Academic journal article New Zealand Journal of Psychology

A Proposed Hauora Maori Clinical Guide for Psychologists: Using the Hui Process and Meihana Model in Clinical Assessment and Formulation

Academic journal article New Zealand Journal of Psychology

A Proposed Hauora Maori Clinical Guide for Psychologists: Using the Hui Process and Meihana Model in Clinical Assessment and Formulation

Article excerpt


Maori mental health inequities are well documented (Baxter, Kingi, Tapsell, Durie, & McGee, 2006; Baxter, Kokaua, Wells, McGee, & Oakley Browne, 2006a; Harris, Tobias, Jeffreys, Waldegrave, Karlsen, & Nazroo, 2006; Baxter, 2008; Newton-Howes, Lacey, & Banks, 2014; McLeod, King, Stanley, Lacey, & Cunningham, 2017). Despite this, universities and professional bodies have demonstrated marked variation in the way professional psychology training programmes prepare students and clinicians to work with Maori clients and whanau. Because of this it is difficult to ascertain the profession's ability to contribute to the reduction of mental health inequities (Levy & Waitoki, 2016; Masters, Nikora, Waitoki, Valentine, Macfarlane, & Gibson, 2016; Waitoki, 2016; Bennett, 2016).

The introduction of The Health Practitioners Competence Assurance Act in 2003 (HPCA, 2003) was designed to provide governance of clinical training programmes. The HPCA 2003 signaled a departure from the Psychologist's Act 1981 through increased scrutiny of professional training programmes. Public protection is the primary purpose of the HPCA, with section 118(i) of the Act mandated cultural competency through "setting standards of clinical and cultural competence, and ethical conduct to be observed by health practitioners of the profession" (HPCAA, 2003, p. 87). Although there is no specific mention of the Treaty of Waitangi, or Maori, in the HPCA Act, the New Zealand Psychologists Board (NZPB), the New Zealand Psychological Society, and the College of Clinical Psychologists have documented opportunities for psychologists to be responsive to Maori. The NZPB Standards and Procedures document, written in collaboration with the Society and College, articulates guidelines for the accreditation of programmes and schemes leading to registration as a psychologist in Aotearoa/New Zealand (NZPB, 2016). The core competencies stand alongside The Code of Ethics for Psychologists Working in Aotearoa/New Zealand (New Zealand Psychological Society, 2002) which includes a value statement that encourages psychologists to apply the principles of Te Tiriti of Waitangi to their work and "seek advice and undertake training in the appropriate way to show respect for the dignity and needs of Maori in their practice." (New Zealand Psychological Society, 2002, p. 6)

The Standards and Procedures document requires that professional training programmes (and supervision to registration schemes) meet the needs and aspirations of both Treaty/Te Tiriti o Waitangi partners' worldviews (NZPB, 2016 p.14). This includes specific clauses related to Maori health curriuclum as follows:

"2.1.3. The teaching and learning methods include consideration of cultural frame of reference, values and world veiws, including those of Maori.

2.2.1. The curriculum is based on principles of scientific method and evidence-based practice, fosters the development of analytical and critical thinking, and includes consideration of indigenous psychologies.

6.2.5 In particular, where possible, students shall have the opportunity to undertake placements within Maori services and/or be supervised by Maori psychologists." (NZPB, 2016, pp 21-24).

However, the repercussions of not meeting these standards is not well documented, and without a clear statement supporting the recruitment of staff who are experts in Maori health curriuclum it is unclear how the above clauses will be met (NZPB, 2016, p 24). For those practising psychology, it is not mandatory that Maori health competencies are required as an ongoing competence measure as a registered psychologist (NZPB, 2011, p.2).

Despite enhanced cultural competencies as one of the central premises of the HPCA Act (HPCAA, 2003) and the Standards and Procedures document (NZPB, 2016) a recently published review of professional psychology training programmes identified that time assigned to Maori health learning outcomes had actually reduced since the HPCAA Act was implemented (Levy, 2002; Levy, 2007; Levy & Waitoki, 2016). …

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