Residential Volatile Substance Misuse Treatment for ...

Substance Use & Misuse, 46:107–113, 2011 C 2011 Informa Healthcare USA, Inc. Copyrigt ISSN: 1082-6084 print / 1532-2491 online DOI: 10.3109/10826084.2011.580225

ORIGINAL ARTICLE

Residential Volatile Substance Misuse Treatment for Indigenous Youth in Canada Debra Dell1 and Carol Hopkins2

Subst Use Misuse Downloaded from informahealthcare.com by Ms. Carol Hopkins on 05/24/11 For personal use only.

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National Youth Solvent Abuse Committee, Saskatoon, Saskatchewan, Canada; 2 National Native Addictions Partnership Foundation, Muskoday, Saskatchewan, Canada centers. It begins with a current and historical overview of VSM among First Nations and Inuit youth in Canada. The consequent development of the YSAP program is then introduced, focusing on its combined implementation of Indigenous culture and Western theories of resiliency and emotional intelligence, contextualized within a positive psychology framework. Positive psychology has roots in humanistic psychology, which dates back to the 1950s, but since the 1990s has become a more focused, empirically based field of study (Seligman & Csikszentmihalyi, 2000). Both treatment practices and client outcome data are used to illustrate YSAP’s approach. The article concludes by noting its limitations.

The Youth Solvent Addiction Program (YSAP) was established in 1996 in response to the misuse of volatile substances among First Nations and Inuit youth in Canada. This article outlines the role of Indigenous culture and its intersection with Western approaches to recovery in YSAP’s operation of nine residential treatment centers for youth. Treatment practices and client outcome data are used to illustrate YSAP’s approach. Limitations of the article are noted. Keywords Indigenous culture, resiliency, positive psychology, emotional intelligence, wellness, residential treatment, recovery, historical trauma

INTRODUCTION

THE MISUSE OF VOLATILE SUBSTANCES AMONG INDIGENOUS YOUTH IN CANADA

Canada has a long history of providing residential treatment for youth volatile substance misuse (VSM). In response to alarming rates of VSM in select First Nations and Inuit populations across Canada, Health Canada and First Nations people partnered in 1996 to develop the Youth Solvent Addiction Program (YSAP). Key to this partnership was that both Indigenous culture and Western approaches to treatment and recovery informed the development of the residential treatment centers’ structures, services, and program delivery. The nine YSAP residential treatment sites across the country have been in operation for more than a decade, are all culturally based, and are governed by First Nations people. There are currently 112 residential treatment beds for First Nations and Inuit youth ranging in age from 12 to 26. Programs vary by structure, gender, focus, duration (between 4 and 6 months), and are either continuous or block intake, meaning the cohort of youth enter either at random intervals or as one group beginning and ending at the same time. This article sets out to illustrate the role of Indigenous culture and its intersection with Western approaches to recovery in the operation of YSAP’s residential treatment

A 2003 report from Pauingassi First Nation in Manitoba revealed that half of the children in the community who were under 18 years of age misused volatile substances (Manitoba Office of the Children’s Advocate, 2003). The current rate of VSM among Canada’s First Nations and Inuit youth population as a whole, however, is not known. Perceptions about its prevalence are thought to be inflated though due to media reporting, and particularly repeated showings of 1993 and 2000 news clips of Innu youth in the communities of Davis Inlet and Sheshatshiu, Labrador, getting high on gasoline (Canadian Broadcasting Company, 2000). In an unpublished 2009 survey of workers in the National Native Alcohol and Drug Abuse Program, Canada’s national program aimed at reducing alcohol, drug, and solvent abuse among on-reserve populations: 25% reported that VSM is currently a problem in their community, 64% relayed it is not a problem, and 11% reported not to know. The response rate was 64%. Reflecting over the past decade, 5% observed that VSM has increased among youth in their community, 37% believed it has

Address correspondence to Debra Dell, National Youth Solvent Abuse Committee, 123 Assiniboine Drive, Saskatoon, SK S7K 1H8, Canada; E-mail: [email protected].

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decreased, and 17% claimed it has stayed about the same. Forty-one percent did not provide the information. Of those respondents who were aware of the approximate number of youth currently misusing volatile substances in their community, they identified approximately 40% to be males and 52% to be females under the age of 10. The most highly identified misused volatile substances were reported to be gasoline, aerosols, propane, and spray paint. Reasons for sniffing were foremost identified as parental/family problems, followed by boredom, poverty, problems at school, lack of prevention efforts, and health issues. It is important to contextualize the misuse of volatile substances among First Nations1 and Inuit youth within the historical and current influences of colonization, including the destructive impact of residential schooling, racism and discrimination, and multigenerational losses of land, language, and culture (Dell & Lyons, 2007). To explain, problems with parenting are a direct, intergenerational consequence of assimilationist federal government policies defined clearly in the 1869 Act for the Gradual Civilization of the Indian and then reinforced through the Indian Act (1876). Of particular significance among the Canadian government’s strategies for assimilation was residential schooling. Residential schools were run through various denominational churches on behalf of the federal government from 1620 to 1969, with the final closure of government-run residential schools in 1996. Assimilation through residential schools meant that children were cut off from all things that facilitated a connection to their First Nations and Inuit identity, including their parents, their Indigenous language, siblings, land, and community. Residential school attendance was compulsory through government law, with some children forcibly removed from their families at early ages, such as 6 years old, and some did not return to their families until they were 18. Poverty and unresolved, intergenerational grief are a direct consequence of the historical trauma connected to the loss of traditional land, language, and culture (Wesley-Esquimaux, 2004). The misuse of volatile substances among First Nations and Inuit youth has been linked in the literature to high rates of disenfranchised life conditions, including poverty, boredom, loss of selfrespect, unemployment, family breakdown, and poor social and economic structures (Dell & Beauchamp, 2006). The youth who enter the YSAP residential treatment centers reflect this portrayal. A sample of youth who entered the nine centers between 2006 and 2008 (N = 267, 37% male and 63% female) relayed complex histories of family addiction (75%), physical, sexual, and emotional abuse and trauma (67%), trouble with the law (55%), disconnection from community and specifically not attending school (37%), and suicide ideation (50%) and attempts 1

“The Constitution Act of 1982 specifies that the Aboriginal people in Canada consist of three groups—Indians, Inuit, and M´etis.. . . The term First Nations came into common use in the 1970s to replace Indian, which some people found offensive. Many communities have also replaced “band” with “First Nation” in their names.” (Assembly of First Nations, 2010)

(45%). The psychosocial challenges and comorbidities (e.g., mental health, non-VSM) of this client group are undeniably extensive. These profiles are similar to both males and females. Given the profile of youth who misuse volatile substances, practitioners and researchers alike have identified the difficulty of providing effective treatment interventions. A 2002 survey of drug user treatment providers in the United States concluded that most treatment programs are not equipped to handle VSM or dependence, and providers have a very pessimistic view about the potential for individuals’ recovery (Beauvais, Jumper-Thurman, Plested, & Helm, 2002). In fact, Jumper-Thurman and Beauvais’ (1992) review of treatment programs designed for VSM concluded that they “rarely survive for more than 9 months” (p. 204). Combined with the fact that there is limited long-term evaluation of treatment programs for substance misuse generally (Hollister, 1992, p. 229), the YSAP’s program development began with limited empirical guidance. However, it did have a strong Indigenous cultural foundation on which to draw. A “MADE IN CANADA” RESIDENTIAL TREATMENT RESPONSE TO VSM

In response to limited empirical guidance, combined with an Indigenous approach to the understanding that is rooted in community relations, a network for the residential treatment centers was established alongside their development. The nine centers are linked through the Youth Solvent Abuse Committee (YSAC) network, involving program directors, YSAP representatives, and field experts. YSAC’s mission is to deliver proactive, social, cultural, and evidence-based programming that empowers First Nations and Inuit youth, families, and communities to improve their quality of life. YSAC’s guiding principles are spiritually grounded treatment and care; partnership with, and accountability to First Nations and Inuit communities in mobilizing health recovery; close harmony with nature and the environment; development of leadership skills for young people; Elder guidance; initiate and support the development of personal wellness care practices; holistic approach that weaves together the physical, spiritual, social, emotional, and mental well-being for the young person, their family, and their community; and continuous assessment of existing and emerging practices. YSAC provides a theoretical framework that guides the residential treatment centers in combining Indigenous culture and conventional Western approaches to addressing VSM among First Nations and Inuit youth. Given the general pessimistic view of practice and literature surrounding VSM, which is frequently pathology focused and can leave treatment providers hopeless, confused, and even paralyzed to act, YSAC has developed a treatment approach based on the elements of positive psychology, including resiliency theory and emotional intelligence, and grounded in an Indigenous cultural understanding. Although a common characteristic across the VSM treatment program is a connection to and the use of

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Indigenous cultural knowledge (Youth Solvent Addiction Committee, 2009–2010), it is important to note that the Indigenous knowledge base that informs each program is derived from the culture of the geographical area where the treatment center is situated. This can include, for example, land-based cultural camps, Elders’ teachings, ceremonial feasts, and the inclusion of community members in the treatment centers. It is important to point out that Western and Indigenous approaches to treating the misuse of substances have been frequently conceptualized and experienced as being “at odds.” For example, Hopkins and Dumont (2010) explain: When reviewing western-based approaches, it is important to understand that they were not created to attend holistically to the mind, body, emotions and spirit of an individual. Many do not attend to family and community, and few place spirit as central to healing. Gaining an understanding of the differences requires self-awareness about one’s own personal beliefs, value system, worldview and academic orientation, as well as any negative biases surrounding spirituality (Coyle, 2001); these will all influence where emphasis is placed.

However, a recent branch of Western psychology— positive psychology—focuses on understanding and fostering the factors that allow individuals, communities, and societies to flourish (Seligman & Csikszentmihalyi, 2000). As a general theoretical orientation to substance treatment and treatment system design, positive psychology overlaps with Indigenous knowledge approaches to health and wellness. An Indigenous Elder from Repulse Bay in Canada offers the following teaching, demonstrating positive psychology from a cultural perspective: They are never to be discouraged about what they can or cannot do. They will always feel better about their life if they are encouraged. They will always try harder then, to exceed their expectation. (National Aboriginal Health Organization, Ajunnginiq Centre, 2007)

It is important to note that Indigenous culture intersects with Western approaches to achieve a complimentary

understanding of a healthy quality of life. The following table illustrates how the foundational elements of positive psychology and Anishinabe, or Indigenous, culture overlap in their promotion of a healthy quality of life. Hopkins and Dumont (2010) report that Anishinabe cultural beliefs have been documented through generations with oral histories and sacred instruments attributed to Edward Benton Banai, Grand Chief of Midewiwin Three Fires Lodge; Midewiwin is translated as “way of the heart,” or healing and wellness of body, mind, and spirit. This understanding of quality of life is rooted in the central concepts of connection, self-efficacy, and meaningful life (Table 1; Hopkins & Dumont, 2010; Seligman & Csikszentmihalyi, 2000). The forthcoming revision of the Diagnostic and Statistics Manual of Mental Disorders provides examples from other health fields, such as psychiatry, in which the role of culture is being discussed. This article now turns to YSAC’s focus on resiliency and emotional intelligence as illustrations of their complimentary attention to both Western and Indigenous understanding and practices.

RESILIENCY—ILLUSTRATION

YSAP’s application of the Western concept of resiliency, combined with a culture-informed understanding, is the foundation of its residential treatment programs. A common Western definition of resilience is the extent to which one can overcome adversity. Theory on posttraumatic stress likewise is laden with the presumption of vulnerability and the absence of resilience. However, YSAP extended this definition to understand it as “a balance between individual strategies of coping with adversity and the availability of community support” (Dell et al., 2003). Tousignant and Sioui (2009) refer to this work as a new “culture-based model of resiliency.” Dell, Hopkins, and Dell (2004) explain: “Traditional Native world view highlights one’s spirit as the core of one’s self—the motivator and animator of one’s life. The spirit is what gives one the ability to bounce back. The conception of

TABLE 1. Comparing positive psychology and Anishinabe culture Elements of quality life 1. Connection—spirituality, perseverance, hope, wisdom

2. Self-efficacy—future mindedness, responsibility

3. Meaningful life—courage, creativity

Positive psychology

Anishinabe culture

Individuals’ connection to and experience One’s spirit “desires” to live life to its fullest, to have spiritual of pleasant emotions as a part of presence in the physical world through human experience. everyday life (see Bone et al.’s article on connection and support, this issue). Individual gifts with unique qualities Individual gifts given by the Creator to define purpose and specific to one’s potential in life set the meaning in one’s life, including the roles and foundation for self-determination—the responsibilities in life with unique qualities that are need for competence, a sense of nurtured through one’s connection to spirit, land, family, belonging, and autonomy. and community. A life purpose is the motivator of an One’s spirit name, connection to land and beings of creation, individual, recognizing that cultural ancestry and influence of ancestors, and nationhood all values and norms influence and make up one’s Indigenous personality, traits, and intimately interact with motivation and characteristics that constitute cultural identity. Cultural purpose. identity is the source for understanding how to live life with meaning.


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resiliency discussed here blends both Native and western philosophies. It is put forth as a set of Native identitybased characteristics that have transcended historical oppression and current-day adversity. The spirit is not a material form, so it is indestructible” (p. 5). The communal concept of society is also important in the traditional Native worldview. In addition to spirit is the communal concept of community. Yeomans and Forman (2009) support that the normative response to crisis is the strengthening of communal relationships on the social level and resilience on the individual level. This culture-based understanding of resiliency is put into practice in YSAP’s intake assessment process; the intake assessment focuses on youths’ strengths alongside the etiology of their VSM. The authors know from more than 35 years of combined practice in the field that more often than not, intake assessments are focused on risks and needs, with limited attention to individuals’ strengths. The assessments are typically informed by adults in the youths’ lives, including a parent or an extended family member, probation worker, addictions counselor, social worker, school counselor, and police. Although information on youths’ behavioral and safety challenges is important for planning intervention services, by design, the assessments are rarely structured to account for youths’ inherent strengths that are derived from their Indigenous identity and cultural heritage. A resiliency scale developed by YSAC and tested across the network of treatment centers facilitates some understanding of the importance of focusing on youths’ strengths. To illustrate, an important resiliency trait is “courage” (Seligman & Csikszentmihalyi, 2000), and when youth are challenged to move through or past certain issues such as those with their peers while living in a residential environment, they are asked by counselors to describe how they learned to be courageous, which is a question that assumes they have and know courage. The question leads to a discussion that is both affirming of the youth’s courage and strengthening of the youth’s ability to transfer the same knowledge and skills gained through previous life experience to face the current challenge. Further discussion may also draw upon the youth’s Indigenous identity, such as their spirit name or clan, with links made to one’s purpose, roles, and responsibilities within the community that are also inherent strengths that can be drawn upon to face the current adversity. In fact, the establishment of cultural strengths is central to the YSAP assessment process; it is fundamental to ensuring a sense of safety in navigating issues underlying substance misuse from a strengths-based foundation. Strengths framed from a cultural context look at cultural identity—spirit name, clan family, connection to land, nationhood, and cultural ceremonies. Booglar Collard (2008) explains: When kids are grounded in culture and country, then they have a positive way forward because they have something special to offer the world. This gives them the confidence to make good choices for themselves, and hopefully it will generate in them a strength that

can’t be broken . . .. You see we have a spiritual life and we are spiritual people, and without spirit we are nothing.

EMOTIONAL INTELLIGENCE—ILLUSTRATION

Emotional intelligence, from within a Western framework, describes the ability, capacity, and skill to identify, assess, and control the emotions of one’s self, in relation to others and groups. YSAP adopted the 6 Seconds Model of Emotional Intelligence, which is based on three actions: Know Yourself—increase awareness, Choose Yourself—act intentionality, and Give Yourself—align with purpose (6 Seconds, 2007), as both a method and a model for treatment program delivery, treatment program curriculum, staff training, Board of Directors training, and emotional intelligence assessment against a core set of competencies. From an Indigenous cultural worldview, knowing oneself comes from a connection to the universal family of creation, one’s biological and extended family, and community. It is through this connection that one is nurtured in awareness of self in relation to others. Choosing self and acting with intention from a cultural perspective is about choosing a life path that is reflective of cultural identity, intrinsically motivated by one’s spirit and one’s spiritual connection to family and community. Cultural knowledge facilitates an understanding about the “truth,” purpose, and meaning of one’s life, which sets the foundation for “giving self.” The following cultural example from a Nimkee NupiGawagan Healing Centre’s staff member demonstrates an alignment with emotional intelligence theory, practiced within a cultural framework, and highlights the significance of developing awareness of self, choosing oneself, and giving oneself. Fasting is a cultural healing ceremony employed at one of the youth VSA treatment programs, Nimkee NupiGawagan Healing Centre. After youth have gained a good foundation in their connection to culture and spirituality, they can choose to fast in isolation on the land, in a sacred lodge, as way of experiencing their spiritual connection with their ancestors and creation as their primordial and eternal family. Youth prepare for their fast in many ways, one of which is to ceremonially feast the spirit of their ancestors. The feast ceremony provides the opportunity for youth to process grief and gain understanding of their spiritual relationship with their ancestors. Many youth will provide food for their deceased parents, aunts, uncles, and friends. While the youth fast, their ancestors visit them in their dreams and it is within the dream that they visit, laugh, play, and converse about all the unfinished business of the relationship and receive messages of encouragement and validation. Finally, the last stage of their fasting is their realization that they have overcome their fear of being alone because they realize they have not been alone, they have been cared for within their spirit family, including the land and all that is there in creation as their family.

The youth in residence at the YSAP treatment centers frequently reference how they “do not know what to do” when they experience the death of a relative or friend. Reflecting on their participation in a ceremonial feast for their fast, they often describe in detail what they felt, what


they were thinking, and what actions they took in response to death. Frequently, this processing is their first expression of thoughts, feeling, and actions related to unresolved grief. Conventional approaches to address grief and loss on their own cannot achieve this depth of healing; in fact, it is the belief in spirit that facilitates this process.


TREATMENT OUTCOMES

Although YSAP has not undertaken a longitudinal evaluation of its treatment centers’ programming, it is confident from the research that it has undertaken (Dell et al., 2004; Fiedeldey-Van Dijk, 2009; Hopkins & Dumont, 2010; Nimkee NupiGawagan Healing Centre Inc., 1997), and culture-based ways of knowing (e.g., Elder’s teachings), that Indigenous cultural knowledge, combined with Western resiliency theory and emotional intelligence within a positive psychology framework, support a strengths-based approach to assessment, treatment planning, and delivery. Nonetheless, a limitation of this article is the absence of published results. YSAP does, however, have newly collected unpublished data to share here. To provide some insights into the YSAP treatment programs’ outcomes, client follow-up data are collected at 3-, 6-, 9-, and 12-month intervals following completed treatment at a YSAP center. It is important to note that data gathering is hampered by high client mobility; however, information was collected over a 2-year period on 154 youth, reflecting approximately 40% of the total client population that received residential treatment service from 2007 to 2009. Half of the youth (49.62%) reported a completely abstinent lifestyle in the 90 days following exit from the YSAP program. And half of these youth (51%) reported to not have had the urge to misuse volatile or other substances during this time (Fiedeldey-Van Dijk, 2009). The numbers corresponding to the second follow-up at 180 days following discharge jump to 74% not using and 68% not having to resist volatile or other substances in the 6 months after the program. This is an important consideration in outcomes research, since abstinence is not the only goal. This data show that even if a youth uses shortly after discharge, it is sometimes to “test themselves,” and they may not return to regular use. The YSAP programs define success as a demonstrated reduction or elimination in inhalant usage, return to school or formal education, a reduction in involvement with the law, and improved social and spiritual functioning. As an example of YSAP’s conceptualization of success, more than half of the youth who completed the YSAP program (54.20%) attend school upon exit from the program, recorded during the first follow-up visit (after 3 months). This number increases to 83.64% with the second follow-up visit (after 6 months). In regard to legal difficulties, 81.13% of the youth were trouble free from legal issues in the first 3 months after the program, with 15.09% in trouble only once, and 3.77% who still got in trouble with the law on a monthly basis (Fiedeldey-Van Dijk, 2009).

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CONCLUSION

Certainly, the complexity, multidimensionality, and nonlinearity of VSM among Indigenous youth is such that a residential treatment program is not and never will be the panacea response. To tackle VSM on a grander scale requires the inclusion of various prevention, intervention, and sociopolitical–environmental efforts. The petrol replacement effort in Australia is one example of a coordinated continuum response (d’Abbs & MacLean, this issue; Schwartzkoff, Wilczynski, Reed-Gilbert, & Jones, 2008). Australia, likewise, offers culture-based treatment programs that similarly rely on family and community responses for youth VSM (see Shaw et al., this issue). Critical to all these efforts is recognition of the need to combine Western and culture-based approaches. YSAP effectively employs resiliency and emotional intelligence theories in the context of Indigenous cultural knowledge and healing practices. Understanding the principles that underlie conventional theoretical approaches to addressing substance misuse is critical for discerning the capacity for meaningful application with Indigenous populations and the potential compatibility with Indigenous knowledge and cultural healing practices. Such understanding and application is critical to the ongoing development of the YSAP treatment centres’ structure, programming, and services to best respond to clients’ needs and strengths. Assessments that focus on cultural identity and one’s connection to or understanding of one’s cultural identity as a source of strength are important for developing culturally safe and meaningful interventions. For example, questions that focus on self-perception of identity can often reveal varying levels of shame attached to identity without realization that the shame is a result of colonization processes. Decolonization must then play a significant role in the planned intervention so that the client can connect to their cultural identity in a positive manner and see their identity as a source of strength. The inclusion of cultural practitioners, who can be relied upon for their cultural knowledge, can enhance the assessment and intervention planning stages of service delivery. Bergson (1927) said, “The eye only sees what the mind is prepared to comprehend.” As treatment providers, it is important that we recognize the strengths of the young clients we work with, and seek to understand their worldviews that may not necessarily be familiar to us. More research is needed specific to the impact of culture, resiliency theory, and emotional intelligence theory in the residential treatment of volatile substance misusers. This research needs to focus on the impact on client treatment outcomes, quality of work life for staff, the impact of staff satisfaction on client outcomes and, most importantly, how these impacts affect client well-being posttreatment. Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

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THE AUTHORS


Debra Dell, M.A., has been working in residential VSM treatment in Canada for more than 25 years, having had many roles from frontline counseling to executive positions, including her current role as National Coordinator for the YSAC network. Debra has a masters degree in Counseling Psychology. Debra has a special interest in all aspects of positive psychology including work with resiliency theory and emotional intelligence in addictions programming.

Carol Hopkins, M.S.W., is Wolf Clan from the Lenni Lenape Nation, otherwise known as the Delaware of the Thames First Nation located in southwestern Ontario. Carol is the mother of four and grandmother of six. She is the Executive Director of the National Native Addictions Partnership Foundation, whose mandate is to advocate on behalf of and support the National Native Alcohol and Drug Abuse Program and the National Youth Solvent Addiction Program for First Nations and Inuit people in Canada. Carol is also the Cochair of the NNADAP/YSAP Renewal Leadership Team whose mandate is to guide the renewal of NNADAP/YSAP. She is also a part-time professor at Kings College, School of Social Work at the University of Western Ontario, and an international speaker on Indigenous culture in addictions.

GLOSSARY

Anishinabe: Anishinabe is an Algonquin language term that means “original man who was lowered to this earth” and is used as an identifier of Indigenous people. Every Indigenous language family has a word that conveys the meaning “people of the land.” This term also conveys the understanding that as people of the land, there is an extended family relationship that connects Indigenous people to each other and to the earth (Hopkins & Dumont, 2010). Cultural competence: Cultural competence is a commitment to engage respectfully with people from other cultures. A commitment to cultural competence is the beginning of an ongoing process that requires motivation and a willingness to improve cross-cultural communication and practice in both individuals and organizations. Cultural competence encompasses and extends the elements of cultural respect, cultural awareness, cultural security, and cultural safety. Cultural competence is a set of congruent behaviors, attitudes, and policies that

come together in a system, agency, or among professionals and enable that system, agency, or those professionals to work effectively in cross-cultural situations (Cross, Bazron, Dennis, & Isaacs, 1989). Importantly, for individuals, cultural competence requires more than becoming culturally aware or practicing tolerance. It can be defined as the ability to identify and challenge one’s own cultural assumptions, one’s values, and beliefs. It is about developing empathy and connected knowledge, the ability to see the world through another’s eyes, or at the very least to recognize that others may view the world through a different cultural lens (Walker & Sonn, 2010). Cultural healing practice: Practices designed to promote mental, physical, and spiritual well-being that are based on beliefs that go back to the time before the spread of western “scientific” biomedicine. When Aboriginal people in Canada talk about traditional healing, they include a wide range of activities, from physical cures using herbal medicines and other remedies to the promotion of psychological and spiritual well-being using ceremony, counseling, and the accumulated wisdom of Elders (Canada Communication Group, 1996, p. 348 in Hill, 2003). Emotional intelligence: The 6 Seconds Emotional Intelligence Assessment (SEI) is based on 6 Seconds’ model of emotional intelligence—a model designed to help people put it into action in their lives. The model consists of eight fundamental skills divided into three pursuits—Know Yourself, Choose Yourself, and Give Yourself. By committing to these three pursuits, people are better able to develop and use their emotional intelligence to create more positive, healthy, and meaningful lives (6 Seconds, 2007). Indigenous cultural knowledge: Indigenous cultural knowledge emphasizes the integration of physical and spiritual realities, such that the manifestation of spirit in physical reality is accepted as proof when the understanding of such manifestation can be tied to cultural teachings. Indigenous knowledge, however, is not static. Human beings are continuously discovering or coming to new understandings about things that have existed in creation from the beginning. The knowledge carried today has the benefit of the knowledge left by our ancestors; something always rooted in the creation stories. It is these stories that hold the knowledge from which all else is derived and understood (Hopkins & Dumont, 2010). Recovery potential: Addiction is not a life sentence and treatment is effective. One’s potential for recovery from an addiction is an interdependent relationship between the person’s status of well-being and the influence on this status by an individual’s environment (risk and resiliency factors), including a treatment program environment (i.e., how it attends to the whole person; National Institute on Drug Abuse, 2010).



Resiliency theory: Resiliency theory is based on strengthsbased psychology, which defines resiliency as the capability of individuals, families, groups, and communities to cope successfully in the face of significant adversity or risk. This capability changes over time, is enhanced by protective factors in the individual/system and the environment, and contributes to the maintenance and enhancement of health. From a First Nations perspective, a critical protective factor is a connection to spirit, land, family, and community as it is believed that it is the spirit that is the source of “elasticity” or a person’s ability to “bounce back” from adversity. Wellness: Wellness is a sense of balance between one’s spirit, emotions, physical, and mental aspects of self. “Spirituality fuels a range of positive outcomes in the form of an enhanced sense of well-being, improved feelings of resiliency, and decreased adverse physical symptoms (e.g., pain and fatigue) and psychological symptoms (e.g., anxiety)” (Boudreaux, O’Hea, & Chasuk, 2002).

REFERENCES Assembly of First Nations. (2010). Fact sheet, terminology. Ottawa, ON: Author. Beauvais, F., Jumper-Thurman, P., Plested, B., & Helm, H. (2002). A survey of attitudes among drug user treatment providers toward the treatment of inhalant users. Substance Use and Misuse, 37(11), 1391. Retrieved November 17, 2011, from Academic Search Premier database. Bergson, H. (1927). Henri Bergson quotes. Retrieved October, 2010, from Think Exist.com Quotations. Retrieved November 17, 2011, from http://thinkexist.com/quotation/the eye sees only what the mind is prepared to/13601.htm Booglar Collard, J. (2008). A strength that can’t be broken. In S. Morgan, T. Mia, & B. Kwaymullina (Eds.), Heartsick for country: Stories of love, spirit and creation (pp. 238–252). North Fremantle, WA: Fremantle Press. Boudreaux, E. D., O’Hea, E., & Chasuk, R. (2002). Spiritual role in healing. An alternative way of thinking. Primary Care, 29(2), 439–454. Canadian Broadcasting Company. (2000). I’ll never stop sniffing gas video broadcast. Retrieved November 10, 2010, from http://archives.cbc.ca/society/poverty/clips/11509/ Canada Communication Group. (1996). Royal Commission report on Aboriginal peoples. Ottawa, ON: Canada Communication Group. Coyle, B. R. (2001). Twelve myths of religion and psychiatry: Lessons for training psychiatrists in spirituality sensitive treatments. Mental Health, Religion and Culture, 4, 149–174. Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care, Volume I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center. Dell, C., & Beauchamp, T. (2006). Volatile solvent abuse in Canada. Ottawa, ON: Canadian Centre on Substance Abuse. Dell, C., Hopkins, C., & Dell, D. (2004). Resiliency and holistic inhalant abuse treatment. Journal of Aboriginal Health, 1(2), 4–12.

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Dell, C., & Lyons, T. (2007). Harm reduction and persons of Aboriginal descent. Ottawa, ON: Canadian Centre on Substance Abuse. Dell, C., Ogborne, A., Begin, P., Roberts, G., Dell, D., Ayotte, D., et al. (2003). Youth residential solvent treatment program design: An examination of the role of program length and length of client stay. Saskatoon: Youth Solvent Addiction Committee. Fiedeldey-Van Dijk, C. (2009). Knocking on YSAC’s door. YSAC Database Analysis Report. Toronto, ON: Unpublished. Hill, D. M. (2003). Traditional medicine. Ottawa, ON: National Aboriginal Health Organization. Hollister, L. (1992). Treatment and prevention research issues. Bethesda, MD: US Department of Health and Human Services, National Institute on Drug Abuse. Retrieved March 8, 2010, from PsycEXTRA database. Hopkins, C., & Dumont J. (2010). Cultural healing practice within National Native Alcohol and Drug Abuse Program and solvent addiction program services. Ottawa, ON: First Nations Inuit Health, Health Canada. Jumper-Thurman, P., & Beauvais, F. (1992). Treatment of volatile solvent abusers. Bethesda, MD: US Department of Health and Human Services, National Institute on Drug Abuse. Retrieved March 8, 2009, from PsycEXTRA database. Manitoba Office of the Children’s Advocate. (2003). Paungassi First Nation report on solvent abuse. Winnipeg, Manitoba: Author. National Aboriginal Health Organization, Ajunnginiq Centre. (2007). Resilience: Overcoming challenges and moving on positively. Ottawa, ON: Author. National Institute on Drug Abuse. (2010). Drugs, brains, and behavior—The science of addiction. Retrieved October, 2010, from National Institute on Drug Abuse (NIDA). Retrieved November 17, 2011, from http://www.nida.nih.gov/ scienceofaddiction/treatment.html Nimkee NupiGawagan Healing Centre Inc. (1997). Annual report. Muncey, ON: Author. Schwartzkoff, J., Wilczynski, A., Reed-Gilbert, K., & Jones, L. (2008). Review of the first phase of the petrol sniffing strategy. Sydney: Department of Family, Housing, Community Services and Indigenous Affairs. Seligman, M., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5–14. 6 Seconds. (2007, August 18). All about emotional intelligence from 6 seconds-EQ-in-action. Retrieved October 16, 2010, from 6 Seconds: The Emotional Intelligence Network. Web site: http:// www.6seconds.org/modules.php?name=News&file=article& sid=277 Tousignant, M., & Sioui, N. (2009). Resilience and Aboriginal communities in crisis: Theory and interventions. Journal of Aboriginal Health, 5(1), 43–61. Walker, R., & Sonn, C. (2010). Working as a culturally competent mental health practitioner. In P. Nola, D. Pat, & W. Roz (Eds.), Working together: Aboriginal and Torres Strait Islander mental health wellbeing principles and practice (pp. 157–180). Sydney: Australian Government—Department of Health & Ageing. Wesley-Esquimaux, P. C. (2004). Historic trauma and Aboriginal healing. Ottawa, ON: Aboriginal Healing Foundation. Yeomans, P., & Forman, E. (2009). Cultural factors in traumatic stress. In S. Eshun & R. Gurung (Eds.), Culture and mental health: Sociocultural influences, theory, and practice (pp. 221–244). West Sussex: Wiley-Blackwell. Youth Solvent Addiction Committee. (2009–2010). Annual report. Saskatoon, SK: Author.