| Cultural Practices in American Indian
by Ruth Sanchez-Way and Sandie Johnson
The use of American Indian cultural activities in substance abuse prevention
programs is part of the indigenous cultural renaissance that has been
under way in tribal communities since the late 1960s. American Indians
pride in their heritage has been growing, as has their awareness of their
unique position as nations within a nation (Beauvais, 1992).
The strategy of applying a cultural approach to social problems began in the early 1970s, when American Indian substance abuse treatment programs began inviting community elders to participate in the healing of their clients. The elders brought with them a holistic approach that involved cultural practices such as participating in sweatlodge ceremonies and smudging with sweetgrass or sage.1
In the 1980s, experts reasoned that if a cultural approach works in treatment, then perhaps applying this approach earlier might prevent American Indian youth from drinking alcohol and going through the hardships of alcohol and drug abuse. Leaders began using cultural activities in substance abuse prevention programs (see sidebar).
Culture has been defined as the complex ensemble of emotions, beliefs, values, aspirations . . . that together make up behavior (Fabrega, 1992:561). Culture is transmitted through language and is constantly changing. It includes the stories, songs, art, and literature of a people. In essence, it is the framework in which childhood socialization takes place (Beauvais, 1992). Research shows that strong cultural identification makes adolescents less vulnerable to risk factors for drug use and more able to benefit from protective factors than adolescents who lack this identification (Zickler, 1999). Although the studies Zickler refers to were conducted with Puerto Rican, African American, and Asian populations, risk and protective factors among youth appear to be universal regardless of ethnicity or gender (Fisher, Storck, and Bacon, 1999).
Although the effect of culture on substance use is not direct, culture acts in combination with family, personality, or peer influences (Zickler, 1999:8). Eugene Oetting and Fred Beauvais (1989), respected researchers on American Indian youth, agree that the effect of culture on substance use appears to be indirect. They believe that culture acts through the family, community, peer clusters, and ceremonies and rituals that transmit its underlying spiritual values.
Although cultural affiliation and cultural identification have been studied for many years, Trimble and Beauvais (in press) point out that research on the link between cultural identification and lower levels of drug and alcohol use is extremely meager, not only for Indian youth, but also for all other minority populations. This may be because the link between cultural identification and reduced alcohol and drug use is indirect and because researchers use different measures of cultural identification.
Nevertheless, powerful testimony from individual American Indians is in accordance with a 1989 youth survey reporting that American Indian adolescents who identify with Indian culture are less likely to be involved in alcohol use than those who lack this sense of identity (Oetting and Beauvais, 1989). Moran and Reaman (in press) cite a prevention program, Project Charlie (Chemical Abuse Resolution Lies in Education), that found a significant correlation between increased affiliation with ones culture and decreased alcohol and drug use. This project was implemented in the 1980s in Rhode Island by the Narraganset tribe.
Acculturation is the process by which a member of an ethnic minority assimilates to the majority culture (Zimmerman et al., 1998). Acculturation stress has been cited as a factor in substance abuse among American Indians (Jilek-Aall, 1981; Fisher, Storck, and Bacon, 1999); however, Oetting and Beauvais (1991) have not found acculturation stress to be an adequate explanatory factor for substance use by American Indian adolescents.
Cultural identification is multidimensional rather than a simple linear matter of acculturation or nonacculturation. An important dimension to cultural identification is having a stake in society. A family that speaks an Indian language and engages in tribal activities develops a stronger stake in American Indian culture than a family that does not. People can have college degrees and jobs off the reservation but still participate in tribal activities and have a high stake in American Indian society.
In contrast, a person can live on a reservation and not have much stake in Indian culture. Some tribal people identify more strongly with the majority culture, but strong identification with non-Indian culture has not been found to be related either positively or negatively to the prevalence of alcohol use and abuse. Instead, having a high stake in both the traditional and the majority cultures appears to be related to decreased alcohol use (Oetting and Beauvais, 1989). In contrast, tribal peoples who live on the margins of both the traditional and the majority cultures are at the highest risk for substance abuse (May, 1986). These findings support the theory that people need a strong sense of group identification to maintain a state of well-being (Moran and Reaman, in press).
The Center for Substance Abuse Prevention (CSAP) has funded more than 400 demonstration grant programs for high-risk youth in almost every State and Pacific jurisdiction, Puerto Rico, and the U.S. Virgin Islands, reaching an estimated 50,000100,000 youth annually.2 A CSAP demonstration grant that emphasized building a bicultural identity as a prevention strategy was implemented in 199596. The project sought to increase emotional strength and self-esteem and decrease substance use by using a storytelling intervention that incorporated cultural symbols (Nelson, 1999). The study population was a group of more than 200 middle school students who resided on a rural reservation in the Southwest. Storytelling was used as a way of helping young people deal with the social, cultural, and emotional factors faced in growing up amidst poverty in a minority community (Nelson, 1999:1).
The programs 27-lesson curriculum covered brain physiology, decisionmaking skills, and multicultural stories. The curriculum enhanced the protective factor of self-identity as an American Indian through storytelling.
At the end of the academic year, results showed that problem-solving skills, positive self concept, and unfavorable attitudes toward drugs had increased, whereas use of inhalants, alcohol, and marijuana had decreased. These results were statistically significant. The study found that as exposure to the curriculum increased over the course of the school year, the number of drugs the students used in the preceding month decreased. The decrease in alcohol use by male American Indians in middle school was especially significant. Nelson stressed the importance of exposing the youth to high dosages (28 hours or more) of this cultural intervention strategy.
Because storytelling is inherent to American Indian cultures, implementing it as a prevention strategy is congruent with the world view of these cultures. Cross, who recommends storytelling as a family strategy, says that in passing on the stories of our lives, we pass on skills to our children, and we parent for resiliency (Cross, 1998:152).
Resilience has been defined as competence despite exposure to significant stressors (Glantz and Johnson, 1999:7). However, resilience, like cultural identification, does not directly influence the prevalence of alcohol use. It has an effect only when inadequate handling of a life crisis might lead to problems that increase the potential for drug use. In other words, resilience only comes into play at times of stress and crises (Beauvais and Oetting, 1999).
Effective Prevention Programs
A cross-site evaluation of CSAPs overall substance abuse prevention programs identified several elements common to successful programs (Sanchez-Way, 2000). Effective programs employ a variety of approaches and interventions in a variety of settings. A common element of successful programs is that they foster caring, supportive relationships with one or more adults. Successful programs create opportunities for youth to develop feelings of self-efficacy and competence.
Youth in the general population who have the following characteristics are less likely to use substances such as drugs or alcohol:
Strong relationships within the family and between parents/caregivers and children.
Family supervision and discipline.
Clear positive standards for behavior.
Family and peer norms that discourage alcohol and drug use.
A stable community environment that sanctions norms, values, and policies that control access to alcohol and drugs.
Meaningful opportunities for children to contribute to their community.
The Culture-Based Approach
Differences by tribal group, culture, degree of Indian ancestry, and reservation/urban residency make it impossible to prescribe a general prevention approach for all American Indian youth (Moran and Reaman, in press), even if that were desirable. Successful approaches, however, will incorporate ethnic and cultural components into prevention programs to promote the characteristics stated above.
With a prevention strategy framework based on values inherent to traditional tribal cultures, the GONA training program quickly became one of the CSAP services most requested by American Indian communities. It is based on a theory of four stages of development: belonging, mastery, independence, and generosity. The underlying concept is that healthy development requires each child, each person, and each community to go through certain stages. If a stage is missed, the individual or community must later go back and work through it in order to develop fully. Because so many tribal communities have been traumatized by substance abuse, poverty, unemployment, and historical grief, tribal leaders have found this model useful in beginning community healing by gathering the people together to develop a community response to the problems they are facing.
Many people, tribes, and organizations and several government agencies (such as the Indian Health Service) contributed to developing and funding GONA trainings and to the recent publication of a shorter, revised GONA manual.6
Although the GONA manual has stimulated interest in many tribal communities, Thurman and colleagues (in press) caution that communities, like individuals, differ in their stages of readiness for intervention and that it is often necessary to prepare a community for collective action and change. Some steps that can be taken to prepare a community include holding prevention training for service providers; writing grants to support needs analysis, strategic planning, and program development and implementation; and disseminating information on prevention programs. Thurman and colleagues developed a nine-stage model of community readiness that ranges from community tolerance of youth alcohol and drug use to implementation and evaluation of substance abuse prevention programs.
One factor to consider is that American Indian substance abuse programs treat the link between prevention and treatment differently than non-Indian programs. Non-Indian practitioners tend to see prevention as one step on a continuum that progresses from primary prevention through intervention to treatment and aftercare/rehabilitation (see figure 1). In contrast, American Indian practitioners see primary prevention as part of a cycle that moves through intervention, treatment, aftercare/rehabilitation and back to primary prevention (see figure 2).
The prevention program of the Red Lake Band of Chippewa in Minnesota exemplifies the connection between prevention and aftercare. One component of Red Lakes program, which has been in effect since the early 1980s, is an after-school community center for youth. The center, which is open from 2 until 10 p.m. every day, is operated by American Indian substance abuse program staff. Youth participate in many activities at the center, including making crafts and powwow regalia, and in camping and rollerskating. Parents are required to participate in the camping and rollerskating activities.
The director of the program, Richard Seki, says that they often need 45 buses to transport 400500 youth and parents to Bemidji, the nearest town to the reservation (a 45-minute ride) for the centers weekly rollerskating activity (R. Seki, personal communications, 2000). Over the past 4 years, approximately 1,000 children from the reservation have attended the summer cultural immersion camp in which the Chippewa, or Ojibwa, language plays a key role. Seki seeks to give youth a sense of belonging and a respect for traditions nearly forgotten in the modern world.
The center and its related activities are referred to as prevention activities, and a core group of 2025 youth form the nucleus of a nonusing peer group. However, when other teens return from addiction treatment, they are encouraged to get involved in youth center activities, which are considered aftercare. Thus, the same cultural activities serve as both primary prevention and aftercare/rehabilitation. Together, the youth participating in the program constitute the major nonusing peer cluster on the reservation.
No discussion of American Indian substance abuse would be complete without mentioning the National Association for Native American Children of Alcoholics (NANACOA). Founded in 1988, NANACOA develops informational materials for American Indian communities, including publications, videotapes, and posters, and works with local and national policymakers to address the needs of American Indian children of alcoholics. In their workshops and conferences, NANACOA members address the effects of intergenerational alcoholism and other types of trauma and strive for the well-being of all American Indians. Over the years, CSAP has helped fund a number of NANACOAs projects, including the Healing Journey Accord and the Buffalo Robe project, which tells the story of the battle with alcohol and drug problems through painting on a buffalo hide.7 In the past year, CSAP has worked closely with White Bison, Inc., an American Indian-owned nonprofit company, to develop prevention materials; organize a sacred walk from Los Angeles, CA, to Washington, DC; and create a Web site offering community kits, videos, and information about American Indian trainers experienced in facilitating substance abuse training.8
Just as there is no single American Indian drinking pattern (May, 1994), there is no single American Indian prevention strategy. It is not a matter of choosing between culturally based prevention strategies and other prevention strategies. Rather, American Indians can create more effective substance abuse prevention programs by combining ethnic and cultural components with other proven prevention strategies. Taking this action as a matter of course will make prevention programs more effective in the long run by enhancing protective factors and mitigating risk factors in the lives of American Indian youth.
For Further Information
Descriptions of additional American Indian substance abuse prevention programs can be found on the Web site for CSAPs Western Center for Applied Prevention Technologies, http://casat.unr.edu/westcapt/.
The full list of references for this article is available online at www.ncjrs.org/html/ojjdp/jjjnl_2000_12/ref.html.
1. Although it is beyond the scope of this article to describe the sweatlodge ceremony, information is readily available in resources such as McClintock (1910), Brown (1953), Fire and Erdoes (1972), Young, Ingram, and Swartz (1989), and Taylor (1996). Smudging involves the use of an incense made of a local natural plant, such as sage, sweetgrass, or cedar, to cleanse the air and change the mood of everyday life to one of respect and reverence suitable for prayer.
2. CSAP is the Federal agency responsible for providing a national focus on the prevention of substance abuse.
3. Making relatives occurs when tribal members ceremonially adopt a nontribal member.
4. Ribbon shirts are made of cotton and have ribbons sewn horizontally on the material. These shirts are worn only during formal ceremonies.
5. A vision quest is an extended meditation or retreat (typically 4 days long) that takes place in an isolated area. The spiritual purposes of the vision quest are to renew faith, sacrifice, and seek guidance.
6. The GONA manual is available from SAMHSAs National Clearinghouse for Alcohol and Drug Information at 8007296686. Ask for item number BKD 367.
7. The Healing Journey Accord presents a vision of strong, healthy American Indian communities for the year 2005 with accompanying strategies. The vision and strategies were identified and the Accord was written at a national tribal summit in 1995.
|Juvenile Justice - Challenges Facing American Indian
On the Front Lines With Senator Ben Nighthorse Campbell
Volume VII · Number 2