Dame la Mano (Give Me a Hand)
The Dame la Mano project, which ran from October 1999 to November 2002,
was a collaborative effort between the Connecticut Department of Mental
Health and Addiction Services, Capital Region Mental Health Center, the
Hispanic Health Council, the Connecticut Community for Addiction Recovery,
Dartmouth College, and Temple University This project was designed to
modify and implement an existing dual-diagnosis (substance abuse and
mental health conditions) treatment program for use with dual-diagnosed,
Spanish-speaking Latinos in Connecticut. Phase I focused on consensus-building
around the culturally-specific modifications to be made to the treatment
model. Phase II was the implementation phase in which clinicians at Capital
Region Mental Health Center in Hartford began using the modified model
with their Spanish-speaking, Latino clients and continued more micro-level
modifications of the model.
The Hispanic Health Council's role in the project was to perform a qualitative
process evaluation which included description and analysis of:
• the content of consensus-building meetings, other project related meetings
and the treatment groups
• the views and concerns of project staff and clients
• the barriers encountered and advantages of the approach.
The methods used to explore these issues included participant observation
in project meetings, trainings, and treatment groups, and one-on-one
interviews and focus groups with project staff and clients. Additionally,
the HHC was responsible for providing ongoing feedback in monthly, quarterly
and final reports to project members and the funding agency.
Key findings and actions included:
• The involvement of dedicated Spanish-speaking, Latino clinicians
who had extensive experience with the client population, greatly facilitated
the modification and implementation of a culturally specific treatment
model.
• A decision-making process based on consensus-building created challenges
in planning, leadership, and direction.
• The practical application of the model included sharing personal experiences
with clients; maintaining flexibility in structure of treatment groups;
reducing the power differential between clinicians and clients; utilizing
culturally relevant words and idioms; framing therapy in terms of culturally
relevant issues (e.g., gender differences, migration, racism, language
difficulties); and acknowledging the importance of family.
• The project directly led to monolingual Spanish-speaking clients being
offered dual-diagnosis treatment for the first time at this agency which
included the development of five treatment groups.
• The project was an important contribution to lowering disparities in
mental health services for Latinos in Hartford.
Research Team
Julie Eiserman, M.A., Ethnographer
Janie Simmons, Ed.D.,Ethnographer
