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Book Reviews   |    
Brief Psychotherapy With the Latino Immigrant Client
Reviewed by Ana E. Campo, M.D.
Psychiatric Services 2003; doi: 10.1176/appi.ps.54.7.1050-a
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by Marlene D. de Rios, Ph.D.; New York, Haworth Press, 2001, 191 pages, $49.95 softcover

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This book is a must not only for the non-Latino therapist who works with Latino patients and wants a realistic overview of Latino patients but also for Latino therapists. Brief Psychotherapy With the Latino Immigrant Client provides readers with advice on how to deal with Latino patients in an effective way that is culturally syntonic and sensitive in this time of managed care and time-limited treatments.

Starting with chapter 2, the book's author, Marlene D. de Rios, provides a wealth of information about sociocultural aspects of immigrant clients that are extremely important in their psychological assessment, such as the heterogeneity of Latino groups, different acculturation patterns, specific communication styles, and value orientation. She discusses the importance of considering adverse social, environmental, and sociopolitical factors when assessing patients or designing interventions. She rightly points out that unless the clinician has a cultural perspective and an understanding of specific Latino health systems and ethnic beliefs, a DSM-IV diagnosis would not be valid.

The next few chapters focus on therapeutic modalities that are beneficial for Latino patients, such as hypnosis, behavior modification, and cognitive restructuring. The use of metaphors and storytelling in psychotherapy is invaluable in the treatment of immigrant patients. Psychotherapy tends to be time limited, and Latino patients who have not had formal education can culturally relate to the metaphors. Dr. de Rios provides useful examples.

Chapter 5 deals with specific aspects of conducting therapy, from the first phone call to ways of addressing Latino clients, helping them fill out forms, and going through and ending the first session. In chapter 6, the author discusses a series of important clinical issues for the treatment of Latino clients. Especially pertinent are the ones focusing on marital problems arising from the immigration process. She discusses issues such as domestic violence, possible role reversals in marriage, and rebellious teenagers. Specific techniques for dealing with old cultural patterns—for example, assertiveness training and administration of medications—are suggested.

The last chapter focuses on recommendations for the non-Latino psychotherapist, including necessary qualifications of interpreters and cultural patterns and values that need to be integrated into the therapy. For the non-Latino therapist especially, the therapeutic process has to be a dialogue and a learning process about the patient's cultural background.

Incorporating the psychotherapeutic techniques offered in this book should enable psychotherapists to be sensitive to Latino patients' culture and to the particular stresses that the immigrant experience has bestowed on them.

Dr. Campo is director of medical student education and associate professor of clinical psychiatry at the University of Miami School of Medicine.




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