The aim of this exploratory study, which was informed by ethnographic principles, was to better understand the intergenerational transmission of historical trauma among urban American Indians/Alaska Natives (AI/ANs) in culturally specific sobriety maintenance programs. The results of the study were organized into 3 overarching categories, which included 10 themes that emerged contextually in relation to participants' lived experience of historical and associated traumas, substance abuse, and current involvement in a culturally specific sobriety maintenance program. This exploratory study was conducted to understand the relationship between the intergenerational transmission of historical trauma and sobriety maintenance among urban American Indians and Alaska Natives (AI/ANs), in order to inform substance abuse and sobriety maintenance programs. According to data collected over the past decade, AI/ANs are in greater need of treatment for substance use disorders than are members of other racial/ethnic groups (National Survey on Drug Use and Health [NSDUH], 2010). Between 2002 and 2005, AI/ANs over the age of 12 were more likely than members of other racial/ethnic groups to report an alcohol (10.7 vs. 7.6%) or illicit drug (5% vs. 2.9%) use disorder in the past year (NSDUH, 2007). According to data collected between 2004 and 2008, although the use of alcohol over the course of a month was lower among AI/ANs than other racial/ethnic groups, the rate of binge drinking among AI/ANs between the ages of 26 and 49 was higher than the national average (NSDUH, 2010). Likewise, illicit drug use among AI/ ANs age 18 to 25 was higher than the national average (NSDUH, 2010). Substance abuse has been linked to lower health status among AI/ANs when compared with other Americans (Indian Health Services [IHS], 2009a), and has also been linked to health disparities (Walters, Simoni, & Evans-Campbell, 2002). AI/ANs have a unique relationship with the Federal government due to historic conflicts and subsequent treaties; thus, members of Federally recognized

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Culturally appropriate mental health services are essential for Indigenous people who suffer the greatest mental health disparities of any ethnic group in the U.S. However, few mental health professionals receive training to work with this population. To fill this gap, a 90‐minute training was created to increase knowledge of and empathy for Indigenous people and culture and therefore, improve mental health services for Indigenous patients. This training is grounded in cultural competency, cultural humility, and decolonialism. The training is presented here for mental health professionals, agencies, and administrators to use as a guide. The training aims to increase knowledge, awareness, and skills and has been implemented in a variety of settings receiving positive feedback from participants and administrators.

Integrated care appears to be an intervention that can ameliorate these disparities by reducing stigma for those seeking care and providing coordinated care to prevent or reduce health care disparities in this population. While integrated care appears to be an effective system of care for Indigenous people, it must be noted that integration of local Indigenous health beliefs and practices is equally necessary.

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