Cultural, interpersonal and psychodynamic factors in caregiving: Towards agreater understanding of treatment noncompliance

The proportion of Hispanic elderly is steadily increasing in the USA. Conco mitant to this increase are the problems associated with aging in Hispanic elders including their experience of caregiving. The needs of Hispanic care givers have, typically, been overlooked and are especially problematic give n the high levels of distress and depression within this group. The followi ng case study examines the treatment of a depressed, Mexican-American woman 's noncompliance with a cognitive-behavioral program for caregivers. Case d ata is analyzed within the framework of acculturation versus alternation mo dels of adaptation. In addition, interpersonal and psychodynamic factors ar e examined to illuminate reasons for treatment failure. Concrete suggestion s for improving the process and outcome of her treatment are offered. Copyr ight (C) 1999 John Wiley & Sons, Ltd.