First Annual AIHEC Behavioral Health Institute
Historical Trauma Clinical Intervention Research and Practice
Understanding the experiences of a community is important in beginning the healing process. Genocide, imprisonment, forced assimilation, and misguided governance has resulted in loss of culture and identity to varying degrees, alcoholism, poverty, and other psychosocial issues. The Historical Trauma and Unresolved Grief Intervention (HTUG), a Tribal Best Practice, offers a healing model within the context of cultural strength and resilience. HTUG theory and practice resonate across tribal communities in the United States and Canada. Through acknowledging our collective past as Native Peoples, both our suffering and our strength, we return to the sacred path.
Purpose and Structure of the Institute
The goal of this Institute was to weave together the theory and practice of Historical Trauma and Community-Based Participatory Research (CBPR) through presentations, discussion with community-academic partners, small group breakouts, interactive activities, reflections on readings, and reflection on one's own research experience. Participants gained an appreciation of the impact of historical trauma and CBPR strengths and challenges, as well as learned hands-on skills necessary for participating effectively in CBPR projects. Both academic discussions and experiential exercises reflected a commitment to co-teaching and co-learning.
- American Indian Historical Experience with Research, Nate St. Pierre
Dr. St. Pierre provides an account of Native "research" methods and Western research approaches. In most Native communities, there is no word for research. Community members acquire knowledge from tribal elders, ceremonies, and oral historians in contrast to non-Native research which is based on dogmatic science. Given these different approaches, Native and non-Native people disagree on some methodologies. Historical experience has revealed the effect of Western research on indigenous people that has led to their exploitation and the misappropriation of their culture. Therefore, future research done in Native communities must protect cultural property and ensure that all parties involved learn from each other.
- Community-Based Participatory Research (CBPR): A Grounding for Action and Social Change, Bonnie Duran
There are different types of participatory research, e.g., action research, emancipatory research, and community-based participatory research (CBPR). CBPR can be defined in many ways but all definitions stress that all entities impacted by the issue being studied must be involved in the research process. CBPR is a long term process that requires the commitment of all those involved. It encourages a holistic view and the sharing of knowledge to all the people participating in the research. There are several principles underlying it. One of the ways it can be used is to decolonize research or make it so that indigenous people "theorize their own lives connecting with past and future generations" (slide 32).
- Decolonizing to Indigenizing Research: Building Indigenist Community Partnerships, Karina Walters
Discoveries made in indigenous communities have positively impacted non-Native communities and yet, history focuses more on Western discoveries than Native American discoveries. It is important that indigenous research and acquisition of knowledge are decolonized. Decolonization leads to more culturally-relevant research which in turn seeks to improve the health and wellness of Native American people by addressing the issues of greatest concern in the community. Dr. Walters also describes the CBPR principles, i.e. "The 8 R' s" (reflection, respect, relevance, resilience, reciprocity, responsibility, re-traditionalization, and revolution).
- Research Partnerships with Natives: Major Challenges, Proven Solutions, William Freeman
Understanding the difference between good and bad research is key to preventing abuse in Native communities. Good research should have a purpose, a way of dissemination, appropriate future use, and values. All of these factors should be united and harmonious and agreed upon between TCUs/tribes and researchers. In this endeavor, an agreement on how data and material will be shared and who can claim ownership to what should be clearly outlined.
- Historical Trauma Informed Clinical Intervention Research and Practice, Maria Yellow Horse Brave Heart, Josephine A. Chase
Historical trauma examines the result of how tragedies in a historical context influence the emotions and subsequent behaviors of present and future generations. The Woope Sakowin (Seven Laws of the Lakota) is used among the Lakota as traditional protective factors. In an effort to reduce historical trauma and the suffering of Native Peoples, the Takini Network/Institute was developed. By using the Historical Trauma & Unresolved Grief (HTUG) intervention, people can begin to heal from their trauma, grief, and historical trauma response features-- anger, low self-esteem, and depression. In other words, they can begin to return to the sacred path or regain the strengths of their traditional culture.
- Wicasa Was'aka: Restoring the Traditional Strength of American Indian Boys and Men, Maria Yellow Horse Brave Heart, Jennifer Elkins, Greg Tafoya, Doreen Bird, and Melina Salvador
This study looked at the disproportionate health disparities of American Indian men and boys in the context of historical trauma. By evaluating the cross-generational problems preventing Native men and boys from carrying out their traditional roles, Brave Heart et al. are able to define interventions and propose policy recommendations. They suggest the development of culturally-sensitive, historically conscious public health programs in order to eliminate the health disparities American Indian men and boys face.
- Developing and Maintaining Partnership with Communities 2012, Bonnie Duran, Nina Wallerstein, Magdalena M. Avila, Lorenda Belone, Meredith Minkler, and Kevin Foley
Duran et al. present five strategies for different entities to collaborate with communities in research. These collaborative partnerships make studies of a particular topic more effective and improve health outcomes. The strategies for institutional-based researchers to begin and sustain partnerships are: to self-reflect and know where they stand with the community, identify good avenues for partnerships, develop a shared research agenda, secure mentorships across the CBPR partnership, and create structures to maintain the partnership.
- Indigenizing CBPR: Evaluation of a Community-Based and Participatory Research Process Implementation of the Elluam Tungiinun (Towards Wellness) Program in Alaska, Stacy M. Rasmus
In this article, scholar Stacy Rasmus seeks to understand the thoughts of an Alaska Native community regarding the CBPR process. Using qualitative methods to describe the effects of CBPR from the perspective of the Yup’ik, Rasmus gathered information on their perceptions of CBPR implementation, level of involvement in the process, ownership of material, outcomes at all levels of society, and challenges associated with the process. Findings showed that community members felt ownership of the intervention through their own process ("a translational and indigenizing process" (p. 1)) which was supported and enhanced by the implementation of CBPR.
- Community-Based Participatory Research Contributions to Intervention Research: The Intersection of Science and Practice to Improve Health Equity, Nina Wallerstein, Bonnie Duran
Community Based Participatory Research (CBPR) is an emerging research approach that aims to reduce health inequities. It blends science with practice through social action of a community. It takes translational science a step further by amending the power imbalance between groups participating in research or one group carrying out projects with another group as subjects. CBPR also encourages co-learning by incorporating community practices into scientific, empirical research. Furthermore, CBPR can address the challenges of implementation and intervention such as external validity (translating scientific findings to another setting), language, evidence, business as usual (universities controlling every step of the research process), sustainability of a program when funds run out, and lack of trust between academia and communities.
- Using Community-Based Participatory Research to Address Health Disparities, Nina Wallerstein, Bonnie Duran
"As CBPR matures, tensions have become recognized that challenge the mutuality of the research relationship, including issues of power, privilege, participation, community consent, racial and/or ethnic discrimination, and the role of research in social change. This article focuses on these challenges, provides examples of these paradoxes from work in tribal communities, discusses the evidence that CBPR reduces [health] disparities, and recommends transforming the culture of academia to strengthen collaborative research relationships" (p. 312).
- "Indigenist" Collaborative Research Efforts in Native American Communities, Karina L. Walters, Antony Stately, Teresa Evans-Campbell, Jane M. Simoni, Bonnie Duran, Katie Schultz, Erin C.Stanley, Chris Charles, and Deborah Guerrero
This publication draws attention to indigenous science and knowledge. The knowledge of Native people has been heavily undermined and undervalued through abuse and myths. Efforts to decolonize research and reinvigorate the success of indigenous practices are also faced with the task of disproving the myths of "the intellectually inferior Indian" (p. 148). Walters et al call for "revitalization of indigenous epistemologies, research practices, and ultimately, indigenous wellness practices." This document also provides an example of how to indigenize collaborative research efforts in a case known as the HONOR Project. Future collaborative efforts in research require reciprocity, and even though those involved in the project may have to give up some control, their work will eventually be rewarded.
- A Focus on Primarily Undergraduate Institutions & Emerging Research Institutions, Jean Flagg-Newton
Dr. Flagg-Newton lists an array of funding sources for undergraduate institutions (UIs) and emerging research institutions (ERIs). This document details how to find a strategy, determine which funds the institution may be available, and sustain funding by building a framework or setting up a funding mechanism at the institution. The essentials of the following grants are provided: the Biomedical/Biobehavioral Research Administration Development (BRAD) program, the Biomedical & Behavioral Research Innovations to Ensure Equity (BRITE) in Maternal and Child Health program, and research supplements that promote diversity in health-related research. The goal of the BRAD Program is to "create (or enhance) research administrative support infrastructures at under-resourced primarily undergraduate institutions (PUIs) and emerging research institutions (EMIs)" (slide 9). The goal of BRITE is to "stimulate maternal and child health equity research within institutions eligible for the AREA R15 program" (slide 28).
- Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes, Michael Muhammad, Nina Wallerstein, Andrew L. Sussman, Magdalena Avila, Lorenda Belone, and Bonnie Duran
This article addresses the role of power in CBPR. In order for CBPR to be effectively applied in communities and achieve the results of health equity, "unequal power relations [should be] identified and addressed" (p. 1). It is imperative that different entities that enter into partnerships equally participate. Michael Muhammad et al carried out seven case studies in which they analyzed differences, and the context in which these differences arise, that could affect power imbalances in research.