Kurt C. Organista

Cognitive-behavioral therapy for depression in low-income and minority medical outpatients: description of a program and exploratory analyses

This article describes the treatment of depression in low-income and ethnic minority medical outpatients with cognitive-behavioral therapy and also reports on preliminary analyses of effectiveness as well as predictors of treatment outcome and dropout. One hundred and seventy-five patients were treated and showed significant pre- to posttreatment reductions in Beck Depression Inventory scores but not to the same extent as results reported in the treatment outcome literature. Patients with the poorest outcome were those with initially high symptoms of depression and not living with spouses/partners. Dropout was most likely in patients who were younger, minority, and treated with group therapy. Clinic procedures designed to reduce traditional barriers to mental health service utilization encountered by ethnic minorities resulted in 14% of referrals coming to one session of evaluation, 29% starting therapy, and 12% completing treatment, for a total service utilization rate of 55%.

HIV prevention with Mexican migrants: review, critique, and recommendations.

Summary:Charged with the task of reviewing the research outcome literature on HIV prevention with Mexican migrants in the United States, the following broad observations and conclusion were made: (1) there is little research on this specialized topic of concern; (2) the research that exists reflects an overly individualistic behavioral science approach designed to reduce individual risk factors, with little regard for structural and environmental factors that influence HIV risk; and (3) there is a compelling need to develop better theoretic frameworks for understanding the complex and dynamic social and cultural processes influencing sexual behavior among Mexican migrants so as to better inform HIV prevention efforts with this unique and diverse Latino(a) population.

Pilot Survey of HIV Risk and Contextual Problems and Issues In Mexican/Latino Migrant Day Laborers

A preliminary survey was conducted with 102 migrant day laborers (MDLs) to assess HIV risk and related contextual problems and issues. These men were primarily Mexican, of low SES background, low in acculturation to the United States, and their income ranged from

Cognitive behavioral therapy with Latinos

100 and

Referral Patterns in Ethnic-Specific and Mainstream Programs for Ethnic Minorities and Whites.

400 a week, 40% of which is sent back home. The psychosocial context of HIV risk included concerns expressed about lack of money and employment, followed by racism, social isolation, sadness and loneliness. High rates of alcohol use and binge drinking that co-occur with sexual activities were reported. While only 7% of MDLs reported illegal injection drug use, needles were frequently shared without bleach cleaning. Men generally did not carry condoms and knowledge of proper condom use was poor. For the most common form of sex reported, vaginal sex, condom use was infrequent. However, men did report confidence in being able to insist on condom use in challenging sexual situations, and they also reported fairly frequent pro-condom attitudes and behaviors within their social circles. Slightly over half of the men reported sexual activity with female partners, during the past 2 months. These female partners were almost evenly divided into regular sex partners, including spouses, and riskier partners such as one time only sex partners, prostitutes, and multiple sex partners. Results also indicated encouraging efforts by MDLs to reduce risk with risky partners (e.g., more condom use).

Alcohol Use and Problem Drinking among Male Mexican and Central American Im/migrant Laborers: A Review of the Literature.

The purpose of this article is to explicate culturally responsive applications of cognitive behavioral therapy (CBT) to Latinos in the United States. The article defines Latinos, summarizes Latino sociodemographic and mental health profiles, reviews the literature on CBT with Latinos, and then describes culturally competent applications of CBT techniques to common problem themes. Future directions in clinical work and research are also discussed.

Predictors of HIV transmission among migrant and marginally housed Latinos.

The present study examined the referral patterns of 1,095 African, 2,168 Asian, 1,385 Hispanic, and 2,273 White Americans (18 years of age and older) in a public mental health system to determine whether group differences in help-seeking and referral patterns were related to participation in ethnic-specific versus mainstream programs. Results indicated that (a) ethnic minorities in both mainstream and ethnic-specific programs were more likely than Whites to have been referred by natural help-giving and lay referral sources (e.g., family or friends, health services, and social services) and (b) ethnic minorities in ethnic-specific programs were more likely than ethnic minorities in mainstream programs to have been referred by natural help-giving and lay referral sources if they were Asian and Hispanic Americans and self-referred if they were African Americans.

Predictors of condom use in Mexican migrant laborers.

This review addresses a growing concern regarding alcohol use in adult male Latino im/migrant laborers in the United States. The review draws from alcohol studies focusing on “Hispanic” populations, and from health behavior studies of Latino im/migrant laborers, research that includes alcohol use. Specifically, this review addresses (a) alcohol consumption and drinking patterns among Mexican and Central American im/migrant laborers, and (b) health and social consequences of alcohol use. After reviewing more than 200 articles, 30 studies meeting key criteria were selected for review. Survey data show lower alcohol use in Latino im/migrants as compared with U.S. Latino and non-Latino populations, but also a relation between problem drinking and acculturation. Ethnographic research reveals heavy drinking and negative health and social consequences in a significant number of Latino im/migrant laborers. How structural-environmental and culture-based factors combine to influence problem drinking in the United States is discussed along with recommendations for future research.

Comparisons Between Caucasian Students, Students of Color, and American Indian Students on their Views on Social Work’s Traditional Mission, Career Motivations, and Practice Preferences

This study examined predictors of HIV-related sexual risk taking in a high risk and understudied convenience sample of 366 predominantly Mexican, migrant adults without stable housing. The sample included 27% men who have sex with men, 28% injectors of illegal drugs, and 21% sex workers. Hierarchical regression analysis showed that sexual risk taking was predicted by low condom self-efficacy, high-risk behavior, and being female. Interestingly, those who engaged in the highest-risk behaviors were more likely to use condoms consistently during sex, although they carried condoms less.

AIDS and Condom-Related Knowledge, Beliefs, and Behaviors in Mexican Migrant Laborers

The purpose of this study was to explore predictors of condom use with occasional sex partners and regular sex partners, as well as carrying condoms in a new high-risk group for HIV infection, Mexican migrant laborers. This study extends previous findings by (1) exploring additional predictors not previously examined, (2) utilizing a large sample of male and female Mexican migrant laborers, (3) carefully controlling for the effects of various demographic and lifestyle variables related to condom use, and (4) assessing the interactive effects of gender on predictors of condom use. Snowball sampling was used to survey 501 adult Mexican migrant laborers. Results revealed that condom use with occasional sex partners was predicted by carrying condoms and condom self-efficacy and that women were more likely to use condoms with occasional partners when both men and women knew someone with HIV/AIDS. Condom use with regular sex partners was predicted by procondom social norms, less negative attitudes toward condoms, not knowing someone with HIV/AIDS, and condom self-efficacy. Carrying condoms was predicted by procondom social norms, less negative attitudes toward condoms, condom self-efficacy, worry about contracting HIV/AIDS, and women were more likely than men to carry condoms when both men and women were married. Understanding these findings, future research directions, and implications for condom promotion strategies with Mexican migrant laborers are discussed.