Randomized Controlled Trial of Spanish Brief Group Neuroscience-Informed Cognitive-Behavior Therapy for Anxiety

Anxiety is an anticipatory reaction to perceived threats, and may involve behavioral, cognitive, emotional, and physiological responses (Abend et al., 2020). Among U.S. Latino/a adults, 12.9% reported having an anxiety diagnosis (Powla et al., 2026). Yet the proportion of U.S. mental health facilities offering treatment in Spanish declined from 40.5% in 2014 to 33.3% in 2019, a net loss of 1,163 facilities (Pro et al., 2022). More recent data show that fewer than 10% of Latino/a adults received counseling in the prior year, while 5% reported needing therapy but were prohibited by cost (Powla et al., 2026). A treatment gap therefore exists from the confluence of limited Spanish-language services alongside financial and other structural barriers. Brief, community-based interventions that are culturally and linguistically responsive may help expand access to anxiety support for diverse Latino/a communities.

Cultural adaptation of an intervention improves fit with a population while preserving its core principles. Bernal et al. (1995) identified eight dimensions of fit, including language, metaphors, content, concepts, goals, methods, and context. Barrera et al. (2013) described adaptation as an iterative process of gathering information, testing modifications, and refining the intervention. A meta-analysis of 13 randomized controlled trials (RCTs) found a small but significant benefit of culturally adapted psychotherapy for depression and anxiety among Latino/a participants (Nelson et al., 2020). An RCT by Alegría et al. (2025) found that a 10-session Spanish-language culturally adapted psychoeducational intervention reduced anxiety and depression relative to enhanced usual care in a predominantly Latino/a adult sample. Cultural adaptation of a psychoeducational intervention thus holds promise in treating anxiety for Latino/a adults.

Psychoeducation is an intervention that combines teaching information about mental health symptoms and treatment with skills practice. Neuroscience-informed psychoeducation, or neuroeducation, is a content-specific variant of psychoeducation that uses accessible information about brain structure and function to help clients understand their experiences and practice regulation strategies (Miller, 2016). Although emerging research has begun to examine neuroeducation, it has received limited direct evaluation as a distinct clinical intervention (Rezapour et al., 2025). Because neuroeducation retains the same structure of psychoeducation, the broader evidence supporting psychoeducation provides indirect empirical foundation for use.

Group psychoeducation interventions for Spanish-speaking adults may retain effectiveness even when delivered in brief, time-limited formats. Peris-Baquero et al. (2025) reported that a five-session psychoeducational group intervention had similar efficacy to an eight-session format in reducing anxiety. Zhou et al. (2025) found that a brief CBT psychoeducational group reduced anxiety with gains maintained at three-month follow-up. Collado et al. (2014) found that a brief behavioral activation intervention delivered in Spanish improved treatment outcomes among Latino/a adults, with high rates of attendance and satisfaction. Brief psychoeducational group interventions for Spanish speakers, including CBT groups, thus appear both efficient and effective.

Neuroscience-informed Cognitive-Behavior Therapy Neuroscience-informed cognitive-behavior therapy (nCBT; Field et al., 2015, 2025) integrates dual processing theory (Kahneman, 2003) with rational emotive behavior therapy (Ellis, 1991) to explain how preconscious, bottom-up limbic processing (Wave1) and conscious, top-down cognitive appraisal (Wave2) each contribute to behavioral, emotional, and physiological responses to activating events. The model targets both waves therapeutically, helping clients increase awareness of and self-compassion toward reflective responses while developing reappraisal skills. The intervention includes neuroeducation on the Waves model.