on cultural values such as personalismo also increases the therapist’s credibility, allowing the
client to view the therapist as trustworthy and effective.xxix “Culturally sensitive therapy” is
another form of therapy endorsed by Sperry. Culturally sensitive therapy involves
psychotherapeutic interventions that address the client’s cultural characteristics such as beliefs,
customs, attitudes, and socioeconomic and historical context. This form of therapy may seem
appealing to clients who question traditional Western approaches. According to Sperry, clients
with low levels of acculturation such as immigrants find this type of therapy to be effective. In
Gabriela and Jose’s case, the use of the multiethnic doll collection to discuss family and moral
values could be considered a form of culturally sensitive therapy. The last type of culturally
competent therapy that Sperry defines is labeled “culturally sensitive intervention”. Culturally
sensitive interventions include Western psychotherapeutic interventions that have been modified
to the client’s cultural customs and practices.xxx Cognitive behavioral therapy is often used to
teach clients’ important problem-solving skills. Another culturally sensitive intervention is the
explanatory model. This model allows clients to explain how they view the causes of their
symptoms. Often, such client explanations and illness perceptions reflect key cultural values,
beliefs, sanctions and taboos that can interfere with the treatment process and outcomes if not
heeded.xxxiIt is important to acknowledge the differences between culturally sensitive treatments
in order to provide the “best fit” intervention. The following interview with a psychology
professor further highlights the responsibilities that therapists working with Latino families
11
should consider when developing a multicultural practice. Patricia Arredondo’s models allow
therapists to identify individual characteristics before choosing the appropriate treatment.
Patricia Arredondo’s specialty is in the area of immigrants and life change processes,
Latina/o issues in counseling, multicultural competency development and organizational
diversity assessment.xxxii She served as the President of the American Counseling Association,
Association of Multicultural Counseling and Development and Latino Professional Network of
Boston.xxxiiiArrendondo’s experience and participation with culturally informed institutions
makes her a consummate follower of the APA’s multicultural guidelines, in particular the third
and sixth guidelines. These guidelines encourage psychologists to employ constructs relating to
multiculturalism and diversity in psychological education as well as support culturally informed
organizational development. Her job as a professor of educational psychology in the University
of Wisconsin allows her to mentor Latino/a students and other emerging professionals. xxxiv In
this interview conducted by Betty Cardona and Lia Softas-Nall, Arredondo states that teaching
multicultural competency to counselors and psychologists is a necessity. Through her private
practice in Boston, she was able to treat women by focusing on their cultural/ethnic and religious
upbringing. Treating Latino immigrant families usually entails acculturation issues between
parents and children. When children learn to navigate the English-dominant world better than
their parents, role reversal and changing values become recurring themes in therapy. This in turn
frustrates both teenagers, who are responsible for many adult matters, and their parents who are
feeling pressure to earn enough to support the family.xxxv Therapists treating immigrant families
should always be aware of the historical, social and socioeconomic factors that are exerted on
their client’s daily life. Arrendondo formed part of a group that prepared Latino-specific
12
competencies in the 2002 version of The Multicultural Counseling Competencies (SantiagoRivera, Arredondo & Gallardo-Cooper). In it, she identifies four different family structures that
therapists must be aware of: intact, single-parent, bicultural and immigrant, each with its own
challenges and implications for counselors.xxxvi The task of the therapist is to explore ethnic
group differences, generational status, languages spoken, socio economic status and analyze how
these factors combine to socialize women and men of a particular culture. Arredondo’s work
with immigrants has allowed her to create the Latino dimensions model. The three dimensions
allow her to tease out differences between individuals. Component A of the model includes
demographic data and categories; economic status and social class are recognized as separate
elements with economic status being influenced by education, occupation and the state of the
economy. Dimension C deals with historical moments that may define and influence an
individual’s life. Their history of colonization, minority status and multiracial heritages are
components that have affected specific Latino populations both economically and socially.
Historical moments of the C dimension interact with components of the A dimension. Dimension
B involves an individual’s personal decisions such as seeking higher education, seeking
citizenship as well as decisions regarding their relationships with their extended family. To better
understand a Latino client’s worldview and experiences, therapists should consider that the A
and C dimensions influence the B dimension.xxxvii As with previous case studies, Arredondo also
uses “narrative” therapy combined with homework assignments such as reading and journaling
and recommends therapists seek community agencies such as churches in order to develop
interpersonal comfort. In the interview, Arredondo mentions social learning theory as an
important tool for therapists who should be aware of how social context plays a role in the
formation of beliefs and biases. Professionals, such as Arredondo, highlight the importance of
13
individual differences in ethnic minority groups. In her roles as an educator, researcher and
practitioner, Arredondo has developed multicultural competent models to aid therapists working
with Latino families. A final discussion about culture by Robert Sherman allows to us to reflect
on the various aspects of American culture that may affect Latino families.
Robert Sherman’s article Culturally Oriented Techniques is a good example of the third
APA guideline that encourages psychologists to address multicultural issues in psychological
education. His publication educates readers on concepts related to culture. When treating
families with a multicultural approach, it is always important to remember that cultures are
dynamic and changing at a rapid pace. This has implications for therapists who assume that
previous experience treating Latino families, is enough to define themselves as culturally
competent in practice. A therapist must acknowledge culture’s instability and must constantly
educate themselves on current values, family structures, economic changes and other external
influences. The author states that culture’s dynamic nature causes individuals to be in a constant
cultural transition; coping with changes within each culture and the need to behave
appropriately.xxxviiiAs seen in previous discussion, changes in cultural values may be commonly
found in immigrant families experiencing acculturation processes in the U.S. Sherman identifies
“belonging” and “succeeding” in a culture, as two important factors that can influence behavior.
This may involve selecting complex goals that may conflict with “psychic bends” (Hamburger,
1968), which refers to an individual’s conflict in completely giving up former cultural patterns.
Another important element therapists should be aware of is a culture’s myths. According to
Sherman, cultural myths describe the reality of the folk and provide guidelines for life. In the
U.S, popular myths include rugged individualism and the American dream.xxxix These myths can
14
shape values and goals within members of a society. Talking to Latino immigrants about cultural
myths both in the U.S and in their country of origin, allows clients to express which cultural
values are important to them and thus aid the therapist in developing appropriate multicultural
interventions. If an immigrant couple moves to the U.S in hopes of improving their lifestyle, the
therapist could educate the client about the “American dream” myth. This could improve a
couple’s acculturation progress, and motivate them to seek useful institutions for more help.
Sherman suggests helping families reconnect with their roots, revitalize or adopt useful customs
and traditions, reexamine and reinterpret cultural myths in a constructive and functional way,
will increase their sense of belonging which will then allow them to function more effectively
within society.xl
Multicultural competency in marriage and family therapy involves many components. By
following the APA’s Multicultural Guidelines, psychologists have slowly begun to tease apart
what it means to understand a culture and how it affects behavior. With respect to Latinos in the
U.S, several researchers and case studies have been conducted to identify cultural differences
between Latino and Caucasian couples, differences between Latinos from different countries and
cultural issues for Latino immigrants. It is the responsibility of therapists and researchers to
continue addressing cultural issues in psychology to bring out change, and prioritize the study of
multicultural competency in every realm of therapy.
15
i
American Psychological Association. (2003). Guidelines on multicultural education, training,
research, practice, and organizational change for psychologists. American Psychologist, 58, 377402.
ii
Constantine, Wing & Sue. Strategies for Building Multicultural Competence in Mental Health
and Educational Settings. Hoboken, NJ, USA: John Wiley & Sons, Incorporated, 2005. Pg.9
iii
American Psychological Association. (2003). Guidelines on multicultural education, training,
research, practice, and organizational change for psychologists. American Psychologist, 58, 377402
iv
Constantine, Wing & Sue. Strategies for Building Multicultural Competence in Mental Health
and Educational Settings. Hoboken, NJ, USA: John Wiley & Sons, Incorporated, 2005. pg.10
v
American Psychological Association. (2003). Guidelines on multicultural education, training,
research, practice, and organizational change for psychologists. American Psychologist, 58, 377402
vi
Constantine, Wing & Sue. Strategies for Building Multicultural Competence in Mental Health
and Educational Settings. Hoboken, NJ, USA: John Wiley & Sons, Incorporated, 2005. pg.10.
vii
American Psychological Association. (2003). Guidelines on multicultural education, training,
research, practice, and organizational change for psychologists. American Psychologist, 58, 377402.
viii
American Psychological Association. (2003). Guidelines on multicultural education, training,
research, practice, and organizational change for psychologists. American Psychologist, 58, 377402.
ix
Constantine, Wing & Sue. Strategies for Building Multicultural Competence in Mental Health
and Educational Settings. Hoboken, NJ, USA: John Wiley & Sons, Incorporated, 2005. pg.11
x
American Psychological Association. (2003). Guidelines on multicultural education, training,
research, practice, and organizational change for psychologists. American Psychologist, 58, 377402.
xi
Constantine, Wing & Sue. Strategies for Building Multicultural Competence in Mental Health
and Educational Settings. Hoboken, NJ, USA: John Wiley & Sons, Incorporated, 2005. pg.12
xii
Taylor, Brent; Gambourg, Maria; Rivera, Manuel; Laureano, Diane. Constructing Cultural
Competence: Perspectives of Family Therapists Working with Latino Families. American
Journal of Family Therapy, Volume 34, Number 5, October-December 2006, pg.435.
xiii
Taylor, Brent; Gambourg, Maria; Rivera, Manuel; Laureano, Diane. Constructing Cultural
Competence: Perspectives of Family Therapists Working with Latino Families. American
Journal of Family Therapy, Volume 34, Number 5, October-December 2006, pg.436.
xiv
Taylor, Brent; Gambourg, Maria; Rivera, Manuel; Laureano, Diane. Constructing Cultural
Competence: Perspectives of Family Therapists Working with Latino Families. American
Journal of Family Therapy, Volume 34, Number 5, October-December 2006, pg.437.
xv
Taylor, Brent; Gambourg, Maria; Rivera, Manuel; Laureano, Diane. Constructing Cultural
Competence: Perspectives of Family Therapists Working with Latino Families. American
Journal of Family Therapy, Volume 34, Number 5, October-December 2006, pg.438.
xvi
Taylor, Brent; Gambourg, Maria; Rivera, Manuel; Laureano, Diane. Constructing Cultural
Competence: Perspectives of Family Therapists Working with Latino Families. American
Journal of Family Therapy, Volume 34, Number 5, October-December 2006, pg.439.
16
xvii
Taylor, Brent; Gambourg, Maria; Rivera, Manuel; Laureano, Diane. Constructing Cultural
Competence: Perspectives of Family Therapists Working with Latino Families. American
Journal of Family Therapy, Volume 34, Number 5, October-December 2006, pg.439.
xviii
Declan T. Barry; Wesley A. Bullock. Culturally Creative Psychotherapy with a Latino
Couple by an Anglo Therapist. Journal of Family Psychotherapy, Volume 12, Issue 4 December
2001, pg17.
xix
Declan T. Barry; Wesley A. Bullock. Culturally Creative Psychotherapy with a Latino Couple
by an Anglo Therapist. Journal of Family Psychotherapy, Volume 12, Issue 4 December 2001,
pg.18
xx
Declan T. Barry; Wesley A. Bullock. Culturally Creative Psychotherapy with a Latino Couple
by an Anglo Therapist. Journal of Family Psychotherapy, Volume 12, Issue 4 December 2001,
pg.18
xxi
Declan T. Barry; Wesley A. Bullock. Culturally Creative Psychotherapy with a Latino Couple
by an Anglo Therapist. Journal of Family Psychotherapy, Volume 12, Issue 4 December 2001,
pg.21
xxii
Declan T. Barry; Wesley A. Bullock. Culturally Creative Psychotherapy with a Latino Couple
by an Anglo Therapist. Journal of Family Psychotherapy, Volume 12, Issue 4 December 2001,
pg.27
xxiii
Parra-Cardona, Jose Ruben; Busby, Dean M. Exploring relationship functioning in premarital
Caucasian and Latino/a couples: recognizing and valuing cultural differences. Journal of
Comparative Family Studies, Volume 37, June 22, 2006, pg.345
xxiv
Parra-Cardona, Jose Ruben; Busby, Dean M. Exploring relationship functioning in premarital
Caucasian and Latino/a couples: recognizing and valuing cultural differences. Journal of
Comparative Family Studies, Volume 37, June 22, 2006, pg.349
xxv
Parra-Cardona, Jose Ruben; Busby, Dean M. Exploring relationship functioning in premarital
Caucasian and Latino/a couples: recognizing and valuing cultural differences. Journal of
Comparative Family Studies, Volume 37, June 22, 2006, pg.352
xxvi
Parra-Cardona, Jose Ruben; Busby, Dean M. Exploring relationship functioning in premarital
Caucasian and Latino/a couples: recognizing and valuing cultural differences. Journal of
Comparative Family Studies, Volume 37, June 22, 2006, pg.353
xxvii
Parra-Cardona, Jose Ruben; Busby, Dean M. Exploring relationship functioning in
premarital Caucasian and Latino/a couples: recognizing and valuing cultural differences. Journal
of Comparative Family Studies, Volume 37, June 22, 2006, pg.355
xxviii
Sperry, Len. Culture, Personality, Health, and Family Dynamics: Cultural Competence in
the Selection of Culturally Sensitive Treatments. Family Journal: Counseling and Therapy for
Couples and Families, volume 18, Jul 2010. Pg.317.
xxix
Sperry, Len. Culture, Personality, Health, and Family Dynamics: Cultural Competence in the
Selection of Culturally Sensitive Treatments. Family Journal: Counseling and Therapy for
Couples and Families, volume 18, Jul 2010. Pg.317.
xxx
Sperry, Len. Culture, Personality, Health, and Family Dynamics: Cultural Competence in the
Selection of Culturally Sensitive Treatments. Family Journal: Counseling and Therapy for
Couples and Families, volume 18, Jul 2010. Pg.317.
xxxi
Sperry, Len. Culture, Personality, Health, and Family Dynamics: Cultural Competence in the
Selection of Culturally Sensitive Treatments. Family Journal: Counseling and Therapy for
Couples and Families, volume 18, Jul 2010. Pg.317.
17
xxxii
Cardona, Betty; Softas-Nall, Lia. Family Therapy with Latino Families: An Interview with
Patricia Arredondo. Family Journal: Counseling and Therapy for Couples and Families, volume
18, January 08, 2010. Pg.73.
xxxiii
Cardona, Betty; Softas-Nall, Lia. Family Therapy with Latino Families: An Interview with
Patricia Arredondo. Family Journal: Counseling and Therapy for Couples and Families, volume
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xxxiv
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