Int J Soc Welfare 2003: 12: 221– 228 © Blackwell Publishing Ltd and the International Journal of Social Welfare 2003. Published by Blackwell Publishing, 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA 221 INTERNATIONAL JOURNAL OF SOCIAL WELFARE ISSN 1369-6866 Vandevelde S, Vanderplasschen W, Broekaert E. Cultural responsiveness in substance-abuse treatment: a qualitative study using professionals’ and clients’ perspectives Int J Soc Welfare 2003: 12: 221–228 © Blackwell Publishing, 2003 As a result of the growing number of ethnic and cultural minority clients in substance-abuse treatment during the last decades, a culturally responsive approach has become more and more imperative. In this article the statements (n = 1330) of professionals (n = 11) and clients (n = 11) representing the substance-abuse treatment centres in the region of Ghent and its suburbs (Belgium) are analysed. In focus are the specific treatment needs of ethnically and culturally diverse substance- abusing clients and the difficulties consequent to treating this target group. Possible approaches to overcoming these difficulties are highlighted and elaborated by means of semi- structured interviews and focus groups. The participants in the study stress the importance of an integrated approach, with special attention given to the factors that can promote or jeopardise treatment. Stijn Vandevelde, Wouter Vanderplasschen, Eric Broekaert Department of Orthopedagogics, Ghent University, Belgium Blackwell Publishing Ltd Oxford, UK IJSW Int J Soc Welfare 1369-6866 © Blackwell Publishers Ltd and the International Journal of Social Welfare 2003 2003 12 3 1 000 Original Article Cultural responsiveness in substance-abuse treatment Vandevelde, Vanderplassschen & Broekhart Cultural responsiveness in substance-abuse treatment: a qualitative study using professionals’ and clients’ perspectives Key words: cultural responsiveness, substance-abuse treatment, ethnic and cultural diversity, qualitative research Stijn Vandevelde, Department of Orthopedagogics, Ghent University, H. Dunantlaan 2, B-9000 Ghent, Belgium E-mail: stijn.vandevelde@rug.ac.be Accepted for publication January 20, 2003 Introduction As outlined in the introductory article to this mini- symposium contribution, therapeutic communities have always considered cultural diversity as an essential concept within their treatment approach (De Leon, Melnick, Schoket & Jainchill, 1993). Currently, because of the increasing number of ethnic minority clients in substance-abuse treatment in general (Finn, 1994, 1996), the need for and implementation of a culturally responsive treatment has become more urgent and widespread (Argeriou & Daley, 1997; Ellis, 1999; Kline, 1996; Terrell, 1993; Westermeyer, 1996). In this context, it is worthwhile noting that the organisation of treatment centres is almost always modelled after the dominant (autochthon) culture (Lee, 1994). Research points out that ethnic minorities often fail to make use of the existing treatment facilities (Ashruf & van der Eijnden, 1996; Longshore, Grills, Anglin & Annon, 1997) and that there is a disproportionate ethnic distribution in some treatment centres, especially in those with a high threshold (e.g. therapeutic communities) (Braam, Verbraeck & van de Wijngaert, 1998; De Leon, Melnick, Schoket & Jainchill, 1993; Vandevelde, Vanderplasschen & Broekaert, 2000). Furthermore, minority clients are less likely to successfully complete treatment (Finn, 1994, 1996) and more likely to experience specific difficulties due to typical characteristics of the (traditional) treatment system, methods and techniques (Tucker, 1985). To cope with these difficulties, recent research has revealed the importance of taking the specific needs of minority clients and other ethno-cultural factors into account when treating culturally diverse client groups (Jackson, Stephens & Smith, 1997; Rounds-Bryant, Kristiansen & Hubbard, 1999; Varma & Siris, 1996). Therapeutic communities and other treatment centres also share these concerns and insist on the necessity of specification. First of all, substance-abuse treat- ment centres are not equally distributed over different cities and regions in Belgium, regardless of need (Vanderplasschen, De Bourdeaudhuij & Van Oost, 2002); moreover, treatment is influenced by many cultural and traditional factors. Important differences can exist – such as country of origin, religion, values and beliefs – amongst persons with culturally diverse