Native Values Can Inform Substance Abuse Treatment

Article excerpt

EXPERT ANALYSIS FROM THE ANNUAL MEETING OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY

SAN FRANCISCO--The foundational beliefs of American Indian and Alaska Native communities play a key role in innovative substance abuse treatment programs, research has shown.

That's a novel finding that could challenge conventional notions of culturally based care, Dr. Douglas K. Novins said at the meeting.

In an ongoing study, he conducted hour-long interviews with 20 administrators and 15 focus groups with clinicians lasting 90 minutes each at 18 alcohol and substance abuse treatment programs serving American Indian and Alaska Native communities. The programs were chosen by an advisory board on the basis of their reputations for innovative services and to ensure a diversity of programs in the study.

Dr. Novins and his associates found that the programs included traditional practices and Western models of treatment, as has been reported in previous studies.

The traditional practices might include crafts or jewelry making, drumming, singing, or fishing by bringing in tribal elders or Native American occupational therapists. The Western element typically included something similar to 12-step programs. That merging of 12-step approaches and traditional practices has been controversial among some American Indian and Alaska Native people. The new finding is the emphasis that these programs place on the foundational beliefs of their cultures--the importance of community and family, meaningful relationships with clients and respect for clients, a homelike atmosphere in the program setting, and an open door policy that never turns clients away (Psychiatr. Serv. 2012;63:686-92).

These core values validate and incorporate the world view of American Indian and Alaska Native cultures, which see individuals as contained in a circle of family, within a circle of community, within a circle of the spirit world. "Many Native peoples will tell you that substance abuse is a sign of broken circles," said Dr. Novins of the University of Colorado, Aurora.

Previous research suggests that the long history of multigenerational traumas experienced by Native Americans as their cultures have been eradicated by nonnatives is a primary cause of substance abuse, he said. …