Acceptability of Exposure-Based Treatments for PTSD Among Latinxs: A Mixed-Methods Study

Clinical Impact Statement This study suggests that Latinx individuals generally find exposure-based treatments for PTSD acceptable and that the mechanism of change resonates with their cultural values. Additionally, adherence to Latinx cultural values predicted treatment acceptability. Taken together, these results suggest that Latinx cultural values might not interfere with exposure-based treatments of PTSD and might even promote treatment engagement. Objective: Latinx individuals are the largest and fastest growing ethnic group in the United States and are substantially impacted by trauma. Despite the potential benefit that Latinx individuals could experience from existing evidence-based treatments, they demonstrate low service-utilization rates. The current study examined treatment acceptability of exposure-based treatment for PTSD, using mixed methodology. Because exposure-based PTSD treatments were developed through a Western cultural lens, we hypothesized that (a) Latinx individuals would have low rates of treatment acceptability, (b) acculturation would positively predict treatment acceptability, and (c) enculturation would negatively predict treatment acceptability. Method: Participants were 95 Latinx individuals. All participants were provided with a vignette depicting a fictional character who underwent exposure therapy for PTSD. A subset of participants completed a semistructured interview assessing their views on exposure-based treatments for PTSD (n = 25), and a subset of participants completed a questionnaire examining treatment acceptability of exposure-based therapy for PTSD (n = 70). Results: Results from the qualitative data revealed that Latinx individuals identified both favorable and negative elements of exposure-based interventions for PTSD. Additionally, we noted that participants had a belief system regarding how they perceived exposure-based treatments to work. Results from the quantitative data indicate that our participants generally found exposure-based therapy to be acceptable and that enculturation (but not acculturation) predicted treatment acceptability. Conclusions: Because attitudes toward treatment contribute to outcomes, we concluded that the aggravating elements, mitigating factors, and perceived mechanism of change together contribute to Latinx acceptability of exposure-based treatment for PTSD.