Psychotherapy and Teletherapy in U.S. Latinx Populations: A Narrative Review

Latinx patients possess a rich cultural background and shared heritage; they also possess culturally distinct medical beliefs and practices, including beliefs around mental health and interactions with mental health systems. Most forms of psychotherapy were not developed for Latinx populations, and the efficacy of existing and novel forms of psychotherapy in Latinx patients as a group has received precious little study. In this study, we review psychotherapy and telepsychotherapy interventions for Latinx patients with mental health disorders. We conducted a literature review applying Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using search criteria involving terms such as "Hispanic," "Latinx," "psychotherapy," and "telepsychiatry." We selected peer-reviewed articles on psychotherapeutic interventions within U.S.-based Latinx populations and excluded studies that summarized existing findings, had limited generalizability, or involved treatments outside the study's scope. Using PubMed, Web of Science, Embase, Cochrane Library, and MEDLINE Ovid databases, we identified 45 articles for our final review. We examined the efficacy of these treatments across depressive, anxious, and other psychiatric disorders in U.S. Hispanic participants to establish both areas of strength in current approaches and areas of ongoing need for improvement. Evidence surrounding therapy and teletherapy in Latinx patients has focused on reducing the burdens of depression, anxiety, and substance use. Culturally adapted behavioral therapies, delivered both in-person and remotely, are the most studied forms of therapy in these populations. Comparative effectiveness studies have been limited, with many studies reporting simple pre-post differences and differences versus status quo or waitlist controls. Limited evidence shows that teletherapy can expand access for rural and limited English proficiency groups and be cost-effective compared with in-person care. The current evidence base around psychotherapy in Latinx patients supports culturally adapted cognitive behavioral therapy (CBT)/behavioral therapies, delivered in-person and via telehealth, as effective, acceptable, and often cost-effective for Latinx populations across depression, anxiety/post-traumatic stress disorder (PTSD), eating disorders, and substance use. Other forms of psychotherapy have also shown promise but are less well studied. Across conditions and interventions, family involvement and targeted cultural adaptations appear to improve both engagement and outcomes.