During the past decade much has been said about the need to include cultural issues as a factor in the helping process. The discussion in social work literature has moved from cultural sensitivity to cultural competence, the ability to integrate cultural knowledge and sensitivity with skills for a more effective and culturally appropriate helping process. This article reports the results of a study of culturally competent helping practices with Native Americans. Sixty-two Native American social workers and social work students completed a survey on knowledge, skills, and values necessary for culturally competent service provision to Native American clients. As both Native Americans and helping professionals, the survey respondents are in an ideal position to articulate how best to serve the Native American population. This article fills a gap in the literature by providing empirical information on culturally competent social work with Native Americans.

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Indigenous peoples have a unique place within a multicultural society. The history of indigenous people in the United States differs from those who came here as immigrants. For many Native Americans a primary goal has been self-preservation through separation and isolation rather than seeking a place within a multicultural society. Many people are not aware that the federal government and some state governments have specific moral and legal rights and responsibilities toward Native Americans, unlike other groups in the United States. Human services providers who work with Native Americans must understand the issues specific to indigenous people in a multicultural society. This article examines the unique status of Native Americans in the United States and explores the practice implications of that status. The article begins with an overview of the components of culturally competent social work with Native Americans, then examines specific issues such as historical trauma and sovereignty with which social workers and other human services workers should be familiar to serve Native American clients effectively.

The Healthy Living in Two Worlds project developed a wellness curriculum for urban, Northeastern Native American youth. The curriculum sought to increase physical activity, decrease or prevent recreational tobacco use, and increase healthy eating practices. The program was delivered in a summer day camp format to 16 Native American youth ages 9-13. These youth have considerable exposure to recreational tobacco use in their households and among their peers but they express an intention to resist pressure to use recreational tobacco products. Some of these youth do not eat regular meals, particularly breakfast and lunch. Program participants appear to be physically active and their activity seems to have increased after the program.

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