Abstract
Using ethnographic findings from two community-based substance abuse programs for indigenous peoples in the United States and Canada, this article examines how greater attention to cultural context can help to inform the treatment of alcohol problems among Native North American women. Cultural context shapes not only therapeutic activities and interactions within substance abuse programs, but also how such programs develop within different communities. These findings add to the growing evidence that gender can powerfully shape how Native American clients engage spiritual resources and respond to conventional styles of psychotherapeutic talk, supporting emergent efforts to rethink “cultural competency” in mental health services for Native North Americans.
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