Treatment+Options

**Kina Mino Bmaadizedaa- Ojibway- “Let’s all live healthy”** **Why is Unique Treatment Important for Aboriginal Peoples?** Unique treatment options are important for Aboriginal peoples because they are among the most stigmatized in treatment. There is a gap in understanding and practice between Western psychiatric/biological views of substance use problems and Aboriginal world views.Traditional approaches to addressing problematic substance use and mental health issues have been historically at odds with a biomedical approach. Westernized strategies for the treatment and prevention of substance abuse in the Aboriginal populations have been met with limited success (McCormick, 2000). In fact, the majority of Aboriginal peoples tend not to use substance abuse programs provided by Westernized service providers for various reasons and about half of those who do use the services drop out after their first session (McCormick, 2000). The disease model approach that attempts to solve simply the problem of substance use, without looking at any other characteristics of the problem (Garrett & Carroll, 2000). Traditional Aboriginal healers also frame Westernized approaches to substance abuse as lacking a connection to Aboriginal culture, families, and communities. Aboriginal peoples accessing Westernized treatment can be visualized as trying to put a circle into a square (Morgan & Freeman, 2009). More mainstream approaches by themselves can be deemed incomplete without a precise knowledge of the cultural and environmental context that substance abuse occurs in (McCormick, 2000). Aboriginal healers question the relevance of serving a population that the service provider does not understand because they do not realize the issues that bring the population to them for help in the first place (Chansonneuve, 2007). This lack of background knowledge can lead to a focus of labeling the short comings of the individual, which can then be generalized to the short comings of all Aboriginal peoples or can result in only solving part of the problem (Garrett & Carroll, 2000). For this reason traditional healing needs to be restored as a viable intervention and prevention to substance use in Aboriginal communities. Many Westernized approaches to the treatment of substance use for Aboriginal peoples living in remote Northern Communities involve removing them from the community and placing them in residential treatment facilities. This approach to treatment has been met with limited success because once through treatment people are returned to the same environment and community that supports the substance use ( Jiwa, Kelly, & St Pierre-Hansen, 2008).
 * Treatment Options**


 * The Importance of Traditional Healing and Returning to Culture**

Reconnection to tradition, spirituality, and community can be healing in itself for Aboriginal populations (McCormick, 2000). Traditional healing needs to be restored as a viable intervention and prevention to the treatment of substance use in Aboriginal communities. This can be done through promoting a return to culture among Aboriginal peoples, which can aid in a sense of identity and belonging (Chansonneuve, 2007). Providing the tools for a return to traditional cultures and historical roots provides the Aboriginal person with pride in their Aboriginal identity, their family, their community and their history (Chansonneuve, 2007). A return to traditional culture can also allow the person facing substance abuse problems to access new ways of thinking, behaving, and living their lives (Chansonneuve, 2007). Aboriginal approaches of healing from substance abuse recognize that a connection to culture is a way of healing and that healing is a life long journey (Chansonneuve, 2007) (McCormick, 2000). Reconnection of Aboriginal peoples to their culture and tradition can be healing in itself because it is this loss of cultural identity that has caused Aboriginal peoples to be unwell and turn to substances in the first place (McCormick, 2000). It has been stated that the most effective to healing from substance abuse incorporates reflection and education on the historical experiences of Aboriginal peoples as a whole (Chansonneuve, 2007). This could be helpful to Aboriginal Peoples who are not be aware of what has happened in the past. Allowing room for education helps Aboriginal peoples who abuse substances to avoid self blame, shame and stereotypes and is a way that acknowledges the role of colonization and historical trauma in the development of substance abuse problems presently (Garrett & Carroll, 2000). This education also plays a role in addressing and acknowledging the loss of identity faced by Aboriginal peoples.


 * The Importance of Community to Healing from Substance Use Issues[[image:blurred-vision-admh-2011/imagesCA11Q25M.jpg width="182" height="158" align="left"]]**

From a holistic framework, there is a connection between the health of individuals and the overall health of a nation, with individual health being an important indicator of family health, community health, and the health of the environment (Chansonneuve, 2007) (McCabe, 2008). If one of these determinants of health is out of balance, the other aspects of health will be affected and the person will be unbalanced, as in the case of a person suffering from a problem with substance use (Garrett & Carroll, 2000) (Chansonneuve, 2007).

The success of Aboriginal approaches of healing, treating, and preventing substance abuse problems lies within the community. For this to happen the community must acknowledge that substance abuse exists in within their community and has become a problem that needs to be addressed (McCormick, 2000). Incorporating the entire community in the treatment and prevention of substance abuse honors the importance of interconnectedness of individuals within the community and allows people to come together collectively with shared experiences. Community based prevention and treatment for substance abuse has positive effects on those who had substance abuse problems (Jiwa, Kelly, & St Pierre-Hansen, 2008). The community can also provide supports and even provide role models for people who are going through substance abuse problems. Because many Aboriginal communities are collective in nature, they are more likely to find greater meaning and support in family and community (McCormick, 2000). Within community based approaches to substance abuse, the community regains the responsibility for healing its people (Morgan & Freeman, 2009). This is a way that community based prevention and treatment programs can also represent self determination and increase self esteem within the community and the individual who is seeking help (McCormick, 2000). Generally, traditional healing for substance abuse focuses on the person and the context of their community (Morgan & Freeman, 2009).


 * Community Based Approach to Treatment and Prevention- Community Empowerment Approach**

A community empowerment approach to the treatment and prevention of substance use in Aboriginal populations is an overall approach that addresses the community rather than the individual. This approach acts to address environmental factors that promote substance abuse. This approach involves developing a flexible plan that is specific to the communities specific needs. The approach can involve using programs such as Alcoholics Anonymous and educational programs that have an added component of cultural relevance. The goal of this approach is to mobilize the community to heal the group as a whole. Treating the whole community, rather than just the individual honors the holisitc approach and the interrelatedness of the individuals within their community. This approach has been highly success in Aboriginal communities, but can take 1-2 years to promote sobriety as a cultural norm (Jiwa, Kelly, & St Pierre-Hansen, 2008).


 * Fusion of Aboriginal Approaches to Treatment of Substance Use with Mainstream Techniques**

Aboriginal peoples are located across the country in both urban and rural settings. In fact, only 30% of Aboriginal peoples remain on reservations (Garrett & Carroll, 2000). Aboriginal peoples access many different types of substance use treatment options. Mainstream techniques are of little use without cultural knowledge (McCormick, 2000). It is important for counselors to have cultural knowledge because it is certain that they will encounter clients of Aboriginal decent. The blending of traditional healing and Western treatment practices has been highly successful. Using traditional healing strategies such as healing circles, talking circles, Elder support, sweat lodge ceremonies, as well as cultural training and support for front line staff has been essential to making programs such as community treatment, residential treatment, and self-help groups like Alcoholics Anonymous more accessible for Aboriginal populations. In the future, working in partnership with Aboriginal communities to develop community specific treatment opportunties will be increasingly important (McCabe, 2007).