American journal o/Orthofisychiatn/, 77(4), October 2001 © 2001 American Orthopsychiatric Association, Inc. Complementary Spiritual Beliefs in the Latino Community: The Interface with Psychotherapy Annecy Baez, M.S.W., Ph.D., and David Hernandez, M.S.W. A model involving a dynamic spectrum of belief by Latinos in the spiritual traditions of Santeria and Espiritismo is proposed as replacement for the more static prevalence model. Die issue of clinical responsiveness to such material is examined and illustrated, and implications for research and practice are discussed. The therapist's task is to treat spirituality as a fa- cilitator of therapeutic outcome. -Harry J. Aponte (1999) T he primary non-Christian spiritual traditions that affect the lives and world views of many Puerto Ricans, Dominicans, Cubans, and their descendants living in the United States (hereinafter referred to as Latinos), are Santeria and Espiritismo (Gonzalez-Wippler, 1979; Har- wood, 1977). Both traditions have long been noted as indigenous mental health support systems in the Latino community (Comas-Diaz, 1981; Delgado & Delgado, 1982). The successful provision of culturally sensitive and culturally inclusive mental health services de- pends in large part on the level of congruence be- tween the client's and the mental health practi- tioner's respective views of mental illness and its treatment (Freidson, 1970; Rogler, Malgady, Con- stantino, & Blumenthal, 1998; Sue & Sue, 1990). It therefore behooves clinicians to acquire suffi- cient understanding of Santeria and Espiritismo that they can assess their impact on their clients' view of mental illness. This is particularly advis- able when the client is Latino and the clinician is not. The belief systems of Santeria and Es- piritismo, because of their broad biopsychosocial implications, represent highly relevant cultural knowledge that can contribute to the quality of un- derstanding between clinicians and Latino clients (Santi, 1997). It is clear from the authors' experience in con- ducting training on complementary spiritual beliefs for mental health practitioners, that practitioners often become preoccupied with the general ques- tion of prevalence of these and other (e.g., the Mexican tradition of curanderismo) spiritual belief systems among Latinos (Kramer, 1995). To judge from the weight of research on the topic, re- searchers share this preoccupation. Some have re- ported high prevalence (Norwood, 1977; Holland, 1963; Rivera, 1988; Sandoval, 1979; Stenger-Castro, 1978), and others low prevalence (Castro, Furth, & Karlow, 1984; Edgerton, Karno, & Fernandez, 1970; Keefe, 1981). Some have found high preva- lence among first generation or older immigrants, and decreasing prevalence in second and third gen- erations (Algeria, Guerra, Martinez, & Meyers, 1977; Applewhite, 1995; Kiev, 1964; Montgomery, 1983). Still others have pointed to geographic loca- tion as a significant variable in prevalence (Castro et al., 1984; Mull & Mull, 1983; Van Oss Marin, Marin, Padilla, & De La Rocha, 1983). It is the authors' contention that such emphasis on low or diminishing prevalence, age, or level of acculturation often represents an American ethno- centric tendency to dismiss the existence and rele- Revised version of a paper submitted to the journal in November ZOOO.Authors are at: Elirenkranz School of Social Work, New York University (Baez); and St. Christopher's, Inc., Dobbs Ferry, N.Y. (Hernandez). 408