PCN 158 Counseling Native Americans Essay for sharing PDF

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Cultural competence multicultural counseling
Native Americans considerations history beliefs Substance abuse...

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1 Kelly Gootee PCN 158 August 26, 2020 Dr. Collins

Counseling Considerations for Native American Populations Indigenous people or archaic hunters and gatherers have been surviving off the land of the United States since 12000-6000 B.C. Historically the beliefs of the largest tribe in the United States, the Navajo culture was fully formed around the year 1100 A.D. (Carey, 2019). Although their beliefs and worldviews have been traumatically dissuaded the origins of these beliefs are very deep seeded and vital to indigenous peoples’ way of life. In order to be a competent counselor it is important to understand and acknowledge their core values and beliefs system. Alcoholism rates are unequivocally higher than other demographics and this maybe because native beliefs and traditions are not incorporated into treatment (McAuliffe, 2020). There are many tribes within the United States and while it is ideal not to generalize Native Americans, there are some similarities, common mental health problems, and treatment options. According to the 2015 Census, there are nearly 6.6 million American Indians and Alaskan Natives residing in the U.S. There are approximately 566 different federally recognized tribes (United Census Bureau, 2016). Each tribe is unique and has varying cultural perspectives, history and languages. Similarly, Native Americans are more than two times more likely to live in poverty. In addition, 33% of Native Americans do not have health insurance and lack adequate healthcare. As a result, the average life expectancy for Native Americans is 6 years lower than the national average (Alay, 2020). Other unique disparities exist amongst tribes such as

2 disproportionately high rates of substance abuse, mental health problems, and suicide. There is a need for special considerations to be taken in the treatment of Native Americans as they all have suffered deep historical trauma and oppression of their unique cultural and spiritual beliefs. Historical trauma and its transgenerational effects have caused the symptoms they suffer from such as substance abuse, depression, and high suicide rates (McAuliffe, 2014). The largest tribe of Native Americans is the United States are the Navajo, gaining national attention because of the high rates of fatal COVID infections. The oldest tribe recognized federally in the US are the Pueblo nation. One of the fiercest and most loyal tribes to their culture are the Apache (Carey, 2019). Regardless of tribal affiliation understanding the needs of this demographic and barriers to care for Native Americans is vital to effective, culturally competent treatment. The social context of tribal people influences the high rates of mental health problems and substance abuse disorder, including economic and cultural oppression. Tribes have varying degrees of mistrust of Western medicine and psychiatry. A unique approach is needed to overcome the historical mistrust of westerners within each tribe and for each individual (Roessel, 2019). Treatment options to overcome the barriers to care of tribal members include strategies developed by communities and researchers focuses on a holistic approach; intertwining evidence-based practices and traditional native teachings. One way to eliminate cultural barriers is through cultural intelligence. Native American beliefs are centered around the idea that everyone is part of something bigger. The focus is not on the individual but on what the individual’s role is for the tribe. This is a common belief amongst Indigenous populations. With such a strong sense of collectivism it is important to incorporate this understanding into treatment ("Behavioral Health Services for American Indians and Alaska Natives: For Behavioral Health Service Providers, Administrators, and Supervisors", 2018). Most treatment models are

3 developed by the dominant culture in the United States. A lot of Western Psychology focuses on the individual via one-on-one talk therapy. Native Americans may be quite silent during traditional “talk” therapy. According to Heinrich, Corbine, & Thomas, a counselor must be able to depersonalize the anger and resentment Native American have for “white” counselors (1990). They also point out that counselors importantly need to be patient, understanding and flexible to drop-ins and changing possible counseling environments. There is not a set of proven techniques that seems to work best with this demographic but research suggests that the use of an existential framework that focuses on direct and honest verbal and non-verbal communication that focuses on human and natural themes is well suited (Heinrich et al., 1990). It is important for the counselor to pay close attention to non-verbal cues as well. Typically, the focus is on selfimprovement and individual coping skills. However, this is non-cohesive with the Native American belief system. Recovery should focus on the importance of how the client can improve relations and the sense of connectedness within his/her community or tribal affiliation. If the focus is only on the ego of the client it will be ineffective ("Behavioral Health Services for American Indians and Alaska Natives: For Behavioral Health Service Providers, Administrators, and Supervisors", 2018). Because of the disproportionately high rate of substance abuse and mental health issues amongst Native populations, there are numerous community and tribal resources to help American Natives with varying problems. A culturally intelligent counselor should adapt to the culture of the clients and not the other way around (Rybak & Fitts, 2009). As a culturally competent counselor it is an asset to be able to connect clients with specific community programs and tribal resources which can help them to recover from a variety of problems. Many of these community programs exist and include Native American Connections (NAC), Indian

4 Health Services (IHS)-a federally funded program, Methamphetamine and Suicide Prevention Initiative (MSPI), Minnesota Indian Women’s Resource Center (MIWRC), Native American Indian General Services (NAIGS), (Alay, 2020).NAC believes that healing can not be separated from culture and aims to incorporate traditional healing with western medicine and works to remove stigma attached to mental health disorders while creating an enriching, safe, communal environment. Information can be found here for group counseling, sweat lodging, vision quests, etc. Housing assistance and other necessary help are also available through this community resource (NAC, 2020). IHS, is a federally funded program designed to address alcohol and substance abuse, suicide, and mental health care for the Native American community (IHS, 2020). The MIWRC aims to empower women and families by using motivational interviewing, art therapy, group and traditional counseling approaches provided by an Elder of the community (Alay, 2020). Many Native Americans do not feel that they belong in traditional “white” AA meetings (Roessel, 2019). A culturally relevant treatment option is the “12 wisdom steps program.” NAIGS have a unique 12 wisdom steps program, which is based on traditional AA but incorporates candles, eagle feathers, talking circles, and other culturally appropriate healing approaches. Community approaches are important to Native Americans as well as including traditional healing methods. Native healing methods to consider in the treatment plan include: annual powwows, ceremonial teepee construction; which builds a sense of connection and selfworth, drum circles; offer meditation and collectiveness, and space cleansing (IHS, n.d.). Cultural differences are what make America unique. There is no “right” or “wrong”. In the field of behavioral health there should be acceptance, tolerance, validation, and respect for each other. When treating Native American populations it is important to recognize how

5 historical trauma is the cause of the disproportionate symptoms exhibited within the tribal population. Care needs to be taken to respect and incorporate millennia’s of wisdom and traditions. The core belief of Native Americans is that we are all a part of nature and that each piece of nature is representative of the deity. We are all in this together, we all shed the same tears, and have the right to heal through our traditions.

6 References

Alay, A. (2020, June 4). Addiction and treatment for Native Americans. Drug Rehab Options. https://www.rehabs.com/addiction-treatment-resources/native-

APA. (2003, November). Psychological Treatment of Ethnic Minority Populations. American Psychological Association (APA). https://www.apa.org/pi/oema/resources/brochures/treatment-minority.pdf

Carey, H. (2019, August 6). Navajo history. Navajo People - The Diné - Information about the Navajo People, Language, History, and Culture. - Navajo Indians. https://navajopeople.org/navajo-history.htm

DIT. (2001, January 3). History. Navajo Nation. https://www.navajo-nsn.gov/history.htm

Heinrich, R., Corbine, J., & Thomas, K. R. (1990, December 2). Counseling Native Americans. Deep Blue. https://deepblue.lib.umich.edu/bitstream/handle/2027.42/89558/j.15566676.1990.tb01473.x.pdf?sequence=1

7 McAuliffe, G. (2014). Resource Guide to Culturally Alert Counseling: Working With African American Clients. SAGE Publications Inc. https://www.sagepub.com/sites/default/files/upmbinaries/24156_ResourceGuideforCounselingAfricanAmericanClients.pdf

NAC. (2020). Behavioral health. Native American Connections. https://www.nativeconnections.org/behavioral-health

Roessel, M. R. (2019, March 4). Working with Native American patients. Home │ psychiatry.org. https://www.psychiatry.org/psychiatrists/cultural-competency/education/bestpractice-highlights/working-with-native-american-patients

Rybak, C., & Decker-Fitts, A. (2009). Understanding Native American healing practices. Counselling Psychology Quarterly, 22(3), 333–342. https://doiorg.lopes.idm.oclc.org/10.1080/09515070903270900...