Evidence-Based Treatments: Adapting Behavioral Medicine Change Strategies to Meet the Needs of Integrated Care with an Appreciation of Culture

Within the past two decades, the cultural adaptation of evidence-based interventions and treatments has emerged as a necessary response for meeting the treatment needs of diverse sectors of the American population. Validated evidence-based treatments (EBTs) have often required modifications for addressing cultural factors in patient assessment and treatment. Such modifications aim is to enhance EBT relevance, fit, and effectiveness when implemented with individuals and communities from health disparity populations. Similarly, integrative care has emerged as a comprehensive approach for treating diverse patients, and especially those from health disparity populations, many of whom are affected by comorbid health conditions. These patients are now able to receive mental health treatments in addition to treatments for recovering from addiction to drugs and/or alcohol. Integrative treatment has emerged as a recognized approach for improving quality of care, and for avoiding the problem of incomplete recovery, which often leads to relapse and the perpetuation of comorbid health conditions. The present chapter thus examines major aspects of cultural adaptations and their implementation within health care systems. This approach seeks to provide patients from health disparity populations with greater treatment accessibility, specificity, cultural relevance, engagement, and acceptability. The overall goal is to increase treatment relevance, fit, and efficacy for the provision of higher quality in care as delivered to persons from diverse health disparity populations, to ultimately reduce health disparities and inequities nationwide.