Native american clinical considerations

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Transcript of Native american clinical considerations

Alaskan Natives

Counseling Considerations for Native Americans

Maggie DunhamKathy Telljohann

A CaveatAlthough this information is presented as considerations for Native Americans as a group, it is vital to remember that each tribe is different, and each person within a tribe is unique. It is important to ask the client how their culture plays into their life.Never assume you are an expert.

This ambiguous, multivocal world makes it increasingly hard to conceive of human diversity as inscribed in bounded, independent cultures. James Clifford, The Predicament of Culture, 1988, p. 23No discoverers, no scientists, no treaties, no anthropologists, no government agents, and no missionaries of scientism have ever had the moral cause or ethical authority to determine the outcome of native rights, consciousness, or sovereignty. G. Vizenor, Fugitive Poses,1998, p. 76The impact of history might be cultural dislocation, but an astute social worker can advocate for culturally sensitive models of practice and service delivery systems for clients with Native ancestry. Carol L. Langer, The Effect of Selected Macro Forces on the Contemporary Social Construction of American Indian Ethnic Identity, 2005, p. 29

Out of the Indian approach to life there came a great freedom, an intense and absorbing respect for life, enriching faith in a Supreme Power, and principles of truth, honesty, generosity, equity, and brotherhood as a guide to mundane relations. Luther Standing Bear Oglala Sioux (1868-1937) Retrieved from: http://www.ilhawaii.net/~stony/quotes.html When questioned by an anthropologist on what Indians called America before the white man came, an Indian simply said, "Ours." (Deloria, 1988, p. 166)

The lack of success on the part of social workers can be attributed to a multitude of reasons but it stems, in general, from the following: (1) lack of understanding of Native American culture, (2) retention of stereotyped images of Native Americans, (3) use of standard techniques and approaches. (Lewis, Ho, 1975).

"Being Indian is an attitude, a state of mind, a way of being in harmony with all things and all beings. It is allowing the heart to be the distributor of energy on this planet; to allow feelings and sensitivities to determine where energy goes; bringing aliveness up from the Earth and from the Sky, putting it in and giving it out from the heart." - Brooke Medicine Eagle

"Humankind has not woven the web of life. We are but one thread within it. Whatever we do to the web, we do to ourselves. All things are bound together. All things connect." Chief SeattleSong by: Olivia Tailfeathers Universe Song, 2005Click to continue

Native AmericansSubgroups are determined by the tribal locationThey do not form a single ethnic groupthey always have resisted a homogeneous definition

NortheasternSoutheasternSouthwesternNorthern PlainsNorthwest CoastAlaska NativesOklahoma IndiansIndians of the Plateau, Great Basin, and Rocky MountainsCalifornia Indians

Kline, M.V. & Huff, R.M. (2007). Health and disease of American Indian and Alaska Native populations: An overview (2nd ed.). Thousand Oaks, CA: SAGE Publications, Inc. p. 355-392.

Schwarzbaum, S. E. & Thomas, A. J. (2008). Dimensions of multicultural counseling: A life story approach. Thousand Oaks, CA: Sage Publications, Inc.

Native Americans of TodaySmallest racial minority in the USPoorestLeast educated29.1% of 25 year olds hadnt completed high schoolMost neglected minority groupYoung populations

Kline, M.V. & Huff, R.M. (2007). Health and disease of American Indian and Alaska Native populations: An overview (2nd ed.). Thousand Oaks, CA: SAGE Publications, Inc. p. 355-392.

Spiritual BeliefsSpirit of balance and harmony with:OthersThe natural worldThe spirit worldAll have spiritsGood or evilLife depended on the careful cultivation of these spirits.Ones health reflected upon the spirits

Major Historical ImpactsManifest Destiny ultimately allowed white settlers to take land from NativesIndian Removal Act of 1830.Impacted beliefs:RacismMaterial progressionTrail of Tears in 1838The forced march westward of the Cherokees Approximately 16,000 Cherokees were held in disease-infested camps prior to their departure for Indian Territory.Removal enforced reservation living, creating dependence on governmental housing, food allotments, and general subsistence.

Langer, C.L. (2005). The effect of selected macro forces on the contemporary social construction of American Indian ethnic identity. Journal of Health & Social Policy, 20(2), 15-32.

Significant EventsGhost Dance of 1890An example of Native revitalization among these Western tribesPlacement of Indian Children in Non-Indian Foster HomesPrior to the Indian Child Welfare Act (ICWA) of 1978, a sinister attempt at assimilation, perhaps even cultural genocide, was the placement of Indian children in non-Native homes.Formation of American Indian Movement (AIM)AIM is one of those Indian-initiated events that inspired Natives and non-Natives alike to begin to redress the many grievances of civil rights violations.In addition, Indian identity was strengthened.

Langer, C.L. (2005). The effect of selected macro forces on the contemporary social construction of American Indian ethnic identity. Journal of Health & Social Policy, 20(2), 15-32.

The Aftermath of Historical EventsHistorical trauma due to what is perceived as cultural genocide

For those who work with Native American populations, understanding this history is a critical piece in the process of acquiring cultural competence.

An understanding of this history helps to explain how and why such cultural nuances and social problems might exist among contemporary populations, including those who have been so marginalized that they might only recently have discovered their heritage.

A historical and analytical model of macro identity formation begins to emerge when these historical phenomena are examined and connected.

Langer, C.L. (2005). The effect of selected macro forces on the contemporary social construction of American Indian ethnic identity. Journal of Health & Social Policy, 20(2), 15-32.

Common Clinical ConcernsDepressionDepressive symptomology caseRate of 41%Triple U.S. general populationSubstance abuseAlcohol mortality 5x higher37.2 vs. 6.8 per 100,000Fetal Alcohol Syndrome33 times higher37.2 vs. 6.8 per 100,000Domestic violenceWomen age 18-5953% have experiencedWomen age 50