Cognitive-Behavioral Therapy With Alaska Native People.

Abstract

and Alaska Natives make up approximately 1% of the total U.S. population. However, in Alaska, where the state population is only 626,000, Alaska Natives comprise approximately 19% (119,241) of the state's people (Alaska Division of Planning, Evaluation and Health Statistics, 2002). Thus, therapists living in Alaska are very likely to work with Alaska Native clients. Therapists living Outside (the Alaskan term for places beyond state borders) may also encounter Alaska Native clients, particularly in the area of the Pacific Northwest.Psychological research regarding the mental health needs and treatment of Alaska Native people is extremely limited. Existing research focuses primarily on American Indians in the Lower 48 (states) and generalizes this information to Alaska Natives. Although there are some similarities, there are also significant geographical, cultural, political, and historical differences between these populations.A search of the American Psychological Association (APA) journals and books database yielded no empirical studies of counseling or psycho-I would like to thank Karen Ferguson, Barbara Fleek, Randall Madigan, and Alan Boraas for their feedback regarding this chapter.

Integrating evidence-based practice, cognitive–behavior therapy, and multicultural therapy: Ten steps for culturally competent practice.

“…For example, cognitive-behavioral assessment is a relatively directive process, and repeated questioning is considered disrespectful in some cultures, particularly among many Native people and elders of diverse cultures, including European American (Weisman et al, 2005). In such cases, the therapist may need to slow down the questioning process, allow for silences, or give the individual more control in the flow and content of information provided (Hays, 2006a). (Of course, cognitively impaired individuals will usually need more structure.)…”

Cultural competency in the treatment of obsessive-compulsive disorder: practitioner guidelines

“…Instead of exclusively promoting rapport within session, clinicians can also focus on overt demonstrations of respect for clients, which may be more valued in many cultures (Hays, 2009). As repeated questioning is perceived as disrespectful in several cultures, providing clients with space and autonomy throughout assessments may promote respect for their preferences (Hays, 2006). Carefully integrating self-disclosure (when appropriate) within small talk may also promote respect for clients who value a warm personal approach (Organista, 2006).…”

Considerations for Culturally Responsive Cognitive-Behavioural Therapy for Māori With Depression

“…Hays and Iwamasa (2006) edited a book that thoughtfully offered a range of cultural considerations in the practice of CBT with diverse cultural groups, including those defined by ethnicity, religion, age, and sexuality. For example, Kelly (2006) emphasises the importance of understanding the American history of slavery when providing CBT for clients of African-American descent; Hays (2006) discussed the importance of appreciating spiritual perspectives in providing CBT for natives of Alaska; and Markus and Kitayama (1991) highlighted the distinct difference in attitudes between Asian and American culture with regard to individuality and the promotion of independence.…”

“…The belief that all things living and non-living possess a spirit, held by some Native American cultures, has been documented extensively (e.g., Hays, 2006;Turner & Pope, 2009). This animistic belief can be compared to the Māori concept of a Mauri.…”

“…In summary, the adaptation of CBT when working with culturally diverse populations is a minimum standard of best practice, and recommendations exist for a wide range of minority groups (e.g., De Coteau, Anderson, & Hope, 2006;Gelman, 2004;Hays, 2006;Organista, 2006). Literature from New Zealand has highlighted limitations of CBT when treating Māori clients (e.g., Blampied, 1999;Evans, 2002), but despite the strong therapeutic predilection of New Zealand therapists toward CBT (Kazantzis & Deane, 1998), literature documenting how CBT might be adapted for Māori clients is scarce.…”