Culturally Motivated Clinician Drift in the Treatment of Eating Disorders: How Clinicians Adopt, Adapt, or Abandon CBT for Latino Clients
Prior research has identified that clinicians in the treatment of eating disorders often do not adhere closely to empirically-supported treatments (EST), and are particularly likely to modify Cognitive-Behavioral therapy (CBT). Several reasons for this phenomenon, dubbed "clinician drift", have been identified, including level of clinician training, education, and type of patient care. In addition to the phenomenon of clinician drift, there has been a growing controversy within the field of clinical psychology about the compatibility of ESTs and multiculturalism. Some argue that the standardization inherent to EST resists the concept of cultural adaptability; while others have countered that cultural adaptability is essential in order for empirically supported treatments to remain relevant, ethical, and effective. In order to shed more light on this issue, this study examined how clinicians tend to drift from CBT in the treatment of Latinos suffering from eating disorders, in order to accommodate Latino culture and elements of eating behavior specific to Latino populations. We both attempted to replicate prior findings regarding predictors of clinician drift, as well as build upon the little existing research into the "culturally-motivated clinician drift." It was discovered that no therapist characteristics or client characteristics were predictive of drift. However, the majority of the sample still adapted or abandoned at least part of the CBT treatment. Their responses regarding the weaknesses of CBT for their Spanish-speaking clients can provide insight into how the treatment can be modified for more diverse clients.