First Nations SEWB Framework

SEWB Framework

A strength-based, trauma-informed model that reflects First Nations 'ways of knowing, being and doing', expanding the concept of health beyond the individual to collective health and wellbeing.

Biopsychosocial Model

A Western-centric, individualistic model that focuses on biological, psychological, and social domains.

First Nations SEWB Framework

A framework that emphasizes a collectivist worldview and includes seven interconnected domains of connection.

Holistic Definition of Health

First Nations health is viewed in a holistic context encompassing mental, physical, cultural, and spiritual health.

Cultural Determinants

Assets, resources, and strengths that help First Nations people achieve positive health and wellbeing.

Inner Circle

The part of the SEWB Framework that represents Cultural Determinants (Protective Factors).

Outer Circle Determinants

Factors outside the Inner Circle that influence social and emotional wellbeing.

Seven Connections to First Nations Culture

1. Body 2. Mind and emotions 3. Family and kinship 4. Community 5. Culture 6. Country 7. Spirituality

Collectivist Self-Conception

The understanding of self in relation to family and community, crucial in First Nations cultures.

National Aboriginal Health Strategy (NAHS)

Defines the holistic concept of health used by First Nations.

Trauma-Informed Model

An approach that recognizes the impact of trauma on individuals and communities.

Cultural Lens

The perspective that considers cultural context and historical background in health assessments.

Salutogenic Approach

Focuses on the origins of health rather than disease.

First Nations Health

Health viewed in a holistic context that includes cultural identity and community well-being.

Ways Forward Report

Published in 1995, it underpins the 9 Guiding Principles of the SEWB Framework.

Interdependence

The interconnectedness of individuals within the community, emphasized in the First Nations SEWB Framework.

Historical Context

The background and events that have shaped the current health status of First Nations peoples.

Wellbeing

A state of health that encompasses mental, physical, cultural, and spiritual aspects.

Cultural Identity

The sense of belonging to a cultural group, significant in First Nations health.

Mental Illness Prevention

The aim of Cultural Determinants to promote positive health and prevent mental illness.

Family and Kinship

Central elements in First Nations culture that contribute to social and emotional wellbeing.

Community

A key aspect of First Nations culture that supports collective health and wellbeing.

Cultural Diversity

The specific content of SEWB domains varies by language or cultural group, necessitating practitioners to 'listen to learn' about individual experiences.

Cultural Continuity

Cultural Determinants facilitate cultural continuity, which protects against self-harm and youth suicide in First Nations communities.

Historical Recognition

Recognition of trauma and loss since European invasion having inter-generational effects.

Impact of Past Policies

Past government policies, including dislocation, dispossession, and the forcible removal of Aboriginal children (Stolen Generations), constituted 'gross violations of human rights'.

Inequitable Access

Differences in access to income, education, employment, housing, and health services are avoidable differences, therefore inequitable.

Social Stressors

Racism, stigma, environmental adversity, and social disadvantage constitute ongoing stressors.

Political Recognition

The human rights of Aboriginal people must be recognised and respected; self-determination is central to health services.

Self-Determination

Relates to the struggle to stop human rights abuses and gain the right to self-determination, a collective right under international law.

Competency 8

Requires the demonstration of a health equity and human rights approach when working with Aboriginal and Torres Strait Islander Peoples, families, and communities.

SEWB Model Understanding

Understanding the SEWB Model helps achieve Competency 8.

Feature of Competency 8

Works with knowledge and understanding of the historical, political, social, and cultural context, including the ongoing impacts of colonisation and racism.

Knowledge of Historical Determinants

Essential to understand trauma and grief, including events like the Stolen Generations and land dispossession.

Knowledge of Social/Political Determinants

Explains ongoing stressors such as racism and lack of self-determination that undermine SEWB.

Trauma-aware

The framework identifies Historical Determinants as the root of trauma and loss since invasion, often leading to complex trauma and inter-generational effects.

Culturally informed

Care must be strength-based and use Cultural Determinants (e.g., connection to family, culture, and spirituality) to buffer the impact of distressing and traumatic events and support resilience.

Cultural Humility

Cultural humility is the required approach, necessitating a willingness for self-evaluation, learning, and self-reflection.

Yarning

Yarning is a culturally appropriate method of communication used in practice and research, referring to sharing knowledge, stories, and experiences through conversation.

Medicalization

Practitioners must avoid the medicalisation of normal human suffering by relying solely on the biomedical model, which often ignores the underlying social, political, or existential contexts contributing to distress.

Assessment Tools

Culturally safe practitioners must ensure they 'first of all, do no harm', avoiding the use of inappropriate Western scales like the Kessler-10 (K10) or K6 for measuring psychological distress in First Nations people.

SEWB Application

A practitioner applies culturally informed care by understanding that historical trauma contributes to current distress, prioritizing strengthening a client's Cultural Determinants.

Dardi Munwurro's men's healing programs

Demonstrates using Cultural Determinants (connecting Aboriginal people with culture and kinship) to combat SEWB problems like reduced family violence and substance misuse.

Connection to family and kinship

A Cultural Determinant that emphasizes the importance of familial relationships in supporting mental health and resilience.

Connection to culture

A Cultural Determinant that highlights the role of cultural identity and practices in promoting mental well-being.

Clinical yarning

A specific type of yarning used in clinical settings to facilitate communication and understanding in healthcare.

Research yarning

A specific type of yarning used in research contexts to gather knowledge and experiences through conversation.

Culturally safe healthcare system

A healthcare system that reflects on one's own cultural background, biases, and assumptions to create a safe environment for all cultures.

Kessler-10 (K10)

An inappropriate Western scale for measuring psychological distress in First Nations people, lacking predictive validity.

K6

An inappropriate Western scale for measuring psychological distress in First Nations people, lacking predictive validity.

K5 scale

The only authorized scale for measuring psychological distress in First Nations people.

Strength-based approach

An approach that focuses on the strengths and resources of individuals rather than their deficits.

Historical trauma

Trauma that is rooted in historical events and experiences, impacting current mental health and well-being.

Complex trauma

A type of trauma that results from prolonged or repeated exposure to traumatic events, often leading to significant emotional and psychological difficulties.