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ctors such as social support, fluency in English, and no health insurance, and no translators that can impact the acculturation process in Mexican Americans. Acculturation is viewed as the extent to which a minority group adopts the customs, language, behaviors, and values of the majority population ( Yeo, 2009).Â Individuals who have family and peer social supports tend to experience less acculturation stress and those who are experiencing high stress tend to experience fewer symptoms of mental distress (Crockett, Iturbide, Torres Stone, 2007; McGinley, Raffaelli, & Carlo, 2007; Hovey, 2000).

Many Mexican American elders have experienced life -long struggles to overcome discrimination and segregation including punishment for speaking Spanish, restaurant segregation, and job discrimination (Furman, Negi, Iwamoto, Rowan, Shukraft, & Gragg, 2009). Additionally, the Welfare Reform legislation of 1996 brought stressors for many Mexican American elderly who had immigrated to the U.S. at early ages and had never applied for citizenship (Morawetz, 2000). History of this population in the U.S. is characterized by open conflict, social inequality, prejudice, and discrimination and these factors have greatly and dramatically shaped the sociocultural realities of the aging (Ramos & Wright, 2010).

McInnis-Dittrich (2005) states that understanding an Elders spirituality helps to understand the older adult view of the world, subsequent behavior and maintaining a sense of continuity and cohesion in order to face changes that accompany the aging process ( p, ). Many Mexican - American elders who attend church monthly, weekly, and more than weekly tend to exhibit slower rates of cognitive decline than those who do not attend church (Herrera, Lee, Nanyonjo, Laufman, & Torres-Vigil, 2009).

Social workers and mental health providers have a moral and ethical responsibility to provide effective interventions to all clients by accounting for cultural contexts and cultural values (Trimble & Fisher, 2006). Social workers and other professionals are becoming more aware of multicultural issues and the need to improve the accessibility quality of mental health services (Sue, 1998), and method of payment for individuals who have historically been oppressed and provided in the client's favored language (Griner & Smith, 2006; Sue, 1998). An assessment should be completed by the social worker and is a great way of identifying strengths and resilience Elders to solve their challenges (McInnis & Dittrich, 2005). Treatment plans and interventions are then developed by a multidisciplinary team. 'Applying a strengths perspective to the assessment and intervention means there is a focus on helping Elders discover and employ their own strengths to help solve problems and achieve their identified goals' (McInnis & Dittrich, 2005).

Limitations this writer identified with this literature review were there was a vast of opinions about what encompasses effective cultural adaptations and some studies varied in the racial/ethnic composition of the intervention groups while other studies had different outcome measures.