INDIAN ALCOHOLISM TREATMENT PROGRAMS AS FLAWED RITES OF PASSAGE

Abstract

Treatment of American Indians has been given high priority by both the National Institute of Alcohol Abuse and Alcoholism (NIAAA) and the Indian Health Service (IHS). Numerous studies have assessed the success rates of the Indian alcoholism treatment programs developed in the last decade in response to this national health concern. The results range from mixed to disappointing (Albaugh 1973; Alday 1971; Bittker and Metzner 1973; Wolman 1970). Even though treatment personnel, the National Task Force on Alcohol Abuse among Native Americans, and most evaluative survey reports call for development of Indian alcoholism treatment programs sensitive to tribal, acculturational, age, and sex differences of their clienteles, Western medical model treatment perspectives predominate (Albaugh and Anderson 1974; Bouche 1979; Everett 1973; Stone 1980; Weibel and Weisner 1980a, 1980b). For the most part these treatment philosophies go unappreciated by Indian clients who are labeled alcoholic by their treatment counselors but who see themselves as neither diseased nor alcoholic. Definitional, motivational, and cultural differences between treatment personnel and clients create treatment contexts in which staff morale is low and client