Indigenous and invisible

The following article was published in the September 2011 issue of the UK journal ‘Counselling Children & Young People’. It is a less academic version of another post on this blog.

It was titled ‘Indigenous and Invisible’ by the editor. However the Indigenous children and young people in the community I work in are very much visible on occasions for many of the reasons discussed in this article.

Indigenous and invisible

Narelle Smith writes about context and clinical practice with a specific population in Australia – but the issues will resonate with all therapists who work with ethnic minority or deprived young clients.

Colonisation and the subsequent dislocation of people from their lands and removal of children from their families has had a traumatic impact on the Indigenous people of Australia – a term that refers to Aboriginal and Torres Strait Islander people and reflects the mobility and heterogeneity of the population.

Indigenous people’s lives are frequently defined by hardship, sufferance and invisibility, and whole communities appear resigned to their condition. Hardship is imposed by poor and inadequate housing, poor nutrition, illiteracy, ill-health, substance abuse, unemployment and family violence. Daily existence can be difficult, and disadvantage on multiple levels reduces access to opportunities to improve their situations when compared to non-Indigenous people.

Indigenous youngpeople are being exposed to the risk factors for poor developmental outcomes, and feature heavily on every measure of disadvantage (social, physical, educational, psychological, incarceration and mental health) in Australia. There is concern that Indigenous youth are synonymous with bad statistics, and their Indigeneity is seen as the cause of their problems. For the non-Indigenous practitioner, there is tension between intervening in Indigenous people’s lives and the desire to provide care and education.

Contextual issues

Indigenous people have a diversity of cultures. Indigenous culture is multidimensional, dynamic and complex, and depends on geographic location (remote, rural, urban), lifestyle, language and engagement. Indigenous communities experience life on a continuum between traditional and contemporary ways. In addition, they may also have a mixed cultural heritage. Stereotypes are erroneous and can create confusion for young Indigenous people about their identity, particularly if they don’t fit into the romanticised notions and images of Indigenous traditional life imposed by mainstream society.

Indigenous youth make the transition through adolescence within the context of the strengths and difficulties of their families and communities, fulfilling the mutual roles and obligations required by their culture, whilst also forming their personal and Indigenous identities1. Indigenous communities believe that spiritual, cultural and identity formation is the most important factor in the development and empowerment of young Indigenous people. But these values are diffused by substance abuse, family violence and child sexual abuse. The effects of poor health, reduced lifespan, and high birth rate in the Indigenous population have resulted in 40 per cent of the Indigenous population being aged 15 years and under. With fewer ‘healthy Elders’2 to turn to, the young people are ‘growing themselves’ up.

Attributions and family factors

When asked where they saw themselves in 10 years, 75 per cent of Indigenous youth in detention3 replied that they would be dead, drunk or locked up, whereas 80 per cent of non-Indigenous youth in detention saw themselves in middle-class settings.

Indigenous young people perceive the causes of their problems as stable and any change outside their control, which results in reduced expectations for their futures3,4. For many Indigenous young people, the peer group replaces the role of family and provides a sense of identity. However, these survival responses set Indigenous young people along a pathway to further risk and negative outcomes, such as leaving school early, violence, teenage pregnancy, unemployment, long-term substance use, self-harm and suicide4. But given the opportunity to participate in and be guided by older mentors and Elders in meaningful, empowering and culturally appropriate activities, Indigenous young people (from a variety of settings) are able to be redirected, supported and encouraged towards more positive outcomes5-8.

Indigenous young people have different trauma narratives to their parents and grandparents9, and it is vital to provide Indigenous young people with the opportunity to define themselves; what they see as their risk and protective factors; and how they negotiate the conflicting roles, responsibilities and expectations of Indigenous and non-Indigenous culture, both individually and collectively. The identification of the needs of Indigenous youth should take into account the amount of acculturation of the young person presenting for assessment10 – an Indigenous young person may have received little or no cultural instruction, or more commonly will cite a culture of disadvantage as Indigenous culture.

Concepts of wellness

Traditional Indigenous concepts of health are holistic and incorporate physical, mental, social, cultural and spiritual elements of wellness11. Aboriginal culture is linked to mythology, and ancestors and nature are experienced as intrinsic to one’s being, thus the self is broader than the relatively narrow Western concept of self. Frequently, a conversation with Indigenous colleagues and clients will include topics such as grief and loss, feeling that bad luck has been cast upon them, spiritual visits by ancestors, and a longing for Country. Indigenous people may discuss mental health problems in terms of an individual ‘having worries’ because ‘being mental’ is stigmatised in many communities12.

Indigenous or non-indigenous services?

There is general distrust of non-Indigenous services. The Indigenous system of addressing worries is to draw upon the immediate family first. If there are still problems, the extended family is called upon to help, and this may mean that the young person relocates to another area, for example, from an urban setting to a rural one. Community, Elders, traditional healers, and Indigenous services will generally be consulted before a non-Indigenous service is considered. By the time a non-Indigenous service is consulted, the difficulties may be so severe that more invasive treatment is recommended.

Western treatment separates the mind from the rest of the system, and removes the individual from family, culture and country11. But within the Indigenous cultural framework, interventions targeted at an individual are possibly going to be more effective if peers, family, and community are involved and supportive. However, there can also be distrust of Indigenous services due to concerns about confidentiality and a lack of confidence in Indigenous workers. Some young people do not wish to identify as Indigenous, as they don’t feel a connection to their culture or don’t want to be regarded as different. Thus, Indigenous young people may present to non-Indigenous services for assistance. They may then become disenchanted with how any of the services relate to them. These young people are frequently caught up in a sense of hopelessness, and quickly become isolated because they don’t trust that their families or communities have the ability to help them and they don’t feel comfortable with any of the service options available to them.

There is currently, therefore, a strong push from Indigenous leaders for non-Indigenous practitioners to become culturally competent, so that all Indigenous people can get the help and support they need from any of the services they choose to link into.

Implications for clinical practice

Practitioners should reflect on their motives for wanting to work with Indigenous people. Non-Indigenous practitioners must be conscious of an attraction to work with Indigenous clients based on their ‘otherness’, and a yearning for acceptance by a collective culture. Alarm bells ring for me when I hear a non-Indigenous worker say: ‘I am totally accepted by the Aboriginal community I work in.’ As a practitioner working with Indigenous people for the past 12 years, I have experienced the warm inner glow when children have called me ‘Aunty’ (a term of respect usually reserved for Elders within the community) and when there is a strong sense of mutual respect between myself and the Indigenous Elders and parents I have worked with.

However, as a non-identified Indigenous practitioner*, I must not become complacent in my interactions with Indigenous people, and I must constantly examine how my white power and privilege impacts on my thoughts, attitudes, words and actions. The small amount of Indigenous knowledge I have obtained must not be used to make decisions on Indigenous people’s behalf or to push my personal or political agendas. When I raised this issue in conversation with Aboriginal Elder, Winsome Matthews, she replied that, as an Aboriginal person, she has to do the same, because she has clean running water and can afford to pay the mortgage, and her identity as an Aboriginal person who is educated and materially well off can affect the interactions she has with Aboriginal people living in poverty.

Unconscious abuse of power

Practitioners also need to examine how they are privileged in different settings and how they are perceived by others. Indigenous people can be offended by non-Indigenous people adopting Aboriginal culture as if it were their own and using Aboriginal English, a process that Hammer, Bennett and Wiseman13 call ‘reversal’ or ‘going native’. The risk here is that non-Indigenous people will assume that they can speak for Indigenous people, and this highlights the importance of having a deep understanding of one’s own identity and sense of self to avoid less visible abuses of power. How we structure the world based on our experiences, our membership in society, our beliefs and attitudes about how people should behave, our values, and our importance in society14, may serve to perpetuate prejudice and stereotypes that are frequently embodied in the identification of ‘resistant’ clients or ‘hopeless cases’.

Therapeutic nurturance

Non-Indigenous practitioners and services should therefore adopt a therapeutic nurturance towards the Indigenous population, both in the way they conduct themselves and the services they assist the communities to develop15. The problems in Indigenous communities reflect the failure of white Australia to offer the appropriate respect to Indigenous people and their culture. Non-Indigenous practitioners and services should question how they can develop greater capacity for supporting Indigenous enablement, strengths-based practice, local solutions to local problems, and attention to Indigenous ways of being15. I use the word ‘enablement’ instead of ‘empowerment’, as any reference to power can be misconstrued.

The practitioner needs to develop professional and personal networks and relationships within the community via an Indigenous liaison officer or cultural consultant, but should avoid making friendships too quickly16. Alignment with one person or family within the community is unwise, as it disrupts power and status within communities and can cause conflict, which will ultimately reflect poorly on our skills, abilities and usefulness. Indigenous people can quickly detect those practitioners who have not been able to disengage from a Western framework11.

Working respectfully

Collaboration and the exchange of ideas and knowledge between Indigenous and non-Indigenous workers are considered respectful ways of working. One of the greatest concerns for Indigenous workers working with non-Indigenous practitioners is to be respected for their knowledge of their community and to further develop their own skills and knowledge in the service of their communities.

The Indigenous worker contributes his or her expertise in relation to the Indigenous cultural domain (protocols, law, culture, country, language, local politics, community, family) and the non-Indigenous worker provides his or her area of specialised professional skill (whether it be health, psychology, youth work, psychiatry, teaching, social work etc). It is good practice for the non-Indigenous practitioner to develop an Indigenous supervision group for cultural validation of the work12 and to form networks with other culturally competent practitioners and services that can provide practical support and advice to clients16 when the professional concerned is unable to provide a service to the client. This, of course, applies to all workers everywhere.

From crisis to therapy

The problems of survival need to be attended to before people can deal with more challenging and in-built problems. Requests for practical forms of assistance are usually the first approaches that Indigenous people make to agencies. Being offered this assistance helps to establish the rapport needed for the person to engage in services that will alleviate the struggle of daily living. Once the immediate problem is dealt with, the client may not return until the next crisis. But if rapport and relationship have been established, the practitioner may invite the client to talk at a deeper level about the longer-term problems they are experiencing. For Indigenous people to return to wholeness, Atkinson17 identifies six processes: create culturally safe places; find and tell their stories; make sense of their stories; feel the feelings; move through the layers of grief and loss; and reclaim their sacred selves. A genogram depicting inter-transgenerational trauma for the client’s family within the context of the impact of colonisation and government policy on Indigenous people may provide the client with an understanding of the social, cultural, political, psychological, family, environmental, and community influences on him- or herself, family and kinship18.

Expectations

Goal setting needs to be realistic, given the environments that clients return to11. The big-picture issues may take years and generations to resolve, and may need a systemic approach to health promotion, prevention and intervention. Moral outrage has its place, but does not solve problems at the grass-roots level. So there is a need for practitioners and services to focus on modest and practical clinical interventions.

The therapeutic process needs to be explained and transparent to Indigenous clients11,12. Practitioners may need to modify their counselling and engagement skills, as the question-and-answer format of many styles may not suit an Indigenous client, who may prefer to ‘yarn’ about his or her problems in a narrative way. In addition, Indigenous young people may find Western therapies frustrating when they are not provided with practical solutions to problems and are asked to find answers for themselves. Practitioners need to become comfortable with silence, giving the young person time and space to formulate responses.

Feedback may be difficult to obtain from Indigenous clients and communities due to the wish not to appear ungrateful. In fact, silencefrom the Indigenous community indicates there is a problem with the way the service is being delivered, and the practitioner may have to seek advice from the cultural consultant. The practitioner will be able to evaluate the effectiveness of the service by the number of incoming referrals resulting from the ‘vouching’ system.

Conclusion

Working with Indigenous people, as with other minority groups, brings all our skills and knowledge sharply into focus, as we engage in the process of deconstructing disadvantage, racism, abuse and suffering. We must constantly engage in an internal dialogue of self-reflection, in an effort to reduce the barriers that prevent Indigenous people accessing the supports and services they require. The work can be confronting – there is a sense of stripping away our layers of social and personal conditioning whilst facilitating the same process for the young people and families we are working with. And the non-Indigenous practitioner must consider the Indigenous worldview of health and wellbeing, and develop cultural competence and strong collaboration with Indigenous workers, communities, families and individuals, in order to be effective and relevant. However, Indigenous young people have challenges that are unique to them, and a strengths-based framework is required to identify the skills they are using to adapt to their circumstances. There is also a strong impetus for us to be curious about the individual and not to have preconceived ideas, allowing the voices of Indigenous young people themselves to relate how culture impacts on them, the struggles they experience, their strengths and their needs.

 

* I have Indigenous heritage but do not identify as an Indigenous worker.

References

1 Larkins SL, Page RP,PanarettoKS, et al. Attitudes and behaviours of young Indigenous people in Townsville concerning relationships, sex and contraception: the ‘U Mob Yarn Up’ project. Medical Journal of Australia. 2007; 186(10):513-518.

2 Goodwin T. Talking stick. Australian Broadcasting Corporation. Aired on ABCTV1, 25 April 2008.

3 Dunn R. Preventing juvenile crime: Aboriginal youth and offending. Australian Institute of Criminology conference proceedings. 1989; 9:17-19.

4 Ogilvie E, Van Zyl A. Young Indigenous males, custody and the rites of passage. Trends and Issues in Crime and Criminal Justice. 2001; 204. See http://www.aic.gov.au/documents/E/0/3/{E0349D8E-591A-4FB6-ABA4-81A5C0D72FE8}ti204.pdf

5 Holmes W, Stewart P, Garrow A, et al. Researching Aboriginal health: experience from a study of urban young people’s health and wellbeing. Social Science & Medicine. 2002; 54:1267-1279.

6 Butt J. Summary of findings from the Get Real Challenge evaluation: issues facing Indigenous youth who misuse volatile substances, and outcomes of a program targeting these issues.Brisbane: UniQuest; 2004.

7 Dawes G, Dawes C. Mentoring 2: a program for ‘at risk’ Indigenous youth. Youth StudiesAustralia. 2005;24(4):45-49.

8 Palmer D, Watson J, Watson A, et al. ‘Going back to Country with Bosses’: the Yiriman project, youth participation and walking along with Elders. Children, Youth and Environments. 2006; 16(2):317-337.

9 Clarke C, Harnett P, Atkinson J, Shochet I. Enhancing resilience in Indigenous people: the integration of individual, family and community interventions. Aboriginal and Islander Health Worker Journal. 1999;23(4):6-10.

10 Westerman TG. Children and domestic violence: an analysis of the nature of violence in Aboriginal communities and the psychological effects on Aboriginal children and communities. www.gtp.com.au/ips/inewsfiles/P17.ppt

11 Vicary DA, Bishop BJ. Western psychotherapeutic practice: engaging Aboriginal people in culturally appropriate and respectful ways. Australian Psychologist. 2005; 40(1):8-19.

12 Vicary DA, Westerman TG. ‘That’s just the way he is’: some implications of Aboriginal mental health beliefs. Australian e-Journal for the Advancement of Mental Health. 2004; 3(3). http://www.auseinet.com/journal/vol3iss3/vicarywesterman.pdf

13 Hammer MR, Bennett MJ, Wiseman R. Measuring intercultural sensitivity: the intercultural development inventory. International Journal of Intercultural Relations. 2003; 27: 421-443.

14 Pedersen A, Griffiths B, Contos N, et al. Attitudes toward Aboriginal Australians in city and country settings. Australian Psychologist. 2000; 35(2):109-117.

15 Petchkovsky L, Cord-Udy N, Grant L. A post-Jungian perspective on 55 Indigenous suicides inCentral Australia; deadly cycles of diminished resilience, impaired nurturance, compromised intewriority; and possibilities for repair. Australian e-Journal for the Advancement of Mental Health. 2007; 6:3. ww.auseinet.com/journal/vol6iss3/petchkovsky.pdf

16 Fan BWS. Intervention model with Indigenous Australians for non-Indigenous counsellors. Counselling, Psychotherapy, and Health. Indigenous Special Issue. 2007; 3(2):13-20.

17 Atkinson J, Edward-Haines C. Social and emotional wellbeing: an Indigenous perspective.Canberra: AIATSIS; 2003.

18 Atkinson J. Principles of practice in defining evidence in research. www.aracy.org.au/AM/Common/pdf/seminars/ArcNetworkEvents_080506.pdf

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About Narelle Smith

Child & Family Worker

9 Responses to “Indigenous and invisible”

  1. Thank you for this wonderful resource. I am slowly making my way through some extremely interesting reading. Keep up the good work!
    Cheers,
    Glenda

    • Hi Glenda

      Thank you for your comment.

      It’s good to see an art therapy blog on WordPress, and to see you writing about Freud. Oh how I love Freud.

      I have an art therapy article to put up on this blog, which was published in the Counselling Children and Young People journal in December. I just have to get around to it.

      Good luck with writing your book. I admire people who are able to sit still long enough to put so many words together in a coherent fashion. I love everything written by Judith Rubin, and had the good fortune to spend two days learning from her – MAGIC.

  2. Ha! Thank you. It’s funny really as I just posted on my challenge in writing a book! It feels like torture some days. I just wish my brain had a USB port so I could just download my understanding file for others! Cheers, Glenda

    • I saw your post. You’re an Aussie, who works in art therapy – that’s a rare thing.

      I have another article to write for a journal and I’m dragging the chain.

      • Oh! Let’s see if we can keep each other motivated. What is your journal article about? I think I probably need it now. 😉

      • Doing parent-child interaction therapy in the real world.

        “Keep swimming Nemo”.

      • That’s great! I always though the Finding Nemo movie a great example of the do and donts in parenting, and a good example to children of a father’s love. It also has some good resiliency themes – especially darling Dory. OK. I have delayed enough. Time to shut down my emails and every other distraction and get a proper focus!

        I am looking forward to reading your article.

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