Indigenous Counselling Research Articles

Community-led Recovery from the Opioid Crisis through Culturally-based Programs and Community-based Data Governance

The opioid crisis is disproportionately impacting Indigenous communities in Canada. There is a need to evaluate practical approaches to recovery that include community-based opioid agonist treatment (OAT) and integration of cultural treatment models. Naandwe Miikan, translated as The Healing Path, is an OAT program that blends clinical and Indigenous healing concepts and providers in a community-based setting. Aside from OAT pharmaceutical treatment, clients work with Indigenous counsellors that integrate culture with treatment, such as land-based activities, that reconnect the community to Indigenous teachings and harvesting. In this paper, we present a case study showcasing community advocacy in creating innovative funding models and engaging with clinicians to provide a shared care OAT model with traditional Indigenous counselling, cultural programs, and data sovereignty. Policy needs are identified.

Weaves of Wellness: Exploring the Experiences of Wellness and Imbalance in Indigenous Youth

This research, which takes place on Treaty 6 lands and involves an Indigenous and decolonized worldview, stems from a personal and professional exploration of what it means for me to be Indigenous. Using a Metissage research sensibility (Hasebe-ludt, Chambers, & leggo, 2009), the research weaves my own experiences in relation to the research participants, and in relation to the land, and other living and non-living beings. The purpose of this study is to better understand the emotional, spiritual, physical, and mental experiences of wellness and imbalance in Indigenous youth in public high schools, and to foster an understanding of the Medicine Wheel. This research ultimately asks, how do the experiences of youth fit within the Medicine Wheel? Participants will share their experiences of wellness and imbalance through storying, sharing circles, art, with the researcher using reflective journaling to reflect on the experience of listening. These stories will be audio or visually recorded. Participants will then place their experiences onto the Medicine Wheel into one or more of the four areas. Given that education and health systems are colonial tools oppression (Stewart, Moodley, and Hyatt, 2017), this research hopes to provide school staff, teachers, therapists, counsellors, health professionals and others with ways to meet the needs of Indigenous youth, in consideration of the Medicine Wheel and the Metissage conceptual trope.
 
 Hasebe-ludt, E., Chambers, C. M., & Leggo, C., 2009. Life writing, and literary Metissage as an ethos for our times. Peter Lang Publishing.
 Stewart, S. L., Moodley, R. & Hyatt, A. (2017). Indigenous cultures and mental health counselling. Four directions for integration with counselling psychology. Routledge.

Feasibility and acceptability of Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy multicomponent implementation intervention and study design for Australian Indigenous pregnant women: A pilot cluster randomised step-wedge trial

BackgroundMany health providers (HPs) lack knowledge, confidence, optimism and skills in addressing smoking with pregnant women. This study aimed to explore the feasibility and acceptability of a) a co-designed multi-component intervention for HPs at Aboriginal Medical Services (AMSs) in culturally-targeted pregnancy-specific smoking cessation care and b) the study design. MethodsUsing a randomised step-wedge cluster design, the Indigenous Counselling And Nicotine (ICAN) QUIT in Pregnancy Trial was evaluated across six AMSs in three Australian states. HPs were provided educational resource packages including live interactive webinars, treatment manuals, patient resources, carbon monoxide (CO) meters, and oral Nicotine Replacement Therapy (NRT). Feasibility was assessed through recruitment and retention rates of both pregnant women (12-weeks) and HPs (end of study) as well as the potential to improve women's quit rates. Qualitative interviews with staff post-trial explored acceptability of the intervention and study, based on capability, opportunity and motivation from the Behaviour Change Wheel. ResultsPregnant women (n = 22; 47% (95% CI: 32%, 63%) eligible) and HPs (n = 50; 54% (95% CI: 44%, 64%) eligible) were recruited over 6 months with retention rates of 77% (95% CI: 57%, 90%) and 40% (95% CI: 28%, 54%) respectively. Self-reported 12-week 7-day point-prevalence abstinence was 13.6% (n = 3) and validated abstinent with CO readings ≤6 ppm. Staff interviewed regarding intervention implementation highlighted the importance of provision and use of resources, including training materials, patient resources, CO meters and oral NRT. Resources helped increase capability and opportunity, restructure the environment, and provided social comparison and modelling. Staff were motivated by greater engagement with pregnant women and seeing the women's reductions in CO readings. Having the intervention at the AMSs improved organisational capacity to engage with pregnant women. Staff reported changes to their routine practice that were potentially sustainable. Recommendations for improvement to the implementation of the intervention and research included reducing training length and the tasks related to conducting the study. ConclusionICAN QUIT in Pregnancy was a pilot study with the ability to enrol Indigenous women. It was feasible to implement and acceptable to most staff of the AMSs in three states, with modifications recommended. Smoking in pregnancy is a key challenge for Indigenous health. The intervention needs to be evaluated through a methodologically rigorous fully-powered study to determine the efficacy of outcomes for women. Trial registrationAustralian and New Zealand Clinical Trials Registry, ACTRN12616001603404. Registered 21 November 2016 - retrospectively registered, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371778

Designing an implementation intervention with the Behaviour Change Wheel for health provider smoking cessation care for Australian Indigenous pregnant women

BackgroundIndigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS.MethodThe Behaviour Change Wheel (BCW), incorporating the COM-B model (capability, opportunity and motivation for behavioural interventions), provided a framework for the development of the Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy implementation intervention at provider and patient levels. We identified evidence-practice gaps through (i) systematic literature reviews, (ii) a national survey of clinicians and (iii) a qualitative study of smoking and quitting with Aboriginal mothers. We followed the three stages recommended in Michie et al.’s “Behaviour Change Wheel” guide.ResultsTargets identified for health provider behaviour change included the following: capability (psychological capability, knowledge and skills) by training clinicians in pharmacotherapy to assist women to quit; motivation (optimism) by presenting evidence of effectiveness, and positive testimonials from patients and clinicians; and opportunity (environmental context and resources) by promoting a whole-of-service approach and structuring consultations using a flipchart and prompts. Education and training were selected as the main intervention functions. For health providers, the delivery mode was webinar, to accommodate time and location constraints, bringing the training to the services; for patients, face-to-face consultations were supported by a booklet embedded with videos to improve patients’ capability, opportunity and motivation.ConclusionsThe ICAN QUIT in Pregnancy was an intervention to train health providers at Aboriginal Medical Services in how to implement culturally competent evidence-based practice including counselling and nicotine replacement therapy for pregnant patients who smoke. The BCW aided in scientifically and systematically informing this targeted implementation intervention based on the identified gaps in SCC by health providers. Multiple factors impact at systemic, provider, community and individual levels. This process was therefore important for defining the design and intervention components, prior to a conducting a pilot feasibility trial, then leading on to a full clinical trial.

The Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy Pilot Study protocol: a feasibility step-wedge cluster randomised trial to improve health providers' management of smoking during pregnancy

IntroductionIndigenous women have the highest smoking prevalence during pregnancy (47%) in Australia. Health professionals report lack of knowledge, skills and confidence to effectively manage smoking among pregnant women in general....

Collective and negotiated design for a clinical trial addressing smoking cessation supports for Aboriginal and Torres Strait Islander mothers in NSW, SA and Qld - developing a pilot study.

Tobacco smoking leads to one in five deaths of Aboriginal Australians and accounts for 17% of the reversible health gap. One in two Aboriginal women are reported to smoke during pregnancy, with no effective strategies currently available for health practitioners to utilise for supporting Aboriginal women. Aboriginal community participation in primary health research is crucial to implementing ethical research, with a clear benefit to the people and communities involved. However, currently there is little evidence on how Aboriginal programs and interventions are being developed in partnership with Aboriginal people and communities. 'Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy' aims to address the prevalence of smoking during pregnancy by enhancing health providers' training in offering evidence-based smoking cessation care to Aboriginal mothers during pregnancy. This paper outlines the participatory research approach adopted for the developmental phase of the 'ICAN QUIT in Pregnancy' project developed in partnership with two Aboriginal Community-Controlled Health Services in NSW, and negotiation processes undertaken to implement a pilot intervention across NSW, SA and Qld.

Evidence-Based Mental Health Counselling Model for College Students

Professional counselling is essentially a process of interpersonal interaction, dialogue and communication based on the faith that each human being has an underlying capacity to take and implement appropriate decisions concerning his/her life. Although one of the oldest therapeutic dialogues was recorded in the Bhagavad Gita, the professional counselling which focuses on the comprehensive development of a person has not become popular in India. The increased incidence of campus violence, ragging menace, adolescent suicides, antisocial activities and complex inter and intrapersonal issues have warranted the need for counselling and social work services in the higher education sector in India. Due to the fact that the widely acknowledged counselling theories and techniques are of Euro-American origin, a strong need arises for indigenous counselling models which reflect the worldview of the Indian sub-continent for efficient intervention and effective outcome. This study uses counselling outcome reports and archival data of student-clients, together with the autoethnography study of the researcher’s counselling process, propose a ‘Single-Session Developmental Counselling’ as an evidence-based indigenous model for counselling Indian college students.

Challenges in Meeting HIV/AIDS Counselling Needs in Nigeria

The HIV/AIDS pandemic is recognized globally as the greatest health challenge of the present generation. It is widely acknowledged to be the foremost killer disease in Africa. Since the first Aids case was publicly announced in 1986, the astronomical increase in victims has been a matter of concern. The rates of HIV/AIDS infection indicate that Nigeria currently has the third largest rate of HIV/AIDS patients. The UNAIDS (2008) reported that as at 2007, the population of children and adults with HIV/AIDS in Nigeria was 2.6 million. Due to the fact that there is no cure for the virus, HIV/AIDS, counselling is an important aspect of its management. Counsellors in Nigeria have provided pre- and post-test counselling, preventive education seminars, and referrals to other health professionals. However, counsellors’ efforts have only yielded limited success because of a number of major challenges. This paper examines some of the challenges involved in meeting the HIV/AIDS counselling needs of Nigerians. Specifically, it addresses challenges faced by government, potential clients, and the Counselling Association of Nigeria, as well as challenges associated with existing cultural practices (indigenous counselling practices). It concludes with specific recommendations for various stakeholders.

Indigenous counseling: A needed area in school counseling in Nigeria

Indigenous counselling has not been given attention in Nigeria’s school counselling programme. This counselling gap was created by European colonialism, which succeeded in developing in the minds of the African that anything indigenous is local, unscientific and unorthodox. Indigenous counselling is one of the casualties of colonial mentality. Counselling which is supposed to be a culturally loaded process for helping individuals to either regain or take direction for their lives is dominated by Western counselling. This neglect of indigenous counselling in the school counselling, forms the basis of this paper. The paper examines the relevant aspects of indigenous counselling and the need for indigenous counselling in Nigeria’s school counselling programme. The paper recommends a synthetic counselling curriculum made up of indigenous and western counselling for the school. Indigenous counselling should have an association of their own as the western trained counsellors in order to keep the ethics of their profession. Government should continue the training of more counsellors to make it possible for most schools to benefit from the counsellors’ services. There is also the need for indigenous counsellors to complement the efforts of the western counsellors in order to assist the students maximize their potentials as best as possible.

Counselling in China

This article reviews the development of psychological counselling in China. It consists of three parts: counselling in ancient China, counselling in China today, and counselling in the future. Counselling ideas can be traced back to ancient China, 2,500 years ago, but Western counselling theories have only recently been introduced into China. Counselling has become more and more popular in China, developing rapidly from schools to hospitals, communities, armies and companies. Although Western approaches are popular, some Chinese psychologists are developing indigenous counselling approaches. Government support for the control of professional counselling training programmes is needed. Despite counselling in China lagging behind the West at present, it is likely that in the future it will help people cope with the stresses and strains of living in such a rapidly modernising and changing society.

Silver and Gold We Have None But What We Have, We Give Unto Thee: Indigenous African Counselling and the Rest of the World

This paper examines the complimentary roles and functions of African indigenous counselling in relationship with non-African forms of counselling. This paper is premised on the view that all forms of counselling, whether African or Western, stand to gain a lot from one another via collaboration and the cross fertilization of ideas. This paper examines the counselling and therapeutic contents of African language, African indigenous education, African indigenous counselling and social practices using the Yoruba culture of Western Nigeria as a reference point. Furthermore, the paper practically examines how the traditional therapeutic resources of African language, African traditional education and African indigenous counselling practices could complement non-African counselling culture. The paper advocates for the evolution of a somewhat global orientation to professional helping. This is possible if counselling practitioners from different cultural orientations develop interest in learning how different counselling cultures could complement one another. This orientation may contribute to mutual self-renewal and self-refinement for all forms of counselling. This paper primarily intends to promote the culture of sharing ideas, practices and concepts from different cultural orientations so that we may develop the mentality of a universal approach to employing counselling strategies to solve humanity's problems.

Traditional helping processes in Nigerian society

A look at traditional counselling, its techniques and effectiveness, seems to bring to mind the indigenous or informal education and counselling systems evident in the Nigerian community ways and means of child rearing and socialisation. Both the techniques and their effectiveness are practically demonstrated in the parent-child relationship, apprentice-craftsman relationship or the individual-community relationships. Through these relationships, the child learns and retains the traditional values, mores and folkways. He learns what the individual should do for his personal growth and development, within the traditional set-up 7 physically, mentally and socially. He learns the language of his people, their religion and values, their counting system, the occupation of his people, how to play and interact with his fellow citizens; so he internalises his people's ways of life through imitation of adult behaviour patterns and engagement in make-believe activities, through conscious instructions by adults. The child is now equipped to live and to be lived with. This means that the traditional community which includes the family, 'as the nursery of human nature' Uka (1966), transmits the culture to the individual and shapes his personality. Within the process of life and living, this individual inevitably experiences problems. Ordinarily, he seeks the advice of those parents, elders, other siblings and members of the age grade who had enabled him to grow to help him overcome his problem and readjust. These problems may arise from his deficiency in personal affairs, or in language, religion, or in the practical mathematics of the day-to-day activities, or in his field of work and progress. After receiving the advice, he realises himself again. Paradoxically, advice is not strictly synonymous with counselling. The traditional counsellor is not one who merely advises. He is something more than that. In Nigeria, there exist men and women whose activities, fame or prestige have cultural or mythical explanations that are really psychological. These traditionals are associated with gods, religion, spirits, supernatural powers, including demons. The people refer to such people as native doctor or divinator. They are

Indigenous counselling techniques among the Yoruba and Igala people of Nigeria

Guidance and counselling are now making a good beginning in Africa. This paper attempts to trace the historical foundations of Yoruba and Igala counselling in Africa and examines what makes for success in traditional therapy—the words, phrases and aphorisms used, the climate set and the personality of the professional. Furthermore, since recent studies show that the training and methods of indigenous practitioners are sound and that their philosophy and practice have much in common with Western approaches, the paper also attempts to introduce their skills for fusion with Western mental health.