Culturally Sensitive Counseling Paper
Running Head: Culturally Sensitive Counseling for Native Americans
Culturally Sensitive Counseling for Native Americans
Catherine D. Dunn
PSYD 8180 OL, SYSTEMS OF PSYCHPTHERAPHY
Course Instructor: Denise Scatena, Ph.D
May 21, 2010
ABSTRACT
Historical trauma is defined as an aggregate of emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma and continues to impacts the group (http://en.wikipedia.org/wiki/Historical_trauma). In the case, of Native Americans, which is due to their historical treatment by the United States’ federal government, such traumas may include the legacies of boarding schools, massacres, and forced relocation. Psychologist should, therefore, …show more content…
be aware of, and respect, the cultural, individual, and role differences of their clients. Psychologist must consider these factors when working with members of such groups (Cory, Cory & Callanan, 2009). My main objective has been, identifying the cultural standards and skills, which are necessary in providing culturally sensitive counseling services to Native Americans who have experienced historical trauma. First, I consider a brief history of Native Americans and the impact of trauma for Native Americans. Second, I discussed the stereotypical images of Native American’s that have been perpetuated continuously. Third, I provided an overview of Native American diversity and identify factors that have impacted Native American’s culturally and traditionally where trauma is involved. Fourth, I identified specific cultural issues that should be considered when applying CBT therapy when the treatment of Native Americans is involved. Lastly, I examined the current therapies germane to Native Americans and the impact of such therapies. The results are that when providing Cognitive Behavioral Therapy for Native Americans, the collective, spiritual, and traditional values of the culture need to be understood.
According to the APA Ethics Code Standard 2.01b, Boundaries of Competence, psychologists need to have knowledge of their client’s cultures and be able to demonstrate competence in the provision of services that are sensitive to those clients’ cultures (Pope & Vasquez, 2007).
Psychologist should thus be aware of, and respect, the cultural, individual, and role differences of their clients. Some of the key parameters might include age, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status. Psychologist must consider these factors when working with members of such groups (Cory, Cory & Callanan, 2009). The purpose of my paper will be to identify cultural standards and skills, which are necessary in delivering culturally sensitive counseling services to Native Americans who have experienced historical trauma. Historical trauma is defined as a cumulative of emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma (http://en.wikipedia.org/wiki/Historical_trauma). For the purpose of this paper, I am interested in exploring Native Americans trauma, which was in direst result of the historical treatment by the United States’ federal government, which includes the legacies of boarding schools, massacres, and forced relocation. My first goal will be to consider a brief history of Native Americans and the impact of trauma for Native Americans. Second, I will discuss the stereotypical images of Native American’s that have been perpetuated continuously. Third, I will provide an overview of Native American diversity and identify factors that have impacted Native American’s culturally and traditionally where trauma is involved. Fourth, I want to identify specific cultural issues that should be considered when applying CBT therapies for the treatment of Native Americans seeking therapy. Lastly, I will examine the current therapies germane to
Native Americans and the impact of such therapies.
Brief Overview of Native American’s Historical Treatment As described, by the Bureau of Indian affairs, a Native American is one who (a) is an enrolled or registered member of a federally recognized tribe or village or (b) has at least one fourth or more in blood quantum and able to demonstrate that fact legally. The most recent U.S. Bureau of the Census (2000) figures determined the size of the Native American people to be slightly more than 2 million of the total population of the United States. In North America, two million Native Americans populated the Americas and there were about 600 tribes that were in the cultural cradle of America before the first Europeans arrived. By the end of the eighteenth century, the remaining population of Americans Indians was only 10% of its original amount. (Richardson, 1981, Swinomish Tribal Mental Health Project, 1991 and Sue & Sue, 1999). The dramatic decline in the American Indian population was due to the decimation caused by wars and diseases that resulted from contact with Europeans. Ultimately, the larger goal of the United States Government’s was to eradicate and seize Native Americans lands. As noted by Sue & Sue, (1999) they had land and authority that were gradually eroded by imposing, colonial, and then federal and state policies. The actions by Europeans were rather traumatic on families and tribal solidarity (Sue & Sue, 1999). By the 19th century, the historical relations between European American and the Native Americans are a combination of cooperation, but more of conflict (McDonald & Gonzales, 2007). In the 1930’s over 125,000, Indians from different tribes were forced from their homes and states to the reservations of Oklahoma (Sue & Sue, 1999). Again, the impact of this action caused trauma for Indians families and, in many cases, disrupted their cultural traditions.
Native American and Diversity The Indian Relocation Act of 1830 created a number of laws and treaties aimed at controlling and squashing Indian resistance while assimilating them as quickly and quietly as possible. Essentially, the law gave the federal government the power to forcibly relocate Native Americans. Once the Natives Americans were forced onto reservations, federal policy shifted to attempts to “civilize” or “assimilate” the Native American. In most instances, social workers, working on behalf of the boarding schools assessed the American Indian families without cultural knowledge, imposing their own economic and cultural values and behavioral standards and interpreting the child’s best interests as served by removal from the Native American family and culture (Earle & Cross, 2001). The impact of these actions by the federal government has been far reaching and large numbers of Native American know little about their history and have no knowledge of, their culture, traditions, and tribal language life. As a result, of the imposed acculturation the gap in culture, language, knowledge and identity of Native Americans and their families was widened (Coyhis, 2002)..
Cultural Identity A traditional Native American is a person who identifies himself or herself as traditional or bicultural and to some degree participates in tribal ceremonies or participates both in tribal and Christian ceremonies, (Coyhis, 2000). Enrollment in a federally recognized tribe does not always guarantee that a person is a Native American because the tribe decides who is enrolled or a member (www.wellbriety-nci.org/.../CulturallySensitiveSubAbuseTX.doc.,2004). The enrollment method is based on blood quantum requirement, such as having one-fourth of blood of Native heritage. Additionally, another tribe’s law may require that one of the person to be enrolled on a historical list of a tribal member, so as to be considered a Native (Indian County Criminal Jurisdiction, N.D.). However, there are many Natives who are enrolled, who grew up in cities and have little exposure or no contact with the tribe or indigenous community.
Government Boarding schools and Adoption Native Americans were adopted by non-natives and made to attend boarding schools and prohibited from using their language, participating in cultural ceremonies, and fulfilling traditional roles. In addition, the transfer of the culture to the next generation was denied. Factors, which furthered the acculturation process, but stunted the ethnic knowledge of American Indian tribes and members (McDonald & Gonzalez, 2002). It is well known that children in the boarding school were often ostracized for using their language or practicing their traditional customs. As noted by Earle & Cross, (2001), in the boarding schools children were frequently beaten severely with whips, rods, fists, chained, shackled; bound hand and foot; and locked in closets, basements, and bathrooms if they attempted to speak or write their language. The boarding school experience often reduced knowledge of culture, resulted in the loss of Native language, created learned helplessness, poor Native self image, and poor parenting and skills (Coyhis, 2002). The boarding schools experience lead to the devaluing of Native culture in many generations. The federal governments historical mass assimilation through the boarding school system has probably had the greatest impact on acculturation and cultural identification of American Indian tribes and members (McDonald & Gonzalez, 2002). Consequently, the contemporary descendents of the indigenous peoples of North America, contemporary Native Americans have been shown to suffer from disproportionately high degrees of psychological trauma and distress (Gone, 2009).
Collectivism, Spirituality and Traditional Healing When mainstream therapy is compared to Native American psychosocial therapies, there are many similarities. Both traditions are marked by empathy, genuineness, respect, acceptance while challenging client’s beliefs and decisions and tapping into the subconscious and role modeling interventions. Despite such similarities, important differences exist. Mainstream therapy, unlike Native American practices, does not address the connection to the spiritual world, traditional ways of healing, and collectivism (McCabe, 2007). When providing therapy for Native Americans it is important to keep in mind that Native American’s place great value on collectivism, “spirit” and traditional healing, which creates a balance between mind, body, and spirit forms the foundation of the Native Americans view of wellness, (McDonald & Gonzales, 2002). Native American culture tends to be far more collectivist than its non-native counterparts. As noted by McDonald & Gonzalez, (2002) a psychologist must take this difference into account when counseling Native Americans. Whereas members of individualistic cultures see themselves as separate and autonomous individuals, collectivistic cultures see themselves as fundamentally connected with others (McDonald & Gonzalez, 2002). Native Americans collectivism equates to the group being dependant upon each another, and the group solves problems as a whole and everyone works together to make life beneficial. The Native American concept of collectivism also has an important spiritual dimension. It also refers to an interconnectedness of us all and what transpired through spirit, which is available to the whole world, including one’s ancestors in the spirit world (McCabe, 2007). Native Americans seem to see existence as a living blend of spirits, nature and people. All are one, inseparable and interdependent. When grasping Native Americans concepts of wellness and healing, spirituality must be addressed. As noted in my discussion of the spiritual dimension of the Native American collectivist culture, the sacred and the profane are intermeshed, so that the spiritual plane of existence is both distinct and coexistent with the physical world. Native Americans can see, hear, touch, or communicate with other spirits on particular, usually significantly and during ceremonial occasions (McDonald & Gonzalez, 2002). This concept is very foreign for non-natives because they tend to conceptualize the sacred and the profane as two seemingly distinct realities that do not exist simultaneous harmoniously (McDonald & Gonzalez, 2002). Native Americans are, however, quite comfortable with this reality. Spirit represents the invocation of a spiritual world that directly guides and influences people. Understanding that Natives Americans belief systems are animistic, in that all things are believed to possess a spirit, it can be people, trees, animals, and inanimate objects, which allows the spiritual world to coexist with the physical world (McDonald & Gonzalez, 2002). Another important Native American cultural practice is interaction with a traditional healer. The healer is not an individual who simply deals with physical maladies. They tackle both physical and psychological problems, since healers view both dimensions as intimately connected. This means that ancient cultural knowledge, beliefs and methods, are used by the traditional healer, to assist the individuals in finding positive ways of dealing with spiritual, physical and psychological problems (McCabe, 2007). One crucial purpose for the traditional healer is to assist the individual in working at sensing and understanding his or her inner conflicts, and the interactions between the internal and the external world. Spirituality for Native Americans restores balance between the Native client and his family and community is strongly emphasized in treatment (Coyhis, 2002). Assessment “The more knowledge and experience a therapist has about his or her client’s culture, the better the therapists can relate to the client’s real situation,” (Hays, 1996). In other words, the key to successful therapy is having an understanding about who the client is, what their needs are, and by exploring their client concerns. For example, a therapist would need to be aware of the Native American collectivist cultural dimension, as opposed to the individualism in Western culture, and how this orientation shapes treatment outcomes. However, if one has knowledge about Native Americans, one would understand that many Native Americans do not prefer assimilation into the larger society, or individuality because they see themselves as an extension of the tribe (Sue & Sue). Because individualism represents stress and alienation on the group and is seen as going against the whole, where to be collective is supportive oh harmony, cooperation and preventing discords in the group. Being knowledgeable about the client and his or her culture is key to success in counseling Native American. “There is a belief among many Native Americans that their current problems are connected to past and contemporary traumas and that psychology as a profession has failed them because of a lack of knowledge and is even perceived as an agent of social control and hegemony” (McCabe, 2007). Western culture has failed and continues to fail Native Americans because Western psychological therapies are often opposed to Native American cultures and their ways of life. Hays, (2001), notes at the onset of the therapy, it is important to access with your client his or her bicultural or multicultural identities, while allowing the client to identifying with both or multiple aspects of their cultural heritage. Further, Hayes (2001) notes that staying mindful of the diversity of cultural influences affecting Native clients means asking the clients about the following issues during the assessment and keeping in mind the following issues, (the acronym ADDRESSING) when counseling Native Americans: 1) Age and influences. These include generational influences, which may play an important role to a person, such as being a father, an aunt or and elder. 2) Developmental and acquired Disabilities. Native people have the disproportionately high rates of disabilities related to car accidents (i.e., acquired disabilities). Additionally, regarding developmental disabilities, fetal alcohol spectrum disorders, which include fetal alcohol (FAS). 3) Religious or spiritual orientation. Religious beliefs and affiliations vary widely among Native American people and the therapist should be full aware of such affiliations. 4.) Ethnicity. Does the client have a bicultural or multicultural identity and identify with both or multiple aspects of their cultural heritage? 5.) Socioeconomic status. There are significant differences among Native American related to socioeconomic status, particularly between college-educated individuals, who are on the reservations and those living in smaller villages. 6.) Sexual orientation. There are Native Americans people who identify themselves as gay, lesbian, and bisexual. 7.) Indigenous heritage. As noted earlier, there are many levels to Native Americans identity. 8.) National origin. Considering that most Native American were born and raised in Americans, but recognize that there are Native Americans who have lived outside of the United States and are influenced by a parent who is of another race 9.) Gender. Does the client relate to the more traditional roles and the activities of Native American culture, which tends to be highly gender-specific? (Hays, 2001). In addition, given these fundamental questions the following questions should be asked when providing counseling so that issues of identity and acculturation levels of Native American are addressed (Sue & Sue, 2001, p. 285). The questions should be asked during the assessment of the Native American. Is tribal “connectiveness” valuable to you? Given the complexities of Native American identities and definitions about what it means to belong to a tribe, this is a crucial point to assess. 2) Do you live on or near a reservation? Reservation life can be a key factor affecting tribal identities, so this is an important element to assess. 3.) Were you raised by your parents, grandparents, extended family member, or someone other than a relative? Given the experiences with acculturation. 4.) Do you speak your tribal language? Explore why the language is spoken or not spoken. 5) Did you, your parents, or grandparents attend a government boarding school? Given the harsh realities of boarding schools for Native Americans 6.) Were you raised in a traditional manner? (http://www.wellbriety-nci.org, 2004. When providing therapy, it is essential to assess the Native American's standard of traditionalism and acculturation in order to provide appropriate therapies.
Cognitive Behavioral Therapy and Native American Psychology In order to provide culturally appropriate treatment, it is crucial that the psychologist make himself or herself aware of stereotypes that are often prevalent in standard images and portrayals of Native Americans. Most non-native have held images ranging from those of the “savage Indians” raiding villages of European settlers to Squanto eating turkey with the pilgrims and Sacagawea happily leading Lewis and Clark up and down the Missouri River with a baby on her back (McDonald & Gonzalez, 2002). Such negative caricatures are particularly potent since there have been generations of propaganda waged by the dominant culture, which often formed the basis for negative, cognitive, emotional, and behavioral processes against Native Americans, Native Americans have internalized such information, which has changed their self-image. Consequently, cognitive assaults have been so consistently reinforced by the dominant culture that Native Americans no longer require majority culture members to directly inform them that they are, "Lazy, stupid, worthless, drunks, heathens, animals and dirty” (McDonald & Gonzalez, 2002). They have internalized such messages to a great degree (McDonald & Gonzalez, 2002). Native Americans have tended to believe these things and, unfortunately, which has caused them to behave in accordance with this conceptualized belief. Historical and Intergenerational trauma has contributed to suicide, alcoholism, domestic violence, child abuse, and other social problems in Native communities, (McDonald & Gonzalez, 2002). However, in order to work effectively with Native American clients, psychologists must cleanse themselves of any stereotypes that were developed from the mass media, television and literature (Coyhis, 2000). Which allows the therapist to work at counteracting the faulty thinking, which can lead to changes in behaviors and assist with restored harmony between mind, body, and spirit, (McDonald & Gonzalez, 2002). While the differences between the Western Cognitive Behavior Therapy model and Native American concepts were discussed earlier, there are compellingly similarities that can lead to successful treatment (McDonald& Gonzalez, 2002). Cognitive Behavioral Therapy (CBT) and Native American psychology have one key idea in common, which is thoughts that occur most often are ones which are most believed. Consequently, negative or positive rethinking is not the problem. Rather the time spent thinking about it over and over again is the key issue. For example, if a Native American perceives him or herself as “ stupid” and internalizes this label, the individual might actually begin to act in a “stupid” manner. However, this flawed thinking can be adjusted by the application of CBT. As noted by McDonald and Gonzales, (2002), when applying CBT, it is not the extent to which a person believes that he or she is actually “worthless” in first person or the spiritual person. What matters is whether the individual sees the thoughts as legitimate or valid. The use of Cognitive Behavioral Treatment is key in undoing faulty thinking for Native Americans who are seeking treatment.
Counseling Issues
Before working with Native Americans, it is necessary to be aware of our own cultural biases, which have their basis in Western values and influences. For example, upon our first interactions with clients we expect clients to establish appropriate eye contact, to discuss deep feelings, and to verbalize concerns. Native Americans not only do not tend to show these behaviors, but such actions can be considered rude within Native American culture. As a result, Non-Native therapist might interpret such culturally different behavior as a sign of unassertiveness (Hays, 2009). Another difference is that in an initial meeting, the therapist should introduce themselves by their first and last name. Often the use of titles and degrees are not emphasized, except with some elders that the Native American is associated with in his or her background. It may be useful to ask clients how they prefer to be addressed. To show respect for their Native elders, one should normally start. My experiences and through my reading about Native Americans support the premise that each individual has a real connection with his or her culture. Mainly, because the culture, connects, and provides support for that person and the group that he or she belongs too. Given this idea, it is still crucial, that this be acknowledged when providing therapy to Native Americans. This be done in a manner where dignity, respect, individuals are applied.
Conclusion:
Cultural orientation should always be considered when working with American Indian clients where counseling is involved because of the vast cultural diversity, unique historical experience, and the different traditions of the hundreds of tribes located throughout the United States. To ensure a client’s successful treatment it is crucial that several key issues be addressed: 1) Therapists should become as cross culturally competent as possible, especially when they know they will be working with ethnic minorities. 2) Part of that competence should include the ability to assess the amount of bi-cultural competence in a client and incorporate it into all aspects of diagnosis and treatment. 3) Therapist should remember that when providing therapy for Native Americans it is necessary to keep in mind that Native American’s have placed significant importance on collectivism, traditional healing, and “spirit” 4) CBT can be an effective treatment modality for American Indians, particularly if the client displays high degrees of bi-cultural or assimilated cultural competence due to his or her assimilation and acculturation. The successful resolution of issues that face Native American communities is contingent upon how accurately those problems are defined. Native Americans issues have to be examined in the context of nonnative impact on the Native Americans culture and historical trauma, and the self-fulfilling internalization of the stereotypes, rather than viewing such issues as a “Native American problem (Coyhis, 2002).
Reference:
American Psychological Association’s (2002). Guidelines for multicultural, education research, practice and organizational change for psychologist competence, Retrieved May 2, 2010 from, http://www.dhhs.state.nc.us/MHDDAS/childandfamily/soctoolbox/toolbox-iv/ivapacultrualguidelines.pdf. Corey, G., Corey, M.S., & Callanan, P. (2009). Issues and Ethics in the Helping Professions (8th ed.). (pp.146-47) Monterey, CA: Brooks/Cole
Coyhis, D. (2000). Culturally Specific Addiction Recovery for Native Americans. In J. Krestan (ED). Bridges to Recovery (pp.77-87). The Free Press: A Division of Simon & Schuster, Inc.
Cliff, S. (2004). Culturally Sensitive Substance Abuse Treatment. Retrieved from http://www.wellbriety nci.org/Publications/CulturallySensitiveSubAbuseTX.doc
Earle, K.A. (2000). Child Abuse and Neglect: An examination of American Indian. Retrieved May 2, 2010, from National Indian Child Welfare Association Web site: www.nicwa.org/policy/research/index.asp
Earle, K., & Cross, A., (2001). Child Abuse and Neglect Among American Indian Alaska Native Children: An Analysis of Existing Data. Retrieved, May 7, 2010, from NationalIndianChilWWelfareAssociation.http://www.nicwaorg/research/04.child%20Ause01.Rpt.pdf.
Edwards, E. (1978). The Destruction of American Indian Families (Book). Social Work, 23(1), 74. Retrieved May 19, 2010 from Academic Search Premier database.
Gone, J. (2009). A Community-Based Treatment for Native American Historical Trauma: Prospects for Evidence-Based Practice American Psychological Association. Journals Department, 750 First Street NE, Washington. Retrieved May 2, 2010, from http://dx.doi.org/10.1037/a0015390.
Hays, P., A. (2006). CBT with Alaska Native people. In P. A. Hays & G. Y. Iwamasa (Eds.), Culturally Responsive Cognitive-Behavioral Therapy (pp. 47-72.) Washington, D.C American.
Historical Trauma. (2009).WikipediaEnclopedia. Retrieved May 2, 2010, from http://en.wikipedia.org/wiki/Historical_trauma.
Psychological Association. Indian Country Criminal Jurisdiction. (N.D.) Who is an Indian? Retrieved May 1, 21010, from http://tribal jurisdiction.tripod.com/id2.html.
McCabe, G., H. (2007). The Healing Path: A Culture and Community-Derived Indigenous Therapy Model. The American Psychological Association. DOI: 10.1037/0033- 3204.44.2.148
McDonald, J. D., & Gonzalez, J. (2006). Cognitive-behavior therapy with American Indians.Washington, DC: American Psychological Association.
Pope, K., S. & Vasquez, M., J.,T. (2007). Ethics in psychotherapy and counseling: A practical guide for psychologists (3rd. ed.).San Francisco: Jossey-Bass.
Sue, D. W., & Sue D. (2003). Counseling the culturally diverse: Theory and practice (4th ed.). NY: John Wiley & Sons, Inc.
Culturally Sensitive Counseling for Native Americans
Catherine D. Dunn
PSYD 8180 OL, SYSTEMS OF PSYCHPTHERAPHY
Course Instructor: Denise Scatena, Ph.D
May 21, 2010
ABSTRACT
Historical trauma is defined as an aggregate of emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma and continues to impacts the group (http://en.wikipedia.org/wiki/Historical_trauma). In the case, of Native Americans, which is due to their historical treatment by the United States’ federal government, such traumas may include the legacies of boarding schools, massacres, and forced relocation. Psychologist should, therefore, …show more content…
be aware of, and respect, the cultural, individual, and role differences of their clients. Psychologist must consider these factors when working with members of such groups (Cory, Cory & Callanan, 2009). My main objective has been, identifying the cultural standards and skills, which are necessary in providing culturally sensitive counseling services to Native Americans who have experienced historical trauma. First, I consider a brief history of Native Americans and the impact of trauma for Native Americans. Second, I discussed the stereotypical images of Native American’s that have been perpetuated continuously. Third, I provided an overview of Native American diversity and identify factors that have impacted Native American’s culturally and traditionally where trauma is involved. Fourth, I identified specific cultural issues that should be considered when applying CBT therapy when the treatment of Native Americans is involved. Lastly, I examined the current therapies germane to Native Americans and the impact of such therapies. The results are that when providing Cognitive Behavioral Therapy for Native Americans, the collective, spiritual, and traditional values of the culture need to be understood.
According to the APA Ethics Code Standard 2.01b, Boundaries of Competence, psychologists need to have knowledge of their client’s cultures and be able to demonstrate competence in the provision of services that are sensitive to those clients’ cultures (Pope & Vasquez, 2007).
Psychologist should thus be aware of, and respect, the cultural, individual, and role differences of their clients. Some of the key parameters might include age, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status. Psychologist must consider these factors when working with members of such groups (Cory, Cory & Callanan, 2009). The purpose of my paper will be to identify cultural standards and skills, which are necessary in delivering culturally sensitive counseling services to Native Americans who have experienced historical trauma. Historical trauma is defined as a cumulative of emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma (http://en.wikipedia.org/wiki/Historical_trauma). For the purpose of this paper, I am interested in exploring Native Americans trauma, which was in direst result of the historical treatment by the United States’ federal government, which includes the legacies of boarding schools, massacres, and forced relocation. My first goal will be to consider a brief history of Native Americans and the impact of trauma for Native Americans. Second, I will discuss the stereotypical images of Native American’s that have been perpetuated continuously. Third, I will provide an overview of Native American diversity and identify factors that have impacted Native American’s culturally and traditionally where trauma is involved. Fourth, I want to identify specific cultural issues that should be considered when applying CBT therapies for the treatment of Native Americans seeking therapy. Lastly, I will examine the current therapies germane to
Native Americans and the impact of such therapies.
Brief Overview of Native American’s Historical Treatment As described, by the Bureau of Indian affairs, a Native American is one who (a) is an enrolled or registered member of a federally recognized tribe or village or (b) has at least one fourth or more in blood quantum and able to demonstrate that fact legally. The most recent U.S. Bureau of the Census (2000) figures determined the size of the Native American people to be slightly more than 2 million of the total population of the United States. In North America, two million Native Americans populated the Americas and there were about 600 tribes that were in the cultural cradle of America before the first Europeans arrived. By the end of the eighteenth century, the remaining population of Americans Indians was only 10% of its original amount. (Richardson, 1981, Swinomish Tribal Mental Health Project, 1991 and Sue & Sue, 1999). The dramatic decline in the American Indian population was due to the decimation caused by wars and diseases that resulted from contact with Europeans. Ultimately, the larger goal of the United States Government’s was to eradicate and seize Native Americans lands. As noted by Sue & Sue, (1999) they had land and authority that were gradually eroded by imposing, colonial, and then federal and state policies. The actions by Europeans were rather traumatic on families and tribal solidarity (Sue & Sue, 1999). By the 19th century, the historical relations between European American and the Native Americans are a combination of cooperation, but more of conflict (McDonald & Gonzales, 2007). In the 1930’s over 125,000, Indians from different tribes were forced from their homes and states to the reservations of Oklahoma (Sue & Sue, 1999). Again, the impact of this action caused trauma for Indians families and, in many cases, disrupted their cultural traditions.
Native American and Diversity The Indian Relocation Act of 1830 created a number of laws and treaties aimed at controlling and squashing Indian resistance while assimilating them as quickly and quietly as possible. Essentially, the law gave the federal government the power to forcibly relocate Native Americans. Once the Natives Americans were forced onto reservations, federal policy shifted to attempts to “civilize” or “assimilate” the Native American. In most instances, social workers, working on behalf of the boarding schools assessed the American Indian families without cultural knowledge, imposing their own economic and cultural values and behavioral standards and interpreting the child’s best interests as served by removal from the Native American family and culture (Earle & Cross, 2001). The impact of these actions by the federal government has been far reaching and large numbers of Native American know little about their history and have no knowledge of, their culture, traditions, and tribal language life. As a result, of the imposed acculturation the gap in culture, language, knowledge and identity of Native Americans and their families was widened (Coyhis, 2002)..
Cultural Identity A traditional Native American is a person who identifies himself or herself as traditional or bicultural and to some degree participates in tribal ceremonies or participates both in tribal and Christian ceremonies, (Coyhis, 2000). Enrollment in a federally recognized tribe does not always guarantee that a person is a Native American because the tribe decides who is enrolled or a member (www.wellbriety-nci.org/.../CulturallySensitiveSubAbuseTX.doc.,2004). The enrollment method is based on blood quantum requirement, such as having one-fourth of blood of Native heritage. Additionally, another tribe’s law may require that one of the person to be enrolled on a historical list of a tribal member, so as to be considered a Native (Indian County Criminal Jurisdiction, N.D.). However, there are many Natives who are enrolled, who grew up in cities and have little exposure or no contact with the tribe or indigenous community.
Government Boarding schools and Adoption Native Americans were adopted by non-natives and made to attend boarding schools and prohibited from using their language, participating in cultural ceremonies, and fulfilling traditional roles. In addition, the transfer of the culture to the next generation was denied. Factors, which furthered the acculturation process, but stunted the ethnic knowledge of American Indian tribes and members (McDonald & Gonzalez, 2002). It is well known that children in the boarding school were often ostracized for using their language or practicing their traditional customs. As noted by Earle & Cross, (2001), in the boarding schools children were frequently beaten severely with whips, rods, fists, chained, shackled; bound hand and foot; and locked in closets, basements, and bathrooms if they attempted to speak or write their language. The boarding school experience often reduced knowledge of culture, resulted in the loss of Native language, created learned helplessness, poor Native self image, and poor parenting and skills (Coyhis, 2002). The boarding schools experience lead to the devaluing of Native culture in many generations. The federal governments historical mass assimilation through the boarding school system has probably had the greatest impact on acculturation and cultural identification of American Indian tribes and members (McDonald & Gonzalez, 2002). Consequently, the contemporary descendents of the indigenous peoples of North America, contemporary Native Americans have been shown to suffer from disproportionately high degrees of psychological trauma and distress (Gone, 2009).
Collectivism, Spirituality and Traditional Healing When mainstream therapy is compared to Native American psychosocial therapies, there are many similarities. Both traditions are marked by empathy, genuineness, respect, acceptance while challenging client’s beliefs and decisions and tapping into the subconscious and role modeling interventions. Despite such similarities, important differences exist. Mainstream therapy, unlike Native American practices, does not address the connection to the spiritual world, traditional ways of healing, and collectivism (McCabe, 2007). When providing therapy for Native Americans it is important to keep in mind that Native American’s place great value on collectivism, “spirit” and traditional healing, which creates a balance between mind, body, and spirit forms the foundation of the Native Americans view of wellness, (McDonald & Gonzales, 2002). Native American culture tends to be far more collectivist than its non-native counterparts. As noted by McDonald & Gonzalez, (2002) a psychologist must take this difference into account when counseling Native Americans. Whereas members of individualistic cultures see themselves as separate and autonomous individuals, collectivistic cultures see themselves as fundamentally connected with others (McDonald & Gonzalez, 2002). Native Americans collectivism equates to the group being dependant upon each another, and the group solves problems as a whole and everyone works together to make life beneficial. The Native American concept of collectivism also has an important spiritual dimension. It also refers to an interconnectedness of us all and what transpired through spirit, which is available to the whole world, including one’s ancestors in the spirit world (McCabe, 2007). Native Americans seem to see existence as a living blend of spirits, nature and people. All are one, inseparable and interdependent. When grasping Native Americans concepts of wellness and healing, spirituality must be addressed. As noted in my discussion of the spiritual dimension of the Native American collectivist culture, the sacred and the profane are intermeshed, so that the spiritual plane of existence is both distinct and coexistent with the physical world. Native Americans can see, hear, touch, or communicate with other spirits on particular, usually significantly and during ceremonial occasions (McDonald & Gonzalez, 2002). This concept is very foreign for non-natives because they tend to conceptualize the sacred and the profane as two seemingly distinct realities that do not exist simultaneous harmoniously (McDonald & Gonzalez, 2002). Native Americans are, however, quite comfortable with this reality. Spirit represents the invocation of a spiritual world that directly guides and influences people. Understanding that Natives Americans belief systems are animistic, in that all things are believed to possess a spirit, it can be people, trees, animals, and inanimate objects, which allows the spiritual world to coexist with the physical world (McDonald & Gonzalez, 2002). Another important Native American cultural practice is interaction with a traditional healer. The healer is not an individual who simply deals with physical maladies. They tackle both physical and psychological problems, since healers view both dimensions as intimately connected. This means that ancient cultural knowledge, beliefs and methods, are used by the traditional healer, to assist the individuals in finding positive ways of dealing with spiritual, physical and psychological problems (McCabe, 2007). One crucial purpose for the traditional healer is to assist the individual in working at sensing and understanding his or her inner conflicts, and the interactions between the internal and the external world. Spirituality for Native Americans restores balance between the Native client and his family and community is strongly emphasized in treatment (Coyhis, 2002). Assessment “The more knowledge and experience a therapist has about his or her client’s culture, the better the therapists can relate to the client’s real situation,” (Hays, 1996). In other words, the key to successful therapy is having an understanding about who the client is, what their needs are, and by exploring their client concerns. For example, a therapist would need to be aware of the Native American collectivist cultural dimension, as opposed to the individualism in Western culture, and how this orientation shapes treatment outcomes. However, if one has knowledge about Native Americans, one would understand that many Native Americans do not prefer assimilation into the larger society, or individuality because they see themselves as an extension of the tribe (Sue & Sue). Because individualism represents stress and alienation on the group and is seen as going against the whole, where to be collective is supportive oh harmony, cooperation and preventing discords in the group. Being knowledgeable about the client and his or her culture is key to success in counseling Native American. “There is a belief among many Native Americans that their current problems are connected to past and contemporary traumas and that psychology as a profession has failed them because of a lack of knowledge and is even perceived as an agent of social control and hegemony” (McCabe, 2007). Western culture has failed and continues to fail Native Americans because Western psychological therapies are often opposed to Native American cultures and their ways of life. Hays, (2001), notes at the onset of the therapy, it is important to access with your client his or her bicultural or multicultural identities, while allowing the client to identifying with both or multiple aspects of their cultural heritage. Further, Hayes (2001) notes that staying mindful of the diversity of cultural influences affecting Native clients means asking the clients about the following issues during the assessment and keeping in mind the following issues, (the acronym ADDRESSING) when counseling Native Americans: 1) Age and influences. These include generational influences, which may play an important role to a person, such as being a father, an aunt or and elder. 2) Developmental and acquired Disabilities. Native people have the disproportionately high rates of disabilities related to car accidents (i.e., acquired disabilities). Additionally, regarding developmental disabilities, fetal alcohol spectrum disorders, which include fetal alcohol (FAS). 3) Religious or spiritual orientation. Religious beliefs and affiliations vary widely among Native American people and the therapist should be full aware of such affiliations. 4.) Ethnicity. Does the client have a bicultural or multicultural identity and identify with both or multiple aspects of their cultural heritage? 5.) Socioeconomic status. There are significant differences among Native American related to socioeconomic status, particularly between college-educated individuals, who are on the reservations and those living in smaller villages. 6.) Sexual orientation. There are Native Americans people who identify themselves as gay, lesbian, and bisexual. 7.) Indigenous heritage. As noted earlier, there are many levels to Native Americans identity. 8.) National origin. Considering that most Native American were born and raised in Americans, but recognize that there are Native Americans who have lived outside of the United States and are influenced by a parent who is of another race 9.) Gender. Does the client relate to the more traditional roles and the activities of Native American culture, which tends to be highly gender-specific? (Hays, 2001). In addition, given these fundamental questions the following questions should be asked when providing counseling so that issues of identity and acculturation levels of Native American are addressed (Sue & Sue, 2001, p. 285). The questions should be asked during the assessment of the Native American. Is tribal “connectiveness” valuable to you? Given the complexities of Native American identities and definitions about what it means to belong to a tribe, this is a crucial point to assess. 2) Do you live on or near a reservation? Reservation life can be a key factor affecting tribal identities, so this is an important element to assess. 3.) Were you raised by your parents, grandparents, extended family member, or someone other than a relative? Given the experiences with acculturation. 4.) Do you speak your tribal language? Explore why the language is spoken or not spoken. 5) Did you, your parents, or grandparents attend a government boarding school? Given the harsh realities of boarding schools for Native Americans 6.) Were you raised in a traditional manner? (http://www.wellbriety-nci.org, 2004. When providing therapy, it is essential to assess the Native American's standard of traditionalism and acculturation in order to provide appropriate therapies.
Cognitive Behavioral Therapy and Native American Psychology In order to provide culturally appropriate treatment, it is crucial that the psychologist make himself or herself aware of stereotypes that are often prevalent in standard images and portrayals of Native Americans. Most non-native have held images ranging from those of the “savage Indians” raiding villages of European settlers to Squanto eating turkey with the pilgrims and Sacagawea happily leading Lewis and Clark up and down the Missouri River with a baby on her back (McDonald & Gonzalez, 2002). Such negative caricatures are particularly potent since there have been generations of propaganda waged by the dominant culture, which often formed the basis for negative, cognitive, emotional, and behavioral processes against Native Americans, Native Americans have internalized such information, which has changed their self-image. Consequently, cognitive assaults have been so consistently reinforced by the dominant culture that Native Americans no longer require majority culture members to directly inform them that they are, "Lazy, stupid, worthless, drunks, heathens, animals and dirty” (McDonald & Gonzalez, 2002). They have internalized such messages to a great degree (McDonald & Gonzalez, 2002). Native Americans have tended to believe these things and, unfortunately, which has caused them to behave in accordance with this conceptualized belief. Historical and Intergenerational trauma has contributed to suicide, alcoholism, domestic violence, child abuse, and other social problems in Native communities, (McDonald & Gonzalez, 2002). However, in order to work effectively with Native American clients, psychologists must cleanse themselves of any stereotypes that were developed from the mass media, television and literature (Coyhis, 2000). Which allows the therapist to work at counteracting the faulty thinking, which can lead to changes in behaviors and assist with restored harmony between mind, body, and spirit, (McDonald & Gonzalez, 2002). While the differences between the Western Cognitive Behavior Therapy model and Native American concepts were discussed earlier, there are compellingly similarities that can lead to successful treatment (McDonald& Gonzalez, 2002). Cognitive Behavioral Therapy (CBT) and Native American psychology have one key idea in common, which is thoughts that occur most often are ones which are most believed. Consequently, negative or positive rethinking is not the problem. Rather the time spent thinking about it over and over again is the key issue. For example, if a Native American perceives him or herself as “ stupid” and internalizes this label, the individual might actually begin to act in a “stupid” manner. However, this flawed thinking can be adjusted by the application of CBT. As noted by McDonald and Gonzales, (2002), when applying CBT, it is not the extent to which a person believes that he or she is actually “worthless” in first person or the spiritual person. What matters is whether the individual sees the thoughts as legitimate or valid. The use of Cognitive Behavioral Treatment is key in undoing faulty thinking for Native Americans who are seeking treatment.
Counseling Issues
Before working with Native Americans, it is necessary to be aware of our own cultural biases, which have their basis in Western values and influences. For example, upon our first interactions with clients we expect clients to establish appropriate eye contact, to discuss deep feelings, and to verbalize concerns. Native Americans not only do not tend to show these behaviors, but such actions can be considered rude within Native American culture. As a result, Non-Native therapist might interpret such culturally different behavior as a sign of unassertiveness (Hays, 2009). Another difference is that in an initial meeting, the therapist should introduce themselves by their first and last name. Often the use of titles and degrees are not emphasized, except with some elders that the Native American is associated with in his or her background. It may be useful to ask clients how they prefer to be addressed. To show respect for their Native elders, one should normally start. My experiences and through my reading about Native Americans support the premise that each individual has a real connection with his or her culture. Mainly, because the culture, connects, and provides support for that person and the group that he or she belongs too. Given this idea, it is still crucial, that this be acknowledged when providing therapy to Native Americans. This be done in a manner where dignity, respect, individuals are applied.
Conclusion:
Cultural orientation should always be considered when working with American Indian clients where counseling is involved because of the vast cultural diversity, unique historical experience, and the different traditions of the hundreds of tribes located throughout the United States. To ensure a client’s successful treatment it is crucial that several key issues be addressed: 1) Therapists should become as cross culturally competent as possible, especially when they know they will be working with ethnic minorities. 2) Part of that competence should include the ability to assess the amount of bi-cultural competence in a client and incorporate it into all aspects of diagnosis and treatment. 3) Therapist should remember that when providing therapy for Native Americans it is necessary to keep in mind that Native American’s have placed significant importance on collectivism, traditional healing, and “spirit” 4) CBT can be an effective treatment modality for American Indians, particularly if the client displays high degrees of bi-cultural or assimilated cultural competence due to his or her assimilation and acculturation. The successful resolution of issues that face Native American communities is contingent upon how accurately those problems are defined. Native Americans issues have to be examined in the context of nonnative impact on the Native Americans culture and historical trauma, and the self-fulfilling internalization of the stereotypes, rather than viewing such issues as a “Native American problem (Coyhis, 2002).
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