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Culture and motivational interviewing

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Are cultural adaptations of evidence-based practices effective?

Culture is a broad term that refers to race, ethnicity, sexuality, gender, religion, and more; but in the U.S., research on cultural adaptations has primarily grappled with issues of race and ethnicity. Historically, efficacy studies did not include sufficient numbers of REM, prompting researchers to investigate whether EBP were effective for REM across a broad range of mental health problems, including anxiety, depression, externalizing problems, schizophrenia, smoking, substance use, and

Are cultural adaptations for motivational interviewing effective?

With respect to Motivational Interviewing, it seems that REM may benefit just as much, if not more, when compared with Whites. Hettema and colleagues [26] conducted a meta-analysis of 72 studies, 37 of which looked at racial/ethnic composition (in the majority of these studies, REM composed no more than 15% of the overall sample). The authors found that effects of MI were significantly larger for minority samples than for White samples. Lundahl and colleagues [27] conducted another

What efforts have been made to culturally adapt motivational interviewing?

Culturally adapted MI is still emerging, and virtually all efforts have been conducted within Latino American and American Indian populations.

Self-determination within social context

In keeping with the practices of intervention science, cultural adaptations for MI should be guided by theory. Self-Determination Theory (SDT) [50], [51], [52] has been used as a rationale for MI and posits that humans naturally tend to pursue activities that lead to growth. When people are allowed to pursue growth on their own accord (i.e. in a self-regulated manner), then their behavioral changes become more stable and durable than the behavioral changes that are forced upon them (i.e.

Framework

In order to advance culturally adapted MI, we must be prepared to conduct a considerable amount of systematic research. Barrera and Castro [21] offer a framework to guide this process. Efforts should begin with a needs assessment of the community, and a determination of whether MI is effectively meeting those needs. If not, preliminary adaptations are made, often by way of focus groups, which inform small pilot studies. Most adaptation research has stopped here, but we really need to go

Cultural responsiveness

We recognize that cultural adaptations run the risk of operating on stereotypes. Culture cannot be reduced to something singular or static – it is variegated and evolving, and people identify with their cultures to varying degrees, or have intersecting identities [53], [54]. And so we acknowledge that adaptations alone are not enough to meet the complex needs of REM and other cultural minorities. Adapting MI to diverse populations should coincide with principles set forth in the cultural

Closing remarks

With rapidly changing demographics around the world, providers must determine whether key components of MI are ubiquitous across cultures. Individuals possess intersecting identities and inhabit evolving cultures, and so MI requires the right posture, a bit of finesse, and a good amount of flexibility in order to respond to the culturally heterogeneous population, especially those who have been historically underserved. Manuel and colleagues [24] concluded that cultural adaptations of brief

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      Specific interventions targeting patients' motivation, such as motivational interviewing (MI), have been shown effective in improving psychotherapy engagement and lead to enhanced outcomes in other clinical populations (Marker and Norton, 2018; Ryan et al., 2011). Moreover, the effectiveness of MI has demonstrated cross-cultural generalizability (Oh and Lee, 2016). However, its utility for refugees receiving treatment for trauma-related mental health consequences is unclear.

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