Treatment engagement and response to CBT among Latinos with anxiety disorders in primary care.
Open accessAbstract
OBJECTIVE: In the current study, we compared measures of treatment outcome and engagement for Latino and non-Latino White patients receiving a cognitive behavioral therapy (CBT) program delivered in primary care. METHOD: Participants were 18-65 years old and recruited from 17 clinics at 4 different sites to participate in a randomized controlled trial for anxiety disorders, which compared the Coordinated Anxiety Learning and Management (CALM) intervention (consisting of CBT, medication, or both) with usual care. Of those participants who were randomized to the intervention arm and selected CBT (either alone or in combination with medication), 85 were Latino and 251 were non-Latino White; the majority of the Latino participants received the CBT intervention in English (n = 77). Blinded assessments of clinical improvement and functioning were administered at baseline and at 6, 12, and 18 months after baseline. Measures of engagement, including attendance, homework adherence, understanding of CBT principles, and commitment to treatment, were assessed weekly during the CBT intervention. RESULTS: Findings from propensity-weighted linear and logistic regression models revealed no statistically significant differences between Latinos and non-Latino Whites on symptom measures of clinical improvement and functioning at almost all time points. There were significant differences on 2 of 7 engagement outcomes, namely, number of sessions attended and patients' understanding of CBT principles. CONCLUSIONS: These findings suggest that CBT can be an effective treatment approach for Latinos who are primarily English speaking and likely more acculturated, although continued attention should be directed toward engaging Latinos in such interventions.
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Latinx are more likely to drop out of cognitive behavioral therapy trials for anxiety.
“Latinx are more likely to drop out of CBT trials for anxiety (Chavira et al., 2014) and are less likely to utilize mental health supports to treat symptoms of depression and anxiety across the perinatal period (Declercq et al., 2021).”
From Exposure Therapy Acceptability Among Pregnant Latinas With Anxiety: A Qualitative Content Analysis (2025) · cites this paper as Chavira et al., 2014
The Discussion reports that Latino participants attended fewer CBT sessions than non-Latino White participants in this primary-care anxiety study. Treatment completion was also lower (64% versus 75%), but that difference was not statistically significant. The paper therefore does not establish the broader claim that Latinx participants are more likely to drop out of CBT trials for anxiety. (LLM, conf=0.88)
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Self-citation
- Authors
- Chavira, D. A., Golinelli, D., Sherbourne, C., Stein, M. B., Sullivan, G., Bystritsky, A., Rose, R. D., Lang, A. J., Campbell-Sills, L., Welch, S., Bumgardner, K., Glenn, D., Barrios, V., Roy-Byrne, P., & Craske, M.
- Affiliations
- University of California, Los Angeles (US)
- RAND Corporation (US)
- University of California San Diego (US)
- University of Arkansas for Medical Sciences (US)
- VA San Diego Healthcare System (US)
- University of Washington (US)
- Los Angeles County Department of Mental Health (US)
- ORCID
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2014-06
- Volume
- 82
- Issue
- 3
- Pages
- 392-403
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC4303048
- OpenAlex
- W2089082545
- Cited by
- 78
- References
- 16
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 2 · 2023: 6 · 2022: 6 · 2021: 7 · 2020: 7 · 2019: 6 · 2018: 8 · 2017: 8 · 2016: 11 · 2015: 5 · 2014: 2
- FWCI
- 12.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (U01 MH057858, U01 MH058915, U01 MH 070022, U01 MH057835 and K24 MH64122, K01 MH072952)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- Hispanic patients, anxiety disorders, cognitive behavioral therapy, treatment engagement, primary care, acculturation, homework adherence, session attendance, treatment outcomes, racial and ethnic disparities
- MeSH terms
- Adult, Aged, Anxiety, Anxiety Disorders, Female, Hispanic or Latino, Humans, Language, Male, Middle Aged, Primary Health Care, Cognitive Behavioral Therapy, Linear Models, Logistic Models, Treatment Outcome, White People
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