Table Of ContentVolume 3, No. 2
Special Edition
“Humankind has not woven the web of life. We are but one thread within it. Whatever we do to the
web, we do to ourselves. All things are bound together. All things connect.” — Chief Seattle, 1854
A Quarterly Newsletter n A Multi-Agency Alcohol and Substance Abuse Prevention Collaboration
Native Youth Today! Bridging the Gap
© Dustinn Craig - 4wheelwarpony
INSIDE
Native Youth Today: Bridging the Gap Between
Bridging the Gap Between Traditional
and Modern Day Practices 1
Traditional and Modern Day Practices
Director’s Corner 2
Evidence-based Practices in American
Indian/American Native Communities 5
Native youth are blending traditional and unique cultural characteristics and traditions of
We R Native: Health Resource for Youth 6 modern best practices across the spectrum the more than 560 federally recognized tribes in
NATIVE YOUTH PERSPECTIVE of behavioral health and wellness promotion. the United States may limit the generalizability
Basic Health Services Lacking 7 They are engaged in efforts to incorporate tradi of interventions across tribes, requiring commu
A Strength-Based Holistic Self-Assessment tional practices—such as healing circles, sweat nity-informed and tribal-specific adaptations
Using Indigenous Teachings 8 lodges, and ceremonies—into community (Gone & Trimble, 2012; Trimble & Beauvais, 2001;
Family Spirit 9 programs. In addition, there are many Evidence Whitesell, Kaufman, et al., 2012). “It is beautiful
“Osapausi Amasalichi” (Choctaw – “I get Based Practices (EBPs) that are targeted towards to see Native youth bringing the traditional
healing from that little garden”) 10 Native youth. Efforts to reduce substance use cultural ways back to communities. For AI/
Model Adolescent Suicide Prevention and prevent substance abuse with Native AN people, our culture is our spirit to the core,
Program (MASPP) 11 youth should be implemented in partnership and these practices are bringing youth and
National UNITY Conference 12 with American Indian/Alaska Native (AI/AN) families out of despair,” says Dr. Jami Bartgis,
The Hero Project 13 communities, incorporate local expertise and President and Chief Executive Officer (CEO) of
knowledge, build on strengths and resources One Fire Associates in Sand Springs, OK, who
Wiconi Ohitika (Strong Life) Suicide
Prevention Project 14 within the communities, and integrate unique works closely with Native American youth and
Resources 15 cultural practices (Brown, Baldwin, & Walsh, communities in the planning process for mental
2012). It is also important to recognize that the health and wellness and evaluation of programs.
Events 16
(continued on page 3
Director’s Corner
on the softball field, carpools, and commu- President Obama, federal agencies, states ,
nity gatherings that allowed for a newfound tribes, and communities have all recognized
understanding of the important role that the importan ce of engaging our youth and
Dr. Marcella youth can have in leadership. L eadership has supporting their efforts. The White House
“Marcy” Ronyak no age limit --it may be the kindergartner Tribal Youth Gathering being held on July 9 ,
who sees another student bullying someone 2015, and the 2015 National United
Director, Office of at the lunch table and asks an adult for help; a National Indian Tribal Youth Conference
Indian Alcohol middle school student who notices a being held on July 10-14, 2015, wil l
and Substance classmate becoming more withdrawn and strengthen the connection to our Native
Abuse depressed and then takes the time to ask if youth by providing them an oppor t u nity to
they are ok; a high school student who learn from each other and have their voices
happens to be an outstanding athlete notices heard. Native youth have a voice, platform,
Education, leadership, innovation, mento-
that an unpopular student doesn’t have a and support of the nation, and we are in for
ring, and holistic healing are all elements fo r
date to the prom and takes them; or students some exciting days ahead as we watch to
improving wellness within a community. As
coming together to support one another or see how their influence can change the
a fed eral employee, community member ,
develop new programming to meet the world, one community at a time.
clinician, coach, and mother, I have
recognized the importance of empowering needs of others in the community. All of
these examples speak to the importance of About Dr. Marcella Ronyak
our youth. In fact, my p rofessional growth
was impacted by the sincere and powerfu l encouraging youth to take a leadership role Ph.D., LICSW, CDP
within their community as they are the
words of my patients and Native youth
change agents. Our youth are speaking out Dr. Marcella Ronyak received her doctora te
within my community. Looking into t h e eyes and using their experiences , special talents, degree in Counseling Psychology &
and faces of Native youth and having the innovate d ideas, motivation, and cultural Educational Leadership from Washington
opportunity to hear their personal stories , connection to help others implement State University in 2004 and completed her
was not only an honor but a way to connect
programs and support, and change. pre-doctoral internship with Colorado
to the inner pain that was held inside. They State University Counseling Center in Fort
had life experiences that changed their Collins, Colorado.
Lifting our youth up and supporting their
worldview and personal wishes, desires, and innovative ideas can shape the way we She completed her Master of Social Work
drive to make a difference in this world.
approach holistic healing within degree at Walla Walla College (University)
It was during the non structure d times, the communities. It is often said that youth are in 1998 as a part of the advanced standing
casual walks in the hallways of Paschal our future, so why not support a future that program and was a recipient of an Indian
Sherman Indian School, numerous hours can be bright and led by our youth? Health Service Scholarship in 1997-1998.
Dr. Ronyak received her Bachelor’s degree
in social work from Eastern Washington
University in 1997.
TIWAHE INITIATIVE
Promotes Family Stability to Fortify Tribal Communities
In Fiscal Year (FY) 2015, the Bureau of Indian Each tribe or tribal organization that
Affairs received a $5 million increase in Tribal receives Social Services (TPA) and ICWA
Priority Allocation (TPA) funding and a $5 (TPA) funding will receive a pro rata share of
million increase in Indian Child Welfare Act these funds. In addition, four sites will be
(ICWA) funding to support the Tiwahe selected as pilot projects for FY15 and will
Initiative. Tiwahe (ti-wah-hay) means Family in receive additional funding to confront child
delivery of services to children and families
the Lakota language, and was developed as a and family violence challenges. The Tiwahe
for the purpose of preserving the family
part of the President’s commitment to protect dollars are recurring, and will serve as a
unit and supporting healthy and productive
and promote the development of prosperous sustainable resource to aid tribes in
families. Moreover, it is the intent of the
and resilient tribal communities. The funding is developing successful strategies to address
initiative to target American Indian/Alaska
designed to support tribal efforts to address these concerns.
Native children, youth, and families exposed
child abuse and neglect, family instability, Tiwahe is a six-year plan to strengthen
domestic crime, barriers to accessing appro Indian families and promote family to violence, especially in domestic violence
stability in order to fortify tribal and child endangerment situations.
priate services and/or programs affecting tribal
communities. Tiwahe is designed to build
members.
capacity and integrate the
Prevention & Recovery 2 Special Edition 2015
Bridging the Gap (continued from page 1)
The programs that are funded by the Substance at the community center help to connect the Establishing a
Abuse and Mental Health Services Adminis generations and teach young people the tradi
youth clubhouse and
tration (SAMHSA) grantees—including the tional ways. We have language and culture
Systems of Care, Circles of Care, and Project classes, because it is important to keep our
activities oriented
LAUNCH (Linking Actions for Unmet Needs in language alive, pass on traditional ceremonies,
Children’s Health) programs—is responsive craft skills, and cooking,” says Angela Valenzuela, around environment
to the youth voice. Staff members involved in a Systems of Care Program Manager for the
and play are more
SAMHSA’s programs see Native youth blending Pascua Yaqui Tribe’s Sewa Uusim Community
traditional and modern day practices first hand. Partnership. Arlene Cocio, the program’s youth
natural ways to
Prevention & Recovery asked for their perspec resource coordinator, adds that intergener
tives on this movement and where it is heading. ational engagement of families organically visit and talk with
generates conversations among youth and
Knowing Who They Are and elders. “These activities strengthen commu a counselor than
Where They Belong nication between the generations—young
appointments or
people and elders know each other and
As part of forming and strengthening their
have meaningful conversations and an open sessions.
identities, Native youth have a strong desire to
dialogue,” she says.
learn cultural and traditional practices. Jennifer
Ruiz, CEO of the Fresno American Indian Health
Harnessing the Healing Power
but unlike a counselor’s office, such activities
Project in California, observed that programs
of Culture do not carry the expectation or pressure to use
that incorporate traditional and cultural activ
words,” he says.
ities are well attended by youth. Her organi Bringing the healing power of traditional
zation conducted a survey of Native youth, practices into modern services is at the heart
Some other examples of blending traditional
which found that most who live in urban and of AI/ANs efforts in behavioral health. “AI/AN
and modern practices include the Gathering
suburban areas feel that having cultural and communities recognize that personal and
of Native Americans (GONA) program, which
traditional knowledge helps them cope. “Native intergenerational traumas are at the root cause
is supporting youth leadership and mentoring
identity is important to them, but many youth of behavioral and physical health problems
in communities across the country. Through a
feel disconnected from their tribal communities such as suicide, diabetes, and substance
4-day prevention curriculum for youth ages 12
or are not in touch with people who could share misuse,” says Dr. Bartgis. She explains that
to 17, imparts four important teachings that
traditional knowledge,” says Ms. Ruiz. Dr. Bartgis Native communities have learned to counter
cross many indigenous cultures and commu
adds that traditional cultural practices signify to these challenges and “are bringing people
nities: Belonging, Mastery, Interdependence,
everyone in the community who they are and back” with traditional cultural practices as part
and Generosity. The curriculum also engages
where they belong—giving them a purpose of a larger healing process.
and encourages youth to consider how each
and pride, which is particularly important for
applies to their own lives, communities, and
suicide prevention. Young people are leading the way when it
the future of both. Program staff members
comes to blending traditional and modern
and community members are involved with
“For the Pascua Yaqui Tribe in Arizona, the practices, and they are also encouraging
fun activities for youth and can teach them
religion, traditions, and culture are really one programs to provide services that are culturally
different cultural practices (e.g., sweat lodges),
and the same and part of our being as people. competent from the youth perspective. In some
and these mentors have a strong influence on
But not all youth have everyday exposure to ways, the two seem to overlap. For example,
the teachings or practices that young people
their culture, so they seek something to guide services underpinned by the deficit model
carry forward.
them and provide spiritual connections as discourage youth from treatment, and they
well as links to the land and each other. When simply do not feel better by talking about
This year will mark the fourth annual GONA
they find those connections, young people problems in a counselor’s office for 50 minutes,
event at One Fire Associates, LLC, which has
experience the peace they did not have before,” says Dr. Bartgis. “Establishing a youth clubhouse
seen increased youth participation every year—
says Mildred Manuel, Program Manager for the and activities oriented around environment and
from 44 young people during the first year to
Ili Uusim Hiapsi program (Project LAUNCH), play are more natural ways to visit and talk with
70 (with a waiting list because of a necessary
which promotes the wellness of tribal children a counselor than appointments or sessions,” she
cap on attendees) during the third year. A
from birth to eight years of age by supporting says. T. Kay Estes, a coordinator from the Pascua
cross-site evaluation of GONA across multiple
their physical, social, emotional, thinking and Yaqui Tribe, agrees that particularly for children,
communities is documenting its outcomes and
behavioral development. positive activities with someone who cares
processes. Young people’s voices are strong
about them is a more effective way of healing.
regarding GONA. “Every year Native youth
Others in this community stress the importance “While engaged in art, equine or other outdoor
indicate that they want more ceremonies from
of intergenerational activities for promoting activities, or various cultural practices, youth
their communities—so the spiritual aspect is
connections to elders and traditional culture. can express—form therapeutic connections—
“Service projects, celebrations, and activities through their senses. This can lead to talking,
(continued on page 4)
Prevention & Recovery 3 Special Edition 2015
Affordable Care Act: Expanding Access to Preventive Services for Youth
Under the Affordable Care Act (ACA), health For children, covered preventive services for sexually transmitted infections for
plans must cover some essential preventive include developmental screening (for adolescents at high risk.
services for everyone—including children children under age 3), autism screening,
and adolescents. These include behav behavioral assessments at certain ages, For more information on the preventive
ioral health preventive services. If covered blood pressure screening, and obesity services covered for children and adoles
preventive services are received in a person’s screening and counseling. In addition to cents, please visit https://www healthcare
provider network, whether it is in the these services, adolescents can receive gov/preventive-care-benefits/children/
Marketplace or Medicaid, they are free. depression screening, alcohol and drug use
assessments, and screening and counseling
Bridging the Gap (continued from page 3)
critical for them,” says Dr. Bartgis. “Trauma gets Ms. Areyan, who is from the Pascua Yaqui Tribe things and need to ask questions to learn.
to you at the spirit, so that is where people but lived in Fresno at the time, was also part of Whenever I have reached out to elders, they
need to heal—something the elders have been a grassroots research project. “The Native youth have always wanted to talk and help me under
saying for many years. Ceremony as part of care, participating in the Fresno project liked the stand the history,” she says. Like most people
especially for mental health, is very important to Medicine Wheel self-assessment for adults, and these days, Native communities and youth use
Native youth,” she adds. because they were tired of ‘gloom and doom’ technology (e.g., text messaging, social media,
assessments, took it upon themselves to adapt and video chatting) to stay connected—both to
Putting the Youth Voice on this tool for people their age,” says Dr. Bartgis. those they have grown up with and others who
Research, Building the Workforce With her guidance—and after learning and share their worldview—and let everyone know
applying information on ethics, recruitment, about the latest events.
Native youth are also taking part in communi
and Institutional Review Boards—youth tested
ty-based participatory research projects—an
and revised the tool through several iterations Listening to Their Voices
approach that equitably involves community
to address measurement issues. The result was a
members, representatives from key organi Throughout their discussions with Prevention
valid, strength-based self-assessment for Native
zations, and researchers in all aspects of the & Recovery, program staff noted that perhaps
young people that is presented in youth-friendly
process and decision-making. This approach is the most important aspect of services for
language and rooted in traditional concepts of
considered the gold standard for research in AI/ Native youth is including their voices. For
holistic health. In addition to teaching youth
AN communities because it empowers them to example, programs that have a youth council
important information and skills, the project
collect and use data in a way that is valuable and show both their intention to listen and offer a
contributed to building the behavioral health
meaningful from their perspective. When the direct mechanism for participation in decision-
workforce of the future. Ms. Areyan, who was
Fresno American Indian Health Project (funded making. Additionally, young people want to see
then in high school and planning to become a
by the SAMHSA Circles of Care Initiative) set that their input is having an impact. “It is really
veterinarian, changed her career path because
out to assess the needs of the local Native important to provide feedback to youth to show
of the experience. “When I saw that kids actually
community, program staff directly involved that the organization is incorporating their
used this tool, I realized that I liked working
youth in the process. suggestions. This shows them that you are truly
with youth and having a positive impact on
listening and improves the event or program,
their overall outlook and direction in life,” she
As part of the Community Needs Assessment including participation,” says Ms. Ruiz. Programs
says. Now in college in Tennessee, Ms. Areyan is
for the Fresno Native community, young people that can connect projects and services to
studying social services: “It’s a broad degree—I
received cameras to conduct photo-voice quali specific youth goals will likely see greater partic
can take it wherever I want.”
tative research. This type of research is similar to ipation. As college student Ms. Areyan notes:
a focus group, except that photographs rather “The success of projects depends on listening to
Moving Into the Future
than verbal questions serve as a springboard what youth want to get out of it. Youth need a
for important conversations about needs, Many programs that engage youth, such reason for everything and it has to be relevant
challenges, and strengths. “Young people love as the photo-voice project and multimedia to them to get them interested.”
to take pictures,” says Rachelle Areyan, who recordings of interviews with elders, incorporate
participated in the needs assessment project technology. Ms. Areyan thinks that using multi
when she was 17 years old. “Taking pictures media tools helps young people engage with
in their communities motivated my peers to elders to ask about life when they were growing
answer questions and discuss issues in a way up and the journey that Native Americans have
that was comfortable to them.” made. “Young people don’t want to offend
anyone, but we want to know the history behind
Prevention & Recovery 4 Special Edition 2015
Evidence-based Practices in American Indian/
Alaska Native Communities
“Community-driven, culturally grounded and substance abuse interventions. All inter targeting Native youth. For more information
prevention interventions, derived from the ventions in the registry have met NREPP’s on these programs, visit SAMHSA’s National
beliefs and values of a given tribe or culture, minimum requirements for review and have Registry of Evidence-based Programs and
has become more acceptable and poten been independently assessed and rated for Practices (NREPP) at http://www .nrepp
tially more effective for Native Youth”, (Gone Quality of Research and Readiness for Dissem samhsa .gov/
& Looking, 2011; Hawkins et al., 2004; Lane ination. The purpose of NREPP is to help the
& Simmons, 2011; Lowe et al., 2012; Moran public learn more about available evidence-
& Reaman, 2002; Nebelkopf et al., 2011; based programs and practices and determine
Okamoto et al., 2014). which of these may best meet their needs.
The National Registry of Evidence-based This newsletter issues includes a variety of
Programs and Practices (NREPP) is a tribally-focused substance use prevention
searchable online database of mental health programs, practices and interventions that are
AMIkids Personal Growth Model
an appropriate treatment plan is developed, mined by the individualized treatment
which combines the following components: plan. Staff implementing this component
must be licensed mental health profes
• Education. The education component
sionals or therapists/counselors who are
uses three primary methods to enhance
supervised by a licensed mental health
learning: experiential education, project-
professional.
Separating a troubled past based learning, and service learning.
from a bright future
Participants attend classes in an academic To learn more about the implementation of
setting, and teachers use a rigorous AMIkids Personal Growth Model, contact:
The AMIkids Personal Growth Model (PGM) is a
curriculum designed to address the partic Judy Estren, J.D. (813) 887-3300
comprehensive approach to treatment for 10-
ipants’ individualized needs and diverse jle@amikids org
to 17-year-old youth who have been adjudi
learning styles. Teachers implementing
cated and, in lieu of incarceration, assigned
this component must be certified and To learn more about the research of AMIkids
to a day treatment program, residential
highly qualified on the basis of State, local, Personal Growth Model, contact:
treatment setting, or alternative school or who
and AMIkids requirements. Kristin Winokur Early, Ph.D. (850) 521-9900
have been assigned to an alternative school
kearly@thejrc com
after failing in a conventional school setting. • Treatment. The treatment component is
The AMIkids PGM, which is intended for use individualized on the basis of each partic Visit, http://www amikids org/our-services/
over 6-8 months, is designed to target and ipant’s assessments, and research-based amikids-personal-growth-model
reduce the risk factors that sustain delinquent mental health and/or substance abuse
behavior and academic failure, reduce recid interventions (e.g., cognitive behavioral This information was obtained from SAMHSA’s
ivism, improve program completion rates, and therapy, motivational enhancement National Registry of Evidence –based
promote academic achievement. therapy, functional family therapy, Programs and Practices (NREPP) http://www
motivational interviewing) are provided nrepp samhsa gov/
Before services are provided through the
to participants, as well as their families.
AMIkids PGM, the risks, needs, and motivation
Participants receive group services on
to change of the youth and his or her family are
a daily basis, and individual and family
assessed. On the basis of these assessed needs,
sessions are provided on a schedule deter
Prevention & Recovery 5 Special Edition 2015
We R Native: A Multimedia Health Resource for Native Youth
We R Native is a multimedia health resource
for Native teens and young adults, run by the
Northwest Portland Area Indian Health Board.
The site focuses on promoting life skills and
healthy decision-making specifically for Native
youth. This is done by providing accurate
health information and encouraging young
people to get actively involved in their own
health and wellbeing. The service was designed
using behavior change theory and formative
research, with extensive input and website
content created by Native youth across the U.S.
The service includes a website (www
weRnative org), a text message service (text
NATIVE to 24587), a YouTube channel, social
media accounts (Facebook, Twitter, Instagram),
and print marketing materials, about 31,000
viewers are reached per week and half of them
access it from a tablet or mobile device.
search through other youth’s questions on the We Believe Native Youth will
We R Native includes content on social,
emotional, physical, sexual, spiritual health, site, or post one of their own. Change our World!
and American Indian/Alaska Native (AI/AN)
Youth Ambassadors To help them achieve this goal, tools, resources,
culture. To celebrate Valentine’s Day in February,
encouragement and inspiration are provided
the site posted a weekly video series called Washington D.C., Nike World Headquarters,
to Native youth. The text message service
Native VOICES. The video was originally filmed the National Indian Health Board Annual
and Facebook page alerts followers to health
for a newly-released, evidence-based HIV/STD Conference… What do these places have in
tips, new contests, internship opportunities,
prevention intervention for American Indian common, you ask? These are just a few of the
and news stories about Native youth. Since
and Alaska Native youth 15-24 years old. To places our We R Native Youth Ambassadors
its launch in 2011, the website has had almost
celebrate Earth Day in April, the site launched a had the opportunity to visit this year. On their
200,000 page views, We R Native’s Facebook
new informational section on My Environment, travels they helped spread the word about We
page has had over 23,000 likes, and the 250
covering topics like: water, land, energy sources, R Native. Last year 16 Youth Ambassadors were
health and wellness videos on YouTube have
and how to take action. trained and supported as they spread positive
had over 26,800 video views.
vibes and created positive changes in their local
Altogether, the website contains over 350
communities. Please Help Us Spread the Word
health and wellness pages, all reviewed by
and Make We R Native Better!
Native youth and experts in public health, Native, Youth-Friendly Media
mental health, community engagement, and Campaigns You can get involved and join the We R Native
activism. Special features include monthly movement by liking them on Facebook (www
We R Native also uses its media platforms to
contests, community service grants (up to facebook com/weRnative) , signing up for the
promote Native, youth-friendly social marketing
$475), an “Ask Auntie” Q&A service, and a blog. text messaging service (text NATIVE to 24587),
campaigns. Recent examples include a series of
or by ordering a free We R Native promotional
Ask Auntie messages in March that let teens know how to
toolkit for use in your community.
Stand Up Stand Strong, Don’t Just Stand By.
Ask Auntie is one of the most popular
The series included resources and tips for teens This is your community’s website, so if you see
sections of the site! Youth can submit their
to be more than just a bystander if they see anything missing, please let them know! They
questions around any topic anonymously,
something that could be violence or bullying. LOVE hearing suggestions on content to add,
and Auntie responds with a short text or
A drug and alcohol prevention campaign—I or getting photos or videos that we can posted
video response. Topics covered range from
Strengthen My Nation—is also regularly and shared. If you have any questions or ideas
drugs and alcohol questions, to identity, to
featured by We R Native. The campaign includes about how We R Native might work together to
handling difficult emotions, to sexual health
posters, Facebook posts, and videos on their spread the word about, please contact native@
questions. No question is off limits. Teens can
YouTube channel npaihb org
Prevention & Recovery 6 Special Edition 2015
NATIVE YOUTH PERSPECTIVE
Basic Health
Services Lacking,
Underfunded in
Indian Country
Teddy McCullough is from the Coyote
Valley Band of Pomo Indians in Northern
California and recently graduated from
American University with a Bachelor’s
degree in Political Science.
It’s hard to imagine the pain and suffering
that an individual of any age must be going
through to make the decision to take their
own life. It’s even more difficult, maybe even
impossible, to imagine what would make a
12-year-old girl decide to end her life. A few
days before Christmas last year Santana Janis,
a 12-year-old Lakota Indian on the Pine Ridge
Reservation in South Dakota, hung herself in
an abandoned building next to her home.
According to a recent Huffington Post
article, Native Leaders Tell Senators How
to Help Stop Youth Suicide by Rebecca or solutions to these problems. Be that as it While it is important to recognize the
Klein, within a six-month period, between may, I believe that the best way to approach necessity of cultural methods in prevention
December and June of this year, at least 14 mental health and substance use prevention and treatment, the fact of the matter is that
young people between the ages of 12 and and treatment is through incorporating resources for basic mental health services
24 took their own lives on the Pine Ridge traditional and cultural practices of healing are lacking in Indian Country. According to
Reservation. In that same amount of time, with contemporary methods. an article that was written in the New York
Pine Ridge Hospital treated close to 400 Post entitled Pine Ridge Indian Reservation
young people, under the age of 19, who had Cultural methods utilized by some of these Struggles With Suicides Among Its Young
planned or attempted suicide. We may never programs vary depending on the history there are currently only six mental health
know what caused these young people and identity of the tribal programs. However, counselors on the Pine Ridge reservation. The
to make a life-ending decision. It could be these methods might include participating Bureau of Indian Affairs states that there are
bullying, sexual abuse, poor living condi in sweat lodge ceremonies, smudging, only six individuals that serve as counselors
tions, or any number of other hardships. One learning sacred dances, horsemanship for a population of close to 40,000.
thing that is certain: suicide has become an programs, and many others. Integral
epidemic, not only on the Pine Ridge Reser to the success of these programs is the How can we honestly believe that six mental
vation but across all of Indian Country. involvement of elders, singing, dancing, and health professionals are enough to help the
learning tribal history, values, and beliefs. 400 young people who have planned or
I could go on and on for hundreds of pages Native people are tied to their tribe’s history, attempted suicide, let alone the hundreds
with statistics and stories of the issues land, and spirituality. By involving Native of others who are 20 and older who have
that Native youth face—from suicide and youth in their culture and identity, you also attempted to commit suicide in recent
substance abuse, to sexual abuse and racist offer spiritual connection that can be very months. If we really want to tackle mental
mascots. Nevertheless, debate rarely arises healing to many Native people, including health, substance abuse, and other issues
over facts and statistics. The debate typically youth. Young people want to get in touch Natives are facing, then we need to start
emerges over why this is occurring and how with their culture in whatever way they can, taking the issues seriously and providing
we should address it. Unfortunately, there and many young Natives are participating in adequate and sustainable resources to
really is no way of defining specific causes traditional methods of healing. combat the problems Native youth face.
Prevention & Recovery 7 Special Edition 2015
INDIGENIZING EVALUATION
Youth Develop a Strength-Based Holistic Self-Assessment
Using Indigenous Teachings
In 2011, the Fresno American Indian Health more relevant for youth and formally linked
Project (FAIHP) was awarded a Substance the four components of health (spirit, mind,
Abuse and Mental Health Services Admin heart, and body) to the GONA curriculum.
istration (SAMSA) Circles of Care three-year The youth brought this tool to the annual
planning grant. The Fresno Family Wellness GONA to formally use the tool as a part of
Project supports the FAIHP and the local the curriculum and to pilot test the tool for
community in a three-year journey to product improvement. A youth who had
develop a system of care model. Using the been trained in GONA facilitation supported
Gathering of Native Americans (GONA) a mini-teaching on the medicine wheel
curriculum and a community-based and as a tool for balance of physical, mental,
participatory evaluation model, the FAIHP emotional, and spiritual health, thereby
partnered with a community evaluator and reinforcing the concepts presented by local
systems consultant to engage local youth elders. The youth then administered the
Native youth programs beyond Fresno
and their families to guide the project. Personal Balance Tool to approximately 60
and this created a renewed momentum
The GONA curriculum uses four worldview Native youth and conducted a smaller focus
to improve the tool for use among other
concepts that are consistent among many group to support product improvement.
Native communities. The youth made a third
indigenous communities. Local elders,
revision to improve the measurement and
spiritual leaders, community helpers, and While youth participating in the pilot project
proceeded to plan and implement a second
trained GONA facilitators came together had a number of tangible suggestions, such
pilot project for the 2014 summer GONA.
for an annual 4-day event focused on youth as using color-coded forms with crayons
Following the same process, the tool was
by instilling a sense of belonging, mastery, and improving upon the questions, they
administered to a group of 70 Native youth
interdependence, and generosity so that identified the usefulness of the tool in setting
and a small focus group provided important
they can be a part of the solution to the personal goals and improving their under
content improvement with suggested
challenges faced by the local community. standing of holistic health. Youth asked
language and recommendations for how to
if FAIHP could “bring back my medicine
deliver the administration of the tool. This
During the Circles of Care project, FAIHP wheel tool” next year so they could see what
resulted in a fourth revision of the Youth
supported and organized a Youth Council progress they had made. Youth participating
Personal Balance tool. Today, the Youth
that provided substantial human resources in the focus group were able to identify how
Council is working with their evaluator to
and leadership to the project. Through the tool helped them identify what areas
write up the tool development in hopes of
training, skill building, and supervision, the of their own life needed improvement and
being published in a peer-reviewed journal
youth conducted their own local needs how it helped them to “set [ their] own goals
focused on American Indian/Alaska Native
assessment by collecting survey data, elder for all parts of [them].” The initial reception
Mental Health to support the spirit of gener
interviews, and a youth-driven Photo Voice of the tool by the participating youth was
osity’ that has become an important healing
project. These early project experiences promising so the Council made a second
component for the local System of Care.
provided the skills and confidence the youth revision to the tool and disseminated it to
needed to engage in evaluation activities. national sources so that other communities
For more information contact: Jennifer Ruiz,
could benefit from its use.
Executive Director, Fresno American Indian
In 2013, the Youth Council took on an even
Health Project at jruiz@faihp org
bigger evaluation project by developing By the spring of 2014, both urban and
and testing the Personal Balance Self-As tribal communities were utilizing the Youth
Acknowledgements: FAIHP would like to
sessment tool, built upon the Medicine Personal Balance tool. San Diego County
give special thanks to the Youth Council,
Wheel, a common tool used across many formally approved its use by the San Diego
GONA planning committee, Community
tribal communities for teaching individuals American Indian Health Center Prevention
Advisory Board, and the Tribes of the San
how to maintain holistic balance.1 With and Early Intervention Program, which
Joaquin Valley who supported the GONA
encouragement from Alan Rabideau and serves San Diego Native youth through
and system of care planning effort with
Shannon Crossbear, founders of the adult funding from the California Mental Health
their time, their prayers, and their resources.
version of the Personal Balance Tool, the Services Act. The Youth Council recognized
Youth Council adapted the tool to make it the impact this tool could make in supporting
1. It is important to note that, while many tribes do utilize the medicine wheel and/or related concepts for teaching balance, not all tribes use this tool
and it is not universal for all indigenous groups.
Prevention & Recovery 8 Special Edition 2015
Family Spirit
Family Spirit is a culturally tailored home-vis
iting intervention for American Indian/Alaska
Native teenage mothers— who generally
experience high rates of substance use, school
dropout, and residential instability—from
pregnancy through 36 months postpartum. The
intervention is designed to increase parenting
competence (e.g., parenting knowledge and
self-efficacy), reduce maternal psychosocial
and behavioral risks that could interfere with
effective parenting (e.g., drug and alcohol
use, depression, externalizing problems), and
promote healthy infant and toddler emotional
and social adjustment (i.e., internalizing and
externalizing behaviors). It also aims to prepare
toddlers for early school success, promote
parents’ coping and life skills, and link families to
(e.g., unstable housing, poverty, weak family consists of 63 structured lessons delivered
appropriate community services.
support, mental health and substance one-on-one by health educators in partic
abuse issues) trigger a high level of coercive ipants’ homes, starting at about 28 weeks
Family Spirit is based on Patterson’s social
parenting associated with early childhood of gestation and continuing to 36 months
interaction learning model, which suggests
behavior problems that predict poor outcomes postpartum. The lessons, designed to corre
that a parent’s stressful life circumstances
in middle and later childhood. The intervention
(continued on page 10)
American Indian Life Skills Development/Zuni
Life Skills Development
Suicide is the second leading cause of death participating in lessons 3 times per week. The Zuni Life Skills Development curriculum
among American Indian/Alaska Native (AI/ Lessons are interactive and incorporate was developed with cultural components
AN) 15 to 24-years-old, according to Centers situations and experiences relevant to AI/AN relevant to the people of the Zuni Pueblo in
for Disease Control and Prevention data. The adolescent life, such as dating, rejection, New Mexico and was tested and evaluated
estimated rate of completed suicides among divorce, separation, unemployment, and with that population. The Zuni curriculum
AI/AN in this age group is about three times problems with health and the law. Most of the served as the basis for the broader American
higher than among comparably aged U.S. lessons include brief, scripted scenarios that Indian Life Skills Development curriculum
youth overall (37.4 vs. 11.4 per 100,000, respec provide a chance for students to employ that is now in use, which can be used with
tively). American Indian Life Skills Development problem solving and apply the suicide-related other AI/AN populations when implemented
(the currently available version of the former knowledge they have learned. with appropriate and culturally specific
Zuni Life Skills Development program) is a modifications.
school-based suicide prevention curriculum Lessons are delivered by teachers working
designed to address this problem by reducing with community resource leaders and repre To learn more about the implementation or
suicide risk and improving protective factors sentatives of local social services agencies. research for the American Indian Life Skills
among AI/AN adolescents 14 -to -19 years old. This team-teaching approach ensures that Development/Zuni Life Skills Development,
the lessons have a high degree of cultural and contact:
The curriculum includes anywhere from 28 linguistic relevance even if the teachers are not
to 56 lesson plans covering topics such as AI/AN or not of the same tribe as the students. Teresa D. LaFromboise, Ph.D. (650) 723-1202
building self-esteem, identifying emotions For example, the community resource leaders lafrom@stanford edu
and stress, increasing communication and can speak to students in their own language
problem-solving skills, recognizing and elimi to explain important concepts and can This information was obtained from SAMHSA’s
nating self-destructive behavior, learning about relate curriculum materials and exercises to National Registry of Evidence –based Programs
suicide, role-playing around suicide prevention, traditional and contemporary tribal activ and Practices (NREPP) at http://www nrepp
and setting personal and community goals. The ities, beliefs, and values. A school counselor samhsa gov/
curriculum typically is delivered over 30 (typically of the same tribe) serves as the
weeks during the school year, with students on-site curriculum coordinator.
Prevention & Recovery 9 Special Edition 2015
“Osapausi Amasalichi” (Choctaw – “I get healing from
that little garden”)
In 2009, the Office of Juvenile Justice and Delin
quency Prevention (OJJDP) solicited applica
tions for the “Tribal Juvenile Detention and
Green Reentry” demonstration grant. Daniel
Mittan, Director of Court Services, is tasked
with the development of the Probation Office
for the Mississippi Band of Choctaw Indians
(MBCI). He was learning about restorative
justice theory and practices before “reentry”
became popular terminology for the process
of offenders being returned into their commu
nities. When he saw this opportunity, he went
to some of the elders to see if the grant could
be worthwhile at Choctaw. He had investigated
a American Indian/Alaska Native growing
method referred to as “The Three-Sisters” and
wondered if it was accepted as Choctaw. One
of the elders replied with chuckles and stated
that he had realized as a boy that his grand
work plans), hiring of staff (Project Coordinator, • The U.S. Department of Agriculture Natural
mother’s way of gardening seemed so different
Adolescent Therapist, and a Secretary), and Resources Conservation Service also had a
from the rows in gardens of others, but what
developing relationships with “partners” on the representative assigned to MBCI
he described was exactly what Mr. Mittan had
Tribal, State, and Federal levels.
discovered on the internet. The application
The purpose of the project was to prevent and
was submitted. Through a selection process,
• Existing tribal agencies/departments like further control delinquency with the devel
MBCI was identified with two other tribes
Behavioral Health and Natural Resources opment of a demonstration program, using
(Hualapai of Arizona and Rosebud Sioux of
environmentally sustainable activities and
South Dakota) to design and implement their • A “green” institution was required by the green technologies as a platform to deliver
demonstration programs. grant and Mississippi State University services, while promoting culturally signif
had an Extension Service Agent already icant and relevant Choctaw ways. The Chahta
The first year was invested in strategic planning
assigned to the tribe Immi (cultural preservation department)
(a master plan, worked in detail down to specific
(continued on page 11
Family Spirit (continued from page 9) The 63 lessons can be delivered in 52 home To learn more about the research of Family
visits, which occur weekly through 3 months Spirit, contact:
spond to the changing developmental needs
postpartum and gradually become less frequent
of the mother and child during this period,
thereafter. The studies reviewed for this summary Nicole Neault, M.P.H.
address topics such as prenatal care, infant
used earlier versions of the intervention that (505) 797-3305, nneault@jhsph edu
care, child development, family planning, and
included fewer visits and fewer lessons, and
healthy living. Each home visit lasts about an
in two of the studies, all planned visits were Allison Barlow, M.A., M.P.H., Ph.D.
hour and includes a warm-up conversation,
conducted within 6 months postpartum. (410) 614-2072, [email protected]
lesson content, question-and-answer period,
Visit, http://www jhsph edu/caih/familyspirit
and review of summary handouts. Health
To learn more about the implementation
Educators, trained American Indian parapro Family Spirit, contact: This information was obtained from SAMHSA’s
fessionals, deliver the lessons using illustrated Kristen Speakman, M.A., M.P.H. (505) 797-3305 National Registry of Evidence –based Programs
table-top flipcharts. The bond formed between kspeakma@jhsph edu and Practices (NREPP) http://www nrepp
the Health Educator and mother is intended to samhsa gov/
facilitate the mother’s progress toward goals.
Prevention & Recovery 10 Special Edition 2015
