February/March 2000 THIS ISSUE: Business Biology Pharmacy Psychology Native American Studies Briefs INDEX:
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Good Medicine by Caroline Lupfer Kurtz As a social worker dealing with teen-agers in trouble, for example, Stewart found encouragement in “establishing a bond with kids and beginning to see that all is not lost, that there is hope.” To foster that hope and better help people of the Salish and Kootenai Confederated Tribes deal with mental and emotional problems, Stewart recently returned to UM as a graduate student under a new federally funded program designed to increase the number of practicing clinical psychologists who are Indian. The Indians into Psychology, or INPSYCH, program gave UM $200,000 in 1998 to support nationwide recruitment and training efforts, and granted another $200,000 in 1999. Only two other universities in the country are involved in the same venture, according to psychology department Chair Nabil Haddad. “The reason Congress gave the Indian Health Service money to fund INPSYCH is simple,” he says. “There are fewer than 60 Native American clinical psychologists in the United States and Canada combined. Clearly there is a real scarcity of such professionals serving communities where equally clearly there is an incredible need for them, especially in rural areas.” The potential impact of the INPSYCH program on this situation could be substantial. Haddad says that right now five of 40 students in UM’s clinical psychology doctoral program are Indian — that’s 12.5 percent, versus 7 percent in Montana’s population as a whole. A healthy balance Although the term ‘psychology’ comes from mainstream Western medicine, Indians historically are familiar with the idea, too, according to INPSYCH Project Director and Assistant Professor Deborah Pace. “Indians have a wellness concept in their world view that ... involves a mental, physical, spiritual and emotional balance,” she says. “This is what they have been living and believing and practicing forever.” Haddad and Pace say that psychologists, especially Indian psychologists, may hold the key to changing behaviors that lead to specific health problems, such as diabetes and alcoholism, that have been prevalent in Indian populations. Too often, they say, treatment has been based solely on the medical model. “Clinics aren’t oriented to changing behaviors,” Haddad says. “They prescribe drugs. But if diabetes, for example, were dealt with behaviorally — by changing eating and exercise habits — treatment would cost less and be more effective.” Challenges and opportunities “It can be very tough to get in to see anyone because the staff is so overworked,” Stewart says. For that reason Indians tend to wait to seek help until they are in crisis or do without altogether. And with their history of being exploited and unfairly treated, Indians find it very difficult to open up to outsiders, she says. Cultural differences between Indians and non-Indians — such as the extended-family support system — also make some mainstream psychology approaches irrelevant. The grieving process and the various causes and manifestations of depression among Indians are other areas in which an understanding of cultural practices and history are essential to therapy. “Psychologists and others need to relate to the person getting help,” according to first-year graduate student Annie Ditloff, a Blackfeet. “With Indians, the intergenerational trauma they have experienced means that a historical perspective is necessary, even in psychology.” And just as important from a research and therapy point of view is the recognition that mainstream psychological testing and evaluation contain cultural biases. “If you are not aware of these biases,” says Pace, “you will be wasting time and running the risk that people will not come back.” Opening the door With this in mind, the psychology department as a whole is seeking to build bridges between the University and tribal colleges and high schools in the state. With help from a $100,000 Health Research and Services Administration grant, a consortium has been formed, and faculty members from UM and the seven tribal colleges are meeting to find out what the colleges need or want in order to provide psychology instruction. “We can design a curriculum based on what each college tells us and provide the money for them to hire instructors,” Haddad says. “It’s a net plus for the tribes.” Haddad and Pace believe that such a collaboration could open doors of opportunity for Indian students, making psychology a viable career option by providing better preparation at the undergraduate level. They hope the consortium will become a national model and plan to apply for ongoing federal Health Career Opportunities Program money to further University-tribal collaborations. INPSYCH and the HRSA grant are all about allowing people to become qualified, Haddad says. In his view, success depends on listening and being responsive. “Past experience has led to skepticism and even cynicism on the part of tribes about ‘programs’,” he says. “We must be responsive to the communities and the culture if we want to be welcome.” Since the writing of this article, Deborah Pace has accepted a position as
director of mental health services for the Kainai Indian Reserve in her home province of
Alberta, Canada. UM’s INPSYCH program continues. |
