Crossroads: The Psychology of Immigration in the New Century

cultural competency must be an inherent part of EBPs. As
noted succinctly by Isaacs, Huang, Hernandez, and Echo-
Hawk (2005),
evidence-based practices could exacerbate
and deepen existing inequalities if they are
implemented without sufficient attention to
cultural competence and/or if policy makers fail
to take into account the many practices within
diverse communities that are respected and highly
valued by these groups. (p. 5)
Research that focuses on systematic application and
measurement of operationalized indicators of cultural
competence is needed to improve access to services and
reduce mental health disparities across diverse groups in
general (Isaacs et al., 2005).
Although the field has made important strides in adopting
cultural competence as a core value in clinical practice and
research, the implementation of the Multicultural Guidelines
has met with varied challenges (Vasquez, 2010). There is a
dearth of literature on the specific ways in which cultural
competence is implemented in clinical practice with
specific immigrant populations and, more important, the
actual impact that such implementation has on outcomes
(Miranda et al., 2005). Thus, there is a need for research that
addresses the unique applications and outcomes of cultural
competence within different immigrant communities.
At the present time, mental health practitioners have limited
access to the lessons learned in clinical and community
settings in which traditional approaches have been modified
effectively with immigrant clients. Furthermore, there is
limited knowledge about psychological tests and assessment
procedures (e.g., clinical interviews) that are contextually
driven (see Assessment With Immigrant-Origin Adults and
Children). To improve the assessment of immigrants, future
research can address the need for relevant psychological tests
and procedures that address contextual factors.
Most training programs do not offer cultural-competency
training specific to the needs of immigrant clients (APA,
2010c). In addition, most practice settings are not staffed
by clinicians of immigrant backgrounds or by interpreters.
Clinicians are also not trained in how to work through
and in tandem with interpreters (APA, 2010c). The lack of
access to immigrant practitioners is of particular concern, as
many immigrant clients prefer to work with a therapist of
a similar background and/or with a therapist who is fluent
Immigrant Populations in Clinical Contexts
in their native languages. The growing gap between the
increasing need for mental health services among immigrant
communities and the disproportionately low number of
immigrant and ethnic minority mental health practitioners
is a problem that needs to be addressed at the systemic level.
At present, there is a dire need for more immigrant-origin,
multicultural, and multilingual clinicians. To address this
need, the APA’s commitment to provide needed resources
to recruit and train mental health service providers that can
understand and effectively address the diverse social and
psychological needs of immigrants is especially important.
It is not sufficient to recruit trainees to programs. Rather,
provisions for financial and professional support and
mentoring are essential to ensure successful training.
These recommendations address the research, training,
and practices that must be put in place to effectively and
equitably meet the mental health needs of the immigrant
populations that now constitute a significant part of the
total U.S. population. Overcoming barriers to services can
and should build on the inherent strengths and resources
of this complex population. By better meeting the needs
of this country’s immigrant-origin population, not only
will psychologists step up to the APA mission to “improve
people’s lives” but help strengthen the very foundation of
this diverse nation.
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