3 - (IOP 31) Hispanic and Latino Family Involvement in the Treatment of Child Anxiety: Parents and Clinicians’ Perspectives

Although cognitive behavioral therapy (CBT) is the strongest evidence-based psychosocial treatment for anxiety disorders in youth, up to 50% do not respond adequately. Parent involvement has been proposed and evaluated as a promising way to enhance outcomes in majority non-Hispanic and Latino White samples. However, considering that CBT was designed from a majority-culture perspective, less is known about Hispanic and Latino (H/L) parents' involvement, and whether current evidence-based treatments (EBTs) are congruent with H/L families’ preferences. The lack of knowledge is largely due to the underrepresentation of H/L families in the youth anxiety treatment literature (Piña, Polo & Huey, 2019; Patriarca et al., 2022), even though H/L youth experience higher rates of anxiety disorders than other ethnic groups (Roberts, Roberts & Xing, 2006). First, the assumption that H/L parents prefer to be involved in their children’s treatment has not been adequately studied, particularly from approaches centering H/L parents’ perspectives. Second, no study has directly examined how, and to what extent, H/L parents’ preferences depend on levels of acculturation (the degree to which individuals identify with the majority culture). Third, no prior study has examined whether skills taught to youth and parents in CBTs for youth anxiety are congruent with H/L families’ preferences. The present study aims to close these gaps in the literature by gathering information from H/L parents seeking services for their child’s anxiety, and by interviewing clinicians who work with H/L families on their perspectives of care. We will present qualitative findings from a semi-structured interview with n=20 H/L parents that assessed 1) their views on parent and extended family involvement in their child’s treatment, and 2) their perspectives on evidence-based parent-related CBT and other skills they might want to learn. We will also present data on n=5 clinicians’ perspectives on 1) H/L family involvement in treatment, 2) skills they typically teach as part of anxiety treatment and how receptive parents are in implementing them, and 3) tailoring treatment based on H/L cultural values. Results from parent interviews indicate that parents want to be involved in their child’s treatment and also want their child to have one-on-one time with their therapist for privacy. Few parents indicated a desire for grandparents to be involved. Skills parents reported a desire to learn include appropriate praising, effectively supporting their child when anxious, and managing their own parental stress. Further, clinician interviews highlighted the perceived importance of parent involvement in therapy, with mothers primarily involved and grandparents involved as needed. Skills they teach include reducing anxiety-related accommodation in a culturally appropriate manner, cognitive restructuring, and facilitating behavioral exposures out of session. These findings indicate overall moderate congruence between clinicians’ practice and H/L parents’ desires in treatment and provide critically needed guidance on ways to enhance the congruence, which may ultimately result in higher engagement and superior outcome in treatment among H/L families.