At best, mainstream mental health services are often ineffective with Native American clients, and, at worst, they are a vehicle for Western colonization. As such, the authors explore the notion of abandoning the Western therapeutic project and rebuilding the helping process on the basis of indigenous knowledge foundations. To this end, they discuss a Native perspective on wellness that emphasizes balance among the interconnected areas of spirit, body, mind, and context or environment. From this perspective, mental health is a product of balance and harmony among these four areas. The authors conclude with a discussion of the practice implications of this relationally based perspective in which practitioners target interventions toward improving balance and harmony.

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This study signifies an initial step at giving family therapists an important assessment tool as they seek to increase cultural competence with Native American families and children. To determine the relevancy and consistency of utilizing a spiritual ecogram assessment tool with Native Americans, 50 Native American participants, with extensive experience with this population, reviewed, rated, and gave feedback on its use. Although some limitations were noted, results showed that spiritual ecograms were moderately consistent with Native American culture and, if used properly, can help family therapists develop culturally appropriate interventions with Native American families and children.

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