1. CHAPTER 15 COUNSELING AMERICAN INDIANS AND ALASKA NATIVES

2. Statistics on American Indians/Alaskan Natives
This group is comprised of a very heterogeneous group of 565 distinct tribes.
This population was 2.9 million in 2010—0.9% of total U.S. population.
About 1.8 million report having Indian roots.
About 34% of American Indians live on reservations and 57% live in metropolitan areas.
They have fewer high school graduates compared to the general population (71% vs. 80%).

3. Statistics on American Indians/Alaskan Natives
The poverty rate is double the U.S. average.
Alcoholism mortality rate is 6 times higher than the national average.
Obesity and diabetes rates are much higher, and injury-related deaths are more frequent.
An individual must have a blood quantum of at least 25% to be considered Indian.

4. American Indians
American Indians have suffered greatly as a result of:
colonization,
disease, and
land distribution.

5. Cultural Loss
Culture and language were systematically stripped from over 125,000 tribes.
Stripping American Indians of their culture has led to high rates of alcoholism.

6. The American Indian and the Alaska Native
This is a very heterogeneous group.
Some families are matriarchal and some are patriarchal in orientation.

7. Tribal Social Structure
Indians see themselves as an extension of their tribe.
Tribe and reservation provide American Indians with a sense of belonging and security, forming an interdependent system.
Status and rewards are obtained by adherence to tribal structure.
The reservation itself is very important for many American Indians, even among those who do not reside there.
Indians who leave the reservation to seek greater opportunities often lose their sense of personal identity, since they lose their tribal identity.

8. Cultural Values for American Indians/Alaska Natives
Sharing
Noninterference
Time Orientation
Spirituality
Nonverbal Communication
Sharing. Among Indians, honor and respect are gained by sharing and giving, while in the dominant culture, status is gained by the accumulation of material goods
Cooperation. Indians believe that the tribe and family take precedence over the individual
Noninterference. Indians are taught not to interfere with others and to observe rather than react impulsively. Rights of others are respected. This value influences parenting style
Time orientation. Indians are very much involved in the present rather than the future. Ideas of punctuality or planning for the future may be unimportant
Spirituality. The spirit, mind, and body are all interconnected
Nonverbal communication. Learning occurs by listening rather than talking. Direct eye contact with an elder is seen as a sign of disrespect

9. Acculturation
Traditional. The individual may speak little English, thinks in the native language, and practices traditional tribal customs and methods of worship.
Marginal. The individual may speak both languages but has lost touch with his or her cultural heritage and is not fully accepted in mainstream society.
Bicultural. The person is conversant with both sets of values and can communicate in a variety of contexts.
Traditional. The individual may speak little English, thinks in the native language, and practices traditional tribal customs and methods of worship.
Marginal. The individual may speak both languages but has lost touch with his or her cultural heritage and is not fully accepted in mainstream society.
Bicultural. The person 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. Although the individual has only been exposed to or adopted mainstream values, he or she has made a conscious effort to return to the “old ways.”

10. Acculturation
Assimilated. The individual embraces only the mainstream culture’s values, behaviors, and expectations.
Pantraditional. Although the individual has been exposed to or adopted mainstream values, he or she has made a conscious effort to return to the “old ways.”
Traditional. The individual may speak little English, thinks in the native language, and practices traditional tribal customs and methods of worship.
Marginal. The individual may speak both languages but has lost touch with his or her cultural heritage and is not fully accepted in mainstream society.
Bicultural. The person 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. Although the individual has only been exposed to or adopted mainstream values, he or she has made a conscious effort to return to the “old ways.”

11. Alcohol and Substance Abuse
Substance abuse is one of the greatest problems faced by American Indians.
It is common to begin drinking alcohol at an early age.
In Alaska, 32% of American Indians/Alaska Natives of childbearing age reported heavy drinking.
Heavy alcohol consumption is associated with low self-efficacy and feelings of powerlessness.
Substance use is related to low self-esteem, cultural identity conflicts, lack of positive role models, childhood maltreatment, social pressures, hopelessness, and a breakdown in the family.

12. Domestic Violence
American Indian women suffer a higher rate of violence (3.5 times) than the national average.
Many do not report assaults.
Violence may be a result of the loss of traditional status and roles for men and women.

13. Suicide
Indian youth have twice the rate of attempted and completed suicide as other youth.
Adolescence to adulthood is the time of greatest suicide risk, especially for males.

14. Implications for Clinical Practice
Before working with American Indians, explore ethnic differences and values.
Determine the cultural identity of the client and family members and their association with a tribe or a reservation.
Understand the history of oppression, and be aware of or inquire about local issues associated with the tribe or reservation for traditionally oriented American Indians.
Evaluate using a client-centered listening style initially and determine when to use more structure and questions.
Assess the problem from the perspective of the individual, family, extended family, and, if appropriate, the tribal community.

15. Implications for Clinical Practice
If necessary, address basic needs first, such as problems involving food, shelter, child care, and employment; identify possible resources such as Indian Health Services or tribal programs.
Be careful not to overgeneralize, but evaluate for problems such as domestic violence, substance abuse, depression, and suicidality during assessment and determine the appropriateness of a mind-body-spirit emphasis.
Identify possible environmental contributors to problems such as racism, discrimination, poverty, and acculturation conflicts.
Help children and adolescents determine whether cultural values and/or an unreceptive environment contribute to their problem.

16. Implications for Clinical Practice
Help determine concrete goals that incorporate cultural, family, extended family, and community perspectives.
Determine whether child-rearing practices are consistent with traditional Indian methods and how they may conflict with mainstream methods.
In family interventions, identify extended family members, determine their roles, and request their assistance.
Generate possible solutions with the clients and consider their consequences from the individual, family, and community perspectives. Include strategies that may involve cultural elements and that focus on holistic factors (mind, body, spirit).