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Advancing suicide prevention research with rural American Indian and Alaska Native populations.

https://arctichealth.org/en/permalink/ahliterature263749
Source
Am J Public Health. 2015 May;105(5):891-9
Publication Type
Article
Date
May-2015
Author
Lisa Wexler
Michael Chandler
Joseph P Gone
Mary Cwik
Laurence J Kirmayer
Teresa LaFromboise
Teresa Brockie
Victoria O'Keefe
John Walkup
James Allen
Source
Am J Public Health. 2015 May;105(5):891-9
Date
May-2015
Language
English
Publication Type
Article
Keywords
Alaska
Cultural Competency
Health Promotion - organization & administration
Health Services Research - organization & administration
Health Services, Indigenous
Humans
Indians, North American
Inuits
Rural Population
Suicide - ethnology - prevention & control
Abstract
As part of the National Action Alliance for Suicide Prevention's American Indian and Alaska Native (AI/AN) Task Force, a multidisciplinary group of AI/AN suicide research experts convened to outline pressing issues related to this subfield of suicidology. Suicide disproportionately affects Indigenous peoples, and remote Indigenous communities can offer vital and unique insights with relevance to other rural and marginalized groups. Outcomes from this meeting include identifying the central challenges impeding progress in this subfield and a description of promising research directions to yield practical results. These proposed directions expand the alliance's prioritized research agenda and offer pathways to advance the field of suicide research in Indigenous communities and beyond.
Notes
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Cites: Arch Suicide Res. 2006;10(2):177-9016574615
PubMed ID
25790403 View in PubMed
Less detail

American Indian and Alaska Native mental health: diverse perspectives on enduring disparities.

https://arctichealth.org/en/permalink/ahliterature129026
Source
Annu Rev Clin Psychol. 2012;8:131-60
Publication Type
Article
Date
2012
Author
Joseph P Gone
Joseph E Trimble
Author Affiliation
Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA. jgone@umich.edu
Source
Annu Rev Clin Psychol. 2012;8:131-60
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alaska
Cultural Diversity
Health services needs and demand
Health Status Disparities
Humans
Indians, North American - ethnology
Inuits - ethnology
Mental Disorders - ethnology
Mental Health - ethnology
Suicide - ethnology
United States
United States Indian Health Service
Violence - ethnology
Abstract
As descendants of the indigenous peoples of the United States, American Indians and Alaska Natives (AI/ANs) have experienced a resurgence in population and prospects since the beginning of the twentieth century. Today, tribally affiliated individuals number over two million, distributed across 565 federally recognized tribal communities and countless metropolitan and nonreservation rural areas. Although relatively little evidence is available, the existing data suggest that AI/AN adults and youth suffer a disproportionate burden of mental health problems compared with other Americans. Specifically, clear disparities have emerged for AI/AN substance abuse, posttraumatic stress, violence, and suicide. The rapid expansion of mental health services to AI/AN communities has, however, frequently preceded careful consideration of a variety of questions about critical components of such care, such as the service delivery structure itself, clinical treatment processes, and preventive and rehabilitative program evaluation. As a consequence, the mental health needs of these communities have easily outpaced and overwhelmed the federally funded agency designed to serve these populations, with the Indian Health Service remaining chronically understaffed and underfunded such that elimination of AI/AN mental health disparities is only a distant dream. Although research published during the past decade has substantially improved knowledge about AI/AN mental health problems, far fewer investigations have explored treatment efficacy and outcomes among these culturally diverse peoples. In addition to routine calls for greater clinical and research resources, however, AI/AN community members themselves are increasingly advocating for culturally alternative approaches and opportunities to address their mental health needs on their own terms.
PubMed ID
22149479 View in PubMed
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American Indian culture as substance abuse treatment: pursuing evidence for a local intervention.

https://arctichealth.org/en/permalink/ahliterature126323
Source
J Psychoactive Drugs. 2011 Oct-Dec;43(4):291-6
Publication Type
Article
Author
Joseph P Gone
Patrick E Calf Looking
Author Affiliation
Department of Psychology, University of Michigan, 2239 East Hall, 530 Church Street, Ann Arbor, MI 48109-1043, USA. jgone@umich.edu
Source
J Psychoactive Drugs. 2011 Oct-Dec;43(4):291-6
Language
English
Publication Type
Article
Keywords
Culture
Evidence-Based Practice
Humans
Indians, North American - psychology
Residential Treatment
Substance-Related Disorders - psychology - therapy
Abstract
Contemporary tribal commitments to traditional cultural reclamation and revitalization find continued expression by recent generational cohorts of American Indians who, when it comes to matters of recovery, healing, and wellness in the context of substance abuse, routinely assert that "our culture is our treatment." And yet, empirical investigations of this culture-as-treatment hypothesis--namely, that a (post)colonial return to indigenous cultural orientations and practices is sufficient for effecting abstinence and recovery from substance use disorders for many American Indians--have yet to appear in the scientific literature. Preliminary activities of a research partnership dedicated to the empirical exploration of this hypothesis for reducing Native American substance use disorders are summarized. Specifically, collaboration between a university-based research psychologist and a reservation-based substance abuse treatment program staff has thus far resulted in a detailed blueprint for a radically alternative, culturally-grounded intervention developed for reservation residents. This proposed alternative intervention--a seasonal cultural immersion camp designed to approximate the day-to-day experiences of prereservation ancestors--was designed for eventual implementation and evaluation with adult clients referred for residential treatment on the Blackfeet Indian reservation. It is anticipated that the proposed intervention will eventually afford empirical evaluation of the culture-as-treatment hypothesis.
PubMed ID
22400459 View in PubMed
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A community-based treatment for Native American historical trauma: prospects for evidence-based practice.

https://arctichealth.org/en/permalink/ahliterature149474
Source
J Consult Clin Psychol. 2009 Aug;77(4):751-62
Publication Type
Article
Date
Aug-2009
Author
Joseph P Gone
Author Affiliation
Department of Psychology, University of Michigan, Ann Arbor, MI 48109-1043, USA. jgone@umich.edu
Source
J Consult Clin Psychol. 2009 Aug;77(4):751-62
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Catharsis
Community Mental Health Services
Comorbidity
Counseling - methods
Cultural Competency
Evidence-Based Medicine
Female
Health Services, Indigenous
Humans
Indians, North American - psychology
Interview, Psychological
Male
Mental Healing
Middle Aged
Social Identification
Stress Disorders, Post-Traumatic - ethnology - psychology - rehabilitation
Substance-Related Disorders - ethnology - psychology - rehabilitation
Abstract
Nineteen staff and clients in a Native American healing lodge were interviewed regarding the therapeutic approach used to address the legacy of Native American historical trauma. On the basis of thematic content analysis of interviews, 4 components of healing discourse emerged. First, clients were understood by their counselors to carry pain, leading to adult dysfunction, including substance abuse. Second, counselors believed that such pain must be confessed in order to purge its deleterious influence. Third, the cathartic expression of such pain was said by counselors to inaugurate lifelong habits of introspection and self-improvement. Finally, this healing journey entailed a reclamation of indigenous heritage, identity, and spirituality that program staff thought would neutralize the pathogenic effects of colonization. Consideration of this healing discourse suggests that one important way for psychologists to bridge evidence-based and culturally sensitive treatment paradigms is to partner with indigenous programs in the exploration of locally determined therapeutic outcomes for existing culturally sensitive interventions that are maximally responsive to community needs and interests.
PubMed ID
19634967 View in PubMed
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Culturally responsive suicide prevention in indigenous communities: unexamined assumptions and new possibilities.

https://arctichealth.org/en/permalink/ahliterature126136
Source
Am J Public Health. 2012 May;102(5):800-6
Publication Type
Article
Date
May-2012
Author
Lisa M Wexler
Joseph P Gone
Author Affiliation
Department of Public Health, University of Massachusetts, Amherst, MA, USA. lwexler@schoolph.umass.edu
Source
Am J Public Health. 2012 May;102(5):800-6
Date
May-2012
Language
English
Publication Type
Article
Keywords
Cultural Competency
Humans
Indians, North American - psychology
Mental health services
Prejudice
Sociology, Medical
Suicide - ethnology - prevention & control - psychology
United States
Abstract
Indigenous communities have significantly higher rates of suicide than non-Native communities in North America. Prevention and intervention efforts have failed to redress this disparity. One explanation is that these efforts are culturally incongruent for Native communities. Four prevalent assumptions that underpin professional suicide prevention may conflict with local indigenous understandings about suicide. Our experiences in indigenous communities led us to question assumptions that are routinely endorsed and promoted in suicide prevention programs and interventions. By raising questions about the universal relevance of these assumptions, we hope to stimulate exchange and inquiry into the character of this devastating public health challenge and to aid the development of culturally appropriate interventions in cross-cultural contexts.
Notes
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PubMed ID
22420786 View in PubMed
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Identifying effective mental health interventions for American Indians and Alaska Natives: a review of the literature.

https://arctichealth.org/en/permalink/ahliterature160592
Source
Cultur Divers Ethnic Minor Psychol. 2007 Oct;13(4):356-63
Publication Type
Article
Date
Oct-2007
Author
Joseph P Gone
Carmela Alcántara
Author Affiliation
Department of Psychology, University of Michigan, Ann Arbor, MI 48109-1043, USA. jgone@umich.edu
Source
Cultur Divers Ethnic Minor Psychol. 2007 Oct;13(4):356-63
Date
Oct-2007
Language
English
Publication Type
Article
Keywords
Alaska - ethnology
Humans
Indians, North American - psychology - statistics & numerical data
Mental Disorders - epidemiology - therapy
Mental Health Services - organization & administration
Treatment Outcome
United States
Abstract
The pursuit of evidence-based practice (EBP) within the mental health professions has contributed to efficacious clinical intervention for individuals struggling with mental health problems. Within the context of the EBP movement, this article reviews the treatment outcome literature for mental health interventions directed specifically toward American Indians and Alaska Natives experiencing psychological distress. Fifty-six articles and chapters pertaining to the treatment of Native Americans with mental health problems were identified, though the vast majority of these did not systematically assess outcomes of specified treatments for Native American clients under scientifically controlled conditions. Of just nine studies assessing intervention outcomes, only two were controlled studies with adequate sample sizes and interpretable results relative to the identification of EBP among American Indians and Alaska Natives. The advantages and limitations of EBP for treatment of Native American mental health problems are discussed.
PubMed ID
17967104 View in PubMed
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Incorporating traditional healing into an urban American Indian health organization: a case study of community member perspectives.

https://arctichealth.org/en/permalink/ahliterature123131
Source
J Couns Psychol. 2012 Oct;59(4):542-54
Publication Type
Article
Date
Oct-2012
Author
William E Hartmann
Joseph P Gone
Author Affiliation
Department of Psychology, University of Michigan, Ann Arbor, MI 48109-1043, USA. williaha@umich.edu
Source
J Couns Psychol. 2012 Oct;59(4):542-54
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adult
Attitude to Health
Community-Based Participatory Research
Female
Focus Groups
Health Services, Indigenous
Humans
Indians, North American - psychology
Male
Medicine, Traditional
Mental Disorders - ethnology - rehabilitation
Middle Aged
Midwestern United States
Needs Assessment
Organizational Case Studies
Substance-Related Disorders - ethnology - rehabilitation
Urban Health Services
Abstract
Facing severe mental health disparities rooted in a complex history of cultural oppression, members of many urban American Indian (AI) communities are reaching out for indigenous traditional healing to augment their use of standard Western mental health services. Because detailed descriptions of approaches for making traditional healing available for urban AI communities do not exist in the literature, this community-based project convened 4 focus groups consisting of 26 members of a midwestern urban AI community to better understand traditional healing practices of interest and how they might be integrated into the mental health and substance abuse treatment services in an Urban Indian Health Organization (UIHO). Qualitative content analysis of focus group transcripts revealed that ceremonial participation, traditional education, culture keepers, and community cohesion were thought to be key components of a successful traditional healing program. Potential incorporation of these components into an urban environment, however, yielded 4 marked tensions: traditional healing protocols versus the realities of impoverished urban living, multitribal representation in traditional healing services versus relational consistency with the culture keepers who would provide them, enthusiasm for traditional healing versus uncertainty about who is trustworthy, and the integrity of traditional healing versus the appeal of alternative medicine. Although these tensions would likely arise in most urban AI clinical contexts, the way in which each is resolved will likely depend on tailored community needs, conditions, and mental health objectives.
Notes
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PubMed ID
22731113 View in PubMed
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Indigenous traditional knowledge and substance abuse treatment outcomes: the problem of efficacy evaluation.

https://arctichealth.org/en/permalink/ahliterature121177
Source
Am J Drug Alcohol Abuse. 2012 Sep;38(5):493-7
Publication Type
Article
Date
Sep-2012
Author
Joseph P Gone
Author Affiliation
Department of Psychology, University of Michigan , Ann Arbor, MI 48109-1043, USA. jgone@umich.edu
Source
Am J Drug Alcohol Abuse. 2012 Sep;38(5):493-7
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Alaska
Ceremonial Behavior
Health Knowledge, Attitudes, Practice - ethnology
Humans
Indians, North American
Medicine, Traditional - methods
Substance-Related Disorders - rehabilitation
Treatment Outcome
United States
Abstract
In the field of substance abuse treatment, American Indian and Alaska Native (AI/AN) communities have routinely incorporated ceremonial practices as one important component in the promotion of recovery and healing. The beneficial effects of such practices are frequently described as plainly apparent by community-based advocates, providers, and professionals alike. In the present era of evidence-based substance abuse intervention, however, indigenous integration of such practices raises questions pertaining to the systematic evaluation of treatment efficacy.
The focus of this article is outcome evaluation. Although intervention outcome researchers recognize the randomized controlled trial as the "gold standard" against which claims of treatment efficacy are measured, AI/AN efficacy assertions grounded in indigenous traditional knowledge (ITK) reflect different concerns that have emerged in non-Western historical contexts. The interface between scientific and indigenous "ways of knowing" is explored here relative to efficacy claims about substance abuse treatment.
Distinguishing features of both scientific knowing and ITK are summarized and compared.
ITK has been described as personal and experiential, reflecting the primacy of autonomous individual knowing. In contrast, intervention scientists are skeptical of personal inference as a basis for efficacy evaluation. The evident divergence between these epistemic paradigms can result in potentially contradictory claims.
Proper appraisal of the status and relevance of ITK for determining treatment efficacy requires further exploration of these marginalized approaches to knowledge.
Intervention scientists who work in AI/AN communities should remain open to the legitimacy and role of ITKs in investigations of substance abuse treatment.
PubMed ID
22931084 View in PubMed
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Redressing First Nations historical trauma: theorizing mechanisms for indigenous culture as mental health treatment.

https://arctichealth.org/en/permalink/ahliterature113516
Source
Transcult Psychiatry. 2013 Oct;50(5):683-706
Publication Type
Article
Date
Oct-2013
Author
Joseph P Gone
Author Affiliation
University of Michigan.
Source
Transcult Psychiatry. 2013 Oct;50(5):683-706
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Acculturation
Adult Survivors of Child Abuse - psychology
Canada
Ceremonial Behavior
Female
Humans
Indians, North American - psychology
Manitoba
Middle Aged
Schools
Spiritual Therapies - psychology
Stress Disorders, Post-Traumatic - ethnology - psychology - therapy
United States
Abstract
Indigenous "First Nations" communities have consistently associated their disproportionate rates of psychiatric distress with historical experiences of European colonization. This emphasis on the socio-psychological legacy of colonization within tribal communities has occasioned increasingly widespread consideration of what has been termed historical trauma within First Nations contexts. In contrast to personal experiences of a traumatic nature, the concept of historical trauma calls attention to the complex, collective, cumulative, and intergenerational psychosocial impacts that resulted from the depredations of past colonial subjugation. One oft-cited exemplar of this subjugation--particularly in Canada--is the Indian residential school. Such schools were overtly designed to "kill the Indian and save the man." This was institutionally achieved by sequestering First Nations children from family and community while forbidding participation in Native cultural practices in order to assimilate them into the lower strata of mainstream society. The case of a residential school "survivor" from an indigenous community treatment program on a Manitoba First Nations reserve is presented to illustrate the significance of participation in traditional cultural practices for therapeutic recovery from historical trauma. An indigenous rationale for the postulated efficacy of "culture as treatment" is explored with attention to plausible therapeutic mechanisms that might account for such recovery. To the degree that a return to indigenous tradition might benefit distressed First Nations clients, redressing the socio-psychological ravages of colonization in this manner seems a promising approach worthy of further research investigation.
Notes
Comment In: Transcult Psychiatry. 2013 Oct;50(5):744-5224142934
PubMed ID
23715822 View in PubMed
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The red road to wellness: cultural reclamation in a native first nations community treatment center.

https://arctichealth.org/en/permalink/ahliterature100128
Source
Am J Community Psychol. 2011 Mar;47(1-2):187-202
Publication Type
Article
Date
Mar-2011
Author
Joseph P Gone
Author Affiliation
Department of Psychology, University of Michigan, 2239 East Hall, 530 Church Street, Ann Arbor, MI, 48109-1043, USA, jgone@umich.edu.
Source
Am J Community Psychol. 2011 Mar;47(1-2):187-202
Date
Mar-2011
Language
English
Publication Type
Article
Abstract
This article explores how Native American cultural practices were incorporated into the therapeutic activities of a community-controlled substance abuse treatment center on a "First Nations" reserve in the Canadian north. Analysis of open-ended interviews with nineteen staff and clients-as contextualized by participant observation, program records, and existing ethnographic resources-yielded insights concerning local therapeutic practice with outpatients and other community members. Specifically, program staff adopted and promoted a diverse array of both western and Aboriginal approaches that were formally integrated with reference to the Aboriginal symbol of the medicine wheel. Although incorporations of indigenous culture marked Lodge programs as distinctively Aboriginal in character, the subtle but profound influence of western "therapy culture" was centrally evident in healing activities as well. Nuanced explication of these activities illustrated four contributions of cultural analysis for community psychology.
PubMed ID
21052824 View in PubMed
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13 records – page 1 of 2.