Introduction
From the perspective of mental health treatment, Native Americans’ and other clients’ expectations and needs might differ drastically, including the need for culture-specific rituals to promote energy healing. Mainstream and minority cultures are also dissimilar in their concepts of self-disclosure, self-discipline, sources of wisdom, and the importance of family and the individual. This essay aims to review such differences and apply the concepts of acculturation and intercultural respect to the alcohol addiction case of Viki, a fifty-year-old Native American woman from the Midwest region.
Native American and European Cultures: Ideas/Behaviors Affecting Mental Health Treatment
Mental health restoration can be associated with departures from negative and disruptive thoughts and “cleansing the soul,” and the latter has culture-specific manifestations. In European Christian cultures, with their reliance on verbal confession, talk therapy aimed at verbalizing issues and searching for solutions might be enough. In Native American cultures, the purification of thoughts can also involve ritualistic behaviors (Substance Abuse and Mental Health Services Administration [SAMHSA], 2019). In particular, starting therapeutic conversations with traditional Native American clients by providing materials for smudging rituals could support patients in setting their minds for profound and change-inducing discussions (SAMHSA, 2019). Additionally, Native American and mainstream American cultures vary in terms of the ideas of acceptable self-expression, with the former valuing self-discipline and humility over uninterrupted self-disclosure and egocentric calls for attention (Garrett & Pichette, 2000). This characteristic might have implications for clients’ readiness to collaborate and verbalize the details of their concerns.
Attitudes to individual versus family needs and the recognition of expert opinions represent other crucial differences that might interfere with behavioral treatments. Being more collectivistic, Native Americans place groups’ needs over individuals’ ones and manifest an increased reliance on the extended family as the source of support and valuable knowledge (Garrett & Pichette, 2000). In contrast, clients of European descent tend to emphasize personal goals and respect subject matter expertise in decision-making (Garrett & Pichette, 2000). Therefore, incorporating the opinions and perspectives of the client’s older relatives might be more important when dealing with Native American individuals since they associate their personal health with the family’s concerns. With mainstream Americans, making treatment, including oral communication, focused on individual-level concerns and aligned with the universally recognized evidence-based treatment modalities might be easier. Nevertheless, relevant skills and cultural competence can enable a provider to explain the rationales for treatment to minority clients in relevant terms.
The Case of Vicki and its Impacts of Acculturation
Vicki, a fifty-year-old Native American woman from the Midwest region, has been referred to a rural residential health center for the treatment of alcohol addictions. Vicki takes care of her drug-dependent sister’s children and has a history of relationships with abusive partners and charges of drunk driving. The process of acculturation and assimilating to the culture of her mother’s tribe is challenging for Vicki (SAMHSA, 2019). Being formally enrolled in her father’s tribe, she currently lives on her maternal line’s reservation. It creates a series of disadvantages, including her inability to participate in tribal council elections, being perceived as an outsider, and the feeling that new neighbors might be prejudiced towards her (SAMHSA, 2019). Despite being able to establish positive relationships, Vicki still feels different from the rest of the tribe. This issue’s psychological impacts could be all-encompassing, including the reduced willingness to share her fears and challenges with others.
Showing Respect for Vicki’s Culture to Improve Patient Outcomes and Relationships
Behavioral health professionals can approach collaboration with Vicki and remain respectful by offering some space and time for rituals that she finds conducive to an open conversation. Specifically, having basic equipment for the smudging ceremony and providing Vicki with an opportunity to perform the ritual in a way that would be correct for her culture is essential (SAMHSA, 2019). This approach can be useful to build the foundation for trust-based relationships while also demonstrating a lack of religious prejudice or attempts to convert Vicki’s mindset to physicalism.
Another strategy to pursue to show respect for the client’s culture is practicing authenticity and respectful inquiries to address the provider’s knowledge gaps pertaining to culture. In Vicki’s case, staying authentic requires behavioral health providers to respect their own heritage and avoid fake cultural identities to earn the client’s trust. Next, even a profound knowledge of the culture of Vicki’s tribe should not give rise to unnecessary generalizations and unchecked assumptions (SAMHSA, 2019). Therefore, asking polite questions is more respectful rather than pretending that no explanations are necessary.
Finally, various communicative techniques, including the adoption of the client’s metaphorical speech, would enable providers to foster better treatment outcomes and consider the client’s heritage and its implications for abstract thinking. Native Americans’ oral traditions can find use in Vicki’s metaphoric language inspired by natural phenomena (SAMHSA, 2019). Asking follow-up questions based on these specific metaphors rather than translating them into the mainstream culture’s worldview or imposing alternative metaphors on the client is essential in Vicki’s case (SAMHSA, 2019). With this approach to communication, providers can demonstrate the acceptance of Vicki’s tendency to personify various phenomena, thus making her more relaxed and ready for an open discussion of solutions for her addiction.
Conclusion
To sum up, the considerations of culture-based perspectives of health are essential in mental health services and counseling. Clients representing the mainstream culture and American Indians might rely on different criteria for assessing information’s credibility. As Vicki’s clinical case demonstrates, non-native behavioral health professionals should demonstrate their cultural competence in various ways, including respecting the value of metaphoric speech and mood stabilization by means of rituals.
References
Garrett, M. T., & Pichette, E. F. (2000). Red as an apple: Native American acculturation and counseling with or without reservation. Journal of Counseling & Development, 78(1), 3-13. Web.
Substance Abuse and Mental Health Services Administration. (2019). Behavioral health services for American Indians and Alaska Natives: For behavioral health service providers, administrators, and supervisors. Treatment improvement protocol (TIP 61). SAMHSA.