Treatment

=**Treatment**= In working with Aboriginal populations, treatment options must encompass different approaches than normal measures in order to be effective. “Aboriginal people tend not to use services provided by the majority culture, and of those who do, approximately half drop out after the first session.” (McCormick 2000)There has been a shift in addictions counselling on how to treat Aboriginal populations within the last 30 years. Our country has begun to make improvements in the availability and effectiveness of these programs. Through the development and integration of the National Native Alcohol and Drug Abuse Program (NNADAP), some 52 government funded residential treatment centres now exist, as well as, 550 prevention programs throughout the country. Developing effective Aboriginal treatment programs has been especially challenging for our social service sector. “Attempts made by mainstream health service providers to assist Aboriginal people in recovering from alcohol and substance abuse has led to minimal success.” (McCormick, 2000) There are a few key concepts that we must consider when hoping to effectively treat addicted Aboriginal Peoples…


 * The importance of enculturation
 * How First Nations’ view alcohol
 * How to build effective client-helper relationships



**The Importance of Enculturation**
Enculturation is “defined as the process by which individuals identify with and participate in their traditional ethnic culture.” (Currie, McKennitt, Wild 2007) Research by Robert McCormick of the First Nation’s treatment in British Columbia suggested that, “reconnection to family, community, culture, nature and spirituality was the primary source of healing for Aboriginal people.” (McCormick 2000) In this study, the community of Akali Lake, British Columbia, decreased their rate of alcoholism from 95% to 5% in 10 years by subscribing to the //Culture is Treatment// model. This was done by, “revitalizing traditional Aboriginal culture and creating a community atmosphere that no longer tolerated alcoholism.” (McCormick, 2000) Other successful programs have, “stressed traditional values, spirituality and activities that enhanced self esteem.” (McCormick, 2000)The Aboriginal culture has a vast knowledge in healing and many traditional practices which allow individuals to reconnect with their heritage and deal with their alcohol abuse. The Alkali Lake model of treatment included;

The tradition of connecting entire communities to celebrate and socialize. The burning of sweet grass to produce smoke which is brushed over the body to promote purification and health. A small hut constructed with willow/brush in which hot rocks are placed inside and soaked with water to produce steam. This ceremony is used to symbolize re- birth, purification and healing. It is often very spiritual for those who partake. Participants form a circle and sit to discuss issues, and in healing circles (more formal) the group focuses on healing individuals and discussing wellness. They are often run by an elder. A very complex symbol used in many Aboriginal cultures to understand interconnectedness to the natural world, spiritual world, one's community and one's self
 * **Pow-wow dancing**
 * **Sweet grass burning (Smudging)**
 * **Sweat lodge ceremonies**
 * **Talking and Healing Circles**
 * **Teaching/incorporating the Medicine Wheel**



If we wish to decrease the number of Aboriginal People with alcohol addiction, we need to incorporate the //Culture is Treatment// model with western, mainstream treatment approaches. It is important for Canadian addiction counsellors directly working with this population, to have a deep understanding of these traditional values and these amazing healing strategies that have existed in Aboriginal cultures for centuries.

**View on Alcohol and Addiction**
“The Aboriginal conceptualization of alcohol abuse and its treatment encompasses more than the biological and experiential explanation provided by mainstream medicine.” (McCormick 2000) Unlike traditional treatment models that use 12 step programs and consider alcoholism as a disease, Aboriginal people believe that alcohol has a spiritual identity that continuously wages war within one’s own spiritual realm. Western beliefs and treatment practices do not share this view, and often fail to understand the identity that alcohol has within Aboriginal culture.

Furthermore, in the Aboriginal culture, it is vital to one's health and wellbeing to connect with creation. "Creation is described in terms of family, community, culture, the natural world and the spiritual world." (McCormick 2000) When one is unable to make this connection, it is believed that mental and physical health issues arise. It is understood that for many Aboriginal people, the disconnection from creation is attributed to the treatment they received from churches and the Government of Canada throughout the 19th and 20th century. "For many Aboriginal people, consumption of alcohol has been their attempt to deal with the state of powerlessness and hopelessness that has arisen due to the devastation of traditional cultural values." (McCormick 2000)

**Effective Client-Helper Relationships**
When working within the helping profession with Aboriginal clients, counsellors must consider the obstacles around building trusting, effective relationships. "One obstacle is that for traditional Aboriginal people it can be very shameful and embarrassing to admit to having problems of drug and alcohol abuse. This can prevent them from seeking help." (McCormick 2000) In addition, many Aboriginal communities have been systematically abused and oppressed by the Canadian government and Western society, that they have an engrained distrust towards Canadian professionals. "The systemic racism in social, medical and educational systems continue to reinforce the assimilation and integration of Aboriginal Peoples into general Canadian Population." (Poonwassie 2001) Therefore, building trust becomes a huge component to the helper-client relationship, and the on-going success of their treatment.

An important facet in building trust is the competence of the counsellor to understand Aboriginal culture. "An effective and helpful counsellor will use a process which is consistent with the client's values, life experiences, and culturally conditioned communication and will work with the client to form suitable goals." (Poonwassie 2001) This is important to note, because if the counsellor is unaware of Aboriginal issues and cultural values they cannot work within this framework and the effectiveness of the relationship is diminished. After all, "An understanding of traditional worldviews and cultural imperatives by the general Canadian population, and particularly those who work with Aboriginal clients, is an important step towards de-colonization and the facilitation of empowerment." (Poonwassie 2001)

Many treatment centres that work with Aboriginal populations, employ Aboriginal healers to bridge the gap between modern medicine and traditional healing. These traditional healers help addicts reconnect with their heritage, and offer an understanding that can sometimes be lost on western counsellors. It is important for counsellors to remember that they are not "experts", but rather, "they must be prepared to relinquish control and learn, and understand realities and worldviews different from their own." (Poonwassie 2001)