Ecological validity and cultural sensitivity for outcome research: Issues for the cultural adaptation and development of psychosocial treatments with Hispanics

This article has two objectives. The first is to provide a culturally sensitive perspective to treatment outcome research as a resource to augment the ecological validity of treatment research. The relationships between external validity, ecological validity, and culturally sensitive research are reviewed. The second objective is to present a preliminary framework for culturally sensitive interventions that strengthen ecological validity for treatment outcome research. The framework, consisting of eight dimensions of treatment interventions (language, persons, metaphors, content, concepts, goals, methods, and context) can serve as a guide for developing culturally sensitive treatments and adapting existing psychosocial treatments to specific ethnic minority groups. Examples of culturally sensitive elements for each dimension of the intervention are offered. Although the focus of the article is on Hispanic populations, the framework may be valuable to other ethnic and minority groups.