While it is well known that multicultural issues have garnered recent prevalence in the field of counseling, the concerns faced by Native Americans continue to be under researched (Garrett & Pinchette, 2000). Although there are now several multicultural competency measures that are continuously undergoing validation research (see review by Constantine & Ladany, 2001; Ponterotto, Reiger, Barrett, & Sparks, 1994;) these instruments fail to consider specific counseling competencies when providing psychological services to Native American clients, their families, and communities. The purpose of this study was to identify the multicultural competencies a mental health professional should possess when working with Native American clients. These competencies were identified via the Delphi technique and qualitative methods were utilized to analyze the data. A panel of three expert checkers was used to reduce researcher bias when summarizing and interpreting each Delphi Round. Nominations for a panel of experts were solicited from the APA Monitor, counseling and psychology list serves (both national and local), anthropology list serves, personal contacts, and via nominations, self or other. Invitation letters were sent to those who expressed interest in the project and a final panel of thirteen experts agreed to participate in the project. Over the course of two years, only one panelist dropped out of the project. Three Delphi Rounds were completed and the results yielded numerous areas for consideration when assessing a mental health professional's competency when working with Native American clients. These included an understanding of heterogeneity amongst and between Native Americans, understanding historical and socio-political factors that influence the counseling process, and a demonstration of core counseling competencies necessary for any successful therapeutic course of treatment. The panel's consensus was that construction of a scale measuring counseling competencies with Native American clients was not feasible. Instead, several areas for further investigation were offered as well as more qualitative forms of investigation in the area of assessing counseling competencies when helping Native American clients. Theoretical, empirical, and applied implications are offered in an effort to further define the meaning of cultural competencies when assisting Native American mental health clients. / Department of Counseling Psychology and Guidance Services

The purpose of this participatory research was to gain the perspective from the youth of a plains tribe Native American community about their concept of mental health and wellness, and to discover how youth participants related these ideas and narratives to their life processes and experiences. This study also investigated the methodological use of participatory photo-elicitation for talking about mental health and using grounded research theory to explore what types of themes and testimony are most common. This participatory research was done in partnership with an American Indian-operated health promotion and disease prevention program that is tackling inequity in mental health youth outcomes. Forty-one children ages 9 to 17 participated in this qualitative study. Semi-structured one-one-one interviews using the participatory photo-elicitation method generated conversation and formed the basis of the raw data. Grounded theory was employed in both data collection and analysis. A “zig-zag” pattern of data collection defined basic subgroups of children by age, allowing for a saturation of themes. The five major themes that emerged were: strategies for mental health, ecology and mental health, identity and mental health, social support/loss of social support and mental health, and, ambivalent feelings/thoughts about mental health. Categories within themes held across the three age groups and overlapping themes held theoretical importance. Photo-creation followed by photo-elicitation resulted in a rich relay of diverse testimony including literal translation, metaphor, analogy, shadowed data, and personally recounted lived experiences, often shared via expository dialogue. The saturation of themes showed fidelity to developmental groupings. Identity, particularly Native identity overlapped with themes of strategy and ecology. This study heightens awareness that most older children in this sample identified loss of a loved one as part of their lived experience of mental health. A majority of children spoke of mental health and wellness strategies that included finding balance, healing, seeking social support and inhabiting at least one positive ecology. Finally, many children related their concept of mental health to their natural surroundings and the sky. Some children used visual and verbal metaphors such as the medicine wheel, a Native quilt, the undulation of a landscape, and the tipi to help describe their concept of mental health and wellness.

This study explores the facilitation of healing for First Nations people living in the province of British Columbia. The purpose of the study is to develop a reasonably comprehensive scheme of categories that will describe, from the perspective of First Nations people, what facilitates healing. The research method involved interviews with 50 adult First Nations volunteers who were long-term residents of British Columbia and also in a position to observe what facilitated their own healing for them . The Critical Incident Technique (Flanagan, 1954) was utilized to elicit 437 incidents from 50 participants. Fourteen categories emerged from an analysis of the incidents reported. Several procedures were used to examine the soundness and trustworthiness of the categories. The results indicate that healing can be facilitated in the following ways: participation in ceremony, expression of emotion, learning from a role model, establishing a connection with nature, exercise, involvement in challenging activities, establishing a social connection, gaining an understanding of the problem, establishing spiritual connection, obtaining help/support from others, self care, setting goals, anchoring self in tradition, and in helping others. A preliminary examination of the healing outcomes of these facilitating events suggests that an effective healing program for First Nations people would invoke empowerment, cleansing, balance, discipline, and belonging. Narrative accounts were analyzed for the purpose of revealing an organization for the categories. Four divisions of categories emerged as a result of this analysis: separating from an unhealthy life, obtaining social support and resources, experiencing a healthy life and living a healthy life. Further analysis of the narratives revealed five overall themes which serve to enhance the categories and outcomes presented in this research. Those themes entail: A broad spectrum of healing resources are available to First Nations people, First Nations people have a different way of seeing the world which has to be understood before effective counselling services can be provided, First Nations people expect that whatever is healing should help them to attain and/or maintain balance, self transcendence followed by connectedness is a common route to healing for First Nations people, and First Nations people are seen to act as agents of their own healing. The findings of this study contribute to the field of counselling psychology by providing a reasonably comprehensive scheme of categories and themes that describe, from the perspective of First Nations people, what facilitates healing. This study suggests promising developments in First Nations healing that have implications for both research and practice.

This study explores the facilitation of healing for First Nations people living in the province of British Columbia. The purpose of the study is to develop a reasonably comprehensive scheme of categories that will describe, from the perspective of First Nations people, what facilitates healing. The research method involved interviews with 50 adult First Nations volunteers who were long-term residents of British Columbia and also in a position to observe what facilitated their own healing for them . The Critical Incident Technique (Flanagan, 1954) was utilized to elicit 437 incidents from 50 participants. Fourteen categories emerged from an analysis of the incidents reported. Several procedures were used to examine the soundness and trustworthiness of the categories. The results indicate that healing can be facilitated in the following ways: participation in ceremony, expression of emotion, learning from a role model, establishing a connection with nature, exercise, involvement in challenging activities, establishing a social connection, gaining an understanding of the problem, establishing spiritual connection, obtaining help/support from others, self care, setting goals, anchoring self in tradition, and in helping others. A preliminary examination of the healing outcomes of these facilitating events suggests that an effective healing program for First Nations people would invoke empowerment, cleansing, balance, discipline, and belonging. Narrative accounts were analyzed for the purpose of revealing an organization for the categories. Four divisions of categories emerged as a result of this analysis: separating from an unhealthy life, obtaining social support and resources, experiencing a healthy life and living a healthy life. Further analysis of the narratives revealed five overall themes which serve to enhance the categories and outcomes presented in this research. Those themes entail: A broad spectrum of healing resources are available to First Nations people, First Nations people have a different way of seeing the world which has to be understood before effective counselling services can be provided, First Nations people expect that whatever is healing should help them to attain and/or maintain balance, self transcendence followed by connectedness is a common route to healing for First Nations people, and First Nations people are seen to act as agents of their own healing. The findings of this study contribute to the field of counselling psychology by providing a reasonably comprehensive scheme of categories and themes that describe, from the perspective of First Nations people, what facilitates healing. This study suggests promising developments in First Nations healing that have implications for both research and practice. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Aboriginal people in Canada experience disproportionately high rates of family violence, suicide, substance abuse, and mental health problems such as depression and posttraumatic stress disorder. However, although culturally based healing resources for aboriginal people are inadequate to meet the need, available mainstream mental health services are underutilized by aboriginal clients. Therefore, while building on previous research looking at the problems faced by mainstream services and non-aboriginal counsellors in engaging and helping aboriginal clients, this research assumed there have been successes and examined aboriginal experiences of successful engagement and healing within such contexts. The methodology for this study is a narrative based approach that meets the mandates for ethical and appropriate indigenous research as described by those of authority in the field of indigenous research, and answers the question: How do aboriginal clients develop, experience, and maintain successful healing relationships with non-aboriginal counsellors in mainstream mental health settings? Narrative analysis of interviews with seven aboriginal mental health clients who believed they had a positive counselling experience in a mainstream setting produced findings that suggest common themes of interaction and discovery mark successful counselling relationships. Generally clients described an increased sense of connection and belonging, harmony, integration of traditional aboriginal and non-aboriginal practice and beliefs, self-acceptance, understanding, and balance as critical. However the defining characteristic of a successful counselling experience was expressed as the capacity of the counselling relationship to increase each client's clarification of how aboriginality is meaningfully and uniquely understood. These findings have implications for mainstream mental health services and indigenous research in general. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

No description available.

The focus of this dissertation is the mental health experiences of Aboriginal people in Montreal as they interface with health policy, and lack thereof, for this population. / Drawing on anthropological fieldwork from Montreal, Eastern Quebec, and Ontario, this thesis endeavours to unravel the jurisdictional tapestry that Aboriginal clients must negotiate when seeking services in Montreal. Using an ethnographic methodology, this project provides an understanding of the ordering of health services for Aboriginal clients from street-level to policy offices. / This thesis draws on three theoretical areas (theories of illness, aboriginality, and public policy) to explicate four themes that emerge from the data. Analysis moves along a continuum between the illness experience and the macro-social determinants of politics and bureaucracy that impact the health of the individual as well as support and organize systems of care. / Discussion of Theme #1 (evolution of mental health and wellness categories in health theory, policy and practice) and Theme #2 ( the culture concept in health policy) demonstrates that despite the progressive evolution of concepts in health theory and policy, Aboriginal people generally do not find services in Montreal that provide culturally-sensitive, holistic care. Discussion of Theme #3 (barriers to wellness created by jurisdiction) argues that jurisdictional barriers prevent clients' access to even the most basic and rudimentary services and that such barriers can actually disable and increase distress. Discussion of Theme #4 ( Aboriginal-specific services) looks at the pros and cons of creating an Aboriginal-specific health centre in Montreal. / Together, these four themes show that understanding Aboriginal people in Montreal requires contextualizing their embodied experience within the colonial history and institutional racism which characterizes many healthcare interactions, and clarifying the bureaucracy that complicates the search for well-being. Montreal's Aboriginal problematic is located in a system characterized by entrenched bureaucracy, jurisdictional complexity and injustice, these elements mapping onto Aboriginal reality with serious repercussions for individual identity and well-being. / Hearing the voices of Aboriginal people in Montreal as they seek out care for mental health problems requires the resolution of jurisdictional and policy clashes that currently silence their suffering. This thesis endeavours to advance this crucial social agenda.