Cross-Cultural Research and Treatment

One of the joys of living in New Mexico is its multicultural population.  We have been able over the years to explore cross-cultural similarities and differences, and also to test with Hispanic and Native American clients the application of evidence-based treatments originally developed with White non-Hispanic populations.

            In our comparisons of New Mexican Hispanic and non-Hispanic clients in addiction treatment, by far the typical finding has been of no significant difference in substance use patterns or response to treatments.  We were also struck by the similarities of substance use patterns and problems among displaced indigenous populations of the world, who are in other respects highly dissimilar (Daugherty et al., 2002).  We were also struck by the similarities of substance use patterns and problems among displaced indigenous populations of the world, who are in other respects highly dissimilar (Daugherty et al., 2002).  We did find that Hispanics were less likely to make use of Alcoholics Anonymous, although no less likely to benefit from it (Tonigan et al., 2002).

When looking for treatment methods that are likely to be effective with a particular cultural group, a good place to start is with methods that have worked in other cultures.  While some treatment approaches cross cultures better than others, the adaptation of an evidence-based treatment to new cultures may have more to do with access and language issues than with a need for fundamental change in the method itself (Miller, Villanueva, Tonigan & Cuzmar, 2007).

            We have found larger cultural differences when comparing Native American with White U.S. people.  A popular developmental model of alcohol dependence attributed to Jellinek was based on a survey with White males in the Northeast.  Dr. Kamilla Venner found that this model was less accurate in describing the experience of White women, far less so of Navajo men, and not at all of Navajo women (Venner & Miller, 2001).  In Project MATCH, where no overall outcome differences were observed among the three treatments tested, a subsample analysis revealed that Native Americans had responded significantly better to motivational enhancement therapy than to either cognitive-behavioral or 12-step treatment (Villanueva et al., 2007).

Publications on Cross-Cultural Research and Treatment (in chronological order)

Carpenter, R. A., Lyons, C. A., & Miller, W. R. (1985).  Peer-managed self-control program for prevention of alcohol abuse in American Indian high school students: A pilot evaluation study.  International Journal of the Addictions, 20, 299-310.

Arciniega, L. T., Arroyo, J. A., Miller, W. R., & Tonigan, J. S. (1996).  Alcohol, drug use and consequences among Hispanics seeking treatment for alcohol-related problems.  Journal of Studies on Alcohol, 57, 613-618.

Brown, J. M., Ashcroft, F. G., & Miller, W. R. (1998).  Purpose in life among alcoholics: A comparison of three ethnic groups.  Alcoholism Treatment Quarterly, 16(3), 1-11.

Tonigan, J. S., Connors, G. J., & Miller, W. R. (1999).  Special populations in Alcoholics Anonymous.  Alcohol Health & Research World, 281-285.

Venner, K. L., & Miller, W. R. (2001).  Progression of alcohol problems in a Navajo sample.  Journal of Studies on Alcohol, 62, 158-165.

Daugherty, M., Love, C. T., James, W. H., & Miller, W. R. (2002).  Substance abuse among displaced and indigenous peoples.  In W. R. Miller, & C. Weisner (Eds.).  Changing substance abuse through health and social systems (pp. 225-239).  New York: Kluwer/Plenum.

Tonigan, J. S., Miller, W. R., Juarez, P., & Villanueva, M. (2002).  Utilization of AA by Hispanic and non-Hispanic white clients receiving outpatient alcohol treatment.  Journal of Studies on Alcohol, 63, 215-218.

Arroyo, J. A., Miller, W. R., & Tonigan, J. S. (2003).  The influence of Hispanic ethnicity on long-term outcome in three alcohol treatment modalities.  Journal of Studies on Alcohol, 64, 98-104.

Walker, D. D., Venner, K., Hill, D. E., Meyers, R. J., & Miller, W. R. (2004). A comparison of alcohol and drug disorders: Is there evidence for a developmental sequence of drug abuse? Addictive Behaviors, 29, 817-824.

Duran, B. G., Wallerstein, N., & Miller, W. R. (2007).  New approaches to alcohol interventions among American Indian and Latino communities: The experience of the Southwest Addictions Research Group.  Alcoholism Treatment Quarterly 25(4), 1-10.

Miller, W. R., Villanueva, M., Tonigan, J. S., & Cuzmar, I. (2007).  Are special treatments needed for special populations?  Alcoholism Treatment Quarterly 25(4), 63-78.

Villanueva, M., Tonigan, J. S., & Miller, W. R. (2007).  Response of Native American clients to three treatment methods for alcohol dependence.  Journal of Ethnicity in Substance Abuse, 6(2), 41-48.

Miller, W. R., Hendrickson, S. M. L, Venner, K., Bisonó, A., Daugherty, M., & Yahne, C. E. (2008).  Cross-cultural training in motivational interviewing.  Journal of Teaching in the Addictions, 7, 4-15.