Fostering Tribal Relations

Cynthia LaCounte, Director, Office for American Indians, Alaskan Natives and Native Hawaiians

April, 2015

Let’s start by changing how you think a bit:

Let’s talk about any context of building a relationship.

It begins with courting and building a friendship… then progresses to hanging out together or dating… then sometimes marriage or a deepening, lasting friendship… and finally growing old together with the satisfaction of a lifetime of work, accomplishments and happy thoughts.

That’s what I’m going to discuss here today. It’s way past time that States and other entities work with Tribes build a lasting lucrative relationship.

Overview

• Coordinating in Indian Country? How do I begin?

• How should the initial contact be made?

• Am I clear about what I can offer?

• Am I willing to listen to their ideas?

• Am I willing to consider that my methods might need to be changed to work with this special population?

• Am I willing to stay for the long haul and make a difference?

• Am I willing to listen and work hard more than talking, while still offering my expertise?

Overview, cont.

• If not. Don’t start.

Coordinating in Indian Country? Where do I begin?

• Accept that tribal population for our elders 60+ are included in your State population.

• Familiarize yourself with the targeting factors in the OAA.

• Title VI or casinos do not replace a state’s obligation to provide services to tribal members both on reservations and in urban areas.

• Work with your policy makers to assure that your state is meeting their obligation to serve American Indians.

Coordinating in Indian Country? How do I begin?

• Become familiar with the Tribes in your area…read…attend events…and learn about their issues.

• Introduce yourself to the Tribal Senior Services Director to learn about the senior program. Invite that person to your office, and request a follow-up meeting to see their facility and to meet some of their seniors.

• Maintain that relationship. Include the tribes in training events, in Board meetings, ask them to do presentation about their program.

• Find out what is needed and how you can help.

How should the initial contact be made?

• Normally the first point of contact is through the highest

elected official’s office (Tribal Chairman, Tribal President, Governor, Chief…).

• Request to come onto tribal land and bring “x” services to tribal members.

• Offer to send written information.

• Offer a face-to-face meeting.

• Ask who to work with further.

• Promise to maintain frequent contact with the leader’s office…AND DO IT!!!

How should the initial contact be made?

• Making your life easier!!! • Contacting Leadership is essential. Their knowledge and

blessing of your involvement is absolutely critical. • At the same time you may also want to contact the Aging

Programs Director to make the same introduction, provide the same information, alert them that you have notified tribal leadership and have/have not had a response. They can assist to elevate your request.

• This is when you need to show that you have a very good idea that you think would work in Indian Country…and be willing to keep your mind open to find those ways to help change the program to be culturally relevant.

Coordination in Indian Country

• Follow-up

• Patience

• Follow-up

• Patience

• Follow-through

• Patience

• Now you’re bought in!!!!

Next steps:

• Am I clear about what I can offer?

• Am I willing to help them determine if it meets their needs?

• Am I willing to listen to their ideas?

• Am I willing to help them determine how the service can become culturally appropriate, and actually “give it to them” to do that?

• Am I willing to try to understand why those cultural differences matter?

• Am I willing to continue offering guidance and expertise?

Promising Prevention Practices in Indian Country

• Tribes have identified concerns with “traditional” evidence-based programs and the evidence-based approach since the conduct was first identified in the aging world.

• The Oregon DHHS identified those concerns as:

– Model programs are not always adaptable in Indian Communities

– Developer training & fidelity testing are often alien processes, and not always available to Tribes.

– Loss of familiar and accepted practices/programs can be traumatic for the Tribe

Promising Prevention Practices in Indian Country, cont.

• Cost is prohibitive.

• Mandate is in conflict with principles of sovereignty, consultation and government-to-government relations.

Caroline Cruz (OR DHHS) Comparison between science & culture

Scientific Validated: Cultural Validated:__________

Transparency – evidence? Does practice have longevity in Replication? in historical tribal history?

Standardization to be reliably Practices that are culturally

replicated. relevant, appropriate & designed in the Indian Way.

Replication – more than once Replication, development, & implementation the Indian way can be adapted per tribe and culturally replicated.

Caroline Cruz (OR DHHS) Comparison between science & culture

Scientific Validated: Cultural Validated:__________ Research – accumulated Meet tribal principles -- Experts knowledge that should be in AI/AN communities are the published. Elders. They provide the basis for understanding what works & why in tribal communities. These teachings have been the basis for healthy communities for many centuries. Outcomes to show that they can Outcomes in Indian Country – Do people help consumers to reach goals continue coming & bring others? Do you & outcomes related to risk factors. hear about it in the community? This is ` the program story. It can be documented, tracked & changed over time.

Caroline Cruz (OR DHHS) Comparison between science & culture

Scientific Validated: Cultural Validated:__________

Fidelity – scale used to verify Our elders within our

that intervention community, our teachers,

is implemented in a manner & the “3 elder women test”

consistent with the treatment is our fidelity scale. The

model – or the research that Elders are our gauge for

that produced the practice. how we are doing.

The scale has been shown to

be reliable & valid.

HISTORICAL TRAUMA IN INDIAN COUNTRY

Historical trauma is cumulative emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma. AI/AN have, for over 500 years, endured physical, emotional, social, and spiritual genocide from the policies of European and American colonialist society. Contemporary AI/AN life has adapted, such that, many are healthy and economically self-sufficient. Yet a significant proportion of Native people are not faring well. The effects of historical trauma include unsettled emotional trauma, depression, high mortality rates, high rates of alcohol abuse, significant problems of child abuse and domestic violence.

HISTORICAL TRAUMA IN INDIAN COUNTRY

Our purpose is to heal from the historical unresolved grief that many indigenous individuals and communities are struggling with. Historical unresolved grief is the grief that accompanies the trauma. The historical trauma response is a constellation of features in reaction to massive group trauma. This response is observed among Lakota and other Native populations, Jewish Holocaust survivors and descendants, Japanese American internment camp survivors and descendants. (Brave Heart, 1998, 1999, 2000) Research of the historical trauma intervention approach has shown significant reduction in anger, sadness, guilt, and shame. (Brave Heart, 1996-1998). A number of excellent Native American researchers have begun conducting strong research and teaching that is beginning to create a more unified approach towards healing.

Historical Trauma in Indian Country

Understanding the experiences of community is important towards beginning the healing process. Genocide, imprisonment, forced assimilation, and misguided governance has resulted in loss of culture and identity, alcoholism, poverty and despair.

Accepted components in working to resolve historical trauma include:

confronting the trauma

understanding the trauma

releasing the pain of historical trauma

transcending the trauma

Historical Trauma in Indian Country

Dr. Yellow Horse Braveheart offers model: three major hypotheses for intervention: 1. Education increases awareness of trauma, 2. Sharing effects of trauma provides relief, 3. Grief resolution through collective mourning/healing creates positive group identity and commitment to community.

It could be a possible solution:

Tribal leadership, scholars, program staff and communities have long identified historical trauma as a negative force behind generational problems that have impacted our families and communities for many generations. We speak in Indian Country of the effect that each action and decision has lasting impact on the next seven generations. Current social factors such as suicide, alcohol and drug abuse, violence, low educational attainment, poor health status, etc. are all blamed on historical trauma.

It could be a possible solution, cont.

What if we could design a Practice Based Evidence Program that would focus on the negative impacts of historical trauma while re-building & strengthening our communities? What if that program had as its “center pole” the elders & historical trauma? What if branching out from that we had suicide prevention for our youth with elder involvement….alcohol/drug abuse with elder involvement…early pregnancy intervention with elder involvement…language & cultural retention with elder involvement…elders mentoring young veterans as they return home…encourage/tutoring with school with elder involvement…members helping other members guided by elders? Think creatively of all the branches that could come off that center pole…all to rebuild our people and our communities and all involving the elders to once again elevate their status as the experts in our communities?

A Challenge & Ask from Indian Country

Help us to design a cultural evidence-based program (Practice Based Prevention) that will work to address historical trauma and it’s impact in our communities: We heal as a community, not as individuals. Help us to design a program that centers around our Elders and historical trauma. Help us to involve our Elders thoughout our communities to heal us from generations of trauma.

Summary

For more information about ACL

U.S. Department of Health and Human Services, Administration for Community Living, Washington DC 20201

Phone: 202-357-0148 Fax: 202-357-3249Email: cynthia.lacounte@acl.hhs.gov Web: www.acl.gov or www.olderindians.aoa.gov