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8/2/2019 Treatment Tips for Working With Native American Clients Understanding Culture
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Treatment Tips for Working with Native
American Clients
Understanding Traditional Views on Health
BY Kim Scott, M.A., M.F.T.
Managing Partner
Practical CE Seminars
In Consultation With Ben Hale, of Navajo Descent
Before treating Native American clients, it is important to become culturally aware by
understanding their traditional views on health. For example, the Native American does not tend
to see his or her health from a linear perspective, but instead tends to view their individual health
as being a symbol that their life or actions are in harmony with nature (Thomason, 322). This
might mean that they are living by the rules, traditions and values of their tribe. Living in
harmony with nature might also mean that they are respecting the earth and all living creatures or
avoiding taboos of their tribe.
This also reflects the Native American perspective regarding the relative insignificance of the
individual in comparison to that of nature, spirit, the tribe, or the family. Considering the
importance of the family and tribe, it is no surprise that an individuals problems are not resolved
in isolation. Their relationship with nature, the family, tribe and community is taken into
consideration as an integral part of an individuals struggle. This leads to the family, communityor entire tribe being involved in the resolution of the individuals problem.
The relative insignificance of the individual in Native cultures also make Western based
therapies, which are client-centered, uncomfortable and incongruous for the indigenous client.
Therefore, using a more directive approach, or family therapy, or even guided imagery or
hypnosis may be more effective. As Duran states, . . . The centered-therapist paradigm is one
that has been proven useful in the shamanic tradition for thousands of years and should be
acknowledged as useful by modern therapists (65). It becomes even more important when
using a therapist-centered approach that the therapist be conscious of his or her worldview and
prejudices in order to avoid inflicting them on the client.
At the beginning of therapy with a Native American client, it is important that the therapist
determine the clients degree of acculturation. Acculturation is defined as assimilating anothers
Clients Level of Acculturation
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culture into ones own culture and identity. Usually, the minority culture assimilates the
dominant culture.
Individuals with different levels of acculturation face different emotional issues and require
different treatment approaches. For instance, an individual who has lived his or her entire life on
a reservation would have very different issues than the individual who was born and raised in the
suburbs of a large city. Acculturation also plays an important part in the individuals sense of
identity. Often the individual, who seems most removed from his or her heritage, may need the
most assistance and prompting to re-explore and re-integrate Native beliefs back into his or her
identity.
Understanding the extent of an individuals acculturation will help the therapist determine, which
treatment approaches may be most helpful. Assessing an individuals degree of acculturation
will also help the therapist determine when and how to weave traditional Native treatment
modalities into psychotherapy.
In Mental Health Care for Urban Indians Tawa M. Witko (12) describes the five categories of
Indianness outlined by La Fromboise, Trimble, & Mohatt. These categories are:
I. TraditionalThe traditional individual has had very little interaction with the worldoutside of his or her tribe. This person shows very little, if any, signs of
acculturation.
II. TransitionalThe transitional person has been exposed to Western culture, but doesnot fully accept the dominant cultures practices and beliefs. Although, thetransitional person continues to practice the traditions of his or her tribe, he or she is
not fully immersed in these beliefs and traditions.
III. MarginalThe marginal individual does not practice the traditions or live by thevalues of his tribe, but he is also not comfortable with the practices and beliefs of
Western society either. The marginal individual does not feel that he or she fits-in,
in either culture.
IV. AssimilatedThe assimilated person has fully embraced the Western culture anddoes not practice any of his or her tribes traditions or values. The assimilated
individual may even deny his or her Native American heritage. This can lead to
identity issues.
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V. BiculturalThe bicultural individual both accepts his Native American heritage andthe Western culture. The person who is assimilated at a bicultural level is the most
functional because this person can move between both worlds and can accept both
parts of himself. This person can also seek help and strength from both cultures.
It is also important at the beginning of therapy, to assess the impact colonization had on the
individuals tribe and family. This can also be a factor contributing to the individuals presenting
problem. Often, individuals do not realize that sociological and political issues can be
contributing to their psychological problems. It is important to help the individual explore how
the historic genocide of Native Americans has impacted his or her family and emotional
development. This framing helps the individual look at his or her problem from a broader
perspective. It also helps normalize the issues and can reduce the pathological stigma and shame
associated with the diagnosis.
Some Native Americans are so thoroughly acculturated that they have virtually no connection totheir heritage. Simply working with them on re-connecting to their culture and spirituality can
be the most important goal of therapy. This reconnecting with ones culture plays an important
part in helping the individual understand their life and challenges. It also helps the individual
improve their self-esteem, develop their sense of identity, and let go of any internalization of
oppression experienced by their ancestors (Duran & Duran, 1995, 89-91).
The therapist must be able to see beyond his or her preconceptions about the Native American
client, and allow the therapeutic relationship to unfold.
If you have enjoyed this article and would like to learn more about working with NativeAmerican Clients, we have a 6 CE Credit call entitled:Reawaken Native Roots
To receive 20% off one of our online courses use discount code: S8RK
Work Cited
Brendel, Johnson. Counseling Multicultural and Diverse Populations: Strategies for Practitioners.
Ed. Nicholas A. Vacc and Susan Beck DeVaney. 4th ed. New York: Brunner-Routledge,
2003.
Duran, Eduardo. Healing the Soul Wound. New York: Teachers College P, 2006.
Duran, Eduardo and Bonnie Duran. Native American Postcolonial Psychology. New York:
State University of New York Press, Albany, 1995.
http://www.practicalceseminars.com/OnlineCEClasses4.html#ReawakenNativeRootshttp://www.practicalceseminars.com/OnlineCEClasses4.html#ReawakenNativeRootshttp://www.practicalceseminars.com/OnlineCEClasses4.html#ReawakenNativeRootshttp://www.practicalceseminars.com/OnlineCEClasses4.html#ReawakenNativeRoots8/2/2019 Treatment Tips for Working With Native American Clients Understanding Culture
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Garrett, J. T., and Michael Tlanusta Garrett.Medicine of the Cherokee: the Way of Right
Relationship. Santa Fe, NM: Bear & Pub., 1996. Print.
Mehl-Madrona, Ph.D., M.D. Narrative Medicine: The Use of History and Story in the Healing
Process. Vermont: Bear & Company, 2007.
Thomason, Timothy C. "Commonalities Between Ericksonian Psychotherapy and Native
American Healing."Journal of Mental Health Health Counseling 31.4 (2009): 351-62.
EBSCO. Web. 10 Feb. 2010.
Thomason, Timothy C. "Counseling Native Americans: An Introduction for Non-Native
American Counselors."Journal of Counseling & Development69.March/April (1991):
321-27.EBSCO. Web. 11 Feb. 2010.
Witko, Tawa M. Mental Health Care for Urban Indians: Clinical Insights from Native
Practitioners. Washington: American Psychological Association, 2006.