Using Reasons for Living to Connect to American Indian Healing Traditions

Article excerpt

Responding to high rates of suicide for American Indian youth, helping professionals often struggle to connect healing traditions from American Indian cultures to tools from European psychology. The differences between American Indian healing and European therapy can be vast. Finding connections or building bridges between these two perspectives may be more difficult than it appears (Duran & Duran, 1995). One method to bring together these worldviews is to use the Reasons for Living Questionnaire (RFL, Linehan, Goldstein, Nielsen, & Chiles, 1983); the Reasons for Living Inventory for Adolescents (RFL-A, Osman, Downs, Kopper, Barios, Besett, Linehan, Baker, & Osman, 1998), or other psychological assessments developed using the RFL as a foundation.

Reasons for Living (RFL) assessments have emerged as powerful strength based tools for assessing suicide risk (Range & Knott, 1997). RFL and RFL-A factors link to a relational worldview common to most American Indian people. A relational worldview considers a balance between forces often identified as spirit, context, mind, and body (Cross, 1998).

Using RFL or RFL-A in suicide assessments allows practitioners to assess where youth may be out of balance in one or more of the four traditional areas: spirit, context, mind, and body. This may assist specific referrals to culturally appropriate healing. RFL and RFL-A assessments could be augmented to improve their correspondence to the relational worldview.


Western approaches to care have not been widely embraced by American Indian populations, and almost any type of mental health treatment tends to have disappointing results with American Indians (Husted, Johnson, & Redwing, 1995). Meanwhile, American Indian communities and mental health practitioners acknowledge that the need for mental health treatment is high. Perhaps the most dramatic illustration of this need is the high rate of suicide among American Indian youth. This rate is well established and has continued for decades to be more than double the national rate for non-Indian youth (Grossman, Milligan, & Deyo, 1991).

To understand American Indian perspectives on causes for the high rate of youth suicide and the need for traditional healing, it will be important to review American Indian history. To describe some of the most common American Indian perspectives of wellness and balance, the relational worldview (Cross, 1998) will be presented. Next, tools for suicide assessment especially the Reasons for Living Questionnaire (RFL, Linehan, Goldstein, Nielsen, & Chiles, 1983) and the related Reasons for Living Inventory for Adolescents (RFL-A, Osman, Downs, Kopper, Barrios, Besett, Linehan, Baker, & Osman, 1998) will be presented. The RFL and RFL-A will be linked to the relational worldview and indigenous healing approaches. Finally, areas where the reasons for living assessments could be further developed for use with American Indian adolescents will be discussed along with cultural guidelines for assessment and intervention with potentially suicidal American Indian youth.


The history of American Indian people is survival in the face of mass destruction. Estimates about the number of American Indians in North American before European contact range from two million to as many as 18 million (Shoemaker, 1999). There were at least 600 different indigenous groups on the scene and there were probably between five and ten million American Indians in what are now the United States and Canada (Nichols, 1998). Indigenous people in North America lived in cities and villages, long houses and kivas, and had social organizations including families, clans, and nations. Millions of people and their homes, families and nations had to be eliminated to make room for European colonization.

Colonization destroyed and demeaned traditional ways of indigenous people (Duran & Duran, 1995). …


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