Group Therapy with Native Americans: Understanding Essential Differences

Many issues for Native Americans are different from those of other minority groups. This article will discuss the legacy of forced assimilation, historic distrust, the diversity among American Indians, and how these issues affect treatment. Group therapy will be explored, including Native American approaches to groups, homogeneous groups, and racially heterogeneous groups. Preparation for heterogeneous groups and issues that may arise are included.     

Neuropsychological evaluation and rehabilitation in mental retardation

A discussion is provided of issues related to neuropsychological assessment of mentally retarded individuals. The first matters considered are test selection in relation to mental age and diagnostic issues. Various methods of evaluation are then considered, including assessment of orientation to sound and visual stimuli, language comprehension, right-left discrimination, and abstract and symbolic processes. Methods are also reviewed for detailed evaluation of language functions including testing for aphasia and for academic skills such as reading, writing, and calculation, as well as for spatial and constructional abilities. A section is devoted to use of neuropsychological assessment for rehabilitation of various disorders such as congenital aphasia, alexia, and spatial-constructional disorders.     

Ethical Challenges Inherent in the Evaluation of an American Indian/Alaskan Native Circles of Care Project

This article provides first‐person accounts of ethical issues inherent in an evaluation of the Native American Indian Center of Central Ohio (NAICCO) Circles of Care project. Circles of Care is a three‐year, infrastructure development program funded through the Substance Abuse and Mental Health Services Administration (SAMHSA) which is part of the federal Department of Health and Human Services (DHHS). The grant program is for American Indian and Alaskan Native (AI/AN) tribes and urban Indian communities and includes a strong emphasis on community engagement and community ownership. The Native American Indian Center of Central Ohio received a Circles of Care grant in the fifth cohort of the program. The first author (Project Evaluator) presents views that typically represent a western approach to evaluation, while the second author (Project Director) presents a Native perspective. Ethical issues are defined as well as the authors’ efforts to address these concerns.     

Educationally-Based,Culturally-Sensitive,Theory-Driven Mentorship Intervention with At-risk Native American Youth in South Dakota: A Narrative Review

Native American youth struggle with many social issues such as poverty, drug and alcohol abuse, teen pregnancy, and dropping out of high school, as a result of historical trauma and the current conditions on the reservation. This narrative review found that existing mentorship programs lack adequate research, particularly with Native American youth and youth from rural settings, yet the limited research does demonstrate potential promise. Available research findings suggest that mentorship programs are supporting at-risk youth generally, particularly with increasing their self-worth as well as having educational benefit for the youth. Two theoretical frameworks, strengths perspective and social learning theory, have been determined to offer support to increase the value of mentorship programs for Native American youth. This narrative review concludes that by understanding the social issues and the impact of historical trauma as well as understanding the use of applied theories, strong programming, and helpful factors or considerations, a culturally-sensitive, educationally-based mentorship intervention has potential to support at-risk Native American youth feel motivated to move forward with their educational futures.     

Cultural Competence When Working With American Indian Populations: A Couple and Family Therapist Perspective

This article focuses on treating the underrepresented American Indian and Alaska Native population in therapy. The lack of literature on this topic may impede the ability of couple and family therapists (CFTs) to work effectively with members of this group. Issues such as the underutilization of therapy, dropout rates, culturally syntonic joining and assessment, religion, and spirituality are discussed. In addition, potential boundary issues of gift giving and community integration are explored. Finally, cultural strengths are addressed so they may be clinically integrated with this unique population.     

State of Multicultural Neuropsychological Assessment in Children: Current Research Issues

Scientific attention to cultural considerations in child neuropsychological assessment has not developed parallel to the focus these issues have received in adult and elderly neuropsychological assessment. There are limited data on the presence, magnitude, etiology, and implications of culture-related differences in cognitive test performance among children. This preliminary report reviews the available empirical literature on the current state of multicultural neuropsychological assessment in children. The review identified articles by searching PubMed and PsycINFO databases, and the tables of contents of Developmental Neuropsychology and Child Neuropsychology from 2003-2008. Of the 1,834 abstracts reviewed, ten papers met inclusion criteria for the review. Five studies were completed in America; four of these compared performance between ethnic groups while the fifth examined neighborhood level poverty indicators exclusively within African-American children. Of the five international studies, all established local normative data and/or were exploratory investigations of neuropsychological functions in specific cultural groups, including Taiwanese infants, South African youth, and bilingual British children. Taken together, the results yield important clinical and research data that begin to inform many of the complex and fascinating mechanisms by which ethnic identity and culture impact cognitive development and the neuropsychological assessment of children. A critique of the existing literature and directions for future research are provided.     

Understanding Native American healing practices

Counselor cultural competency with respect to Native Americans requires understanding of common healing practices and ceremonies and of their spiritual significance. Historical trauma serves as a general backdrop for Native America experience and identity. Particular tribal practices and the individual's degree of affiliation with such practices provide a more specific context for client worldview. Knowledge of the symbolic significance of common ceremonies and healing practices will support counseling efforts to be relevant and effective with respect to Native American clients. Direct interaction and involvement with Native American communities facilitate a deeper understanding of Native American cultural identity and healing practices.     

A Re-Examination of Risk and Resilience During Adolescence: Incorporating Culture and Diversity

We consider risk and resilience within the developmental contexts of youth of African, Asian, Latino, and Native American descent. Conceptual and definitional issues are explained in terms of the role that culture and diversity play in specifying risk and resilience factors for youth of African, Asian, Latino, and Native American descent. We promote a conceptual model of risk and resilience as multidimensional phenomenon. The relevance of culture and diversity in a developmental perspective of youth of African, Asian, Latino, and Native American descent is discussed in a manner that incorporates community psychology principles.     

Counseling Native Americans

This article addresses the issues facing White counselors in providing services to Native Americans, whose values differ significantly from the dominant culture's. Native Americans have been consistently threatened with cultural assimilation. Previously published recommendations to counselors are reviewed and the relevance and possible uses of traditional Native American healing practices are discussed. One such practice, the vision quest, is described in detail. Counselors need to learn culturally relevant metaphors in order to promote healing and change and, in effect, must themselves undergo an acculturation process.     

The state of psychological assessment in Asia

The collection of articles in this special section provides a much-needed examination of the state of psychological assessment in various Asian countries or societies. In particular, the contributors review and critique assessment of personality, depression and anxiety, children and adolescents, and neuropsychological evaluation. The reviews cover the use of, and research on, imported measures (Western derived) as well as indigenous measures that were developed locally. The articles make a valuable contribution toward understanding not only the state of assessment in Asia but also larger issues such as the universal applicability of assessment instruments and the cross-cultural validity of models of human behavior.     

A survey of psychological test use patterns among forensic psychologists

Clinical psychologists are frequently called on to testify in court regarding mental health issues in civil or criminal cases. One of the legal criteria by which admissibility of testimony is determined includes whether the testimony is based on methods that have gained "general acceptance" in their field. In this study, we sought to evaluate the psychological tests used in forensic assessments by members of the American Psychology-Law Society Division of the American Psychological Association, and by diplomates in the American Board of Forensic Psychology. We present test results from this survey, based on 152 respondents, for forensic evaluations conducted with adults using multiscale inventories, single-scale tests, unstructured personality tests, cognitive and/or intellectual tests, neuropsychological tests, risk assessment and psychopathy instruments, sex offender risk assessment instruments, competency or sanity-related instruments, and instruments used to evaluate malingering. In addition, we provide findings for psychological testing involving child-related forensic issues.     

Validation of a telephone screening test for Alzheimer's disease

Financial constraints, mobility issues, medical conditions, crime in local areas can make cognitive assessment difficult for elders and telephone interviews can be a good alternative. This study was carried out to evaluate the reliability, validity and clinical utility of a Brazilian telephone version of the Mini Mental State Examination (Braztel-MMSE) in a community sample of healthy elderly participants and AD patients. The MMSE and the Braztel-MMSE were applied to 66 AD patients and 67 healthy elderly participants. The test-retest reliability was strong and significant (r = .92, p = .01), and the correlation between the Braztel-MMSE and the MMSE were significant (p = .01) and strong (r = .92). The general screening ability of the Braztel-MMSE was high (AUC = 0.982; CI95% = 0.964-1.001). This telephone version can therefore be used as a screening measure for dementia in older adults that need neuropsychological screening and cannot present for an evaluation.     

Coming to Terms, Depression, and Relationship Satisfaction for Native Americans in Intimate Relationships

This study examined the relationships between childhood family of origin (FOO) adversities, coming to terms with them, and adult intimate relationship satisfaction for Native American individuals. The sample consisted of 186 self-identified Native American individuals in committed relationships. The data for this study was collected from the RELATE assessment (see www.relate-institute.org). Results from structural equation modeling indicated that coming to terms buffered the negative effects of childhood family of origin adversities on depression and relationship quality. Results also suggest that coming to terms may help Native American individuals deal with FOO adversity and improve intimate relationship quality. Coming to terms with childhood FOO adversity should be considered in the treatment of Native American individuals in intimate relationships. Clinical implications and directions for future research are discussed.     

Red as an Apple: Native American Acculturation and Counseling With or Without Reservation

The United States has a long history of advocating policies of both extermination and assimilation of Native peoples. This historical context provides an important backdrop for understanding issues of trust/mistrust and the impact of acculturation on Native Americans who often find they have to reconcile 2 cultures. Therefore, counselors must assess a Native American client's level of acculturation rather than making assumptions based on the limited information offered by appearance or other personal characteristics. The Native American Acculturation Scale is presented as an operationalized means of formally or informally assessing a Native American client's cultural identity.     

The factor structure of the Anxiety Sensitivity Index among Northern Plains Native Americans

Within our current research climate, an emphasis has been placed on examining the cross-cultural applicability of psychological tools, and exploring their utility with people of different backgrounds. Within this line of investigation lies the risk of classifying people too broadly and masking important regional, tribal, or dialectical differences. This may be particularly potent among Native Americans, given the number of distinct indigenous entities. This study examined the psychometric characteristics of the Anxiety Sensitivity Index with a tribally homogeneous sample, as compared to previous tribally-heterogeneous and majority culture findings. Results suggested that data from a homogeneous Native American sample poorly fit factor solutions reported from heterogeneous Native American and Caucasian samples, and favored a unifactorial solution. Implications for assessment with Native American peoples are discussed.     

Principles of forensic mental health assessment: implications for neuropsychological assessment in forensic contexts

Forensic mental health assessment (FMHA) is a form of evaluation performed by a mental health professional to provide relevant clinical and scientific data to a legal decision maker or the litigants involved in civil or criminal proceedings. Such FMHA evaluations can be further specialized when the clinical and scientific data are primarily neuropsychological. This paper provides an adaptation of 29 recently derived principles of FMHA (Heilbrun, 2001) that have been described in two forms: general guidelines for application in FMHA, and guidelines for application to neuropsychological assessment in forensic contexts. Each principle is described, and the general guideline is compared with the highly specialized neuropsychological guideline. In this way, the applicability of such FMHA principles to forensic neuropsychological assessment is described.     

Screening for Medical and Neurodevelopmental Disorders for the Professional Counselor

This article reviews several assessment factors useful identifying the presence of a possible medical illness or neurodevelopmental disorder contributing to a client's adjustment problems. Use of behavioral observations, record reviews, brief neuro-behavioral screening tests, and the taking of a history are outlined that can assist in raising the index of suspicion for organic influence. Also addressed are issues pertaining to referral for medical and specialty assessments, including neuropsychological evaluation.     

The Relationship between Cultural Identification,Family Socialization and Adolescent Alcohol Use among Native American Families

The enculturation or teaching of Native American traditions to Native American adolescents has been incorporated into substance-use prevention interventions in recent decades; yet, little is known about how enculturation may impact substance use through family socialization. The current study aimed to test the relationship between family identification with Native American culture and alcohol use among Native American families residing on or near a reservation, and determine if this relationship was mediated by family socialization practices. To achieve this aim, data (n? =?2368) collected as part of the NIDA-funded Drug Use among Young American Indians was used. No direct relationship was found between identification with Native American culture and alcohol use. Native American culture had an indirect effect on substance use through family communication and parental monitoring, such that a higher identification with Native American culture was associated with more communication and less monitoring, which were associated with drinking behavior. Findings reveal that identification with Native American culture may be related to family socialization, a relationship that could be important to address when designing alcohol-use prevention interventions for this population.     

Computerized assessment in neuropsychology: A review of tests and test batteries

This article contains detailed reviews of 13 computerized neuropsychological and performance test batteries and six stand-alone computer tests. Tasks found on these instruments are described and tables illustrate which batteries employ which measures. In addition to issues of reliability and validity, special considerations apply to computerized assessment. These issues are discussed and readers are provided information to help them assess computerized tests in relation to their particular clinical and research needs. Since many computerized tests were developed as performance assessment tools, the relationship between performance and neuropsychological assessment is examined.