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Comparing Psychotherapeutic Treatment Rates in University Counseling Centers between American Latinx and International Latinx University Students

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Title: Comparing Psychotherapeutic Treatment Rates in University Counseling Centers between American Latinx and International Latinx University Students
Language: English
Authors: Jason M. Hoskin, Heidi Vogeler, Jessica Kirchhoefer, Brett M. Merrill, David Erekson (ORCID 0000-0001-6214-485X), Mark E. Beecher, Derek Griner (ORCID 0000-0002-0378-6403)
Source: Journal of College Student Mental Health. 2024 38(1):207-221.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 15
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Psychotherapy, Guidance Centers, College Students, Hispanic American Students, Foreign Students, Latin Americans, Severity (of Disability), Mental Health, Outcomes of Treatment, Counseling Effectiveness, Attendance, Cultural Differences, Student Characteristics
DOI: 10.1080/87568225.2022.2163953
ISSN: 8756-8225
1540-4730
Abstract: As the press for services at university counseling centers increases, so does the need to provide optimal therapeutic services. Ethnic glossing in previous research has combined rather disaggregated the mental health treatment experiences of American Latinx (AL) students and International Latinx (IL) students. The purpose of this paper was to examine potential differences in (1) the number of attended sessions, (2) symptom severity, and (3) treatment improvement rates. We used a nationwide dataset including 13,156 AL students and 911 IL students. Results indicated that (1) there was no significant difference in attendance rates, (2) AL students had significantly worse initial symptom severity (d = 0.24), and (3) there were no significant differences in improvement rates. We discuss the importance of understanding the different clinical presentations of AL and IL students, as well as the importance of addressing ethnic glossing in future research and clinical work.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1420191
Database: ERIC
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  Value: <anid>AN0178074300;[nm80]01jan.24;2024Jun27.08:14;v2.2.500</anid> <title id="AN0178074300-1">Comparing Psychotherapeutic Treatment Rates in University Counseling Centers between American Latinx and International Latinx University Students </title> <p>As the press for services at university counseling centers increases, so does the need to provide optimal therapeutic services. Ethnic glossing in previous research has combined rather disaggregated the mental health treatment experiences of American Latinx (AL) students and International Latinx (IL) students. The purpose of this paper was to examine potential differences in (<reflink idref="bib1" id="ref1">1</reflink>) the number of attended sessions, (<reflink idref="bib2" id="ref2">2</reflink>) symptom severity, and (<reflink idref="bib3" id="ref3">3</reflink>) treatment improvement rates. We used a nationwide dataset including 13,156 AL students and 911 IL students. Results indicated that (<reflink idref="bib1" id="ref4">1</reflink>) there was no significant difference in attendance rates, (<reflink idref="bib2" id="ref5">2</reflink>) AL students had significantly worse initial symptom severity (d = 0.24), and (<reflink idref="bib3" id="ref6">3</reflink>) there were no significant differences in improvement rates. We discuss the importance of understanding the different clinical presentations of AL and IL students, as well as the importance of addressing ethnic glossing in future research and clinical work.</p> <p>Keywords: Latinx; psychotherapy; university students; counseling centers; young adults</p> <p>Every year, millions of young adults in the US seek higher education through full-time attendance in a college or university setting (National Center for Education Statistics, [<reflink idref="bib24" id="ref7">24</reflink>], January). The number of students who seek higher education has increased in recent years, as half of the young adult population study in a college or university setting (Snyder & Dillow, [<reflink idref="bib31" id="ref8">31</reflink>]; Xiao et al., [<reflink idref="bib39" id="ref9">39</reflink>]). With the increase in students attending college, the demand for accessible mental health services has also grown (Gallagher, [<reflink idref="bib12" id="ref10">12</reflink>]; Kim, Park, La, Chang, & Zane, [<reflink idref="bib21" id="ref11">21</reflink>]). In addition, the severity of presenting concerns for college counseling center clients has increased significantly (Watkins, Hunt, & Eisenberg, [<reflink idref="bib36" id="ref12">36</reflink>]). Student concerns of depression, anxiety, and other, more serious mental health issues are rising in counseling centers (Benton, Robertson, Tseng, Newton, & Benton, [<reflink idref="bib4" id="ref13">4</reflink>]; Xiao et al., [<reflink idref="bib39" id="ref14">39</reflink>]). Due to more students attending higher education, increased demand for mental health services, lack of resources at college counseling centers, and increased severity in client concerns, some professionals have deemed the circumstances to be a "crisis" (Xiao et al., [<reflink idref="bib39" id="ref15">39</reflink>]), Watkins et al. ([<reflink idref="bib36" id="ref16">36</reflink>]) argue that one possible reason for this "crisis" is that today students who previously would not have been able to attend college due to mental health issues can now do so, having access to mental health resources and medication.</p> <p>Recognizing the increase in demand for services, many colleges and universities have worked to expand to meet these needs (Bailey et al., [<reflink idref="bib3" id="ref17">3</reflink>]). Because of these expansions, students have better access to mental health treatment, which tends to decrease mental health stigma on campus (Watkins et al., [<reflink idref="bib36" id="ref18">36</reflink>]). Other benefits from counseling center usage include a decrease in psychological distress (Minami et al., [<reflink idref="bib23" id="ref19">23</reflink>]), an increase in positive academic outcomes (Choi, Buskey, & Johnson, [<reflink idref="bib8" id="ref20">8</reflink>]), and a lower likelihood of dropping out of school (Wilson, Mason, & Ewing, [<reflink idref="bib37" id="ref21">37</reflink>]).</p> <p>While counseling centers have expanded their services and are reaching more students with mental health service needs than ever before, psychotherapists have typically overlooked the unique needs of minority students (Kearney, Draper, & Barón, [<reflink idref="bib19" id="ref22">19</reflink>]). A lack of awareness of multicultural issues at an institutional level can lead those from minority backgrounds to utilize counseling services less, resulting in more severe and unregulated emotional and academic issues (Choi et al., [<reflink idref="bib8" id="ref23">8</reflink>]; Minami et al., [<reflink idref="bib23" id="ref24">23</reflink>]). Today, there are more students from ethnic minority backgrounds who attend higher education than at any previous time (National Center for Education Statistics, [<reflink idref="bib24" id="ref25">24</reflink>], January). It is likely that as more students from historically marginalized backgrounds continue to attend college, more students from historically marginalized backgrounds will also attend college counseling centers. This increase in service utilization makes it increasingly important for counselors to give more attention to the unique needs of students from historically marginalized backgrounds.</p> <p>Despite the increasing number of diverse students attending post-secondary education, students with racial and ethnic minority backgrounds typically utilize mental health services at lower rates than their White counterparts both in community and university samples (Alegria et al., [<reflink idref="bib1" id="ref26">1</reflink>]; Ramos-Sanchez, [<reflink idref="bib25" id="ref27">25</reflink>]; Sullivan, Ramos-Sanchez, & McIver, [<reflink idref="bib33" id="ref28">33</reflink>]). Some factors that may contribute to lower levels of utilization include institutional barriers, acculturation, culturally different treatment methods, stigma, the ethnic composition of the counseling staff, and preference for keeping personal information within the family unit (Hayes et al., [<reflink idref="bib16" id="ref29">16</reflink>]; Sullivan et al., [<reflink idref="bib33" id="ref30">33</reflink>]).</p> <p>In the US, the American Latinx[<reflink idref="bib1" id="ref31">1</reflink>] community is one of the fastest-growing minority groups. The US Department of Health and Human Services ([<reflink idref="bib35" id="ref32">35</reflink>]) has predicted that by the year 2050, the Latinx population will account for 25% of the total population. While members of the Latinx population are typically underrepresented on college campuses, their number in universities has recently grown and is expected to continue to increase (Gonzalez, [<reflink idref="bib15" id="ref33">15</reflink>]). People of many different ethnicities face stigma related to seeking mental health services, and this is particularly true in the Latinx community (Alegria et al., [<reflink idref="bib1" id="ref34">1</reflink>], [<reflink idref="bib2" id="ref35">2</reflink>]). Most research on utilization of mental health services among the Latinx community has shown lower utilization rates than individuals from other minority backgrounds, even when a need and for services is present (Alegria et al., [<reflink idref="bib1" id="ref36">1</reflink>], [<reflink idref="bib2" id="ref37">2</reflink>]). Community sample research shows that barriers such as a low number of bilingual clinicians, value conflicts, limited access to care, and lower recognition of mental health problems dissuade individuals in the Latinx community from attending therapy (Alegria et al., [<reflink idref="bib1" id="ref38">1</reflink>], [<reflink idref="bib2" id="ref39">2</reflink>]).</p> <p>Emotional and academic stressors that go untreated due to lower levels of counseling service utilization could contribute to people from the Latinx community consistently being the ethnic group in the US with the lowest levels of post-secondary education (Constantine, Gloria, & Barón, [<reflink idref="bib9" id="ref40">9</reflink>]; Gloria & Rodriguez, [<reflink idref="bib14" id="ref41">14</reflink>]; Reyes, [<reflink idref="bib26" id="ref42">26</reflink>]). Furthermore, people from the Latinx community are more likely to drop out during their first two years of college (Constantine et al., [<reflink idref="bib9" id="ref43">9</reflink>]; Reyes, [<reflink idref="bib26" id="ref44">26</reflink>]), resulting in only 9.6% of people from the Latinx community obtaining degrees (Constantine et al., [<reflink idref="bib9" id="ref45">9</reflink>]; Gloria & Rodriguez, [<reflink idref="bib14" id="ref46">14</reflink>]; Jimenez, [<reflink idref="bib18" id="ref47">18</reflink>]; Reyes, [<reflink idref="bib26" id="ref48">26</reflink>]). While all students experience barriers in adjusting to college, students with ethnic and racial minority backgrounds tend to have more severe negative experiences, even when students from minority backgrounds are the majority of a student body (Gloria & Rodriguez, [<reflink idref="bib14" id="ref49">14</reflink>]; Rodriguez, [<reflink idref="bib27" id="ref50">27</reflink>]). These negative experiences could be because American-born members of the Latinx community (AL) experience several stressors, including gender role conflicts, academic struggles, racism, discrimination, acculturation, poverty, and isolation (Duarte, [<reflink idref="bib11" id="ref51">11</reflink>], March; Romero, [<reflink idref="bib28" id="ref52">28</reflink>]; Sue & Chu, [<reflink idref="bib32" id="ref53">32</reflink>]).</p> <p>Research suggests that internationally-born students from the Latinx community (IL) face many of the same challenges as AL members of the Latinx community when coming to the US for college. However, IL students face additional unique obstacles such as language barriers, immigration documentation, guilt about being away from family, homesickness, learning a new culture, conflicts with identity or culture norms, and financial and academic concerns (Romero, [<reflink idref="bib28" id="ref54">28</reflink>]; Sue & Chu, [<reflink idref="bib32" id="ref55">32</reflink>]; Wilton & Constantine, [<reflink idref="bib38" id="ref56">38</reflink>]). In the 2013–2014 academic year, 6.9% (or 61,439) of all international students came from Latin American countries to study in schools in the US (Institute of International Education, [<reflink idref="bib17" id="ref57">17</reflink>]). With the growing number of Latinx international students and the emotional and academic stressors felt by this group while attending school, it important for counseling center personnel to better understand the unique challenges these students experience, and how these experiences differ from their AL peers.</p> <p>Although the presenting concerns and barriers faced by AL and IL students may differ, the general trend in the current literature is to aggregate these two groups, a practice that has been termed ethnic glossing (i.e., treating diverse ethnic groups monolithically; Trimble & Bhadra, [<reflink idref="bib34" id="ref58">34</reflink>]). Conflating the AL and IL student populations likely results in a loss of critical information that could help researchers and therapists understand utilization trends and roadblocks to the Latinx subpopulations seeking mental health services. The current study examined differences in treatment utilization and retention, presenting concerns, level of distress at intake, and treatment outcomes between AL and IL students who attended counseling in university counseling centers. Given the potentially higher stress load for IL students and the literature noted above, we hypothesized that:</p> <p></p> <ulist> <item> IL students attended fewer psychotherapy sessions than AL students,</item> <p></p> <item> Overall distress at intake would be higher amongst IL students compared to their AL peers, and</item> <p></p> <item> IL students would improve in treatment at similar or slower rates compared to their AL peers.</item> </ulist> <hd id="AN0178074300-2">Methods</hd> <p>We utilized data from the Center for Collegiate Mental Health (CCMH), a multidisciplinary practice-research network of over 400 college counseling centers and other organizations that provide information about college students' mental health. We collected data between the years 2015–2017 from 163 college counseling centers across the US. We did not obtain data collected more recently than 2017 due to CCMH researcher-access-restriction policies. Clients of CCMH-affiliated counseling centers signed consent forms and completed demographic and psychological distress measures that contributed to the CCMH database. We deidentified student and institution information. Local Institutional Review Boards (IRBs) from each university approved all data contributing to the database. Our university IRB deemed the current study exempt due to the archival nature of the data used. This dataset has also been used in a similar study examining differences between Asian American and International Asian college students (Caldwell et al., [<reflink idref="bib7" id="ref59">7</reflink>]).</p> <p>For the initial data set (<emph>N</emph> = 364,025), at the time participants presented for their first course of therapy, 41.4% of students identified as White, 6.0% as Hispanic, 5.7% as African American, 5.4% as Asian American/Asian, 3.2% as multi-racial, 1.1% as self-identify, 0.3% as American Indian or Alaskan Native, and 0.1% as Native Hawaiian or Pacific Islander, with 36.7% missing data. Participants identified as 55.9% non-International Student and 3.6% International Student, with 40.6% missing data. Forty percent identified as woman, 21.5% as man, 0.7% as self-identify, and 0.3% transgender, with 37.1% missing data. The average age was 22.2 (<emph>SD</emph> = 4.7), with 3.6% missing data.</p> <p>For the current study, we selected only students who identified as Hispanic/Latinx. Because our dataset did not include any free-response options, we were not able to include any Hispanic/Latinx students who marked "self-identify" in the ethnic identity category. Also, we included participants if they met the following qualifications: (<reflink idref="bib1" id="ref60">1</reflink>) identified as either an undergraduate or graduate student, (<reflink idref="bib2" id="ref61">2</reflink>) answered the question "Are you an international student?," (<reflink idref="bib3" id="ref62">3</reflink>) completed mental health outcome data (both first and last session through the Counseling Center Assessment of Psychological Symptoms-34 (CCAPS-34)), and (<reflink idref="bib4" id="ref63">4</reflink>) engaged exclusively in individual therapy. Additionally, we selected only the first course of therapy for each student. The resultant data set included 14,067 unique participants. For detailed demographic information, see Table 1.</p> <p>Table 1. <emph>Demographics (N = 13,889)</emph>.</p> <p> <ephtml> <table><thead><tr><td>Demographic Category </td><td>Undergraduate American Latinx (N = 11,652) </td><td>Undergraduate Int'l Latinx (N = 559) </td><td>Graduate American Latinx (N = 1,341) </td><td>Graduate Int'l Latinx (N = 337) </td></tr><tr><td>n (%) </td><td>n (%) </td><td>n (%) </td><td>n (%) </td></tr></thead><tbody><tr><td><bold>Gender Identity</bold></td><td /><td /><td /><td /></tr><tr><td>Woman</td><td>7,733 (66.4)</td><td>304 (54.4)</td><td>912 (68.0)</td><td>200 (59.3)</td></tr><tr><td>Man</td><td>3,667 (31.5)</td><td>203 (36.3)</td><td>407 (30.4)</td><td>137 (50.7)</td></tr><tr><td>Transgender</td><td>53 (0.5)</td><td>1 (0.2)</td><td>2 (0.1)</td><td>0 (0.0)</td></tr><tr><td>Other/Missing</td><td>199 (1.7)</td><td>51 (9.1)</td><td>20 (1.5)</td><td>0 (0.0)</td></tr><tr><td><bold>Sexual Orientation</bold></td><td /><td /><td /><td /></tr><tr><td>Heterosexual/Straight</td><td>8,979 (77.1)</td><td>450 (80.5)</td><td>1,078 (80.4)</td><td>283 (84.0)</td></tr><tr><td>Lesbian</td><td>212 (1.8)</td><td>3 (0.5)</td><td>24 (1.8)</td><td>5 (1.5)</td></tr><tr><td>Gay</td><td>421 (3.6)</td><td>17 (3.0)</td><td>61 (4.5)</td><td>27 (8.0)</td></tr><tr><td>Bisexual</td><td>1,056 (9.1)</td><td>37 (6.6)</td><td>93 (6.9)</td><td>11 (3.3)</td></tr><tr><td>Questioning</td><td>343 (2.9)</td><td>18 (3.2)</td><td>20 (1.5)</td><td>6 (1.8)</td></tr><tr><td>Other/Missing</td><td>641 (5.5)</td><td>34 (6.1)</td><td>65 (4.9)</td><td>5 (1.5)</td></tr></tbody></table> </ephtml> </p> <hd id="AN0178074300-3">Counseling Center Assessment of Psychological Symptoms-34 (CCAPS-34)</hd> <p>The CCAPS-34 is a multidimensional assessment of psychological symptoms intended for routine use in college populations (McAleavey et al., [<reflink idref="bib22" id="ref64">22</reflink>]). It is an abbreviated version of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62; McAleavey et al., [<reflink idref="bib22" id="ref65">22</reflink>]), containing a subset of the same items but revised for more frequent administration. The CCAPS-34 comprises seven factors (i.e., depression, generalized anxiety, social anxiety, academic distress, eating concerns, frustration/anger, alcohol use) that encompass a general distress index. This factor structure differs from the CCAPS-62 in that it omits family distress and changes the name of substance use to alcohol use, as the subset of questions for that factor only contained questions about alcohol.</p> <p>Based on a national dataset of 22,060 participants, the CCAPS-62 has an acceptable reliability, with Cronbach's alphas ranging from.78-.91 across subscales, and 1-week test-retest reliability ranging from.78 to.92. The CCAPS-62 also shows strong convergent validity with established measures of symptom distress. The CCAPS-34 likewise indicates strong convergent validity (<emph>r</emph> =.52 –.78). Similarly, the CCAPS-34 has acceptable reliability, with Cronbach's alphas ranging from.76 –.89 across subscales. Test-retest reliability ranges from.79 to.87 for a one-week period and.74 to.86 for a two-week period. We included total number of sessions for each client in the database. Additionally, we used the initial CCAPS score and the final CCAPS score for each client to examine change over time.</p> <hd id="AN0178074300-4">Statistical analyses</hd> <p>For the first hypothesis, we conducted a MANOVA in SPSS 26, where group membership (i.e., AL vs. IL) was the independent grouping variable. We included total scheduled sessions, total attended sessions, and the ratio of attended to scheduled appointments as dependent variables. For our second hypothesis, we conducted a MANOVA with group membership as the independent variable and the CCAPS subscales as the dependent variables. Finally, for our third hypothesis, we conducted a repeated-measures MANOVA, where we included group membership and total number of sessions as independent variables, with initial subscale scores and final subscale scores over time as the dependent variables. We included an interaction effect for the total number of sessions over time (or whether the total number of sessions was related to the overall pre-post change) and for group membership over time (our variable of interest – do AL and IL students differ in their pre-post change).</p> <hd id="AN0178074300-5">Post hoc analyses</hd> <p>Because graduate students may have significantly different experiences from undergraduate students, we examined this hypothesis in post hoc analyses that follow the same analysis plan indicated above, but separated by student status (i.e., graduate student vs. undergraduate student).</p> <hd id="AN0178074300-6">Results</hd> <p>We first hypothesized that IL students would attend fewer sessions of mental health services than AL students. In examining the mean number of scheduled sessions, the number of sessions attended, and the proportion of sessions attended, there were no significant differences between the two groups regarding utilization rates (see Table 2). Our first hypothesis was, therefore, disconfirmed. After finding no significant differences, we ran post-hoc tests to determine if there was any significant difference between patterns for undergraduate AL and IL students and graduate AL and IL students. From these findings, we noted that there was a significant difference in attendance rates. For undergraduate students, we found a significantly lower attendance rate for scheduled appointments among IL students (<emph>t</emph>(607.87) = 2.86, <emph>p</emph> <.00, <emph>d</emph> = 0.13). For graduate students, we found the opposite effect – significantly lower attendance rates among AL students (<emph>t</emph>(<reflink idref="bib1" id="ref66">1</reflink>,<reflink idref="bib676" id="ref67">676</reflink>) = −2.67, <emph>p</emph> =.01, <emph>d</emph> = −0.16).</p> <p>Table 2. Attendance rates and sessions attended, American Latinx (AL) & International Latinx (IL) (Independent Samples t-test).</p> <p> <ephtml> <table><thead><tr><td>Category</td><td>AL Mean (SD)</td><td>IL Mean (SD)</td><td><p><graphic href="wcsp_a_2163953_ilm0001.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mover xmlns=""><mrow><mrow><mi mathvariant="italic">x</mi></mrow></mrow><mo accent="false">‾</mo></mover></math></p> diff</td><td><italic>t</italic></td><td><italic>p</italic></td><td>Cohen's <italic>d</italic></td></tr></thead><tbody><tr><td># Sessions Scheduled</td><td>5.44 (5.57)</td><td>5.72 (5.28)</td><td>−0.27</td><td>−1.42</td><td>0.12</td><td>−0.04</td></tr><tr><td># Sessions Attended</td><td>4.11 (4.40)</td><td>4.32 (4.19)</td><td>−0.21</td><td>−1.40</td><td>0.16</td><td>−0.04</td></tr><tr><td>Attended/Scheduled</td><td>0.79 (0.21)</td><td>0.79 (0.21)</td><td>0.00</td><td>0.27</td><td>0.79</td><td>0.01</td></tr></tbody></table> </ephtml> </p> <p>1 Note. Equal variances are assumed. <emph>df</emph> = 13,887 for all analyses.</p> <p>Second, we hypothesized that IL students would show a higher severity of initial presenting concerns and more overall distress at intake than their AL counterparts. In our MANOVA we found a significant overall main effect for initial distress on CCAPS subscales (<emph>F</emph>(<reflink idref="bib8" id="ref68">8</reflink>, 13,<reflink idref="bib879" id="ref69">879</reflink>) = 9.37, <emph>p <</emph>.001). In examining specific initial CCAPS-34 subscales, AL students showed significantly higher initial distress in depression, anxiety, social anxiety, academics, frustration/anger, and the overall distress index, disconfirming our second hypothesis and indicating differences in the opposite direction of our predicted differences. Effect sizes were small but significant, ranging from <emph>d</emph> = 0.08 (frustration/anger) to <emph>d</emph> = 0.24 (overall distress). Only eating concerns and alcohol concerns showed no differences between groups. Full results can be seen in Tables 4 and 5.</p> <p>Table 3. Severity of Concerns – Initial Session, American Latinx (AL) & International Latinx (IL) (Independent Samples t-test).</p> <p> <ephtml> <table><thead><tr><td>CCAPS Index</td><td>AL Mean (SD)</td><td>IL Mean (SD)</td><td><p><graphic href="wcsp_a_2163953_ilm0002.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mover xmlns=""><mrow><mrow><mi mathvariant="italic">x</mi></mrow></mrow><mo accent="false">‾</mo></mover></math></p> diff</td><td><italic>t</italic></td><td>(df)</td><td><italic>p</italic></td><td>Cohen's <italic>d</italic></td></tr></thead><tbody><tr><td>Depression</td><td>1.82 (1.03)</td><td>1.58 (1.03)</td><td>0.23</td><td>6.59</td><td>(13,887)</td><td>0.00*</td><td>0.23</td></tr><tr><td>Anxiety</td><td>2.04 (1.01)</td><td>1.80 (0.99)</td><td>0.24</td><td>6.76</td><td>(13,887)</td><td>0.00*</td><td>0.23</td></tr><tr><td>Social Anxiety</td><td>2.00 (1.03)</td><td>1.85 (0.98)</td><td>0.15</td><td>4.39</td><td>(1,037.40*)</td><td>0.00*</td><td>0.15</td></tr><tr><td>Academics</td><td>2.12 (1.09)</td><td>1.98 (1.08)</td><td>0.13</td><td>3.56</td><td>(13,887)</td><td>0.00*</td><td>0.12</td></tr><tr><td>Frustration/Anger</td><td>0.99 (0.88)</td><td>0.92 (0.83)</td><td>0.07</td><td>2.49</td><td>(1,038.52*)</td><td>0.02*</td><td>0.08</td></tr><tr><td>Eating</td><td>1.04 (1.17)</td><td>1.08 (1.23)</td><td>−0.03</td><td>−0.80</td><td>(1,011.04*)</td><td>0.43</td><td>−0.03</td></tr><tr><td>Alcohol</td><td>0.63 (0.91)</td><td>0.63 (0.89)</td><td>−0.00</td><td>−0.12</td><td>(13,887)</td><td>0.90</td><td>−0.00</td></tr><tr><td>Distress Index</td><td>1.87 (0.82)</td><td>1.67 (0.82)</td><td>0.20</td><td>7.03</td><td>(13,887)</td><td>0.00*</td><td>0.24</td></tr></tbody></table> </ephtml> </p> <p>2 *Equal variances are not assumed.</p> <p>Table 4. Severity of Concerns – Final Session, American Latinx (AL) & International Latinx (IL) (Independent Samples t-test).</p> <p> <ephtml> <table><thead><tr><td>CCAPS Index</td><td>AL Mean (SD)</td><td>IL Mean (SD)</td><td><p><graphic href="wcsp_a_2163953_ilm0003.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow xmlns=""><mrow><mrow><mi mathvariant="italic">x</mi></mrow></mrow></mrow></math></p>- diff</td><td><italic>t</italic></td><td>(df)</td><td><italic>p</italic></td><td>Cohen's <italic>d</italic></td></tr></thead><tbody><tr><td>Depression</td><td>1.55 (1.04)</td><td>1.34 (1.01)</td><td>0.21</td><td>5.85</td><td>(13,887)</td><td>0.00*</td><td>0.20</td></tr><tr><td>Anxiety</td><td>1.84 (1.03)</td><td>1.62 (0.98)</td><td>0.22</td><td>6.37</td><td>(1,035.04*)</td><td>0.00*</td><td>0.21</td></tr><tr><td>Social Anxiety</td><td>1.86 (1.02)</td><td>1.73 (0.95)</td><td>0.14</td><td>4.01</td><td>(1,041.63*)</td><td>0.00*</td><td>0.13</td></tr><tr><td>Academics</td><td>1.96 (1.12)</td><td>1.83 (1.09)</td><td>0.13</td><td>3.42</td><td>(13,887)</td><td>0.00*</td><td>0.12</td></tr><tr><td>Frustration/Anger</td><td>0.83 (0.83)</td><td>0.79 (0.78)</td><td>0.04</td><td>1.38</td><td>(1,040.45*)</td><td>0.17</td><td>0.05</td></tr><tr><td>Eating</td><td>0.96 (1.14)</td><td>1.02 (1.18)</td><td>−0.06</td><td>−1.43</td><td>(1,013.05*)</td><td>0.15</td><td>−0.05</td></tr><tr><td>Alcohol</td><td>0.55 (0.85)</td><td>0.56 (0.84)</td><td>−0.01</td><td>−0.29</td><td>(13,887)</td><td>0.77</td><td>−0.01</td></tr><tr><td>Distress Index</td><td>1.66 (0.86)</td><td>1.48 (0.82)</td><td>0.17</td><td>5.88</td><td>(13,887)</td><td>0.00*</td><td>0.20</td></tr></tbody></table> </ephtml> </p> <p>3 *Equal variances are not assumed.</p> <p>Table 5. Rate of change: main effects of time and Int'l status, covariate of number of attended sessions, and interaction terms.</p> <p> <ephtml> <table><thead><tr><td>Variable (CCAPS Index) </td><td>F<sup>a</sup></td><td><italic>p</italic></td><td><p><graphic href="wcsp_a_2163953_ilm0004.gif" content-type="Graph" /><math xmlns="http://www.w3.org/1998/Math/MathML"><mover xmlns=""><mrow><mrow><mi mathvariant="italic">x</mi></mrow></mrow><mo accent="false">‾</mo></mover></math></p> diff<sup>b</sup></td><td>Partial η<sup>2</sup></td></tr></thead><tbody><tr><td>Time (Depression)</td><td>39.83</td><td>0.00*</td><td>0.25*</td><td>0.00</td></tr><tr><td>Int'l</td><td>41.87</td><td>0.00*</td><td>0.22*</td><td>0.00</td></tr><tr><td>Sessions Attended</td><td>48.01</td><td>0.00*</td><td /><td>0.00</td></tr><tr><td>Time <sup>x</sup> Attended</td><td>1,282.62</td><td>0.00*</td><td /><td>0.09</td></tr><tr><td>Time <sup>x</sup> Int'l</td><td>2.40</td><td>0.12</td><td /><td>0.00</td></tr><tr><td>Time (Anxiety)</td><td>23.02</td><td>0.00*</td><td>0.19*</td><td>0.00</td></tr><tr><td>Int'l</td><td>44.34</td><td>0.00*</td><td>0.22*</td><td>0.00</td></tr><tr><td>Sessions Attended</td><td>28.80</td><td>0.00*</td><td /><td>0.00</td></tr><tr><td>Time <sup>x</sup> Attended</td><td>954.11</td><td>0.00*</td><td /><td>0.06</td></tr><tr><td>Time <sup>x</sup> Int'l</td><td>1.70</td><td>0.19</td><td /><td>0.00</td></tr><tr><td>Time (Social Anxiety)</td><td>7.95</td><td>0.01*</td><td>0.13*</td><td>0.00</td></tr><tr><td>Int'l</td><td>17.26</td><td>0.00*</td><td>0.14*</td><td>0.00</td></tr><tr><td>Sessions Attended</td><td>1.30</td><td>0.25</td><td /><td>0.00</td></tr><tr><td>Time <sup>x</sup> Attended</td><td>746.59</td><td>0.00*</td><td /><td>0.05</td></tr><tr><td>Time <sup>x</sup> Int'l</td><td>1.28</td><td>0.26</td><td /><td>0.00</td></tr><tr><td>Time (Academic)</td><td>26.98</td><td>0.00</td><td>0.16*</td><td>0.00</td></tr><tr><td>Int'l</td><td>12.43</td><td>0.00</td><td>0.13*</td><td>0.00</td></tr><tr><td>Sessions Attended</td><td>116.71</td><td>0.00*</td><td /><td>0.01</td></tr><tr><td>Time <sup>x</sup> Attended</td><td>373.64</td><td>0.00*</td><td /><td>0.03</td></tr><tr><td>Time <sup>x</sup> Int'l</td><td>0.13</td><td>0.72</td><td /><td>0.00</td></tr><tr><td>Time (Frustration/Anger)</td><td>17.16</td><td>0.00</td><td>0.12*</td><td>0.00</td></tr><tr><td>Int'l</td><td>3.38</td><td>0.07</td><td>0.05</td><td>0.00</td></tr><tr><td>Sessions Attended</td><td>35.52</td><td>0.00*</td><td /><td>0.00</td></tr><tr><td>Time <sup>x</sup> Attended</td><td>750.57</td><td>0.00*</td><td /><td>0.05</td></tr><tr><td>Time <sup>x</sup> Int'l</td><td>5.69</td><td>0.02*</td><td /><td>0.00</td></tr><tr><td>Time (Eating)</td><td>1.26</td><td>0.26</td><td>0.07*</td><td>0.00</td></tr><tr><td>Int'l</td><td>1.50</td><td>0.22</td><td>−0.05</td><td>0.00</td></tr><tr><td>Sessions Attended</td><td>12.54</td><td>0.00*</td><td /><td>0.00</td></tr><tr><td>Time <sup>x</sup> Attended</td><td>188.73</td><td>0.00*</td><td /><td>0.01</td></tr><tr><td>Time <sup>x</sup> Int'l</td><td>2.07</td><td>0.15</td><td /><td>0.00</td></tr><tr><td>Time (Alcohol)</td><td>11.02</td><td>0.00</td><td>0.08*</td><td>0.00</td></tr><tr><td>Int'l</td><td>0.09</td><td>0.76</td><td>−0.01</td><td>0.00</td></tr><tr><td>Sessions Attended</td><td>56.04</td><td>0.00*</td><td /><td>0.00</td></tr><tr><td>Time <sup>x</sup> Attended</td><td>251.84</td><td>0.00*</td><td /><td>0.02</td></tr><tr><td>Time <sup>x</sup> Int'l</td><td>0.26</td><td>0.61</td><td /><td>0.00</td></tr><tr><td>Time (Distress Index)</td><td>41.37</td><td>0.00</td><td>0.20*</td><td>0.00</td></tr><tr><td>Int'l</td><td>44.39</td><td>0.00*</td><td>0.18*</td><td>0.00</td></tr><tr><td>Sessions Attended</td><td>7055.00</td><td>0.00*</td><td /><td>0.00</td></tr><tr><td>Time <sup>x</sup> Attended</td><td>1,442.35</td><td>0.00*</td><td /><td>0.09</td></tr><tr><td>Time <sup>x</sup> Int'l</td><td>3.92</td><td>0.05*</td><td /><td>0.00</td></tr></tbody></table> </ephtml> </p> <ulist> <item>4 <sups>a</sups>For all models, Time, Time <sups>x</sups> Int'l, and Time <sups>x</sups> Attended = Within-Subjects F; Attended and Int'l = Between-Subjects F. <sups>b</sups> Mean Difference (I – J) based on estimated marginal means. For Time, I = Initial score and J = Final score; Int'l, I = AL and J = IL.</item> <item>5 *p <.05.</item> </ulist> <p>In post-hoc examinations, we also found significant overall initial severity effects for we found a significant difference between initial severity of concerns for undergraduate (<emph>F</emph>(<reflink idref="bib8" id="ref70">8</reflink>, 12,<reflink idref="bib201" id="ref71">201</reflink>) = 7.00, <emph>p <</emph>.001) and graduate students (<emph>F</emph>(<reflink idref="bib8" id="ref72">8</reflink>, 1668) = 4.19, <emph>p <</emph>.001). For undergraduates, AL and IL students were significantly different on depression (<emph>t</emph>(<reflink idref="bib12" id="ref73">12</reflink>,<reflink idref="bib209" id="ref74">209</reflink>) = 5.00; <emph>p</emph> <.00; <emph>d</emph> = 0.22), anxiety (<emph>t</emph>(<reflink idref="bib12" id="ref75">12</reflink>,<reflink idref="bib209" id="ref76">209</reflink>) = 4.84; <emph>p</emph> <.00; <emph>d</emph> = 0.21), social anxiety (<emph>t</emph>(618.24) = 2.95; <emph>p</emph> <.00; <emph>d</emph> = 0.12), academics (<emph>t</emph>(<reflink idref="bib12" id="ref77">12</reflink>,<reflink idref="bib209" id="ref78">209</reflink>) = 3.00; <emph>p</emph> <.00; <emph>d</emph> = 0.13), eating concerns (<emph>t</emph>(605.59) = −2.40, <emph>p</emph> =.02, <emph>d</emph> = −0.11), and the overall distress index (<emph>t</emph>(<reflink idref="bib12" id="ref79">12</reflink>,<reflink idref="bib209" id="ref80">209</reflink>) = 5.02; <emph>p</emph> <.00; <emph>d</emph> = 0.22). This closely parallels the results from the full sample, with the exception of the addition of eating concerns and the exclusion of frustration/anger. In each of these subscales, AL students showed greater distress. For graduate students, we found a significant difference between initial severity of concerns for AL and IL students only for anxiety (<emph>t</emph>(<reflink idref="bib1" id="ref81">1</reflink>,<reflink idref="bib676" id="ref82">676</reflink>) = 2.81; <emph>p</emph> =.01; <emph>d</emph> = 0.17) and academics (<emph>t</emph>(<reflink idref="bib1" id="ref83">1</reflink>,<reflink idref="bib676" id="ref84">676</reflink>) = 2.07; <emph>p</emph> =.94; <emph>d</emph> = −0.12), where, parallel to results for undergraduate students, AL graduate students showed more distress.</p> <p>Third, we hypothesized that IL students would demonstrate similar or slower treatment improvement rates than AL students. This improvement rate was indicated by the interaction between our time variable and international student status. In our multivariate test for differences in change over time between AL and IL students, we found no significant differences (<emph>F</emph>(<reflink idref="bib8" id="ref85">8</reflink>, 13,<reflink idref="bib879" id="ref86">879</reflink>) = 1.19, <emph>p =</emph>.30). Additionally, in post hoc analyses separating undergraduate and graduate students, we found no significant differences in rates of improvement (undergraduate students: <emph>F</emph>(<reflink idref="bib8" id="ref87">8</reflink>, 12,<reflink idref="bib201" id="ref88">201</reflink>) = 1.44, <emph>p =</emph>.18; graduate students: (<emph>F</emph>(<reflink idref="bib8" id="ref89">8</reflink>, 1668) = 1.29, <emph>p =</emph>.24)). We therefore retain the null hypothesis, meaning that the data suggests no significant difference in rates of improvement between the two groups.</p> <hd id="AN0178074300-7">Discussion</hd> <p>The purpose of this study was to investigate the treatment utilization of Latinx students and determine whether American-born members of the Latinx community and internationally born members of the Latinx community differ in their treatment patterns. Most research has combined AL and IL students into the same category when making treatment comparisons. Because of this tendency to conflate, minimal research exists that compares possible differences in mental health utilization between the two groups. Our study used a nationwide database, the CCMH, to detect possible variations in session utilization, presenting concerns, and outcomes between AL and IL students.</p> <p>Our first hypothesis stated that IL students would attend fewer sessions of psychotherapy than AL students. This hypothesis was founded on research that suggested level of acculturation and culturally different treatment methods act as additional barriers to IL students seeking treatment (Hayes et al., [<reflink idref="bib16" id="ref90">16</reflink>]; Sullivan et al., [<reflink idref="bib33" id="ref91">33</reflink>]). However, when looking at the nationwide CCMH treatment data, there were no significant differences in the number of attended sessions between the AL and IL students. Nevertheless, when we ran post-hoc tests to see if there was a significant difference in attendance rates between AL and IL undergraduate and graduate students, we found that IL undergraduate students had a significantly lower attendance rate for scheduled appointments than their AL peers; graduate students, on the other hand, showed the opposite effect: AL students had significantly lower attendance rates. Possible explanations for our findings could be that IL students do not have as much exposure to mental health treatments, whereas IL students in graduate school, due to age and experience, may feel better able to access mental health services. Because we did not have any way to specify levels of acculturation, this explanation remains speculative and should be examined in future research.</p> <p>Our second hypothesis stated that IL students would show a higher severity of initial presenting concerns and overall distress at intake than their AL counterparts. The reasoning for this prediction is grounded in research that IL students face additional challenges when attending university in a foreign nation than their AL student counterparts, such as homesickness, language barriers, and conflicts with identity or cultural norms (Romero, [<reflink idref="bib28" id="ref92">28</reflink>]; Sue & Chu, [<reflink idref="bib32" id="ref93">32</reflink>]; Wilton & Constantine, [<reflink idref="bib38" id="ref94">38</reflink>]). Our findings yielded opposite results: in general, AL students reported greater psychological distress at intake than IL students on all indices of the CCAPS except Eating and Alcohol (see Table 3). While there are several differences between the two groups of students, differences are most pronounced between initial levels of depression, anxiety, and overall distress. In general, post-hoc tests corroborated the finding that AL students showed greater distress for both undergraduate and graduate students.</p> <p>Further research is needed to establish possible reasons for these findings. One possible explanation may be that AL students tend to have unique stressors that IL students do not have, leading to more severe initial distress levels. Possible stressors could include marginalization of AL students as they were growing up, difficulties in the cultural divide between parents and children, and the likelihood of having lower socioeconomic status in the US (Cabrera, Hennigar, Yumiseva-Lackenbacher, & Galindo, [<reflink idref="bib6" id="ref95">6</reflink>]). Again, future research can help clarify why AL students in our nationally representative sample appeared to be experiencing higher distress when presenting for therapy than their IL peers.</p> <p>Our third hypothesis stated that IL students would demonstrate similar or slower treatment improvement rates than AL students, as previous research indicated that Spanish-dominant areas have higher amounts of mental health stigma (DeFreitas, Crone, DeLeon, & Ajayi, [<reflink idref="bib10" id="ref96">10</reflink>]; Hayes et al., [<reflink idref="bib16" id="ref97">16</reflink>]; Sullivan et al., [<reflink idref="bib33" id="ref98">33</reflink>]). The results from our study suggested no significant differences in treatment improvement rates. These findings are not consistent with previous studies that have suggested that AL students would likely have more success in therapy sessions due to increased exposure to therapy (Bohon, Macpherson, & Atiles, [<reflink idref="bib5" id="ref99">5</reflink>]; Ruiz-de-Velasco & Fix, [<reflink idref="bib29" id="ref100">29</reflink>]). This finding is particularly interesting in light of a recent study aggregating national data on international students and comparing them to domestic students (Keum et al., [<reflink idref="bib20" id="ref101">20</reflink>]). In this study researchers found that on average, international students had higher distress at the end of therapy when controlling for initial severity (suggesting a slower improvement rate for international students). Our findings demonstrate that disaggregating international students can yield unique and important findings, despite more global trends. Further research should be conducted to understand potential differences between these groups, or to confirm our findings that outcomes are similar. Several factors might contribute to differences: increased exposure to US-based therapeutic services; decreased language barriers; and cultural discrepancies, which may allow for a quicker therapeutic process for those individuals (Bohon et al., [<reflink idref="bib5" id="ref102">5</reflink>]; Ruiz-de-Velasco & Fix, [<reflink idref="bib29" id="ref103">29</reflink>]). In a university counseling setting, however, these factors may have less of an impact than in other settings.</p> <p>The current study had several limitations. First, due to the archival nature of our study, we did not have a way to manipulate variables of interest, control the environment, or include follow-up. Consequently, causal inferences cannot be drawn from our findings. Additionally, the naturalistic setting used and aggregate findings from this study help make macro comparisons, but they omit the individual experiences of Latinx students. Furthermore, there are even finer distinctions that can be made in the Latinx populations that could impact results, such as possible differences in nationality, gender identity, sexual orientation, and age. We further acknowledge that in our efforts to disaggregate AL and IL students, we also engaged in the practice of combining all IL students into one group. Unfortunately, we did not have a large enough sample of students from each country included in the overall IL category to accurately examine potential similarities and differences. These variables were beyond the scope of the current study and are important areas of study for future research.</p> <p>Despite these limitations, the current study had many strengths. Our study had a large sample size, allowing for enough power to detect differences between groups. In addition, the nationwide dataset included a diverse range of colleges and backgrounds, giving this study high ecological validity across the United States. We also used a common measure for all participating universities, allowing for consistent data across institutions.</p> <p>Our findings suggest potential clinical efforts with IL students and AL students. Outreach to undergraduate IL students that encourages them to seek help if they feel they need it, and multicultural training for clinicians around international student experiences may help IL undergraduates better utilize the treatment available to them. Additionally, understanding that treatment appears to be equally effective for both IL and AL students can help clinicians set expectations, particularly for IL students that may feel more reluctant to engage in therapy.</p> <p>This study was a preliminary effort to separate experiences between AL and IL students. We call for future research that accounts for differences within ethnicity rather than reinforcing ethnic glossing through traditional groupings. While we found that the groups were similar in many respects, there were also important differences (most notably the higher intake distress of AL students) that can guide both research and clinical work. Future research could explore which potential factors (e.g., socioeconomic, cultural, etc.) contribute to AL student's higher distress. Future research could also examine other variables that may distinguish between different Latinx subpopulations that we were unable to explore (e.g., first-generation status). This may be done quantitatively, and could also include qualitative explorations, allowing for further understanding of the lived experiences of AL and IL students. By separating and comparing experiences between AL and IL students (rather than treating them as a homogeneous group), researchers and practitioners are likely to be better informed and equipped to provide therapeutic services for individuals with a diverse set of backgrounds, ethnicities, cultures, and needs.</p> <hd id="AN0178074300-8">Disclosure statement</hd> <p>No potential conflict of interest was reported by the authors.</p> <ref id="AN0178074300-9"> <title> Note </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Researchers have increasingly used <emph>Latinx</emph> as a gender-inclusive cultural identifier to acknowledge the array and invisibility of sexual and gender identities of the lesbian, bisexual, transgender, and queer (LGBTQ) population in Spanish-dominant countries (Scharrón-del Río & Aja, [30]). 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  Label: Title
  Group: Ti
  Data: Comparing Psychotherapeutic Treatment Rates in University Counseling Centers between American Latinx and International Latinx University Students
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Jason+M%2E+Hoskin%22">Jason M. Hoskin</searchLink><br /><searchLink fieldCode="AR" term="%22Heidi+Vogeler%22">Heidi Vogeler</searchLink><br /><searchLink fieldCode="AR" term="%22Jessica+Kirchhoefer%22">Jessica Kirchhoefer</searchLink><br /><searchLink fieldCode="AR" term="%22Brett+M%2E+Merrill%22">Brett M. Merrill</searchLink><br /><searchLink fieldCode="AR" term="%22David+Erekson%22">David Erekson</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-6214-485X">0000-0001-6214-485X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Mark+E%2E+Beecher%22">Mark E. Beecher</searchLink><br /><searchLink fieldCode="AR" term="%22Derek+Griner%22">Derek Griner</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-0378-6403">0000-0002-0378-6403</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+College+Student+Mental+Health%22"><i>Journal of College Student Mental Health</i></searchLink>. 2024 38(1):207-221.
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  Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Label: Peer Reviewed
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  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 15
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
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  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Psychotherapy%22">Psychotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Guidance+Centers%22">Guidance Centers</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Hispanic+American+Students%22">Hispanic American Students</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Students%22">Foreign Students</searchLink><br /><searchLink fieldCode="DE" term="%22Latin+Americans%22">Latin Americans</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+%28of+Disability%29%22">Severity (of Disability)</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Outcomes+of+Treatment%22">Outcomes of Treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Counseling+Effectiveness%22">Counseling Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Attendance%22">Attendance</searchLink><br /><searchLink fieldCode="DE" term="%22Cultural+Differences%22">Cultural Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Characteristics%22">Student Characteristics</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/87568225.2022.2163953
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 8756-8225<br />1540-4730
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: As the press for services at university counseling centers increases, so does the need to provide optimal therapeutic services. Ethnic glossing in previous research has combined rather disaggregated the mental health treatment experiences of American Latinx (AL) students and International Latinx (IL) students. The purpose of this paper was to examine potential differences in (1) the number of attended sessions, (2) symptom severity, and (3) treatment improvement rates. We used a nationwide dataset including 13,156 AL students and 911 IL students. Results indicated that (1) there was no significant difference in attendance rates, (2) AL students had significantly worse initial symptom severity (d = 0.24), and (3) there were no significant differences in improvement rates. We discuss the importance of understanding the different clinical presentations of AL and IL students, as well as the importance of addressing ethnic glossing in future research and clinical work.
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  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1420191
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1420191
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  BibEntity:
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      – Type: doi
        Value: 10.1080/87568225.2022.2163953
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 15
        StartPage: 207
    Subjects:
      – SubjectFull: Psychotherapy
        Type: general
      – SubjectFull: Guidance Centers
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Hispanic American Students
        Type: general
      – SubjectFull: Foreign Students
        Type: general
      – SubjectFull: Latin Americans
        Type: general
      – SubjectFull: Severity (of Disability)
        Type: general
      – SubjectFull: Mental Health
        Type: general
      – SubjectFull: Outcomes of Treatment
        Type: general
      – SubjectFull: Counseling Effectiveness
        Type: general
      – SubjectFull: Attendance
        Type: general
      – SubjectFull: Cultural Differences
        Type: general
      – SubjectFull: Student Characteristics
        Type: general
    Titles:
      – TitleFull: Comparing Psychotherapeutic Treatment Rates in University Counseling Centers between American Latinx and International Latinx University Students
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              Y: 2024
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              Value: 8756-8225
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