Client culture can have a significantly impact on client perceptions of substance abuse. To accurately diagnose and provide therapy to clients of different cultures, it is important for the clinician to understand the role of family, values, and spiritual beliefs as it relates to the culture. For Latinos, the family is the core of the culture. For Latinos, family can include immediate, as well as extended family, and family friends. Since the Latino culture has a strong focus on family, problems within the family causing isolation and adjustment difficulties to for example, immigration can be precursors for substance abuse in youthful members. Family members who use drugs can have a significant influence on other members which can exacerbate the problem. Clients are often supported and supplied with drugs from family members. These family members believe they are helping the client cope; they do not perceive it as bringing harm to the client. In treating a Latin client for substance abuse, it is imperative that the family is included. Therapy that focuses on the importance of each member’s role and responsibility toward the good of the family as a unit, is critical. Instead of placing blame on the values of the family, the family needs to be used as a support system for the client. It is also helpful for clients to heal familial relationships that were broken as a result of substance abuse. The Latino value of simpatia is important for clinicians to discuss with clients and the client’s family. Simpatia is the value of maintaining pleasant social relationships and family unity. Clients can learn how their actions related to their substance abuse impact their simpatia while family members can learn not to be confrontive and avoid conflict with the client who is struggling with the substance abuse issues (Gloria & Peregoy,1996).
In the Latin culture, individuals value personalismo, a person’s unique inner qualities involving respect, dignity and self-worth. Personal communication with others is preferred. A Latino client may seek to be personally connected with their therapist. A close personal connection can foster trust that will ensure ongoing interactions between the clinician and the client. Latinos will often view substance abuse as moral weakness. In this culture, it is shameful to have to obtain help outside of the family. As a result, clients may try to hide their substance abuse from outsiders, such as the clinician and isolate themselves. Spirituality and religious beliefs can be a significant part of an individual’s culture that must be considered. Religion should not be generalized. Clinicians must consider the client’s level of commitment and how their beliefs influence their substance abuse and ability to abstain. Some Latinos have the belief that they do not have control over their substance abuse and will not be open to treatment. This belief should not be interpreted as denial, but rather that the substance abuse is caused by a higher power. For clients with these beliefs, a clinician should consider assistance from a church leader (Gloria & Peregoy,1996).
In providing therapy, it is important for clinicians not to place blame on the client or his/her culture for the client’s issues. Also, it is critical that clinicians evaluate the level of a client’s acculturation and commitment to cultural values. Trust, which is critical to keeping the client engaged in treatment, can be established if the clinician embraces the client’s cultural values (Gloria & Peregoy,1996).
In diagnosing a client for a substance abuse disorder, a clinician must determine is a maladaptive pattern exists which leads to distress or impairment that is clinically significant for a minimum of a year. There are 11 criteria for substance abuse disorder that involves how the substance abuse impacted a person’s life, including their social and interpersonal functioning, ability to meet role obligations, extent of use, dependence, cravings, and time spent obtaining the substance (Paris, 2015; APA, 2013). Clinicians must learn the meaning and reasons that sustain the client’s substance abuse. To understand the client’s stressors that trigger the substance abuse, it is critical for the clinician to gather information pertaining to the client’s environment, social history, political, economic and personal concerns. Clinicians who work within a client’s cultural framework, will go far to empower the client because they have respected respect and validated their values and beliefs (Gloria & Peregoy,1996).