A Systematic Review of Trauma Interventions in Native Communities

Abstract

American Indian/Alaska Native and First Nations communities suffer from health disparities associated with multiple forms of trauma exposure. Culturally appropriate interventions are needed to heal current and historical trauma wounds. Although there are evidence‐based trauma interventions for other populations, few have been implemented or evaluated with Native communities. Understanding the extant research on trauma interventions in Native communities is crucial for advancing science and filling gaps in the evidence base, and for meeting the needs of underserved people. In this systematic review of the literature on trauma interventions in Native communities in the United States, Canada, Australia, and New Zealand, we identified 15 studies representing 10 interventions for historical and/or current trauma. These studies involved the community to some extent in developing or culturally adapting the interventions and suggested positive outcomes with regard to historical and interpersonal trauma symptoms. However, notable limitations in study design and research methods limit both internal validity and external validity of these conclusions. Only one study attempted (but did not achieve) a quasi‐experimental design, and small sample sizes were persistent limitations across studies. Recommendations for researchers include working in partnership with Native communities to overcome barriers to trauma intervention research and to increase the rigor of the studies so that ongoing efforts to treat trauma can yield publishable data and communities can secure funding for intervention research.

Understanding Historical Trauma for the Holistic Care of Indigenous Populations: A Scoping Review

“…Literature reviews have focused on the impacts of historical trauma on families (O'Neill et al, 2018), on youth (Smallwood et al, 2020), and on those who attended residential schools (Wilk et al, 2017). Recent systematic literature reviews have examined historical trauma resulting from the residential school experience in the United States and Canada (Gone et al, 2019) and interventions to address historical trauma in the Native communities of North America, Australia, and New Zealand (Gameon & Skewes, 2020). Historical trauma study is currently a complex, growing field with topically, geographically, and methodologically diverse emphases.…”

Indigenous and non‐Indigenous parents separated from their children and experiencing homelessness and mental illness in Canada

“…Interventions that address homelessness/housing, mental illness, addictions, and violence against women must account for the importance of children in the lives, identities, and recoveries of mothers—particularly, indigenous mothers. They must include trauma‐informed practices and trauma‐specific services (Gameon & Skewes, 2019; Hartmann et al, 2012; Kirst et al, 2017)—specifically, those focusing on indigenous historical trauma (Gone et al, 2018). It is important for practitioners to recognize that there is no single pan‐indigenous worldview, and that each individual's healing journey is unique.…”

Indigenous Trauma Intervention Research in Canada: A Narrative Literature Review

“…The need for empirical research in the field of trauma and mental health that is collaborative with Indigenous communities and culturally relevant has been widely documented (Adelson, 2005;Bombay et al, 2009). Culturally relevant interventions are either developed for a distinct cultural group (culturally grounded) or adapted for use in a cultural group (culturally adapted; Gameon & Skewes, 2020). Existing research on mental health interventions with Indigenous Peoples points to the indelible link between cultural continuity 2 and positive health outcomes (Bombay et al, 2009;Chandler & Lalonde, 2008), and the need for community-based interventions that are rooted in cultural models of health and healing and control of resources by Indigenous Peoples (Stewart & Marshall, 2017).…”

“…This preliminary search established that there have been very few empirical studies about culturally relevant trauma interventions with Indigenous Peoples. We understood culturally relevant interventions to include approaches that were culturally grounded and/or culturally rooted interventions (Gameon & Skewes, 2020). There have been two systematic reviews about psychotherapy research with Indigenous communities (Drawson et al, 2016 [n = 9]; Pomerville et al, 2016 [n = 20]).…”

“…All of the studies reviewed looked at integrated Indigenous and Western approaches to psychotherapy. There has been one systematic review, which compiled 15 studies representing 10 interventions, that specifically looked at trauma interventions in Indigenous communities (Gameon & Skewes, 2020). Gameon and Skewes (2020) reviewed culturally adapted and culturally grounded trauma interventions, including three Canadian studies [cited studies Heilbron & Guttman, 2000;Marsh et al, 2016;Thomas & Bellefeuille, 2006].…”