Honouring Our Strengths: Culture as Intervention in Addictions Treatment
FUNDING: Canadian Institute of Health Research Operating Grant, Institute of Aboriginal Peoples’ Health
PARTNERS: Elders, Indigenous and non-Indigenous researchers, cultural practitioners, service providers and decision makers. Nominated Principal Investigator: Colleen Anne Dell (University of Saskatchewan) Co-Principal Investigators: Carol Hopkins (National Native Addictions Partnership Foundation), Peter Menzies (Independent, formerly Centre for Addiction and Mental Health), Jennifer Robinson and former designate Jonathan Thompson (Assembly of First Nations) Co-Applicants: Sharon Acoose (First Nations University of Canada), Peter Butt (University of Saskatchewan), Elder Jim Dumont (Nimkee NupiGawagan Healing Centre), Marwa Farag (University of Saskatchewan), Joseph P. Gone (University of Michigan at Ann Arbor), Rod McCormick (Thompson Rivers University, formerly University of British Columbia), Christopher Mushquash (Lakehead University), David Mykota (University of Saskatchewan), Nancy Poole (BC Centre of Excellence for Women’s Health), Bev Shea (University of Ottawa), Virgil Tobias (Nimkee NupiGawagan Healing Centre) Knowledge Users: Mary Deleary (Independent, formerly Nimkee NupiGawagan Healing Centre), Renee Linklater (Centre for Addiction and Mental Health), Mike Martin (National Native Addictions Partnership Foundation), Kasi McMicking (Health Canada), Brian Rush (Independent, formerly Centre for Addiction and Mental Health), Sarah Steves and former designate Darcy Stoneadge (Health Canada) Collaborators (Treatment Centres): Willie Alphonse (Nenqayni Wellness Centre), Ed Azure (Nelson House Medicine Lodge), Christina Brazzoni (Carrier Sekani Family Services), Patrick Dumont (Wanaki Centre), Cindy Ginnish (Rising Sun), Yvonne Howse and former designate Hilary Harper (Ekweskeet Healing Lodge), Karen Main (Leading Thunderbird Lodge), Zelda Quewezance (Saulteaux Healing and Wellness Centre), Yvonne Rigsby-Jones (Tsow-Tun Le Lum), Ernest Sauve (White Buffalo Youth Inhalant Treatment Centre), Virgil Tobias and former designate Mary Deleary (Nimkee NupiGawagan Healing Centre), Norma Saulis (Wolastoqewiyik Healing Lodge) Contributors (Treatment Centres): Iris Allen (Charles J. Andrew Youth Treatment Centre), Rolanda Manitowabi (Ngwaagan Gamig Recovery Centre Inc. [Rainbow Lodge]), Susan Thomas (Sagkeeng Mino Pimatiziwin Family Treatment Centre), Sadie Greenway (Kackaamin Family Development Centre), Yvonne Olivier (Siksika Medicine Lodge), Delena Tikk (Three Voices of Healing Society), Jordan Head (St. Paul’s Treatment Centre), John Dixon (Dilico Adult Residential Treatment Centre) Collaborators (Leadership): Chief Austin Bear (National Native Addictions Partnership Foundation), Debra Dell (Youth Solvent Addiction Committee), Val Desjarlais and former designate Janice Nicotine (National Native Addictions Partnership Foundation), Rob Eves and former designate Rita Notarandrea (Canadian Centre on Substance Abuse), Elder Campbell Papequash (Saskatchewan Team for Research and Evaluation of Addictions Treatment and Mental Health Services) Contractors (Methodology): Elder Jim Dumont (Nimkee NupiGawagan Healing Centre), Randy Duncan (University of Saskatchewan), Carina Fiedeldey-Van Dijk (ePsy Consultancy), Laura Hall (University of Saskatchewan), Margo Rowan (University of Saskatchewan) Management: Barbara Fornssler and former designate Michelle Kushniruk (University of Saskatchewan)
AIM: Drug addiction among Indigenous peoples is a serious health concern in Canada. Building on our core community-based research team’s history of collaborative work, the aim of this project is to evaluate the effectiveness of First Nations culture as a health intervention in alcohol and drug treatment. Health for First Nations is broadly envisioned as wellness and is understood to exist where there is physical, emotional, mental, and spiritual harmony. It is recognized at the National Native Alcohol and Drug Abuse Program (NNADAP) and Youth Solvent Addiction Program (YSAP) treatment centres that Indigenous traditional culture is vital for client healing. However, there is a serious absence of empirical documentation of its impact on client wellness. This project will gather understanding of how Indigenous traditional culture is understood and practiced at a sample of 12 NNADAP and YSAP treatment centres; from this, a valid instrument to measure the impact of cultural interventions on client wellness will be developed and tested, and the findings applied. The expertise of our diverse team members well-positions us to undertake this project while adhering to the Tri-Council Policy Statement. The outcome will be improved health programming and policy for Indigenous youth and adults in drug and alcohol treatment in Canada. This project is suitably timed with core processes underway in the NNADAP and YSAP treatment systems. The NNADAP and YSAP renewal process will be finalized in 2011, of which a key recommendation is the establishment of a culturally competent evidence base to document the nature and demonstrate the effectiveness of cultural interventions within treatment programs. Further, a national data management system for NNADAP and YSAP is under development, and the opportunity exists to influence its design so that data specific to evaluation can be collected, and in turn, contribute to the sustainable offering of effective cultural interventions.
RESEARCH QUESTIONS: 1. What are the indicators of healthy client wellness as an outcome of participation in traditional Indigenous cultural interventions while in treatment for problematic substance use? 2. Drawing on this understanding, what is the validity of a culturally competent instrument developed to measure change in wellness among clients in treatment for problematic substance use? Answering these questions will contribute to the development of a future study examining the role of First Nations culture in individuals’ continued wellness upon release from treatment and long-term in their community.
OBJECTIVES: (1) to improve and promote the health of First Nations who problematically use substances through innovative health intervention research; (2) to document and generate knowledge on indicators of the impact of Indigenous cultural interventions on client wellness; (3) to design a culturally valid instrument to measure change in client wellness; (4) to disseminate the research findings and implement knowledge translation strategies within the national NNADAP and YSAP treatment system, and specifically inform the development of the national addictions data management system; (5) to provide a successful model of collaborative Indigenous health intervention research that is rooted in research being conducted by, for, and in balance with First Nations health stakeholders; and (6) to facilitate mentoring opportunities among the diversity of partners involved in the study.
VIDEO #1 – Project final video: Products & Processes (Approx 6 minutes)
VIDEO #2 – Introduction to the project (Trailer) (Approx 4 minutes)
VIDEO #3 – Introduction to the project methodology (Elder Jim Dumont) (Approx 3 minutes)
VIDEO #4 – Reflecting on our team’s project process (Treatment Centre Directors) (Approx 5 minutes)
TIMELINE: Click HERE to print the Project Timeline
MONTHLY COMMUNITY UPDATES:
A summary of the complete project processes and products is available in a 90 minute, recorded webinar, hosted by the Centre for Addiction and Mental Health on June 19, 2015. You can access it here.
RESEARCH FINDINGS FOR YOU: KNOWLEDGE TRANSLATION PRODUCTS!
Cooking as Culture Recipe Cards & Measuring Spoons – Click Here!
Connecting With Culture: Growing Our Wellness Facilitators’ Handbook & Activity Guide – Click Here!
Growing Our Wellness Wildflower Blend (to be used in conjunction with the Activity Guide – see above).
Indigenous Wellness Framework – Poster (Contact our office for copies)
Honouring Our Strengths: Culture as Intervention in Addictions Treatment Reference Guide
The wall cards listed below are all shared within this Reference Guide, along with plain language explanations. (Click here for pdf file)
Wellness Wall Cards – See below!
Definition of Wellness (Click Here for pdf file)
Definition of Culture (Click Here for pdf file)
Indigenous Wellness Framework (Click Here for pdf file)
Indigenous Wellness Framework (another way to see it) (Click Here for pdf file)
Common Cultural Interventions (Click Here for pdf file)
(French version – coming soon!)
The NWATM is made up of two assessment forms:
(1) Self-Report Form (completed by client)
(2) Observer-Rating Form (completed by treatment provider)
The assessment is administered twice during the treatment cycle for each client.
There is an administrator’s manual and a scoring guidebook. The manual will be available in both English and French soon. The instrument will be undergoing further pilot testing for the next year with the NNADAP/YSAP centres, and will be available for broader community distribution around Summer, 2016 along with scoring manual.
The NWATM is a strengths-based holistic assessment that focuses on the relationships in a client’s life and reflects the impact of cultural programming on client wellness.
It is a culturally consistent and psychometrically valid assessment ready for application across the country in NNADAP and YSAP facilities, and with data to be captured in the Addictions Management Information System.
The instrument has been tested to be valid for women and men, across age groups, and across cultures.
An article will soon be available that describes the development and validation of the Native Wellness AssessmentTM.
SELECT PRESENTATIONS, PUBLICATIONS & POSTERS:
B. Fornssler, L. Hall, C. Dell, C. Mushquash, R. Duncan, P. Butt, C. Hopkins, N. Poole, P. Menzies, M. Rowan, D. Dell, M. Martin, C. Fiededey-Van Dijk. (Forthcoming). “Travelling the Möbius Strip: The Influence of Two-Eyed Seeing in the Development of Indigenous Research Accomplices”. In R. Innes, N. Van Styvendale & R. Henry (Eds). Global Perspectives on Indigenous Health. USA: Arizona Press.
M. Rowan, N. Poole, B. Shea, D. Mykota, M. Farag, C. Hopkins, L. Hall, C. Mushquash, B. Fornssler, C. Dell. (2015). A scoping study of cultural interventions to treat addictions in Indigenous populations: methods, strategies and insights from a Two-Eyed Seeing approach. Substance Abuse Treatment, Prevention, and Policy. 10:26. DOI: 10.1186/s13011-015-0021-6
C. Fiedeldey-Van Dijk, M. Rowan, C.A. Dell, C. Hopkins, B. Fornssler, L. Hall, D. Mykkota, C. Mushquash, M. Farag, B. Shea. “Honouring Indigenous Culture-as-Intervention: Development and Validity Evidence of the Native Wellness Assessment (NWA™)”. Journal of Ethnicity in Substance Abuse. Forthcoming.
L. Hall. “Two-Eyed Seeing in Indigenous Addiction Research and Treatment”. In L. Greaves, N. Poole & E. Boyle (Eds). Transforming Addiction: Gender, Trauma, Transdisciplinarity. New York: Routledge. pp. 69-76.
L. Hall, C.A. Dell, B. Fornssler, C. Hopkins, C. Mushquash, M. Rowan (2015). Research as Cultural Renewal: Applying Two-Eyed Seeing in a Research Project about Cultural Interventions in First Nations Addictions Treatment. The International Indigenous Policy Journal. 6(2), pp.1-15.
C. Hopkins and B. Fornssler (2014). Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment. Centre for Addiction and Mental Health webinar.
M. Rowan, N. Poole, B. Shea, J.P. Gone, D. Mykota, M. Farag, C. Hopkins, L. Hall, C. Mushquash & C. Dell (2014). Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study. Substance Abuse Treatment, Prevention, and Policy. 9 (34) doi:10.1186/1747-597X-9-34
C. Hopkins, B. Fornssler, C. Dell. (2014). “Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment”. Ottawa, ON.
B. Fornssler & C. Dell (2014). Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment. FASDLive 2014: Mapping Our Road to Success. 90 minute workshop. Saskatoon, SK.
Elder J. Dumont, C. Hopkins, C. Dell, P. Menzies & Team. (2013). “Culture as Intervention in Addictions Treatment: Appreciating the Evidence within Indigenous Knowledge”. Issues of Substance – Canadian Centre on Substance Abuse. Ottawa, ON.
C. Dell (2014). “Honouring our Strengths: Culture as Intervention. Advances in Addiction Research in Canada”. 2014 NIDA International Forum. Peurto Rico, USA.
C. Hopkins, B. Fornssler, C. Dell. (2014). “Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment”. Honouring Our Strengths. Ottawa, ON.
C. Dell. (2013). “Culture as Intervention”. Assembly of First Nations Mental Wellness Strategy Group. Ottawa, ON. (via teleconference).
N. Sartoris and Project Team. (2013). “Aboriginal Culture as Intervention”. U of S Engaged Scholar Day, Saskatoon, SK. Prize acknowledgment.
B. Fornssler & C. Dell. 2013. “How has Aboriginal Culture Helped You, or Someone You Know, on the Journey of Healing from Addictions?” Prairies HIV Conference. Saskatoon, SK.
B. Fornssler and Project Team (2013). “Honourng Our Strengths: Indigenous Culture as Intervention in Addictions Treatment”. U of S Engaged Scholar Day, Saskatoon, SK.
N. Sartoris and Project Team. (2013). “Aboriginal Culture as Intervention”. U of S Aboriginal Achievement Week, Saskatoon, SK.
B. Rush. (2012). “Bringing a Spiritual and Cultural Paradigm to Addictions Treatment: Lessons Learned from Indigenous and non-Indigenous Experiences”. Seventh international Forum of the Spirituality of America’s Indigenous Peoples. Lima, Peru.
M. Kushniruk. (2012). “Honouring Our Strengths: Cultural as Intervention in Addictions Treatment”. Saskatchewan Institute of Applied Science and Technology. Prince Albert, SK.
C. Dell (2012). “How has Culture Helped You, or Someone You Know, on the Journey of Healing From Addictions?”. Saskatchewan HIV Conference 2012 – Getting to Zero Through Culture and Healing. Regina, SK.
Researchers Launch A World First Tool to Help Indigenous Addicts Recover – Global Saskatoon, June 24, 2015
New Indigenous Program finds Culture Key to Overcoming Addictions. Native Wellness Assessment Instrument First of its Kind in the World – CBC Saskatchewan, June 24, 2015
Native Wellness Assessment Tool Launched in Saskatoon – News Talk 650, CKOM, June 25, 2015
Thunderbird Brings Culture Into Indigenous Health – Star Phoenix, June 25, 2015
Culture Is Strength News Release – University of Saskatchewan and National Native Addictions Partnership Foundation, June 24, 2015
Research Links Culture to Healing – Star Phoenix, November 7, 2013
Harper Government Supports Health Care Innovation in Saskatchewan – Canadian Institutes of Health Research, July 2012
Team members Carol Hopkins and Colleen Dell attended and spoke at the official June, 2012 launch of the CIHR Signature Initiative: Pathways to Health Equity for Aboriginal Peoples and at which our team’s project was highlighted.
National Native Alcohol and Drug Abuse Programs Treatment Centre Directory.
CONNECT WITH US:
Facebook: Aboriginal Culture As Intervention
Twitter: #CultureAsWellness & #HonouringOurStrengths
Related project website: How has Aboriginal culture helped you, or someone you know, on the journey of healing from addictions? On this website you will find videos, songs, poetry, written narratives, drawings and music that will share how people’s stories are their identity – you will hear about how choosing a healthy sense of self as an Aboriginal person is fundamental to the continued journey of wellbeing.