Integrating Native American Indigenous Healing Practices in the Eurocentric Behavioral Health Care System of New Mexico

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Integrating Native American Indigenous Healing
Practices in the Eurocentric Behavioral Health
Care System of New Mexico 

• Jay Azua
• Nanizhoozhi Center, Inc.
• www.wellbriety-nci.org

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Objectives

• Know the components of traditional (indigenous)
  healing knowledge and practice.
• Introduce techniques for integrating indigenous
  and eurocentric approaches.
• Understand the practical task of identifying best
  practices

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Can Eurocentric evidence-based practices and
indigenous healing practices be used together?

• Why?
• Can they?

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Why?

• Eurocentric research continually validates that
  culturally appropriate interventions result in
  poor outcomes.
• New Mexicos indigenous population is
  significant.
• Research emphasizes cultural competency and
  appropriateness.
• Behavioral health problems are not being
  significantly impacted by Eurocentric practices.

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Can integration happen?

• Yes.
• Understanding the strengths of two worldviews.
• Indigenous interventions are based on historical
  and empirical knowledge for specific populations.
• Some Eurocentric interventions are similar to
  indigenous worlviews.

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Native American Barriers

• Colonization and forced migration of tribes
• Internment of tribes after conquest
• Repression of indigenous practices, beliefs,
  language, and identity

Paternalism by governmental institutions,religious
organizations, and reorganization of established
governance.
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Deconstructing Colonization

• Tradition is Enemy of Progress

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• Substance abuse or misuse is not condoned within
  the indigenous value system.
• The norm is for respect yourself by not using
  substances that are not indigenous or acceptable
  to the tribe (Doo dilzin da abuse of the natural
  world).

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Euro-centric Treatment

• Disease Model-based
• AA Philosophy driven
• 12 Step design
• Confrontational styles
• Morals driven
• Individual focused
• Recovery oriented
• Relapses considered bad
• Indigenous approaches never considered valid.

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Dissimilar Helping Paradigms

• Eurocentric Paradigms (boxing)
• Treatment
• Chronic condition
• Individual orientation
• Physical symptoms
• Indigenous Paradigms (circular)
• Healing
• Non-chronic condition
• Social orientation
• Behavioral problems

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Motivational Interviewing Native American Model

• Historical trauma
• Dependency
• Violent behavior
• Domestic violence -Homicide
• High mortality rates
• High rates of substance abuse
• Alcohol -Drugs
• Tobacco -Food

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Prochaskas Stages of Change

• Prayer and blessings motivate.
• Spiritual practices focus upon the development of
  resilient persons, particularly in environments
  of poverty.
• Healing, not treatment, is the primary aim of
  indigenous interventions.
• Stages of Change Model has application

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Indigenous Healing Models
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Stages of Change

• Non-verbal and verbal cues

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Ke

• Each individual has a relationship with
• another
• person,
• place,
• the
• world

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Kinship Many tribes, particularly in the
southwest, have strong clan or family systems
that enhance community resiliency and personal
worth.
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Stages of Change

• Listening

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Listening

• Listen, before talking.
• Think, before, talking.

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Reverence
Responsibility is each persons to respect and in
honor of self and relationships.
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Belonging

• Premise all persons belong and have purpose.
• Cognitive-behavioral therapies provide good
  framework for motivated clients.

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Medicine Wheel
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Stages of Change

• ACTION

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Talking Circle
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Natoh

• Contemplation creates motivation for action and
  change.
• Indigenous use of herbal smoking promotes this.

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Sweat Lodge Sacred Mountains
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Stages of Change

• Being resilient

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Asking
Sacred Practices
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spirituality

• Indigenous Understanding of Balance
• ach'ah sodizin protective blessing
• Hozho ji celebratory blessing

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Service Definitions

• Based on context of treatment.
• Group
• Individual
• Family
• Residential
• Based on activities
• Case management
• Medication management
• evaluation

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Indigenous Services
Smudging -individual -group -family Herbal
medicine -individual -group -family

• Sweatlodge
• Group
• Individual
• family
• Talking Circle
• Group
• family
• Tobacco
• Individual
• Family
• group

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Credentialing

• Dine Medicineman Association is the formal
  indigenous practitioner organization that is
  accepted by Navajo government and incorporated
  within the Eurocentric incorporation system.
• Apache are there formal indigenous practitioner
  organizations?
• Pueblos are there Pueblo-specific formal
  indigenous practitioner organizations?

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What Matters
Talking Circle

• Increasing American Indian identity
• Decreasing structural poverty
• Doing so will decrease the probability of alcohol
  symptoms and drug use.

AMERICAN INDIAN SERVICES UTILIZATION, PSYCHIATRIC
EPIDEMIOLOGY, RISK AND PROTECTIVE FACTORS PROJECT
(AI-SUPERPFP) , University of Colorado at Denver
and Health Services Center
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Eurocentric Best Practices

• Stages of change
• Cognitive behavioral therapy
• Motivational interviewing
• Motivational enhancement therapy
• Contingency management
• Community reinforcement

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Indigenous Best Practices

• Sweatlodge
• Talking Circles
• Tobacco ceremony
• Herbal medicine
• Smudging
• Blessings

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Similarities

• Indigenous teachings emphasize
• alertness
• listening
• Attending
• Responsible behavior
• Relationships
• Cognitive-behavioral approaches are similar

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Recommendations

• Include indigenous healers.
• Integrate indigenous healers.
• Trust indigenous healer competency.
• Understand the levels of competency within the
  healing community.
• Rely on indigenous healer leadership.
• Let go of bias and prejudices
• Be culturally competent