371 © Springer International Publishing AG 2017 L.T. Benuto (ed.), Toolkit for Counseling Spanish-Speaking Clients, DOI 10.1007/978-3-319-64880-4_17 Treatment Considerations and Tools for Treating Latino Adolescents with Externalizing Disorders Rory T. Newlands and Amanda M. Muñoz-Martínez Externalizing disorders, such as attention-deficit/ hyperactivity disorder, oppositional defiant disor- der, and conduct disorder, are characterized by impulsivity, inattention, and overreactivity and are associated with negative psychosocial out- comes (Nock, Kazdin, Hiripi, & Kessler, 2006). Distinguishing between “normal” teen misbehav- ior and pathological behavior can be difficult given that most teens (70%) will engage in delin- quent behavior at some point (Elliott, Huizinga, & Ageton, 1985; Farrington, 1995). Unfortunately, the empirical literature regarding the prevalence, etiology, and treatment of externalizing disorders among Latino youths remains limited. Lending to this knowledge gap is the fact that the Latinos tend to underutilize mental health services when compared to their non-Latino counterparts (Ojeda & McGuire, 2006). Given these considerations, the aims of this chapter is to provide: • A brief overview of current research on exter- nalizing disorders and empirically supported treatments • Cultural considerations for modifying current treatment practices • Session plans and Spanish language work sheets Common Externalizing Disorders and Their Prevalence Attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and to a lesser extent oppositional defiant disorder (ODD) vary across populations and genders. For instance, rates of ADHD have been found to range anywhere between 1.7% and 17.8% (Costello, Mustillo, Keller, & Angold, 2004; Elia, Ambrosini, Rapoport, 1999; Faraone, Sergeant, Gillberg, & Biederman, 2003). Males appear to have elevated rates of ADHD compared to their female coun- terparts, 11.8% in boys and 5.4% in girls (Froehlich et al., 2007). While less is known regarding the prevalence of ADHD in Latino populations, research suggests that Mexican- American youths have lower rates than Caucasian youths (Merikangas et al., 2010), which may be due to the fact that Latino youths are less likely to be diagnosed by parental report than Caucasians (Stevens, Harman, & Kelleher, 2005). ADHD and CD are the most commonly co- occurring psychiatric disorders among youths (Merikangas et al., 2010; Costello et al., 2004), and similar to ADHD, conduct disorder (CD) is about 3–4 times higher in boys than girls (Merikangas, Nakamura, & Kessler, 2009). For the general population, estimates of CD range R.T. Newlands, BS (*) A.M. Muñoz-Martínez, MS (*) Department of Psychology, University of Nevada, Reno, Mail stop (0296) 1664 N. Virginia Street, Reno, NV 89557, USA e-mail: rorynewlands@gmail.com; amandamile@gmail.com 17