Puerto Rican family functioning, acculturation and attitudes toward family counseling

Puerto Ricans are the second largest Latino group in this country. Although this is a group whose demographics are changing and will probably be major consumers of counseling services in the near future, there is very little research on Puerto Rican families. A major problem identified in the mental health literature with Latinos is the underutilization of services. This study attempts to explore Puerto Rican family functioning and utilization of family counseling services. This investigation examines the validity and applicability of the Family Functioning Scale (FFS) using a Principle Components Analysis with varimax rotation with a sample of Puerto Ricans. The FFS was found to be partially successful in measuring aspects of Puerto Rican family functioning. To further assess the validity of the FFS with Puerto Ricans, the results of this study are compared to the results in two other studies, one using a multicultural sample and one that did not. Acculturation, using the Puerto Rican Acculturation Scale (PRAS) was used to assist in determining whether acculturation impacted the resu.lts on the FFS and with family therapy utilization. Further, it was also intended to separate acculturation from other possible explanations for results (confounding variables), such as socioeconomic status and educational level. Unfortunately, the Maximum likelihood factor analysis with varimax rotation did not provide evidence that the PRAS could measure acculturation adequately in this sample. Therefore, the results could not be analyzed further to determine acculturation levels. Although this was the case, differences were found with respect to Puerto Ricans compared to other groups. However, because acculturation could not be measured adequately, the results are open to interpretation. Acculturation may have influenced the results, but the outcomes could have been affected by socioeconomic level, a powerful confounding variable in this study. Furthermore, a combination of factors may have affected the results. In terms of family therapy utilization, family counseling appears to be a viable option for Puerto Ricans, given this group's strong orientation toward the family. The results of this study support this assertion in that among those who received family counseling, there was a lower drop out rate, and the majority of the subjects found family counseling to be very useful. Although this was the case, a larger percentage of Puerto Ricans nevertheless failed to utilize counseling services, and a large percentage indicated that they did not have problems that may be helped by family counseling .


Preface
This project came about as a result of personal interest in multicultural issues. Although my interests are geared toward multicultural issues, my research has focused on Latino and Puerto Rican cultures. Because there is so little attention paid in the literature to understanding Latino groups issues, I decided to focus my research on Latinos to assist in facilitating understanding of group differences and similarities .
In addition, both from reviewing the literature and from personal experience working with Latino individuals and families, I found that it has been extremely useful to include family members in the therapy process. The eclectic family therapy approach may be among the more useful therapy modalities for Latinos. Unfortunately, not enough research has been done in this area to verify this. This interest in multicultural and Latino issues is also personal, for I too am a Puerto Rican living in the United States and can relate to many of the issues described in this investigation. One of the most difficult aspects in conducting this research is attempting to understand and explain why Puerto Ricans encounter the difficulties that they do while living in United States. It was disappointing to see that in this sample over 40% were possibly below poverty level. One of the questions for future research, is how can we turn this around for people? It is my hope that this research project will facilitate understanding of some of the issues Puerto Ricans in the United States face.
Research is meaningless if it does not help in trying to understand these important issues. V 1 1987), Puerto Rican Acculturation Scale (PRAS)  and the Attitudes Toward Family Counseling Questionnaire (Levin, 1995). In addition, demographic information will be obtained. Some of the goals of this study are: 1) To assess the validity of the FPS with a multicultural group; specifically a sample of Puerto Ricans; 2) To determine if acculturation affects responses to the (FPS) and, 3) To see if acculturation in Puerto Ricans affects the utilization of family therapy services.

Family Therapy and Multicultural Psychology:
Important gains have been made in the field of psychology with regard to understanding what roles culture, race and ethnicity play in the therapy process. The study of multicultural psychology is a relatively new one, but, there is now a small but constantly growing research literature in this area. It has been observed that the family therapy literature, in particular, has contributed much of what has been learned about therapy with diverse ethnic groups (Martinez, 1994). Salvador Minuchen, a noted family therapist, was one of the first to work with poor urban families in New York City as early as the 1960's (Minuchen, Montalvo, Guemey, Rosman & Shumer, 1967;Nichols and Schwartz, 1991). Papajohn and Spiegle (McGill, 1992) wrote about the role of culture and values as early as 1975 a~d McGill (1992) notes that one researcher in particular, Falicov (1983) helped to promote more acceptance of diversity and multiculturalism. Falicov expanded on the role of culture in family therapy with his broadened definition of culture and its many dimensions (Martinez, (1994;McGill, 1992). In his review of the family therapy literature, Martinez (1994) indicated that there were important contributions made from other family therapists such as McGoldrick, Pearce and Giordano (1982), Boyd-Franklyn (1989), Pinderhughes (1982), Rotheram-Borus 1989), and Sue and Zane (1987).
The history of family therapy and multiculturalism demonstrates that the former has played a major role in the treatment of Latinos and other ethnic groups. It is, therefore important to learn as much as possible about ethnic families. Research is needed that addresses how these families function and what factors influence their development, particularly in the United States. This is crucial in order to create new models, improve existing models and provide culturally sensitive treatment approaches for these families.
Although there is a scarcity of information on the efficacy of family therapy with Puerto Rican families, many researchers have documented the usefulness of family therapy approaches with Latino and other multicultural groups (Sciarra and Ponterotto, 1991;Martinez, 1994;Cortes, 1995;McGoldrick, Giordano and Pearce, 1996). Szapocznik and Kurtines (1993) recognized that the individualistic approaches were of limited value in their work with Cuban adolescents in the 1970's. They argued that cultural factors were influencing the way families interacted in specific ways. This in tum, created family dynamics that appeared to underlie many of the problems of Cuban youths. They adopted a family approach that incorporated structural family therapy concepts and understanding families within a culturally pluralistic environment (Szapocznik and Kurtines 1993).
An important part of the Puerto Rican culture is the strong sense of family . Garcia-Preto (McGoldrick, Giordano and Pearce, 1996) describes some of the characteristics of Puerto Rican families in the following manner. Puerto Rican families tum to each other and to their extended network of friends. Family members, especially those who are in leadership positions and the more stable members, are obligated to help. Puerto Ricans tend to utilize mental health services as a last recourse because of this reliance on the family {McGoldrick, Giordano and Pearce, 1996). One can surmise that therapy with Puerto Ricans would more than likely require the inclusion of one or several members of the family.
Even though gains have been made, the field of psychology continues to lack theories and empirical data with communities of color to validate past and present research findings. As of 1996, there was no psychotherapy treatment research that met the criteria for demonstrating treatment efficacy for diverse or Non-Euro American ethnic groups {Chambless, Sanderson, Shoham, Johnson, Pope, Crits-Christoph, Baker, Johnson, Woody, Sue, Beutler, Williams and McCurry, 1996). Chambless et al. {1996) assert that "More research is clearly needed before conclusions can be drawn, but the point is that the data do not, at present, exist, or at least have not been reported" {p. 7). As more attention is given to multicultural issues in psychology and as more ethnic psychologists advocate for these issues, there is an increasing awareness of the importance and need for more research. Ivy, Ivy and Simek-Morgan {1993) state that "Along with expanded competence, however, the field is coming to the realization that present theories are limited by lack of awareness of multicultural and gender issues" {p. 1).
It is believed that because of the Civil Rights Movement and the creation of community mental health programs in the 1960's, psychologists encountered populations they were not normally accustomed to serving (Rogler, Malgady, Costantino & Blumenthal, 1987). These professionals found themselves having to deal with problems faced by clients who were ethnically, culturally, racially and linguistically different. In addition, many were poor, had low levels of education, and lived in ghettos or barrios . With these encounters came frustration by Psychologists who accepted the universality of traditional therapies (psychodynamic, cognitive behavioral and humanistic) because they were not able to address the problems the clients in question presented. "Traditional therapies, based largely on the therapeutic needs of middle-class clients, often proved to be of questionable effectiveness with minority persons living in inner-city neighborhoods, thus prompting pleas for culturally sensitive modalities" (Rogler, et al. 1987. p.565).
With the awareness that there were deficiencies in the traditional service systems and theories, efforts have been made to make traditional therapies more culturally sensitive and inclusive. There are now several theoretical approaches that address multicultural issues. Among them are: psychodynamic counseling and therapy, cognitive-behavioral counseling and therapy, existential-humanistic approaches and family therapy (Ivy, Ivy and Simek-Morgan (1993).

Psychodynamic Models:
Of the three approaches, the most criticized is psychodynamic therapy because of insensitivity toward women and ethnic groups (Ivy, Ivy and Simek-Morgan (1993). Rogler, et al (1987) asserted that early on psychoanalytic therapists were not particularly interested in working with these populations because of stereotypical images of poor people of color.
"Their widely shared image of the of the psychologically distressed Hispanic 5 was of a person pressured and harassed by problems of poverty, slum life, and lack of acculturation into American society" (Rogler, et al. 1987. p. 567). As a result of these stereotypes, it was believed that psychodynamic or insight oriented therapies could not adequately address the stress in the lives of Latino clients.
Several psychologists working in the area of insight oriented therapy sought to change this perspective. In 1982, Bluestone and Vela asserted that culturally informed adjustments can be made to the insight oriented approach and demonstrated this with a sample of low socioeconomic status (SES) Puerto Ricans in New York City . Comas-Diaz and Mintrah (1985) concluded that issues of race and ethnicity were a significant part of the psychodynamic treatment process (Ivey, Ivey & Simek Morgan, 1993). Taub-Bynum (1984 elaborates on these ideas with a complex extension of the psychodynamic model from the individual unconscious to the family unconscious. He noted that we learn about ourselves and our culture via our families (Ivey, Ivey & Simek Morgan, 1993).
These efforts, however, have not gained widespread acceptance in the field of psychology. "The issue remains, however, that even with a liberal interpretation of these qualifications, traditional insight therapy would be would be an inappropriate modality for most members of economically disadvantaged, inner-city, Hispanic communities" (Rogler, et al. 1987. p.567).

Cognitive-Behavioral Approaches:
With regard to multicultural issues, the cognitive-behavioral perspective received criticism because of its emphasis on control in the therapeutic process. "Early ventures in behavioral psychology often gave the therapist, counselor, or teacher almost complete power, and decisions 6 sometimes focused on controlling the client rather than helping the client control himor her-self' (Ivey, Ivey & Simek Morgan, 1993 p. 219). This very often becomes an issue when the client has experienced oppression and the therapist is from the oppressive culture. Behavioral psychologists were forced to address these issues because of the criticism of advocates and minority clients. One of the efforts to change some of these problems came from Cheek (1976) who attempted to make behavioral therapy more multiculturally applicable. He was the first to demonstrate a culturally sensitive approach to using assertiveness training with African-Americans (Ivey, Ivey & Simek Morgan, 1993). Meichenbaum (1985) emphasized the importance of cultural differences in determining adaptive coping mechanisms (Ivey, Ivey & Simek Morgan, 1993). He is one of the psychologists responsible for moving behavioral therapy in the direction of the more integrated cognitive-behavioral approach. Despite the issues with the cognitive-behavioral orientation, cognitive-behavioral techniques have become more accepted by ethnically diverse clients (Ivey, Ivey & Simek Morgan, 1993).

Existential-Humanistic Models:
The existential-humanistic tradition is another theoretical approach that has made multicultural adjustments. Lerner (1992) asserts that because of the egalitarian approach and the positive view of human nature, the existential humanistic approach is appealing to multicultural groups (Ivey, Ivey & Simek Morgan, 1993). Lerner (1992) also notes that this approach is limited because it places the burden of responsibility for growth, development, and change on the individual. He states that external influences are minimized. One of the criticisms of this theory is the 7 importance it places on the individual, more specifically, on the concept of "I Centered" theory. Ballou and Gabalac (1985) state that women and oppressed groups are not included in this theory's system of rewards and necessary conditions for growth (Ivey, Ivey & Simek Morgan, 1993 Simek-Morgan (1993).

Other Developments in Multicultural Counseling and Therapy:
In addition to the counseling theories, culturally sensitive concepts such as cuento therapy, the use of dichos (cultural metaphors) in therapy, cultural genograms and cultural storytelling have been developed (Costantino, Malgady, and Rogler 1986;Zuniga, 1992;Hardy and Laszloffy, 1992). In 1986, Costantino, Malgady and Rogler were among the first to extract elements of culture and create a form of modeling therapy. They trained their bilingual/bicultural staff in New York City to include Puerto Rican folk tales of cuentos in therapy. These authors believed that "Because folk tales convey a message or a moral to be emulated by others, flocculate characters can be presented therapeutically as models of adaptive emotional and behavioral functioning within the Puerto Rican and American cultures (Costantino, Malgady an4 Rogler, 1986. p. 640). " Malgady, Rogler and Costantino (1990) continue their research with Cuento therapy developing two versions, one based on stories from Puerto Rican folklore and the other based on adaptations created to bridge the gap in cultures. A related concept is the use of cultural metaphors or Dichos in therapy which according to Zuniga (1992) is crucial in therapy with Latinos, in particular with Mexican-Americans. She asserts that dichos can be useful in the therapeutic process when clients resist direct statements. In addition, the use of dichos offers the clinician a way to add strength to an argument, make it more interesting, and culturally relevant. Zuniga (1992) asserts that "the Dicho offers the clinician the opportunity to use the client's culture to motivate the client" (p.58).
Cultural stories and cultural genograms were used in family therapy early on in the movement toward multiculturalism (McGill, 1992). McGill (1992) contends that in order for therapists to become culturally competent, they must view the family and their problems within a cultural framework.
The concept of the cultural story has its roots in contemporary family therapy (narrative, meaning, and beliefs). These stories offer families a way to re-tell their family history, tell their present and future status and create their own meaning of family. The cultural genogram can be used as a method of working toward that family story. Cultural genograms can record stories of generation, gender, ethnicity, race, class and migration (McGill, 1992). McGill (1992) cautions that these stories are not static, they develop further throughout the therapeutic process.

Challenges for Culturally Sensitive Services:
What does providing culturally sensitive services mean? Rogler et al. (1987) identified three commonly used therapy approaches with multicultural populations.
The first approach involves making traditional treatments more accessible to Latinos. The second is the selection by the therapist of a therapeutic modality to fit perceived features of the client's culture. With the third approach, the therapist draws from Latino culture and uses the information to alter traditional treatments or uses these elements as innovative therapy tools. There are two crucial elements to the first approach. In making services more accessible to Latinos, a level of congruence has to be achieved between the therapist and the client and their understanding of illness and treatment. The other element is that the service provider work within the lay referral system of Latinos. Rogler et al. (1987) state that this referral system can vary with the individual possibly having more flexibility in their health care decisions or the other extreme where the individual acts in strict accordance with the cultural help seeking pathways.
They assert that " ... an accessible treatment program for Hispanics should increase the congruence between professional mental health values and indigenous Hispanic values and also incorporate elements of the lay referral systematically forward its own purpose (Rogler et al. 1987. p. 566)." Because Latinos received culturally inappropriate treatments in the past, it is now important to select the therapy modality to correspond with perceived features of Latino culture. Rogler et al. (1987) point this out as the second attempt toward providing culturally sensitive services. Many of the issues raised regarding culturally inappropriate therapy arose when psychologists attempted to use insight oriented therapies with minorities living in inner-cities . With regard to the third approach, Rogler et al. (1987) affirm that if and when therapies are selected to fit clients needs, aspects of the therapy can be adjusted to agree with the client's cultures. They provide an example of this with the use of language switching.
Language switching is the client's spontaneous use of their native language.
It is thought that client's use language switching to avoid dealing with emotionally charged issues. Another thought is that emotional expressions are freer and more spontaneous in the client's native tongue.
The literature discusses the culturally sensitive service approaches and the importance of continuing these efforts. It appears that the field of psychology would benefit greatly from learning more about and implementing these approaches, especially because Latino groups will probably be major consumers of mental health services in the near future.
Although we have information about these three approaches, there is still a need to learn how best to implement them on every level of service provision.

Latinos/Hispanics: Who are they?
Demographers predict that ethnic populations are growing and will continue to grow in the United States. It is thought that Latinos will be the largest ethnic group in this country in the next fifteen years (Marcos, 1988;Lorenzo, 1988;Comas-Diaz, 1990;Woodward, Dwinell and Arons, 1992;Rosado and Elias, 1993). Some of the reasons for this rapid growth include higher birth rates, larger family sizes and a higher rate of immigration into the United States from Spanish speaking countries (Comas-Diaz, 1990). In addition to this increase, the population of whites in this country is predicted to decrease. This is due largely to smaller family sizes, and lower numbers of births.
Given the fact that Latinos will be the largest ethnic group in this country, it is important to gain knowledge about these groups in order to provide culturally sound services. In the literature to date, Latinos have been found to be more predisposed to mental health problems due to pathology, stress, drug addiction, HIV disease, among other health related problems (Comas-Diaz, 1990;De La Rosa 1989). Many of these problems are not due necessarily to higher pathology in Latinos but to predisposition to stressors that are related to these health problems such as, the severe stress caused by poverty, unemployment, language barriers, discrimination and problems that can arise from acculturation (De La Rosa, 1989). Making it more difficult for Latinos living in the United States is that for several reasons, Latinos health related service needs are not being met (De La Rosa, 1989).
With these areas of concern and future demographics, one can predict that Latinos will be major consumers of mental health services. Although these facts are known, there is still one major problem the severe underutilization of services remain. This fact has been documented extensively in the literature over the last twenty years or so (Rosado and Elias, 1993;Woodward, Dwinell & Arons, 1992;Sanchez, 1992;Dolgin, Salazar and Cruz, 1987). De La Rosa (1989) states that over the past twenty years there has been some increase in health service utilization by Latinos because of improved health care policies toward the poor. Despite the fact there were some increases in the use of services by Latinos, they still severely underutilize the U.S. health care system. There has been much work done in this area in order to try to figure out possible reasons for this underutilization. Overreliance on extended family supports, location of mental health facilities, inflexible institutional policies, language barriers, less visible psychiatric disorders, lack of health insurance, larger average family 13 size, cultural methods of treatment, and prejudice were among some of the possible reasons for the underutilization of services by Latinos found in the literature (Dolgin, Salazar and Cruz, 1987;Woodward, Dwinell & Arons, 1992;Sanchez, 1992;De La Rosa, 1989).
Because there are no definitive solutions to the many issues related to the utilization of services by Latinos, it is important to learn from the groups directly via research. Rogler, Cortes and Malgady (1991) affirm that although research with Latinos has increased over the years, there is little effort to integrate the research conclusions. Woodward et al. (1992)  underlying assumption that the groups sharing these identifications have common features, among them shared experiences with discrimination, common health concerns, and language Gones-Correa, Leal, 1996). Both the terms Latino and Hispanic have been criticized in the literature. Some researchers argue that the terms mean nothing when one examines the complexity of the individual groups and others argue that the terms were created in the U.S. purely for instrumental purposes Gones-Correa and Leal, 1996). Although both the terms Latino and Hispanic have been criticized, the term Hispanic has been criticized the most.
The term Hispanic is a term that was assigned to Spanish speaking individuals by the U.S. Census Bureau Gones-Correa, Leal, 1996) Jones- Correa and Leal (1996) in an article that addressed these issues, provide a brief history of these terms and their meanings to the diverse groups they describe. They note that the U.S. Census Bureau responded to questions about the term by acknowledging that the term Hispanic was created as a way to describe an amorphous group. In fact, the term actually came from the dictionary Gones-Correa and Leal, 1996). "The perceived failure of "Hispanics" to unite in common action lies, some say, in the fact that those targeted by the term have nothing more in common than their designation as a group by an agency of the U.S. Government" (Gones-Correa and Leal, 1996. p. 216).
The terms Latino and Hispanic are now being described in the literature as panethnic identifications (Jones-Correa and Leal, 1996).
Panethnicity refers to a common Latin-American origin that individuals use on the basis of a larger grouping than nationality alone. Specifically, panethnicity refers to an ethnic grouping where no one country is identified.
The use of panethnic identifiers is seen mostly in the United States. "What the data suggest is that Hispanic identity is (as many have suggested) largely constructed in the United States, rather than being brought wholesale to the United States by immigrants from Latin America Oones-Correa and Leal, 1996. p.239)." The evidence in the literature suggests that people identified as Latino/ Hispanic tend to identify themselves first by their national labels as opposed to panethnic identifiers. This is believed to be a result of deep-rooted identities Oones-Correa and Leal, 1996). Panethnic identities are often used as secondary identifiers by people in the individual groups. In fact, individuals that use a panethnic identifier as a primary identifier alone, tend to have a weaker sense of ethnicity than those who use a national identifier and a panethnic identifier together Oones-Correa and Leal, 1996).
One of the errors in much of the existing literature on Latinos is that these terms are used and do not provide information about the individual subgroup(s) being investigated. From these investigations, researchers made inaccurate generalizations. Jones-Correa and Leal (1996) note that the " ... governments heavy handed stereotyping denies different historical experiences among populations-among some who have a common history of oppression and exploitation and others, newly arrived immigrants, who, whatever their social class, have never been oppressed or exploited in this country" (p.216-217.) Latinos from varying backgrounds were and continue to be treated as one group by health care providers (Woodward, Dwinell and Arons, 1992). Rosado and Elias (1993) maintain that in order "To service clients fairly and ethically, psychologists must develop an investigative, nonassumptive, and flexible stance concerning the characteristics of member of the various Latino groups with whom they work" (p . 451). The general categories, Latino and Hispanic do not capture the richness and diversity of each individual subgroup. These subgroups have their individual histories, culture and experiences. Aponte (1991) asserts that it is important for researchers to gather information on the subgroups individually within the context of their history, socioeconomic status and settlement in the U.S. Sanchez (1992) points out that one of the reasons researchers band Latinos together as one group is to allow for greater strength in numbers . She states that this lumping together of the groups sacrifices cultural individuality.
The most studied group to date are Mexican-Americans. This is due primarily to the fact that this is the largest Latino subgroup in the United States and they have a longer history in the United States. Rogler et al. (1991) point out that 62% of the Hispanic population in the U.S. are Mexican Americans. The next largest group are Puerto Ricans (12%) followed by Cubans (6%), Central and South Americans (10%) and other Hispanic (8%) (Comas-Diaz, 1990).
Many of the problems with the research on Latinos stem from an overabundance of white samples in the studies, the use of unrepresentative and deviant samples, and the use of small numbers of subjects in the studies (Chambless, et al. 1996;Okazaki and Sue, 1995). In addition, Okazaki and Sue (1995) note that problems arise because researchers often use terms that are not agreed upon by all. Ethnicity, race and culture are terms often used interchangeably in the literature. The definitions of these terms are not agreed upon by all and are many times interpreted differently by each researcher.

Language and Acculturation:
In conducting research to determine what may be the cause(s) of some of the problems Latinos face in the United States, it is important to consider acculturation. Otherwise, there is the possibility that inaccurate attributions may be made about Latinos, and about the problems they face in the United States. Acculturation is the process of adaptation that individuals and families undertake when they migrate or immigrate to a new country.
Cortes, Rogler and Malgady (1994) define it as " ... the process through which immigrants and their offspring acquire the values, behavioral norms, and attitudes of the host society ... " (p. 708). There are many stressors associated in the migration process, one in which many Latinos find themselves in a position of interacting with a new host culture and with its accompanying language, values, and behavioral norms. They often confront language barriers, low socioeconomic status, unemployment, and limited acculturation to the host culture. Acculturation is different from assimilation in that with assimilation, members of one cultural group become integrated into the social, political, and cultural life of the host culture (Burnam, Telles, Kamo, Hough and Escobar, 1987).
An interesting topic that has not significantly been addressed in the literature is how the acculturation process affects the dominant or host culture . Negy and Woods assert that "Although theoretically possible, rarely is acculturation discussed in reference to majority group members assimilating into an ethnic or minority subculture" (p. 224).
They further argue that the existing theories fail to account for the influence of Latino cultures on the host culture. The process of acculturation involves mutual contact by both cultures and to a certain degree influence each other.
The impact of Latino cultures on U.S. Americans can be seen in the adoption of certain foods, music, etc. .
The research conducted with Latinos and acculturation has overwhelmingly been focused on acculturation and mental health status (Rogler, Cortes and Malgady, 1991). Acculturation plays a role in many areas of psychological functioning including, personality, cognitive and the expression of psychopathology (Burnam, Telles, Karno, Hough and Escobar, 1987). Although this is important, Rogler et al. (1991) assert that there is little to integrate the findings in this area. They state that the knowledge gained in this research is as rudimentary today as it was ten years ago. In their review of the literature Rogler et al. (1991) found that many articles refer to acculturation directly, and others focus on the relationship of mental health status and acculturation. This relationship is examined via concepts such as ethnic identity, ethnicity, and loyalty to culture of origin. These studies have been largely conducted by comparing non-Hispanics with Hispanics.
Acculturation has also been assessed via generational status, collections of related factors thought to relate to acculturation, and scales developed with reliability and validity issues in mind (Rogler et al., 1991).
There have been many acculturation scales developed over the years (Rogler et al., 1991). Rogler et al. (1991) point out two problematic assumptions related to these scales. The first is that there is a bipolar model of acculturation that contrasts American culture with Hispanic culture. The problem with this bipolarity, is that there is an assumption that increases in involvement in American culture means decreases in Latino culture. Many psychometrically sound instruments have been developed under the bipolar assumption, however, these scales often fail to account for biculturalism (Rogler et al., 1991). The second problematic assumption is that psychometrically sound acculturation scales are thought to be applicable to all Latinos. The various Latino groups differ in their history, culture, foods, music, dances, use of Spanish, migrations and experiences in the United States. Rogler et al. (1991) state that "Recognition must be given to the fact that cultural elements specific to Hispanic nations, or configurations of such elements composing a nation's cultural heritage are being left by the wayside as a result of this assumption" (p.587).
In a review of the literature, it was noted that acculturation has been an area of focus in the study of Latino groups since the late 1960's (Ramirez, 1967). One of the earliest studies examined acculturation in Mexican-Americans and how this group retained features of Mexican culture despite being in the United States for generations (Ramirez, 1967). In earlier studies, acculturation was described as being a complete rejection of culture and values. In the early literature, not being able to acculturate meant extreme identification with culture of origin values and culture (Ramirez, 1967). One of the most cited articles in the literature is that of Szapocznik, Scopetta and Kurtines (1978). These researchers were the first to point out that acculturation is a complex phenomenon that occurs on an individual basis as well as on a societal level. Szapocznik, et al. (1978) noted that aspects of acculturation were related to high rates of family disruption. Family disruption often occurred as a result of intergenerational differences in acculturation. Most importantly they provided some of the first hypotheses concerning the process of individual acculturation (Szapocznik, et al., 1978). One hypothesis is that individual acculturation is a linear process that is affected by the length of 20 time the individual is exposed to the host culture. The more time one has been in the host country, the more acculturated the person becomes. A second hypothesis asserts that the rate of acculturation is affected by age. The younger the person the more quickly they acculturate into the host culture.
The third hypothesis argues that rates of acculturation differ based on gender.
Males tend to acculturate more rapidly than females. Szapocznik, et al. (1978) note that earlier studies contribute toward a fourth hypothesis. This hypothesis describes two dimensions of acculturation, specifically, behavioral acculturation and value acculturation . Behavioral acculturation refers to the gradual adoption of the most obvious aspects of the host culture. This includes: language, habits, customs, and lifestyles. Value acculturation is based on the slow process of adopting the host culture's values (Szapocznik, et al. 1978).
By the early 1980's, it was observed that studies using acculturation scales used different sample populations and have used varying constructs and different operational definitions of acculturation (Cuellar, et al., 1980).

Some of the significant factors used in later studies of acculturation included:
language usage and familiarity, ethnic interaction, ethnic identity and pride, cultural heritage, generational status, and ethnic distance and perceived discrimination (Cuellar, Harris, and Jasso, 1980). Neff, Hoppe and Perea (1987) explored the role of acculturation in alcohol use in Mexican Americans. They describe the concept of "cultural marginality" that is brought about by the acculturation process. "One possible implication here is that the stress of acculturation may be greatest among those who have at least partially distanced themselves from traditional cultural practices and social networks but who have not yet fully adopted 21 mainstream cultural values and lifestyle" (Neff, et al 1987 p. 154). Mena, Padilla and Maldonado (1987) observe that there are conflicts that arise often for immigrants in the process of trying to minimize or resolve cultural differences. The term used to describe this conflict is acculturative stress, described as being a multivariable interaction of the individual's internal resources, support systems, and the types of stressors experienced (Mena, et al., 1987). Mena, et al. (1987) note that how a person responds to the acculturative stress depends on certain personality characteristics including: self esteem, locus of control, and perceived racial discrimination. What was most stressful for respondents in their study was being isolated and perceived discrimination. In addition, the more the subjects hold on to their ethnic identity, the greater the level of stress and the lower the self esteem (Mena, et al., 1987). Acculturation studies in the 1970's and the 1980's have been observed to be related to mental health status, available levels of social support, deviancy, alcoholism and drug abuse, political and social attitudes, coronary heart disease risk, and suicide (Marin, Sabogal, Marin, Otero-Sabogal and Perez-Stable, 1987). Marin, et al. (1987) point out some of the problems with the acculturation literature. The majority of the acculturation scales have been created for one Latino group. Another problem is that many lack extensive and appropriate psychometric analyses. A major limitation of these scales is the use of sociodemographic ch_ aracteristics as a measurement of acculturation as opposed to a correlate of acculturation . To support acculturation scales, generational status was used in many studies as a validation criterion of acculturation. In addition, external validity of an 22 acculturation scale was measured by length of residence in the U.S. .
Researchers thought that having a bicultural orientation where there is an equal balance of both cultures is ideal in that these individuals demonstrate greater psychological adjustment (Moyerman, Forman, 1992). In their study, Moyerman and Forman (1992) argue that socioeconomic status had more of an impact on adjustment than acculturation level. They found that lower SES samples showed higher rates of symptomatology and conflict throughout the acculturation process. Unfortunately, many acculturation studies do not account for SES .  state that SES often has a stronger effect on research findings than acculturation level.
The idea that bicultural individuals are more psychologically adjusted may hold for individuals who have higher SES and educational levels. Moyerman and Forman (1992) argue that " ... family conflict exists across cultures, and when acculturation is accompanied by increasing SES and development of ethnic support systems, the general ability to cope with stress is increased despite ongoing familial discord" (p.178).
There is no question about the importance of the role of the family in the acculturation process. Many of the studies address family issues as they relate to acculturation Curtis, 1990;Negy, 1993). Negy (1993) states that acculturation studies with Latinos should include observation of changes in familism and socialization and  state that one of the core characteristics of many of the Latino groups is familism, described as a value of attachment and identification of 23 individuals with families. It is believed that Latino individuals with lower rates of mental health problems are those who have the strong family supports when they arrive to the U.S. . Sabogal et al. (1987) note that acculturation impacts the three dimensions of familism: familial obligations, perceived family support, and family as referents.
Family as referents is a term that was used in their study to refer to questionnaire items that dealt with attitudes and behaviors of relatives in the family, as opposed to asking about the individual's attitudes and behaviors.
In essence, questions were not asked in this study about the individual in · relation to the family, but were asked in the context of other relatives. For example, one item reads: "The family should consult close relatives (uncles, aunts) concerning its important decisions" . The individual in relation to the family orientation oriented question might read: "I consult with close relatives concerning important decisions. " It was noted that higher acculturated individuals had lower perceptions of family obligations and family as referents compared to lower acculturated individuals. Perceived family support was the factor that was least affected by acculturation level. Acculturation therefore, did seem to affect some core cultural values. However, Sabogal et al (1987) state that even the highest acculturated Latinos do not resemble mainstream Whites perceptions of familism. What was important for Whites in this study was familial obligations and perceived support. The family was not seen as a significant referent ).
Based on the results of their review, Rogler et al. (1991) assert that acculturation is not a bipolar process where one exchanges one culture for another. It is multidimensional. Felix-Ortiz, Newcomb, and Myers (1994) 24 assert that bicultural individuals who can identify as very ethnic and very American, can not accurately be assessed using unidimensional scales .
Keeping this and the problematic assumptions in mind,  developed the Puerto Rican Acculturation Scale for Puerto Ricans. This scale was developed to assess biculturality in Puerto Ricans. The items for this scale were developed with the input from Puerto Ricans and these items were later tested in studies using large numbers of Puerto Ricans in order to asses the scales validity and reliability. Because of the validity and reliability of this scale with Puerto Ricans and because it incorporates the concept of biculturalism, it was used for this investigation.

Puerto Ricans in the United States:
Puerto Rico was first colonized by Spain in 1493. This was the beginning of three centuries of exploitation and virtual extinction of the is described as a belief system that incorporates loyalty, solidarity, and reciprocity toward family members. The family is thought of as an extension of the self (Cortes, 1995). Cortes (1995) asserts that for Puerto Ricans in the United States, the family is one of the most conserved cultural influences.
The history of Puerto Ricans in the United States is a relatively long one compared to other Latino groups with the exception of Mexican-Americans. One of the largest waves of migration of Puerto Ricans to the United States was from the mid 1940's to the mid 1960's (Rodriguez, 1992).
Puerto Ricans tended to migrate to large metropolitan areas in the United States such as New York, Chicago, New Jersey, Connecticut, the Great Lake States, Florida and Texas (Santiago, 1992). The diminishing employment opportunities on the island, industrialization and increased poverty provided incentives for migration to the U.S. In addition, people were lured by promises of well paying jobs and opportunities in the "land of opportunities" (Rodriguez, 1992). Darder (1992) argues that to obtain a better understanding of the Puerto Rican experience in the United States, one has to understand the impact of colonization and immigration. Puerto Ricans are faced with a dual reality of having to historically accept foreign political and economic control as well as the cultural influence characteristic in a colonized society (Darder, 1992 (Rodriguez, 1992). Continuing this downward trend, economic levels for Puerto Ricans worsened over the last ten years (Rodriguez, 1992  . Rogler, et al. (1994) (Darder, 1992).
Puerto Ricans remain one of the most economically poor groups in the United States today (Darder, 1992;Rodriguez, 1992). Darder (1992) points out that social science researchers have taken the problems of the poor and labeled them with terms such as "disadvantaged," "culturally deprived," and "underclass." Darder (1992) argues that these labels and distortions can create barriers that distance the researcher from the people being studied. In addition, she notes how these terms can negatively impact the groups in question. "In many instances, when a group is labeled, the members of such a group learn to perceive themselves as persons who deserve the label and 27 hence, come to act accordingly" (Darder, 1992. p.151). Some of the recommendations for changing this is to empower · the people by including them in every aspect of the investigative process and in the creation of recommendations (Darder, 1992).
One of the deficiencies noted in the literature is its relative focus on blaming the group in question, specifically Puerto Ricans, for its problems.
Aponte (1993)  joblessness (Rodriguez, 1992;Aponte 1993). Researchers fail to recognize that there has been a tremendous loss of industries over the last few decades.
There have been massive decreases in manufacturing, trade, and other forms of low skilled jobs (Aponte, 1993). The few jobs that are available are in demand by growing numbers of other Latino groups including Dominicans and possibly other undocumented people. Also, the newly created job market calls for more educated professionals for a job market that is extremely competitive. In addition, the number of households lead by Puerto Rican females has increased and impacted the economic well being of the group.
Another factor has been the effects of ethnic and racial discrimination (Rodriguez, 1992). In addition, Puerto Ricans have not received the support from the United States in order to thrive the way that other groups have. Aponte (1993) observed that certain Cuban groups, for example, received great support from the United States that has resulted in extremely high levels of success and in many instances wealth. "Indeed, the favorable background characteristics of their initial and major migratory waves, along with the positive reception accorded their arrival, provided Cubans with a far more advantageous base for advancement than that afforded other Latino groups" (Aponte, 1993. p. 529). Aponte (1993) points out that poorer groups such as Puerto Ricans and Mexicans did not receive special government help.

Purpose of the Study:
The purpose of this investigation was to examine family functioning and acculturation in Puerto Ricans in order to determine whether the Family Functioning Scale (FFS) (Tavitian, et al., 1987) is applicable and findings from other studies generalizable to include Pue_ rto Ricans. At present there is only one investigation that used the FFS with a multicultural sample (Levin, 1995). The rest of the research on the FFS was conducted with predominantly white middle class families. In Levin's (1995) investigation, it was found that the FFS was applicable with multicultural families. However, this investigation did not take language and acculturation factors into account.
The present study used the FFS in English and Spanish. This was the first investigation using a Spanish translation of the FFS, therefore, one of the goals of this study is to determine the effectiveness of the translated version. In addition, the Puerto Rican Acculturation Scale , both in English and Spanish, was used in this investigation in order to examine how acculturation affects how families respond to the FFS.
It is hypothesized that acculturation will have an impact on how subjects respond to the FFS. Those more acculturated individuals rating 29 higher on the acculturation scale and those that are more bicultural will probably respond much in the same manner as those in previous studies.
Those low acculturation rating lower on the acculturation scale will probably not respond to the FFS in the same manner as those in past investigations. In addition, acculturation will probably impact on the knowledge and utilization of family therapy services.
Another goal of this investigation is to address the issue of Latinos underutilization of services, in particular family therapy services by using the Attitudes Toward Family Counseling Questionnaire (Levin, 1995). In accordance with the literature, it is predicted that Latinos in general will underutilize family therapy services. It is also hypothesized that less acculturated Puerto Ricans know about and use family therapy services less than more acculturated Puerto Ricans.

Method:
Participants: The participants in this investigation consisted of one hundred fifty Attempts were made to recruit one adult member of each family to participate in the study, however, the numbers were too few for analysis. All subjects were recruited voluntarily.

Instruments:
Four instruments were used in this investigation, and all four were provided for subjects in either English or Spanish.
FFS items were either added or dropped according to the salience of the factor loadings in previous studies. Items were dropped from the FFS if they loaded values less than .40. As used in previous investigations, loading factors of .40 or greater will be considered substantial.
The FFS was translated into Spanish by the principal investigator who is bilingual. To verify the translated version, the researcher back translated the FFS from Spanish to English. In addition, a second person who is fully bilingual repeated the procedure. This was the first time the FFS was used in Spanish.
Puerto Rican Acculturation Scale: The Puerto Rican Acculturation Scale (PRAS)  was used for this investigation to measure acculturation levels of the subjects. The PRAS is a 50 item questionnaire that examines two factors, involvement in Puerto Rican culture and involvement in American culture. This instrument was provided by   where the first is, l="Strongly Agree" to 6="Strongly Disagree" and the second is l="Rarely" to 6="Most of the time." The other two allowed for four choices of responses: "Strongly disagree," "Disagree a little," "Agree a little," "Strongly disagree" or " Rarely," "Some of the time," "Occasionally," and "Most of the time." For the PRAS, factor loadings of .30 and greater were used measure the salience of the items by the creators of the scale . For the latest version of the PRAS, Cronbach alpha coefficients for the involvement in Puerto Rican culture factor was .8434 and for the involvement in American culture was .7586.  conducted Zero-order correlations on the subscales and found no significant differences between the two. It was further validated by comparisons to the number of years in the United States and place of birth.

Attitudes Toward Family Counseling Questionnaire
The Attitudes Toward Family Counseling questionnaire (ATF) (Levin, 1995) was developed to examine help-seeking behaviors with a multicultural sample. Participants were asked to answer questions about family counseling service utilization. The first page of the form asked whether subjects had ever been in family counseling. If they had not, they were asked whether their family had problems that might have been helped by family therapy. Then they were asked to examine an~ select among sixteen possible reasons why their family might not pursue family counseling services. More than one selection from these items was possible.
The respondents who did participate in family counseling were asked to fill out the second page of this questionnaire. The questions included, number of sessions attended, effectiveness of the counseling, ethnicity of the counselor, respondent's perception of the cultural sensitivity of the counselor, and reasons for utilizing family counseling services. In addition, the participants were asked about problems that might have occurred in the process. The subjects had the option of selecting from a number of possible problems. This questionnaire was designed to elicit descriptive statistics.
The ATF was translated into Spanish by the principal investigator who is bilingual. To verify the translated version, the researcher back translated the A TF from Spanish to English. In addition, a second person who is fully bilingual repeated the procedure.

Demographic Questionnaire
The demographic questionnaire that was used for this study was developed by Levin (1995). Initially the questionnaire gathered information about age, gender, marital status, religious preference, highest level of education, annual family income, position in the family, a list of persons living in the household, and year and country of origin ( if the subject immigrated to the United States).
Some changes were made to the demographic questionnaire to obtain additional information that is more pertinent to the Puerto Rican culture.
The race question was changed to "Race/Nationality" because Puerto Ricans tend to use national labels as ethnic identifiers. The selections for this item were "Puerto Rican" and "other ." Questions about country of birth were asked for the individual, their parents, and their grandparents. This was added to obtain information about generational status, which has been used in other acculturation studies to validate results of acculturation scales. The respondents were asked about where they live now (state and city), type of dwelling and whether they rent or own their dwellings.
The background questionnaire was also translated into Spanish using the same translation -procedure described above for the FFS and the AFT.

Procedures:
Participants in this study were asked to take part in this investigation by the principal investigator and trained research assistants. The assistants were contact people at the City University of New York at Hunter College, Community Healthlink in Worcester, MA, University of Rhode Island, social networks, church, community groups in New York, Rhode Island, and Massachusetts. Subjects were recruited both individually and in groups. The majority of the subjects were recruited from groups of individuals in community centers, community organizations, and social networks. All of the participants filled out the surveys independently .

35
The subjects were told that their participation would assist the researcher in describing Puerto Rican family functioning, acculturation and attitudes toward family counseling. The researcher or assistants then presented and explained the consent forms and what was involved in the process of participation. The consent forms, the FPS, the Background Questionnaire, and the Puerto Rican Acculturation Scale forms were offered to the participants in Spanish and English and were selected according to subject preference. No personally identifiable information was recorded on the forms. None of the subjects were paid for their participation. It took subjects between twenty to thirty minutes to fill out the survey.
Because subjects were largely recruited in groups, there were very few members from same families in these groups. The consent forms were kept separate from the forms in order to protect subject confidentiality. The forms were color coded according to the state in which the participants lived in by the principal researcher. Red stickers were used to identify subjects from New York, green stickers were used for Massachusetts subjects, and blue for Rhode Island.

Results
In the process of data collection, approximately two hundred surveys were circulated. Data collection ended when one hundred and fifty subjects completed surveys. Upon review of the data, it was noted that four surveys could not be used for this study because of excessive missing data. Four additional subjects were sought to complete the one hundred and fifty participants required for valid statistical analyses.   As in previous studies, items loading > .40 were considered valid for a component (Tavitian et al., 1987). The components obtained in this PCA partially corresponded to the five components in past studies (Tavitian, et al, 1987;Levin, 1995;Wolfner, 1996) Insert Table 1 about here The internal consistency of the (FFS) scales was assessed using the Cronbach alpha procedure (see Table 2).  Table 3 for interscale correlations).
Insert Table 2 about here Insert Table 3 about here The Spanish translation of the FFS appeared to yield valid responses to the items of the FFS as suggested by the subscale loading scores which were comparable to scores in other studies.
One of the goals of this study was to compare the results of the PCA using a Puerto Rican sample with the results of two studies, one using a multicultural sample and one that used largely a Euro-American, middle class sample (Levin, 1995;Wolfner, 1996 ). For the sake of ease, the study using a Euro-American, middle class sample will be referred to as "Euro-American." The study using a multicultural sample will be referred to as "Multicultural group," and results from this study will be referred to as Insert Table 4 about here The three studies were further examined by comparisons of valid high and low loading factors for the five subscales (See Table 4  Average scores were computed for the valid factor loading scores for the three studies. In general, the scores were higher for Euro-Americans, followed by the Multicultural group, and lowest for Puerto Ricans ( See Table   4 for scores).

Puerto Rican Acculturation
The Puerto Rican Acculturation Scale (PRAS) was analyzed using the same statistical procedures as the original study . A Maximum Likelihood Factor Analysis with varimax rotation was performed using the 50 item PRAS with 150 subjects. The initial exploratory factor analysis yielded 15 factors that accounted for 62.5% of the varianc~, which differed from the original study. The original study yielded six factors that accounted for 46% of the variance .  narrowed the factors down to two, one was involvement in Puerto Rican culture and the second was involvement in American culture. In accordance with the original study, a second Maximum Likelihood Factor Analysis was attempted with a forced 2 factor solution. The two factors accounted for 23.96% of the variance in this sample.
Out of the 50 items, 25 items describe involvement in Puerto Rican culture and 25 describe involvement in American culture .   factor loadings greater than .30. The highest factor loading (.71) was for the item: "How comfortable would you be in a group of Americans who don't speak Spanish?" The lowest valid factor loading was .32 for the item: "My family is not always that important to me." (See Table 5 for the PRAS Factor Loadings). Four items loaded on both factors. All four items were on the involvement in Puerto Rican culture subscale. Three of the items loaded on opposite factors. Two of these were in the involvement in American culture subscale and one in the involvement in Puerto Rican culture subscale. There were 28 items that did not have any factor loadings >.30. Both subscales had 14 items each that did not have valid loadings on either subscale.
Insert Table 5  Because the PRAS did not appear to be a valid measure of acculturation based on the results of the factor analysis, no further interpretations on acculturation using the PRAS will be made.

Attitudes Toward Family Counseling
Information regarding Puerto Rican utilization of family counseling services will be provided in terms of frequencies and percentages. Out of 147 subjects who responded to the Attitudes Toward Family Counseling Questionnaire (ATF), 68% have never been in family counseling, and 32% have received family counseling services. With regard to the individuals who have not received family counseling services, 47.9% indicated that they did not have any problems that may be helped by family therapy services.
Another 30.9% indicated that they had problems that may be helped by family · counseling, and 21.3% answered "maybe" to this item.
The subjects were asked to select possible reasons for not utilizing family counseling services. The ten most rated choices, out of sixteen, will be listed (See Table 6). Out of the 100 subjects who responded to these items, the majority of the subjects, 76.1 % selected "my family works out problems that come up." The second highest rated response (50.4%) was "in my family, we seek help for family troubles by talking to friends or relatives." Another 32.7% Insert Table 6 about here Out of the 47 subjects who participated in family counseling, 44 responded to the question about number of sessions. Of these, 29.5% attended 20 or more sessions, 13.6% attended between 15 and 20 sessions, 6.8% between 10 and 15 sessions, 13.6% between 5 and 10 sessions, 9.1% between 3 and 5 sessions, 11.4% between 1 and 3 sessions, and 15.9% attended only one session. In terms of helpfulness, 15.2% checked off that family counseling was not helpful. Another 17.4% indicated that it was a "little bit helpful" and 8.7% checked off "moderately helpful." Thirty-four point eight percent indicated that it was quite a bit helpful and 23.9% said that family counseling was extremely helpful.
In terms of the ethnicity of the counselor, 46 people responded to the item. Of these, 50% had a clinician of the same ethnicity and 50% did not.
Twenty-nine subjects responded to the question about whether they would like a counselor of the same ethnicity. Of those that responded, 69% indicated that they would like a counselor of the same ethnicity and 31% indicated that they would not. Forty-five participants responded when asked about the counselor's understanding of their family's cultural values. Of these, 11.1% said "no", 66.7% indicated "yes," and 22.2% chose "maybe." The participants were asked for reasons why they came to counseling.
Out of 47 subjects, 40.4% went at the recommendation of a family doctor.
Another 27.7% went at the recommendation of their children's school.
Nineteen point one percent went at the recommendation of a friend or 48 relative. Fourteen point nine percent went because of court related reasons, and 10.6% went because of the Department of Social Service involvement.
The subjects were then asked about possible problems during the family counseling. Out of the 47 subjects who attended family therapy, 36.2% indicated that getting family members to attend was a problem. Twenty-nine point eight percent identified transportation as a problem. There were two responses that were rated equally (25.5%) by the participants: cost of counseling, and finding the time for counseling. Another 21.3% indicated that language was a problem. Nineteen point one percent identified childcare as a problem, and 12.8% indicated that location of the counselor was a problem. 49 Puerto Rican Family Functioning

Discussion
The results of this investigation yielded valuable information about the differences between Puerto Rican families and other cultural groups, particularly, Euro-American families. It is also important because it provides further evidence for the need to re-examine the FFS for its applicability with multicultural groups. The construct validity of the FFS was partially demonstrated with Puerto Rican families. The component structure was replicated with some variations compared to Levin's (1996) study using a multicultural sample. Levin (1996), the only other researcher who used the FFS with a multicultural sample, found that the component structure for the FFS with non-white families was comparable to that of Euro-American families. In this study, however, the Family Conflict, Family Rituals, and Family Worries subscales were valid for Puerto Rican families. The Family Communication and the Positive Family Affect subscales did not successfully meet the criteria for inclusion. Possible reasons for these findings will be explored below.
One of the major findings in this investigation was that the Positive Family Affect subscale was not valid for this sample of Puerto Ricans because it had only two items that load values > .40. One hypothesis for this result is that because the items for this subscale are worded with an orientation toward individualism, they do not fit with the family orientation of the Puerto Rican culture. Sabogal et al. (1987) asserted that even the most acculturated Latinos still have a stronger family orientation than Euro-Americans. All of the questions on this subscale have to do with the individual and the individual's perspective on how the family perceives and interacts with him or her .
In a study that examined Latino familism, Sabogal, et al. (1987)  With regard to Latino family functioning, some of the dimensions that have been explored in other studies include, loyalty to the family, strictness of child rearing, respect for adults, separation of sex roles, male superiority, time orientation, religiosity, and cooperation (as opposed to competition) (Negy, 1993). These are also dimensions that are very close to acculturation.
The family orientation of Puerto Ricans is such that the individuals within the family often do not think of themselves as separate from the Family. Garcia-Preto (McGoldrick, et al. 1996) stated that the emphasis is not on the individual but rather the family as a group. Negy (1993) observed that family and socialization are considered to be among the major differences between Euro-Americans and Latinos. Aspects of individualism such as "emptying the nest," when children are over the age of 18 and individual success that Euro-Americans embrace are not necessarily shared by Puerto Ricans. Garcia-Preto (McGoldrick, et al. 1996) asserted that for Puerto Rican families, "the family guarantees protection and caretaking for life as long as the person stays in the system. Leaving implies taking a grave risk" (p.186).
With Puerto Rican families, the success of one is the success of all in the family.
Another interesting result for the Positive Family Affect subscale is that four out of the eight items loaded on the Family Rituals subscale. The four items that dealt with positive feelings about the self in relation to the family were the ones to load values> .40. The items were, "my family accepts me as I am," "people in my family listen when I speak," "I feel respected by my family," and "I fe~l loved by my family." Levin (1996) noted that a possibility for other items loading on the Family Rituals subscale is the relationship between rituals and values. Garcia-Preto (McGoldrick, et al. 1996) states that Puerto Rican families have "a system of ritual kinship with binding mutual obligations for economic assistance, encouragement, and even personal correction (p. 186)." Puerto Ricans are a very proud people who value their culture and their families. In many ways, the family is the hallmark of the culture for Puerto Ricans . The four items that loaded positively on the Family Rituals subscale may be the result of the combination of pride in the family, family rituals and cultural pride.

52
The results of the Family Communication subscale were similar to that of the Positive Family Affect subscale. The major difference was that for the Family Communication subscale six items loaded on the corresponding factor. Of these, two were complex, with values> .40 on two subscales (Family Communication and Family Rituals). Two additional items loaded on the Family Rituals subscale totaling the number of items to four. Levin, (1996) found similarities with the multicultural sample she used. She hypothesized that this may have occurred because of the importance of rituals in multicultural family life as described above. The communication aspect adds another layer to the rituals hypothesis. Levin (1996) states that one of the major forms of communication in multicultural groups is via the rituals.
The only component that loaded >.40 for all of the items was the Family Conflict subscale. It was independent of all the other subscales in that it did not have valid factor loadings on any of the scales. One possibility for this finding is that these items are true for all families. In addition, another possibility is that together with the possibility that these items are true for all families, the questions were not worded with an "I" orientation making them more family oriented. None of the questions were worded with an "I" orientation. Instead the statements began with "the children," "people in my to be further examined in future research. One is that many Puerto Rican families do not eat meals together. The other is that this concept of eating a meal together is nice but with the economic hardship of many Puerto Rican families, a major concern or worry is to just have food on the  factor. This finding is unclear but one hypothesis may be that this may be related to what was discussed above in terms of disagreeing with persons of authority and avoiding conflict.
Differences were found in the way Puerto Ricans responded to the FFS compared to a multicultural sample and a sample of Euro-Americans used in other studies (Levin, 1995;Wolfner 1996). In general, subscale scores for Puerto Ricans were the lowest among the three groups, followed by the multicultural sample, and the highest average scores were for the Euro-American sample. Acculturation level may have played a role in these results. It is hypothesized that because Levin (1995)  A more detailed analysis of the results using the PRAS will be provided in the next section.

Puerto Rican Acculturation
The results of the PRAS with this sample of Puerto Ricans were discouraging. Because this was a fairly new instrument, the same statistical analyses were conducted as in the original studies by the creator of the PRAS . A Maximum Likelihood factor analysis with varimax rotation was conducted to assess the two factors. In conducting these analyses, it was noted that the items, which were supposed to measure involvement in Spanish. It is estimated that the sample is probably divided evenly between less acculturated and bicultural individuals.
Unfortunately, accurate determinations about the effect acculturation had on the FFS and the ATF could not be made due to the problems with the PRAS. Two major goals of the study were directly impacted as a result. The full impact of acculturation on how subjects respond to the FFS is estimated but not obtained. The same issues impact the results of the ATF questionnaire which will be discussed in the following section.

Attitudes Toward Family Counseling
One of the issues facing service providers is the underutilization of mental health services among Latinos (Rosado and Elias, 1993;Woodward, Dwinell & Arons, 1992;Sanchez, 1992;Dolgin, Salazar and Cruz, 1987 -Preto's (McGoldrick, et al. 1996) assertion that family problems are expected to be worked out among the family members. She further stated that Puerto Ricans will use social services as a last resort.
Although many Puerto Ricans in this investigation have not used family therapy services, 30.9% indicated that they had problems that may have been helped by family counseling and another 21.3% indicated that it may be a possibility.
Among the reasons why families did not seek family counseling services, the most cited response was that families work out their problems on their own. The second most selected response was that they relied on friends and relatives for help with family troubles. The third most cited reason for not seeking family counseling was feeling uncomfortable talking to someone not known to the family. These findings were not surprising given the strong orientation of Puerto Ricans toward the family and the compadrazgo network (friends and extended relatives). These three reasons were the same reasons chosen by the subjects in Levin's (1995) study with a multicultural sample. Another finding that supports the strong orientation toward the family was the fourth most selected reason. Twenty-nine point two percent of people indicated that they would be interested in family therapy but their family would not attend. As in Levin's (1995)

Consent Form For Research
I have been asked to participate in the research project described below . The researcher will explain the project to me thoroughly. I am encouraged to ask questions, if I have them. If I have more questions later, Maria Vazquez, the person who is mainly responsible for this study, (401) 274-0846, will be available to discuss them with me.
I am over the age of eighteen.
I have been asked to participate in this study which is intended to learn about Puerto Rican families, how they live and what thlngs affect their families. This study will also describe how living in the United States influences Puerto Ricans lives and how they feel about their culture. It will also investigate how Puerto Ricans feel about family counseling.
If I decide to participate in this research project here is what will happen: I will fill out a series of surveys from a researcher for about a half an hour.
There are no risks or discomforts involved in participating in this study .
Although there will be no direct benefit to me for participating in this study, the researcher will learn more about Puerto Rican families and what things impact their lives in the United States . The results of this study can help service agencies learn more about whafPuerto Rican families needs are .
My participation in this study is confidential. My name will not appear on the survey. None of the information will identify me by name. All of the records will be kept together in a file by the main researcher, Maria Vazquez.
Taking part in this research project is confidential, within the limits of the law. The researchers and the University of Rhode Island will protect my privacy, unless required by law to provide information to city, state, or federal authorities, or to a court of1aw. Otherwise, everything will be confidential and the records will be kept in a file by the main researcher.
Once again, my participation in this study is anonymous. My name will not appear on the survey or anywhere else besides this consent form.
The decision to participate in this study is mine. I do not have to participate in this research project . If I decide to partiopate in this project, I can quit at any time. What ever I decide will not affect me or the services I receive. lf I want to quit, f can just inform Maria Vazquez, 274--0846, of my decision.
I may discuss with Maria Vazquez any complaints if I am not satisfied with any part of this study or the way it is performed. If I wish to do this anonymously, I can call Dr. Lawrence Greostein at (401)