Implementation of a Culture-Specific Intervention for a Native American Community

Psychiatric services provided to Native Americans should be culturally relevant and integrated with the values and beliefs of the culture since Native Americans use Western health care as a last resort. Reduced utilization of services may be the result of cultural beliefs that sickness or illness comes from disharmony with oneself, one's community, and nature. Treatment entails resolving the disharmony and restoring a state of balance and integration. Western psychiatric services have not usually provided active psychiatric treatment, while simultaneously encouraging participation in native ceremonies and traditions of healing. For 3 years, the Wyoming State Hospital has offered Sweat Lodge ceremonies administered by the Wind River Reservation as part of a pattern of working together to improve the care of Native Americans admitted to the facility. Results indicate increased utilization of hospital services as well as increased patient and tribal satisfaction, improved health care outcomes, and reduced length of stay. This report argues that culturally specific and sensitive treatment interventions provide a concrete and specific benefit to the population which is targeted.     

Adapting Manualized Treatments: Treating Anxiety Disorders Among Native Americans

Although there is a small but growing body of literature examining the psychopathology of anxiety among Native Americans, no data are available regarding the efficacy of empirically supported treatments for anxiety disorders among Native Americans. Moreover, exceptional challenges arise in adapting mainstream approaches to Native Americans, such as language barriers, contrasting beliefs about the cause and treatment of emotional illness between mainstream and traditional Native American culture, problems with homework compliance, allowing extra time for rapport building, and the need for a spiritual component in the treatment of anxiety disorders. Native Americans also confront the challenges of rural living and low socioeconomic status. The focus of this article is largely conceptual in nature, informed by the limited psychopathology data and the first author’s experience with cognitive behavioral treatment protocols for anxiety disorders and the provision of mental health services to Native Americans. In this article we highlight the unique challenges of adapting manualized anxiety treatments for Native American clients.     

Issues in the Treatment of Native Americans With Alcohol Problems

The author reviews the literature on the treatment of Native Americans who have alcohol abuse or dependence disorders and provides an interpretation of the research on this topic. The most common alcohol treatment modalities used with Native Americans are described and critiqued, including adapted versions of standard treatments. Several practiced recommendations are made regarding revising standard treatments to make them more culturally appropriate for Native Americans.     

7 Suicide: The Scourge of Native American People

Reportedly, Native Americans have a rate of suicide that is greater than any other ethnic group in the United States, especially in the age range of 15–24. Many who are concerned as to why this is the case offer a variety of theories. Most of the theories have yet to be tested. This particular presentation focuses on the traditional tribal structure of most Native Americans and events of history that have impacted the cultures of Native American Tribes. The particular events covered refer to Western education, various religions, and legislation as playing a most significant role in impacting the cultures of Native Americans. With the hope that we can all work together to diminish the scourge of Native American people, I repeat the words of Chief Seattle, “… be just and deal kindly with my people.”     

Native american alcoholism: A transcultural counseling perspective

Alcohol-related mental and physical health problems are critical problems among Native Americans. The intensity of these problems increased proportionately to the destruction of traditional/aboriginal ways. Despite centuries of attempts at physical and cultural genocide a semblance of traditionalism survived to the presence among many tribal groups. Nonetheless the vast majority of contemporary Native Americans are ‘marginal’—caught between their traditional culture and the demands of the dominant United States society. Treating Native Americans merely from the conventional clinical perspective spells of ethnocentrism while a pure traditional approach often serves to restrict both off-reservation mobility and inter-tribal interactions. Here the transcultural approach offers a needed bridge for effective Native American alcohol and mental health counseling.     

Mending the Broken Circle: Treatment of Substance Dependence Among Native Americans

Issues surrounding substance dependence of Native Americans are examined through the cultural concept of the Broken Circle. Traditional cultural views of wellness and healing are described using the traditions of Indian Medicine, the value of the Circle, and what it means to live in harmony and balance. Underlying factors in substance dependence of Native Americans are presented along with practical counseling recommendations and implications for treatment through both contemporary and traditional Native healing methods.     

Native Americans and alcohol: past, present, and future

Native Americans have higher rates of alcohol use, frequency of use, and increased rates of fetal alcohol syndrome, compared with other ethnic groups (J. Hisnanick, 1992; P. A. May, 1996; J. M. Wallace et al., 2003). High prevalence rates of alcohol misuse among Native Americans must be understood in light of their unique history, which has resulted in trauma and exposure to many risk factors for problem alcohol use. Many risk factors have been identified in the general population; however, only some of these risk factors have been examined among Native American populations. The unique history and world view of Native Americans mean that, often, risk factors operate differently from the way they do in other populations. The authors discuss interventions and promising treatments.     

Native Americans and Alcohol: Past,Present, and Future

Native Americans have higher rates of alcohol use, frequency of use, and increased rates of fetal alcohol syndrome, compared with other ethnic groups (J. Hisnanick, 1992; P. A. May, 1996; J. M. Wallace et al., 2003). High prevalence rates of alcohol misuse among Native Americans must be understood in light of their unique history, which has resulted in trauma and exposure to many risk factors for problem alcohol use. Many risk factors have been identified in the general population; however, only some of these risk factors have been examined among Native American populations. The unique history and world view of Native Americans mean that, often, risk factors operate differently from the way they do in other populations. The authors discuss interventions and promising treatments.     

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.     

Intellectual differences among Mexican Americans, Papagos and Whites, independent of g

Patterns of intellectual abilities for Mexican American and Native American Papago children were contrasted with those of White children, independent of overall differences in ability. Large differences in highly verbal skills remained, with Whites consistently outscoring the other two groups. Native Americans showed higher performance than Whites on spatial-visualization tasks but Mexican Americans exceeded Whites on no tasks. These race-related patterns of ability are nearly opposite those found in Black–White comparisons.     

Counseling Native Americans: An introduction for Non-Native American Counselors

This article provides a primer on counseling Native American clients for non-Native American counselors and psychotherapists. The diversity of this population is described and a general model of healing from a traditional Native American perspective is presented, with implications for counseling practice. Relevant research is reviewed and practical suggestions are offered for providing counseling services to Native Americans.     

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.     

Facing Down the Representation of An Impossibility: Indigenous Responses to a ‘Universal’ Problem in the Repatriation Context

This paper explores the ways Native Americans and Native Hawiians have responded to what Ernesto Laclau has called ‘the representation of an impossibility’—the discursive crisis faced by non-dominant groups who seek to advance rights claims in ways that are culturally rooted but universally audible to ideologically dominant audiences. Taking the NAGPRA law of 1990 as its case study, this paper asserts the need for a re-theorisation of indigenous religious discourse in order to illuminate the ways native peoples build rather than concede agency through self-representations in the current political moment. Pursuing this argument, the paper charts an analytical course specifying the relationship of rights claims to discourse, hegemony, articulation, tradition, and religion. The paper then focuses upon specific examples of religious claims in the context of the Native American Graves Protection and Repatriation Act to demonstrate the ways Native Americans have faced down an ‘impossibility’.     

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 use of the thematic apperception test in the study of Native American psychological characteristics: a review and archival study of Navaho men

The present study was designed as a "snapshot in time"--an archival analysis of the psychological characteristics of four Navaho men taken from Navaho Veterans--A Study of Changing Values (E. Z. Vogt, 1951). From a sample of 15 men, Vogt judged 2 as "most acculturated" and 2 as "most unacculturated." The present study was an attempt to examine the Thematic Apperception Test (TAT) protocols of these men on the basis of any recurring and psychologically significant thematic patterns, shared and unshared by the "acculturated" and "unacculturated" subjects. Vogt administered cards from the original TAT set created by H. A. Murray (1943). In this article, a section concerning the definitional use of the term acculturation is provided, followed by a discussion of the limitations inherent in the analysis of TAT protocols. A general survey of psychological and cultural studies of Native Americans using the TAT or TAT modifications is also provided. The examination of the protocol sets resulted in the identification of four themes or approaches to the TAT cards that were thought to be most pervasive and significant across both levels of acculturation: economic deprivation and physical suffering, loneliness/isolation, interpersonal conflict/violence, and individualistic vs. familial orientations. These themes and approaches are illustrated with quotations from the original protocols and are later summarized as the first four categories of a table comparing the psychological characteristics of the most acculturated men with the most unacculturated men. Results of the thematic analyses are discussed within the framework of economic and social pressures traditionally experienced by Native Americans.     

Ethnic variation in depressive symptoms in a community sample in Hawaii

A modified CES-D was administered to a community sample of 176 European Americans (EA), 209 Native Hawaiians (NH), and 357 Japanese Americans (JA), yielding measures of depression, positive affect, depressed affect, somatic disturbance, and disturbed interpersonal relations. Positive affect was lower in JA relative to EA, consistent with findings among Native Japanese, a pattern attributed to cultural variation in emotion regulation. NH reported lower positive affect than EA, accompanied by elevated negative affect and somatic disturbance, suggesting generally higher levels of depressive symptoms. The three ethnic groups varied in mental health care usage with differing associations between depressive symptoms and experiences of stressful life events. Taken together, these results suggest ethnic variation in depressive symptoms may arise from differing cultural beliefs.     

Finding the “Meaning” of Native American Substance Abuse: Implications for Community Prevention

The author examines chemical use by Native Americans with a proposal for a holistic prevention program involving enhancement of cultural interdependence.     

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.