title: Toward an adaptation of interpersonal psychotherapy for Hispanic patients with DSM-IV major depressive disorder.
abstract: BACKGROUND
  Spanish-speaking individuals comprise a growing percentage of the United States population. They have greater difficulty than most in accessing and remaining in psychiatric treatments, including psychotherapy, their stated preference. The literature on cultural competence in treating Hispanic patients provides few details of psychotherapeutic adaptations.
  
  
  OBJECTIVE
  This article, based on interpersonal psychotherapy (IPT) supervision for a low-socioeconomic sample of monolingual Spanish-speaking New York City patients, describes culturally specific psychotherapy.
  
  
  METHODS
  In conducting IPT for Spanish-speaking patients with DSM-IV major depressive disorder, we reviewed cases in weekly supervision over 3 years (January 2005 to January 2008) to explore treatment themes and evaluate the congruence of IPT in addressing them. Important themes are illustrated by case example.
  
  
  RESULTS
  Key themes include (1) the centrality of family, (2) conflicts due to migration and acculturation, (3) gender roles, (4) need to avoid humiliating or irrevocable social confrontation, and (5) equanimity in facing an unpredictable environment.
  
  
  CONCLUSIONS
  IPT appears a compatible intervention, focusing on and adaptable to these important issues for Hispanic patients.
authors.affiliation: New York State Psychiatric Institute, New York, NY 10032, USA. jcm42@columbia.edu
authors.forename: John C
authors.initials: JC
authors.lastname: Markowitz
authors.forename: Sapana R
authors.initials: SR
authors.lastname: Patel
authors.forename: Ivan C
authors.initials: IC
authors.lastname: Balan
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Bell
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.forename: Maria
authors.initials: M
authors.lastname: Yellow Horse Brave Heart
authors.forename: Stephanie Buttacavoli
authors.initials: SB
authors.lastname: Sosa
authors.forename: Roberto
authors.initials: R
authors.lastname: Lewis-Fernández
mesh_terms: D000069:Acculturation; D000328:Adult; D000339:Affect; D054521:Cultural Competency; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D005783:Gender Identity; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008297:Male; D008388:Marital Therapy; D008875:Middle Aged; D019303:Multilingualism; D009519:New York City; D011613:Psychotherapy / Q000379:methods*; D012945:Social Values; D012959:Socioeconomic Factors; D016896:Treatment Outcome