Tuesday, July 3, 2012

Worldviews and Therapy: Counseling American Indians

Worldview and Perceptions, Attitudes, Beliefs, Values, and Behaviors


Although many American Indians are acculturated in American society, some are not. This is an essential consideration when beginning counseling with anyone from this diverse population (Sue & Sue, 2007). Traditional American Indians believe the "deep mystical experiences and the invocation of a spirit world... directly guide(s) and influence(s) people in this world" (McCabe, 2007, p. 156). Traditionally, this culture has preconceived expectations of healers, who must be genuinely and deeply connected to the spirit world and use the connection as a source of healing. Additionally, the counselor/healer must have knowledge of spiritual ceremonies and be able to apply sacred teachings to the therapy (McCabe, 2007).

The Tribe as the Family

American Indians have strong patriarchal and collectivist familial structures that include other tribe members, friends, or the entire tribe (Sue & Sue, 2008). Thomason (2011a) found effective counseling for this population must include building relationships with the client's community, such as tribal elders, attending to the client's spiritual needs, and incorporating them into the therapeutic process. Contrary to typical therapeutic alliances, counselors are encouraged to "attend tribal social and cultural events (and) spend time in the community, attend training workshops, and socialize with Native Americans" (Thomason, 2011a, p. 3). Including traditional healing practices in psychotherapy is critical for this population (Gone, 2010; Trujillo, 2000).

Implications of Perspectives in Counseling

Considerations for Counselors

Although I would welcome the invocation of deep spirituality in the therapeutic relationship, the specific nature of American Indian spirituality may disturb the religious beliefs of some counselors. Counselors must be prepared to relinquish personal beliefs and attitudes regarding fundamental family structure as well as individualist beliefs and values (Thompson, 2011b). With issues related to any one family member, understanding the complex nature of the extended family structure will help provide interventions that include all appropriate family and tribe members. Interventions must accommodate their strong collectivist nature, otherwise the process may be of little to no consequence.

For example, singling out one family member in therapy may antagonize the family's as well as the tribe's cohesiveness (Sue & Sue, 2008). Counselors may have difficulty working with children who are culturally taught to refrain from competing with their peers (Sue & Sue, 2008). From an individualist perspective, this may obscure one child's aptitude or his or her need for individual help. Counselors will need to consider the implications of this population's beliefs and worldviews when working with any individual as separate from the family or tribe.

Personal Considerations

I believe domestic violence and abuse perpetuates the oppression of women. Because this population has a high rate of domestic violence, this would be an issue with personal implications (Sue & Sue, 2008). Further complicating this issue is that in American Indian populations, women tend to remain reticent about their abuse (Sue & Sue, 2008). This significant problem must be addressed appropriately and effectively - not from a personal sense of advocacy. Another issue that may cause a personal challenge is the negative implications of promoting individualism. Although I may perceive a client is in need of individual assistance, advocacy for any individual, separate from the family or tribe, might be contraindicated for the collective good.


Gone, J. P. (2010). Psychotherapy and traditional healing for American Indians. The
Counseling Psychologist, 38(2), 166-135. Doi: 10.1177/0011000008330831

McCabe, G. H. (2007). The healing path: A culture and community-derived indigenous
therapy model. Psychotherapy, 44(2), 148-160. Doi: 10.1037/0033-3204.44.2.148

Sue, D. W., & Sue, D. (2008). Counseling the culturally diverse: Theory and practice (5th ed.). Hoboken, NJ: John Wiley & Sons.

Thomason, T. (2011a). Best Practices in Counseling Native Americans. Journal of Indigenous Research, 1(1), 1-5. Retrieved June 28, 2012, from http://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=1005&context=kicjir

Thomason, T. C. (2011b). Assessment and diagnosis of Native American clients: Results
of a survey. Journal of Rural Mental Health, 35(2), 24-34.

Trujillo, A. (2000). Psychotherapy with Native Americans: A view into the role of religion and spirituality. In P. S. Richards & A. E. Bergin (Eds.), Handbook of psychotherapy and religious diversity. Washington, D. C.: American Psychological Association.

Note:  If any Native Americans read this entry, I would appreciate any input you can offer me.  Thank you.

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