Academic journal article Health and Social Work

A Native American Perspective on Spiritual Assessment: The Strengths and Limitations of a Complementary Set of Assessment Tools

Academic journal article Health and Social Work

A Native American Perspective on Spiritual Assessment: The Strengths and Limitations of a Complementary Set of Assessment Tools

Article excerpt

The legacy of oppression continues to affect the mental health status of Native Americans (Harris, Edlund, & Larson, 2005). In some cases, the mechanisms of oppression are relatively apparent. Discrimination in the health care system serves as a case in point (Burgess, Ding, Hargreaves, van Ryn, & Phalan, 2008).

In other cases, however, the mechanisms are more subtle (Fanon, 1952/1957, 1961/1968). Master narratives, created by elites with social and cultural power, reflect the interests of dominant groups (Yellow Bird, 2004). Indigenous assets that support health and wellness are often framed negatively. Conversely, expressions--even unhealthy expressions--of dominant groups are framed positively.

Driven by the power of a pervasive media complex, these culture-shaping narratives exhibit a potent socializing effect (Yellow Bird, 2004). In keeping with social cognitive theory, these master narratives shape the public's understanding of themselves, the meaning of life, and what values should be affirmed or discounted (Signorielli, 2004; Stone, English, Ekman, & Fujimori, 2008). As a result, people are subtly encouraged to accept the perception of societally dominant groups as normative, even when this conflicts with healthy self- and group interest (Yellow Bird, 2004).Thus, as healthy ways of being are unconsciously exchanged for culturally foreign, destructive modes of existence, these master narratives, in a certain sense, impose various forms of ill-health on minority groups (Fanon, 1952/1957, 1961/1968).

In recognition of the deleterious effects such dominant narratives can exert, some observers have emphasized the importance of research designed to increase the level of cultural competence among mental health practitioners (Sue & Sue, 2008). As various professional documents testify, the social work profession is committed to providing effective, culturally competent services, particularly to vulnerable populations such as Native Americans (NASW, 2001, 2008). Yet--somewhat paradoxically given the profession's stated commitments--Weaver (1999) reported that empirical work on cultural competency with Native Americans was essentially absent from the social work literature.

As just implied, cultural competency is critical for effective service provision to Native Americans because they tend to operate from a different worldview than does the dominant secular culture (French, 2004; Whitbeck, 2006). Consequently, the assumptions that inform wellness in mainstream mental health discourse are frequently incongruent with Native suppositions regarding wellness (Gone, 2004; Pace et al., 2006). Native Americans often have different understandings of wellness and the road that must be traveled to achieve it (Weaver, 2002, 2005).

Concurrently, the considerable diversity among the millions of Native Americans living in the United States should also be borne in mind (U. S. Census Bureau, 2000). There are over 550 federally recognized tribes (and many more that are unrecognized), each having its own distinct set of beliefs and values (Fuller-Thomson & Minkler, 2005; Goldston et al., 2008). Tribal values can overlap with those of the dominant secular culture, and some individual Native Americans have adopted mainstream perspectives. Although this diversity must always be considered in any discussion of tribal peoples, a number of commonalities serve to demarcate Native Americans as a relatively distinct cultural group. Among these factors are a shared history of oppression and the centrality of spirituality to existence.

Although various understandings of spirituality exist among tribes, most affirm an interconnected, spiritually based view of reality (Gilgun, 2002; Miller, 2003; Trujillo, 2000). Within this relational worldview, lack of wellness is caused by an imbalance in one's spirit, mind, and body (Cross, 1997; Weaver, 2002). Indeed, although the dominant secular narrative often ignores spirituality, or even frames it as pathological, spirituality plays a central role in health and wellness for many Native Americans (Cross, 2001; Limb & Hodge, 2008; Napoli, 1999). …

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