Cultural competence and organizational change: Meet the researcher, Dr. Erick Guerrero

October 15, 2017

Maureen Fitzgerald
ATTC Network Office
Great Lakes ATTC

Photo credit:Shutterstock

National Hispanic Heritage Month (September 15-October 15) celebrates Hispanic and Latino heritage and the countless ways that Hispanics and Latinos have contributed to the arts, sports, literature and science. And in behavioral health, Hispanic and Latino researchers and scientists are among those who are helping to build our understanding of how race and culture influence access to and engagement in treatment.

Dr. Erick Guerrero is an Associate Professor in the Suzanne Dworak-Peck School of Social Work with a joint appointment in the School of Business at the University of Southern California. His research and publications focus on identifying and reducing racial and ethnic disparities in behavioral health services, integration of behavioral and primary care, and implementing culturally responsive evidence-based practices.

Early on, Dr. Guerrero started to ask the question of how health systems could be more responsive to people with substance use disorders (SUDs). Working as a clinician in a program for children and families referred by the criminal justice system, he was challenged by the lack of evidence-based approaches to improve access to and engagement in SUD treatment. That led to additional training and study, including a master’s degree in clinical psychology, followed by a PhD in Social Work that combined management, organization science and implementation science.
Read more about Dr. Guerrero’s career journey in this story from the USC News: Going Big: Erick Guerrero is Changing Systems to Make Getting Substance Abuse Treatment Easier

Addressing barriers to treatment

Much of Dr. Guerrero’s work has focused on the barriers that Latinos face when seeking SUD treatment. “It’s well established that certain minorities encounter more barriers to access, engage in, and complete treatment,” says Dr. Guerrero. “While we are gaining ground in identifying interventions to improve access when working with Latinos with substance use disorders, I’ve found in my own work that, even when culturally adapted, these interventions need additional implementation strategies to be effective.”

Dr. Guerrero says that a culturally-informed management strategies can help decrease waiting times and increase retention. “That includes strategies such as outreach to the Latino community, hiring bilingual staff who understand the culture of the populations served, payment policies that are responsive to low-income clients, and scheduling treatment on evenings and weekends to accommodate work schedules.”

Five Tips for Building Culturally Competent Services

Dr. Guerrero offers the following strategies that treatment organizations can use to improve access and engagement for their Hispanic and Latino clients:

Who are Hispanics and Latinos?  "A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race."  From the National Hispanic and Latino ATTC Factsheet: Meet your new clients: Hispanics and Latinos
1. Recognize that the Latino population in the United States is very diverse. “Sometimes, treatment programs think that they can increase access and engagement simply by hiring Latinos to treat Latinos, but it’s not a guarantee,” says Dr. Guerrero. “The Latino population in the U.S. is very heterogeneous and there are cultural and linguistic differences among Latino subgroups that need to be considered as well when tailoring services.” For example, a client who grew up in a rural environment in Mexico may have a world view that is different from that of a provider from Argentina who grew up in a large city.

2. Test for Spanish language proficiency. Hiring staff with high Spanish language proficiency is critical to engage this group in the process of change. It’s important to make sure that there is effective communication when providing treatment to patients who mainly speak Spanish. “For many Latino treatment providers in the U.S., English is the dominant language, even if they grew up in bilingual households. They may not have language proficiency skills in a professional setting.” One solution is to have bilingual staff take a language proficiency test to assess their skills. “One of our studies found that higher Spanish language proficiency improved retention in treatment for Latino clients.”
Related resource from HHS: The Guide to Providing Effective Communication and Language Assistance Services
"Don't be afraid to contact a researcher about the work the they're doing. The behavioral health field needs people who are interested and engaged and who want to make a change for vulnerable groups that need help accessing care." 
3. Emphasize empathy through reflective and engaging practices. “An essential quality for working with those that have been underserved is empathy,” says Dr. Guerrero. “Clients respond better to counselors who show that they are interested in the client’s culture and context. A responsive and compassionate counselor who shares a similar world view as the patient and those who reflect clients’ reality and use this understanding to engage tend to be effective in engaging bilingual and bicultural clients. ”

4. Cultivate cultural humility. Guerrero encourages anyone interested in working with diverse populations to have an open mind in terms of understanding the complexity of working with people from other cultures and with different degrees of English speaking proficiency. “Be open to the concept of cultural humility, which can help mute the national and international narrative on one race or one group,” says Dr. Guerrero.
Related resource from the American Psychological Association: Reflections on cultural humility
5. “Reach out to researchers,” says Dr. Guerrero. “Don’t be afraid to contact a researcher about the work they’re doing. The behavioral health field needs people who are interested and engaged and who want to make a change for vulnerable groups that need help accessing care.”

Interested in Dr. Guerrero’s research? Contact him at:

More Related resources:

National Network to Eliminate Disparities in Behavioral Health

Pew Research Center



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  3. Great post! The month of November is Native American Month, I would like to read your thoughts of cultural competence when treating Native American clients. How can we use your information and integrate the methods to this population?

    1. Kevin, thank you for your interest.

      The cultural competence framework and measures we use in our study can be adapted to other cultures. The focus is on training treatment providers on cultural humility and competence to understand and use cultural knowledge, services and personnel practices to connect with clients and get their buy in on their recovery. Applied to Native American clients, the framework can address many deep seated beliefs that may prevent them from trusting the therapeutic process, which is necessary to achieve recovery.

      I hope this response is helpful. Please feel free to contact me if you have other questions or suggestions on how to improve our work.


  4. I always gain knowledge and understanding from Dr. Guerrero's research. I have followed his research since participating on one of his research projects.

  5. Thank you Demy. It was an honor working with you.

    Best regards,


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