Innovative Telephone-based Mental Health Treatment for Rural Latinos with Depression

In a previous National Institute of Minority Health (NIMH) funded randomized pilot study conducted in partnership with the Yakima Valley Farm Workers Clinic, Dr. Aisenberg and colleagues demonstrated the effectiveness of a manualized, 8-session cognitive behavioral therapy (CBT) intervention delivered by telephone to rural Latino adults struggling with depression.  Because it was delivered by phone in English and Spanish languages and available beyond traditional clinic hours, this intervention addressed several barriers to accessing care: lack of transportation, stigma, language barrier, and the difficulty to come to the clinic due to work responsibilities.

Now, Dr. Aisenberg, in partnership with the Yakima Valley Farm Workers Clinic Heritage University and the Latino Center for Health, has developed a ground-breaking specialized curriculum and training program for paraprofessionals to effectively deliver this evidenced-based and culturally tailored CBT for rural Latinx experiencing depression. Four cohorts of bachelor-level social work students at Heritage University have been trained and supervised to deliver by phone this manualized CBT depression treatment to rural Latinos via telephone.  Findings reveal that they are very effective in reducing the depressive symptoms of depressed Latinx adults. For example, the mean score of clients using the PHQ-9 screener for depression was 13.  A cut-off score of 10 or above indicates moderate depression.  Following treatment, the clients’ mean PHQ-9 score was 3.

Image description: A black flip phone with gray buttons and a green screen

Here are a few client comments:

This program really helped me. I feel better than before.”     

 “One thing I liked or enjoyed about the program was that the sessions were when it was convenient for me and I didn’t have to leave the house.”

“I started having symptoms like before, but I was able to use what I learned and didn’t let my symptoms get the better of me.”

This program is valuable, and I hope that more people can take advantage of it like me.” 

This program is the first in the country to train non-degreed Latinx students to effectively deliver evidence-based, culturally tailored, telephone-based depression care to rural Latinx adults. In doing so, this program is expanding the Latinx workforce and helping address the shortage of trained bilingual and bicultural rural Latinx mental health practitioners by providing a clear and needed pathway for workforce development in the field of mental health. In addition, it provides a cost-effective manner to treat Latinx adults in their preferred manner. Active ongoing adaptive engagement is imperative to promote client engagement among BIPOC participants in mental health treatment interventions, and critical to representative progress towards health equity.