Providers' Perceived Benefits and Challenges in Providing a Culturally Sensitive Intervention to Latinx Immigrant Families with Young Children

Background: Facing chronic trauma and varying obstacles in daily lives (Chavez-Dueñas et al., 2019; Bruhn, 2022), many Latine immigrant families with young children in the United States are in great need of services and interventions, especially those tailored towards cultural differences and individual needs. While bilingual/bicultural community-based mental health service providers play crucial roles in implementing culturally responsive interventions to immigrant families with young children, exploration of their thoughts and perceptions regarding program implementation remains scarce. Therefore, this study, conducted collaboratively with a community agency, seeks to explore mental health providers’ implementation experiences, particularly their perceived benefits and challenges, while implementing Early Connections/Conexiones Tempranas (EC/CT), a culturally responsive trauma-informed adaptation of Child-Parent Psychotherapy (CPP) for Latine immigrant families with young children in the United States.

Methods: Seven bilingual/bicultural providers (6 clinicians and 1 family support partner) who provided services in Spanish, participated in semi-structured interviews responding to questions regarding overall perceptions and implementation experiences of EC/CT. Interviews which were conducted remotely from September to December 2018, with one interview in 2021, were recorded, cleaned, and transcribed. After developing an initial code book, a thematic approach was used to analyze the interviews through line-by-line coding in NVivo 12 by two researchers independently. Subsequently, initial codes were compared and discussed, and then condensed into larger themes and subthemes.

Findings: Several themes emerged from the analysis. In terms of EC/CT’s benefits, 1) all providers emphasized its uniqueness and effectiveness in addressing both the therapeutic as well as other life necessities of individual families, especially through the ongoing collaboration with a family support partner; 2) most providers stressed the importance of its cultural responsiveness, where they felt confident and valued in bringing a cultural lens while interacting with clients to enable optimal services; 3) most providers emphasized that receiving ongoing team support throughout the implementation through reflective supervision and case consultation furthered their personal and professional growth in serving vulnerable young children and caregivers; 4) almost all providers also emphasized that EC/CT played a vital role in facilitating the connection between local service providers and gathering communal resources for Latine immigrant children and families. Regarding specific challenges and areas of improvement of EC/CT, 1) almost all providers reported struggling to balance between supporting parents’ trauma recovery and children’s healthy development during dyadic interactions; 2) some providers expressed concerns over the limited duration, scope, and capacity of EC/CT to effectively address Latine immigrant families’ chronic and multifaceted challenges resulting from systemic barriers and oppression; 3) all providers called for further efforts in intervention adaptations, particularly adequate modifications that align with the cultural context of Latine immigrant families.

Conclusions & Implications: Although the sample size is small, findings from this qualitative study show the unique experiences of bilingual/bicultural providers, both benefits and challenges, in attempting to offer a culturally responsive intervention to immigrant young children and caregivers in the U.S. Findings can offer guidance for researchers and practitioners to develop and adapt culturally responsive practices in the U.S. for immigrant communities.