The Suitability of Insight-Oriented Therapy for the Hispanic Poor

The suitability of insight-oriented therapy for Hispanic poor has been a subject of controversy (Costantino, Malgady, and Rogler, 1986; Padilla, Ruiz, and Alvarez, 1975). It has been suggested that insight-oriented therapy is uneconomical and irrelevant in the context of the Hispanic life (Ruiz, 1981; Sue and Sue, 1977). By contrast, Minuchin's Family Therapy Model (Minuchin, Montalvo, Guerney, Rosman, and Schumer, 1967), Cuento Therapy (Costantino, Malgady, and Rogler, 1986), and other similar treatment interventions are heralded as the most appropriate treatments. They are assumed to address directly the socioeconomic and sociopolitical problems frequently confronting poor Hispanics in a presumably culturally sensitive manner. The underlying assumption of these interventions is that poor Hispanics are uninterested in exploration or are unable to engage in exploratory psychotherapy due to the negative impact of the “culture of poverty” (Allen, 1970; Lewis, 1964, 1966; Malgady, Rogler, and Costantino, 1987; Rogler, Malgady, Costantino, and Blumenthal, 1987; Sarbin, 1970).

This paper reviews the possible sources of these negative assumptions about the poor. It also advances the proposition that it is possible to apply psychoanalytic principles in the treatment of disadvantaged Hispanic individuals in the context of their socioeconomic, sociopolitical, and cultural realities. Clinical data are used to illustrate the extent to which these factors may influence the nature of the therapeutic process.

In reviewing the assumptions normally made about the poor, one is immediately directed to Oscar Lewis' (1964, 1966) numerous contributions to the description of the poverty condition and its psychological correlates. He suggested that socioeconomic and sociopolitical deprivation and disorganization are brought about by conditions where (1) a set of values exists in the dominant