Background: Cultural interventions offer the hope and promise of healing from addictions for Indigenous people. a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness. Methods: This review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the “PICO” (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012. Results: The search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies. Conclusions: Evidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational or contextual fit of cultural practices given a particular place, time, and population group. Addiction researchers and treatment providers are encouraged to work together to make further inroads into expanding the study of culture-based interventions from multiple perspectives and locations.

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Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study

The alcohol and other drug (AOD) problems arena is extending its organizing center from knowledge drawn from the study of addiction-related pathologies and clinical and social interventions to knowledge drawn from the lived experience of long-term addiction recovery. A distinctive element within this shift is the increased use of non-clinical, peer recovery support services as an adjunct or alternative to specialized, professionally directed addiction treatment. This paper reviews the context of this shift, notes the evolution from competing to integrated service models, and outlines a decade of experience integrating peer recovery support services within the City of Philadelphia’s behavioral healthcare system. Integrated models of peer-professional addiction recovery support have the potential of capitalizing on the respective strengths of clinical and environmental interventions into severe AOD problems.

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The Recovery Agenda: The Shared Role of Peers and Professionals

https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?article=1206&context=psy_fac

Focus groups to increase the cultural acceptability of a contingency management intervention for American Indian and Alaska Native Communities.

Identity's Architect: A Biography of Erik H. Erikson. By Lawrence J. Friedman. (New York: Scribner, 1999. 592 pp. $35.00, ISBN 0-684-19525-9.)

Indigenous peoples of the United States are distinct from other ethnic minorities because they have experienced colonization as the original inhabitants. Social and health disparities are connected...

The Historical Oppression Scale: Preliminary conceptualization and measurement of historical oppression among Indigenous peoples of the United States:

White Bison has been effective in training 388 peer recovery support persons, known as Firestarters, to implement standardized, Native-focused, peer recovery programs based on the traditional knowledge of tribal elders. Following the elders' Four Laws of Change, White Bison has demonstrated the program capacity to build indigenous support communities of Wellbriety, which are facilitated by these healthy and sober spiritual leaders. Using the Native paradigm of evidence-based model programs, effectiveness has been measured and validated through success at generating this human capital of civic leadership. In turn, using a clan model of Wellbriety, community coalitions have begun to emerge to sustain the work of the Firestarters through local Healing Forests that correct for multigenerational family problems that have grown up in the wake of high rates of addiction.

David Moore

Papers

The Multicultural Wellbriety Peer Recovery Support Program: Two Decades of Community-Based Recovery