Chapter 13 - Counseling American Indians/Native Americans and Alaskan Natives
AI/AN form a highly heterogeneous group composed of 566 distinct tribes, with about 170 languages (U.S. Census Bureau, 2015)
over a quarter (26.7%) of AI/AN people speak another language other than English in the home.
About 22% of American Indian people live on reservations, whereas 60% reside in metropolitan areas (Office of Minority Health, 2020).
less likely to graduate public high school, highest national poverty rate
Although most do not live on reservations or with their tribes, many are returning because of casino jobs or a more nurturing environment
What constitutes someone who is American Indian/Alaska Native or Indigenous is often an area of controversy
The U.S. Census depends on self‐report of racial and ethnic identity
Congress - An individual must have an “Indian” blood quantum of at least 25% to be considered an American Indian/Alaska Native
Some tribes have developed their own criteria and specify either tribal enrollment or blood quantum levels.
Because AI/AN make up such a small percentage of the U.S. population, they are relatively “invisible,” and many times publicly available statistics do not include information on AI/AN groups
The death rate by any cause is nearly 50% higher for AI/AN persons than for White individuals
AI/AN individuals have death rates for unintentional injuries due to motor vehicle traffic crashes, poisoning, and falls that are 1.4 to 3.0 times higher than among White Americans
Injuries and violence account for 75% of all deaths for AI/AN between the ages of 1 and 19
The pregnancy‐related mortality rates for AI/NA women and babies is over twice that of their White counterparts and all forms of violence directed against AI/AN girls and women have reached epidemic levels
racism also influences AI/NA mental health
American Indian high school and college students who viewed these types of images (stereotyped portrayals of them in sports teams and the public in general) reported higher levels of depression, lower self‐esteem, and decreased feelings of community worth
Sociohistorical Context
Indigenous people in the Americas have a long and rich history
Indigenous peoples were thriving in complex cultural systems for at least 20,000 years before European colonialization.
In North America, wars and diseases that resulted from contact with Europeans decimated the AI/AN population - only 10% remained by end of 18th century
tribes suffered massive loss of their land
their land and status were severely eroded by imperial, colonial, and then federal and state policies
For years, extermination and seizure of lands seemed to be the primary governmental policy toward Indigenous peoples
in the 1830s, more than 125,000 people from different tribes were forced from their homes in many different states to a reservation in Oklahoma
traumatic
disrupted their cultural traditions
Assaults against their culture also occurred in the form of attempts to “civilize” them
children sent to English-speaking boarding schools, forced to spend 8 continuous years away from family and tribes
Children were also removed from their homes and placed with non‐Indian families until the Indian Child Welfare Act of 1978 prohibited these practices
tremendous negative impact on family and tribal cohesion and created barriers to the transmission of cultural values from parents to children.
“historical trauma,” in which the distress experienced by an individual can be passed down intergenerationally
Individuals may have unresolved grief—“soul wounds”—that lead to psychological distress and substance abuse
Strengths & Resiliencies
Tribal Community Structure and Relationships
the tribe and the reservation, provide Native Americans with a sense of belonging, security, and it is a source of cultural education.
Tribal connections are significant because individuals see themselves as an extension of their tribe
status
rewards gained
adherence to tribal arrangements
Adopting a collectivistic orientation and wanting to ensure the greater good, many American Indian people judge themselves in terms of whether their behaviors are of benefit to the tribe or larger Indian country.
implications
interventions & decisions should consider importance placed on tribal relationships
urban‐based youth were more likely to identify personal, familial, and environmental strengths than were tribal‐based youth, whereas the latter identified more tribal strengths
The reservation is a place to conduct ceremonies and social events and to maintain cultural identity.
American Indians who leave the reservation to seek greater opportunities sometimes report losing their sense of personal identity
Family Structure & Relationships
For most Indigenous groups, the extended family is the basic unit.
Children are often partially raised by relatives, such as aunts, uncles, and grandparents, who live in separate households
Close friends become part of the extended family network in which youth can draw on for support and guidance
Grandparents and elders in the community play significant roles in socializing youth, assisting families, imparting wisdom, and ensuring cultural traditions are passed on
implications
The concept of the extended family is often misunderstood by people of European descent who often operate under the concept of the nuclear family
In work with children, counselors should determine the roles of various family members, so that interventions can include appropriate individuals
If the goals or techniques of therapy lead to discord within the family or tribal community, they will not be effective
Interventions may need to include the input of family, relatives, friends, elders, or tribal leaders.
Cultural & Spiritual Values
sharing
honor & respect gained by sharing & giving
Once enough money is earned, youth and adults may stop working and spend time and energy in ceremonial activities'
accumulation of wealth is not a high priority but is a means to enjoy the present.
Interventions targeting alcohol or drug use should take into consideration the emphasis on sharing
cooperation
Having a harmonious relationship is important and the tribe and the family take precedence over the individual
Children are often sensitive to the opinions and attitudes of their peers and may actively avoid disagreements or contradictions
Most do not like to be singled out and made to perform in school unless the whole group benefits.
Instead of going to work or school, children or adults may prioritize assisting a family member needing help
Children may be seen as unmotivated in school because of their reluctance to compete with peers.
noninterference
It is important not to interfere with others and to observe rather than react impulsively - extends to parenting style
AI/AN are more tolerant and less punitive than parents from other ethnic groups
One culturally sensitive parent education program developed for this population included
(a) use of the oral tradition of storytelling to teach lessons to children
(b) an understanding of the spiritual nature of child rearing and the spiritual value of children
(c) use of the extended family in child rearing
included social time for parents and children before each session, including storytelling and a potluck meal. The program applied traditional teaching methods, such as nurturing, use of nature to teach lessons, and use of harmony as a guiding principle for family life
spirituality
The spirit, mind, and body are all interconnected. Illness involves disharmony between these elements
Traditional curative approaches attempt to restore spirit–mind–body harmony
sweat lodge
vision quest
Counselors can help clients identify factors involved in disharmony, determine curative events, behaviors, and feelings, and use client‐generated solutions to create balance
Specific Challenges
Educational Concerns
Educational gaps between AI/AN youth and White youth persist
by the fourth grade, a pattern of academic decline, disengagement, and truancy develops; a significant drop in achievement motivation often occurs in middle school.
traditional cultural values and beliefs are incompatible with those of the educational system, there is increasing support for the view that perceived barriers to mobility are the culprit behind reduced academic performance.
structural issues within the school, including limited resources, a lack of teacher preparation or cultural sensitivity, and racial discrimination, are in fact pushing AI/AN youth out of traditional school settings
implications
many youths who leave school report feeling “pushed out” and express mistrust of teachers, who represent the same White community that has historically exerted control over the economic, social, and religious lives of American Indians
At a systems level, positive changes could occur if public schools and institutions of higher education were to
(a) recognize the sociocultural history of AI/AN and acknowledge their perceptions of schools as a potentially hostile environment
(b) increase efforts to accommodate some of the social and cultural differences of the students, including by adapting curricula to reflect their cultural background
Some tribes have given up on the public school system and have developed their own learning centers and community colleges.
Acculturation Conflicts
may experience conflict over exposure to two very different cultures, a factor that may result in failure to develop a positive self‐image or strong ethnic identity
Many youth are caught between the expectations of their parents that they will maintain traditional values and the pressures to adapt to White middle class culture to advance in their careers
five levels of cultural orientation
Traditional. The individual may speak little English and practice traditional tribal customs and methods of worship.
Marginal. The individual may be bilingual but has lost touch with his or her cultural heritage, yet is not fully accepted in the mainstream society.
Bicultural. The individual is conversant with both sets of values and can communicate in a variety of contexts.
Assimilated. The individual embraces only the mainstream culture's values, behaviors, and expectations.
Pantraditional. The individual has been exposed to and adopted mainstream values but is making a conscious effort to return to the “old ways.”
implications
Counselors need to discuss the client's tribal affiliation (if any), languages spoken, self‐identity, and residential background, and find out whether there is a current relationship to a tribe or tribal culture
Individuals with a traditional orientation may be unfamiliar with expectations of the dominant culture and may want to develop the skills and resources to deal with mainstream society.
American Indian people who hold on to more assimilated or “marginal” viewpoints may want to examine self‐identity conflicts and may face issues such as
(a) lack of pride in or denial of their heritage
(b) pressure to adopt White middle class cultural values
(c) guilt over not knowing or participating in the cultural customs or events
(d) negative views regarding their group
(e) a lack of an extended support or belief system
AI/AN individuals with high levels of acculturated and bicultural beliefs have found success with all components of cognitive behavioral therapy (CBT)
whereas those who are traditionally oriented are responsive to the short‐term focus, activity schedule, and homework assignments in CBT but have difficulty with the underlying theoretical assumptions regarding the association between thoughts and emotional symptoms
Alcohol & Substance Abuse
Although rates of alcohol use vary across tribes and regions, anywhere from 22% to about 30% AI/NA adults report binge drinking in the past month
some youth are exposed to the effects of alcohol use and abuse early in life
Although drinking alcoholic beverages may initially have been incorporated into cultural practices as an activity of sharing, giving, and togetherness, heavy alcohol use is associated with other factors, such as feelings of historical loss in terms of language, land, and traditions
living in extreme poverty with little access to jobs with a living wage can lead some to turn to alcohol or other substances to dull the pain
implications - Successful drug treatment programs have incorporated appropriate cultural elements.
prevention and interventions should involve not only the individual but also the community and family, including siblings, cousins, and friends
addressing some of the pain of historical loss through revitalizing traditional culture and taking a strong community stance against alcohol abuse
Programs have the greatest chance of promoting health when they incorporate cultural strengths, evidence‐based strategies, and traditional tribal practices such as talking circles and ceremonies
Domestic Violence
statistics indicate that AI/AN women experience domestic violence and physical assault at much higher rates than women of other ethnicities
Native women often experience sexual and physical abuse early in life; abuse is especially high among lesbian and bisexual women
may result from changes in traditional gender roles because of colonialization as well as substance abuse and stressors associated with social and economic marginalization.
implications
Native American women who are abused may remain silent because of cultural barriers, a high level of distrust of White‐dominated agencies, fear of familial alienation, and the historical failure of state and tribal agencies to protect women from domestic crimes
Jurisdictional struggles between state and tribal authorities can also result in a lack of help for women
When working with a domestic‐violence issue with a Native American woman, tribal issues, tribal programs, and family support options should be identified.
Suicide
Suicide rates have reached epidemic proportions among AI/AN
The high incidence of suicide is associated with alcohol abuse, poverty, boredom, family stress, and historical loss or disconnection from one's culture and community
Feeling a sense of belonging and cultural connection, having a commitment to tribal spirituality, and tribal community control over resources help protect AI/AN people from taking their own lives
implications
For those who live on a reservation or identify with a tribe, community activities sometimes focus on reducing suicidal ideation and promoting resilience in youth
some AI/AN people believe that mental health issues are a result of unbalanced spiritual relationships
In traditional belief systems, there is not only a seen world but also an unseen world. Events that disrupt the unseen world disturb the harmony in the seen world. Therefore, if intervention focuses only on the seen world, change will likely not occur
effective program
included role‐playing, building self‐esteem, identifying emotions and stressors, recognizing and eliminating negative thoughts or emotions, receiving information on suicide and intervention strategies, and setting personal and community goals
effective in reducing feelings of hopelessness and suicidal probability ratings