Does Receiving Traditional
Healing as a Vocational Service
Lead to More Successful
Outcomes?
Post Employment Training American Indian
Rehabilitation Cycle VII~Researchers
Purpose of our Study:
• The purpose of this study is to determine the effect
of spirituality on successful Vocational Rehabilitation
(VR) outcomes.
• In this project the researchers examined the
traditional healing component of American Indian
Vocational Rehabilitation (AIVR) and how it affects
consumer employment outcomes.
Native American Vocational
Rehabilitation
“The American Indian and Alaska Native people
are the most underserved, misrepresented,
and unknown population that require
assistance in achieving employment and
independence”(American Indian Vocational
Rehabilitation (AIVR) History, N.D.).
Native American Vocational
Rehabilitation
• According to Marshall, Johnson & Lonetree (1993), “state and
federal agencies provided funds to provide vocational
rehabilitation services on Tribal reservations as early as 1947,
and subsequent work over the years led to a greater
recognition of the psychosocial barriers facing Native
Americans, generally” (p. 327).
• Despite this early recognition of Native Americans as an unserved or underserved population, little was done by
vocational providers to include them or reach out to them.
Native American
Vocational Rehabilitation
• A major addition to the Rehabilitation Act of 1973
was Section 130 which was written into Title I.
• This section provided for American Indian projects
to serve Indian people on reservations. While this
was a major achievement for Native Americans, no
funding was provided to the programs.
Native American
Vocational Rehabilitation
• The Navajo Nation led the movement to include a
funding mandate into the Act, and finally succeeded
in 1983. They were the only AIVR program until
1985.
• This achievement came more than forty years after
the 1947 memorandum (Kelley, 2010).
Native American Vocational
Rehabilitation
•
A1978 Department of Education-Rehabilitation Program Annual Report sums up
the failure of the State Vocational Rehabilitation to provide adequate services:
The greatest problems that face VR in the effort to improve services to
Native Americans are ones that relate more to the potential client’s
status as an American Indian than to disability status. The Indian
population on reservations, including the disabled population, is not
conveniently located for easy participation in general Federal and State
programs; they are usually dispersed in large rural areas. If there is a
single, important step that RSA should consider in order to improve VR
services to Native Americans, that step is developing ways to take VR to
the reservation Indians. It is not likely that they will or even can come to
VR in significant numbers. American Indians have one of the highest
disability profiles in the country, yet have been identified as unserved and
underserved by State Vocational Rehabilitation systems (as cited in AIVR
History, N.D.)
Native American
Vocational Rehabilitation
• According to the United States Department of the
Interior there are currently 565 Federally
Recognized Indian Tribes, Bands and Nations (TBN)
(2011).
• In 2010 there were eighty-two AIVR Programs in 25
states (Kelley, 2010).
Native American
Vocational Rehabilitation
• AIVR programs are competitive grants
awarded and administered through the
Rehabilitation Services Administration under
the United States Department of Education.
• In 2008, AIVR successfully rehabilitated 1,609
American Indians with disabilities (Kelley, 2010).
Native American
Vocational Rehabilitation
• The percentages of successfully rehabilitated Native
Americans has held steady at 66% and over for the past 4
years (Kelley, 2010).
• West (2009) reports the reason for the success [of] tribal
vocational rehabilitation is because “the programs are able to
maintain continuous presence on the reservation, are aware
of and observe tribal customs, employ primarily native staff,
use non-traditional or native employment, and where possible
and necessary communicate in the native language” (p.1).
Why is TVR Unique?
• The Medicine Wheel or Sacred Circle has been used
in various forms and aspects in different Tribes
throughout history, and it is a universally recognized
symbol to most Native Americans.
• One aspect that makes AIVRs unique is the view of
the consumer as a whole person, mind-body-spirit.
Spirituality is New to Many Fields
• In a Gallop Poll conducted in June 2011, 92% of Americans
stated that they believe in God, and these numbers have held
steady at over 90% since 1968 (Newport, 2011).
• It was only in 2000 that the American Psychological
Association (APA) began to include religion in its standards
for graduate school accreditation (APA, 2000).
• Phillips (2003) found that fields such as nursing, occupational
therapy and medicine have begun to recognize the
importance of r/s in patients’ lives in relation to their
perceived mental and physical health.
Spirituality is New to Many Fields
• The benefits of engaging in spirituality have been
identified with advantages such as:
improvement in certain relationships, increase selfesteem and confidence, promotes the awareness of
values such as honesty, patience, wisdom, hope,
kindness, creativity, and joy, sense of inner peace and
acceptance of most problems a person is faced with,
sense of optimism, and quicker recovery from
certain illnesses (Cory, Gerald. 2010).
Spirituality is New to Many Fields
• Levin (2001) reviewed over 200 epidemiological studies which
dealt with the impact of spirituality/religion (s/r) beliefs on
individual’s mental and physical health. His results indicated
the following:
any religious affiliation benefits an individual’s health by
promoting health and wellness behavior; participation in
worship (prayer, meditation) benefits health through the
physiological effects of positive emotions; having faith benefits
physical and mental health relating to hope and positive
expectations; and religious Americans have a longer mortality
rate than nonbelievers.
Spirituality is New to Many Fields
• While consensus is emerging which supports
incorporating religion/spirituality (and culture) into
mental health treatment…
• Hansen, N.D., Randazzo, K.Y., Schwartz, A., Marshall,
M., Kalis, D., Frazier, R., (2006) studied multicultural
competencies among psychologists and found that
their sample integrated racial/ethnic derived
religious/spiritual beliefs and practices into treatment
significantly less than they report they should.
Modern Native Spirituality
• To understand r/s in modern Native Americans, you must first
understand Native American history.
• "So, Native communities experienced many
generations of trauma and loss, with no traditional
ways of addressing and healing them," states Beth
Boyd, PhD, University of South Dakota psychologist.
“In fact, it was illegal to practice traditional Native
American spiritual and ceremonial forms of healing
until 1978, when Congress passed the American
Indian Religious Freedom Act”, she notes.
(DeAngelis, 2009).
Modern Native Spirituality
• Due to the forced assimilation, boarding schools, and
various laws passed that tried to “kill the Indian, save
the man”, today’s modern Native Americans span
the spectrum from Traditional spirituality to
Christianity, and everything in between.
• Which begs the question, ‘What is Spirituality’?
What is Spirituality~
• Spirituality can mean many different things to
different people.
• Spirituality is not always associated with religion.
Spirituality is a process of self discovery of the idea
or a process of a journey to learn about one self.
• Spirituality can be connection between a person,
others, or a higher power.
What is Spirituality~
• Spirituality can be personal or with an openness with
others or a person’s surroundings.
• Spirituality may serve as a guidance of moving
forward in a direction of a purpose, meaning in a
person’s life.
Importance of Spirituality and
Counseling
• Some professional counselors may be aware that
spiritual and religious issues matter; and have ethical
views, therapeutically pertinent, and potential
significant to a client problem.
• Counseling and Spirituality can address not only the
motivation of a person, but can address the mind,
body, and spirit.
Importance of Spirituality and
Counseling
• Counseling and Spirituality can aid a person to gain
insight into the core values and beliefs that can
reflect on a person’s behavior. Clients may
understand that he or she may need to re-evaluate
these values.
• A counselor must be properly trained and ready to
deal with his or her clients’ issues of the human
spirit.
Symbolic
• “Symbolic forms and activities are the basic building blocks of
culture…” (Bolman and Deal, 2008, p. 278).
• Cultural lifestyle is the behavior, beliefs, and attitudes of a
Native American society; culture is the pattern of person’s
thoughts, language, actions, communication, values, and
beliefs.
• Culture is a characteristic of a person or a group of people; it
defines this person or group.
Symbolic
• For Native Americans there is a cultural bond that is ethnic;
there are shared beliefs, activities, and values.
• The influence of most Native American spiritual culture is the
geographic, Tribal affiliation, and preservation of what Native
people have left.
• The symbolic framework within Tribal communities in which
this is demonstrated is taught is through traditions such as
seasonal dances, sun dances, prayers, sweat lodges, the drum
religion, the Native American church, as well as non-native
practices.
Spirituality & Native Americans
• Many people may believe that Native Americans and
spirituality go hand in hand; many followers of Native
American spirituality do not regard his or her
spiritual practices and beliefs as a “religion” as a
Catholic or Christian.
• Native American spirituality is not evangelistic; to
walk the way of a true Native American in a spiritual
understanding is a cultural lifestyle always.
Spirituality & Native Americans
• Most Native Americans spirituality practices and
beliefs form an essential and flawless part of his or
her being.
• A Native Americans spiritual/cultural life-style is the
belief of promoting and preserving what is mother
earth has given everyone; from the air that he or she
breaths to ground that he or she walk on; mother
earth is always giving so a person can survive.
Spirituality & Native Americans
• Cultural life style is the behavior, beliefs, and
attitudes of a Native American society; culture
is the pattern of person’s thoughts, language,
actions, communication, values, and beliefs.
• Spirituality is simply being Native American, a
reflection of his or her self in a good way.
Spiritual Leaders/Helpers
• Laverne Haag, MSW, Treasurer for Native American
Church Chapter in Kansas, member of the Ponca
Tribe.
a. Dawn interviewed Mrs. Haag on 9/21/11.
b. Grew up knowing the positive effects of the
Native American church ceremony.
c. Family members were and continue to
advocate and educate others on the American
Indian Religious Freedom Act.
Spiritual Leaders/Helpers
• Mary Webster, spiritual helper, member of the
Menominee Tribe.
a. Carey interviewed Ms. Webster on 9/16/11.
b. Plays an important role in helping clients connect
to other spiritual leaders in the community.
c. Has worked in the human service field for over
20 years.
Spiritual Leaders/Helpers
• Angie Merrill, tribal elder and member of the St.
Croix Chippewa Tribe.
a. Director of the Ojibwa Language program.
b. Served as the coordinator of the Johnson
O’Malley(JOM) and Trails Youth Program.
c. Born and raised on the reservation and
brought up in the traditional way.
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
Questions for our Spiritual leaders/Helper
1. Is the community at large aware of the spiritual leaders in
the community and the types of services they offer?
a.
Mrs. Haag replied as follows:
…that if individuals have been brought up in knowing traditional ways
then they would be aware of the traditional leaders in the community.
However, on the other hand the opposite is true that if community
members have not been brought up this way then these leaders would
not be familiar to them. In Mrs. Haag’s experience, she said unless a
client specifically asked for spiritual help then it is not really addressed
or offered. (L. Haag, personal communication, September 21, 2011)
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
1. Is the community at large aware of the spiritual leaders in the
community and the types of services they offer?
b. Angie Merrill responded by saying that “Most of the
Community who practice the traditional way [is] aware of the
spiritual leaders and healers. Most of the community also
know who to ask (elders) if they need advice, guidance, or to
be directed to a healer” (A. Merrill, personal communication,
September 22, 2011).
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
1. Is the community at large aware of the spiritual leaders in the
community and the types of services they offer?
c. Mary Webster preferred to be called a helper. She said a healer is a
medicine man. She also went onto say that “[A] helper… can find people
that can do sweat lodges, pipe carrier ceremonies, and naming
ceremonies.” One common practice that is used in Native communities is
the offering of tobacco when asking others for help. Ms. Webster
practices this and when she is approached by community members
enquiring about the services of other spiritual leaders in her community
she first gives them tobacco and asks permission to give out their
information. The Indian way for the releasing of information in the form of
offering tobacco is unknown and is not practiced in both Native and nonnative social service agencies. (M. Webster, personal interview, September
16, 2011).
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
2. Are Spiritual leaders easily accessible to community members?
a. Mrs. Haag replied by the following: “yes they are easily accessible to
those who are familiar to them so if they attend ceremonies and they see
the leaders that stand up and talk they see the person taking charge, and
leading the ceremonies, leading prayers…then those are familiar faces to
them.” However, on the other hand she goes onto say that “no, these
spiritual leaders are not easily accessible to community members that [do
not] go around [those] ceremonies that are not familiar with these people
that wouldn’t know this person, the spiritual leader, if they seen them in
the grocery store or around the community somewhere or in the clinic …
because they have not been exposed to that familiar face” (L. Haag,
personal interview, September 21, 2011).
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
2. Are Spiritual leaders easily accessible to community members?
b.
Ms. Merrill replied “the tribe doesn’t have their own medicine man, but
the elders and traditional Natives know how to get a hold of the healer if
needed.” Ms. Merrill’s goes onto say that “most of the Traditional
Natives also attend Traditional ceremonies, such as big drum, so finding a
spiritual leader or elder is relatively easy” (A. Merrill, personal interview,
September 22, 2011).
c. Ms. Webster responds by saying that “When I am approached by a
community member, the spiritual need is asked. I go to the person that
can help with tobacco at hand to give to the spiritual person I am asking
for help.” (M. Webster, personal interview, September 16, 2011)
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
3. Is spirituality incorporated into individual plans of employment (IPEs) and
service plans for spiritual leaders who have to document their teachings,
and how is it documented?
a. Ms. Haag said that she “did not believe spirituality is really incorporated into the
treatment plans …it is only a suggestion, it might be a suggestion of a VR
counselor of a drug and alcohol counselor or a social worker. She also goes on to
say that “you can make those suggestions all day long and now whether or not the
individual takes that upon themselves to incorporate that willingly or whatever
unless it is mandated or kind of like court ordered.” A tribal drug court might
recommend that clients do this. She went onto acknowledge that “Mainstream
society like even Indian Health Service [do not] recognize yet though it’s changing
but yet [do not] recognize cultural and traditional ceremonies as a part of a
person’s treatment plan.” She did agree that “for spiritual leaders who have to
document their teachings ...it probably should be documented somewhere in case
notes and it should be required.” (L. Haag, personal interview, September 21,
2011)
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
3. Is spirituality incorporated into individual plans of employment (IPEs) and service
plans for spiritual leaders who have to document their teachings, and how is it
documented?
b. Ms. Merrill said that “Most of the western treatments are separate from
Traditional. It is thought (by this leader/elder) that living in the Traditional way
would preclude need for western medicine, such as AODA counseling. The
creator will help, and show you the path, so the need for treatment will likely not
be needed.” (A. Merrill, personal interview, September 17, 2011)
c. Ms. Webster reports that “She will annotate that she [discussed] this holistic
healing of what the topic is and place it in her monthly report and she will also
“pass a rock around [and] I ask the people I am speaking to what they have
learned today.” She watches body language and feels good in knowing if a person
learned one thing then she did her part.
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
4. When do you refer people seeking healing to other resources (like a
medical doctor or AODA treatment)?
a. Mrs. Haag replied that “The methods of treatment they are so varied they
enhance one another.” She considers “traditional cultural events or
activities like sweat lodges, Native American Church, drum doings,
as…those things are part of our spirituality that enhance [and] they are
resources. Mrs. Haag makes a valid point in adding that “they’re our
church, they’re the support system, [and] they’re the cushion around our
lives that hold us safe.” A resource book would be helpful for consumers
because these activities and events could be made available to consumers.
She goes onto add that there are “people that do merely just the clinical
piece and [do not] do the traditional/cultural piece and …somehow some
people walk on both spectrums, one foot’s on this clinical side and one
foot is on the traditional/spiritual side.” (L. Haag, personal interview,
September 21, 2011)
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
4. When do you refer people seeking healing to other resources (like a medical
doctor or AODA treatment)?
b. Ms. Webster replies by saying that she does not refer a client to an AODA
counselor anymore but instead replies by saying “I work with a cultural spiritual
group. If someone [wants] AODA and [it is] brought to my attention, I give this
information to my supervisor, or tell them how to get started, or refer them to
the front desk to get started.” She also reports that “A community in Canada
works with traditional people that work with the clinics. Even the clinic refers
people to the traditional people and …have brought this up to the Menominee
Clinic but it did not get far” (M. Webster, personal interview, September 16,
2011)
c. Mrs. Merrill contends and believes that “the creator should help with all of these
things. If you are sincere and walk in the Traditional way, the creator will give you
help and guidance to deal with your issues.” (A. Merrill, personal interview,
September 22, 2011)
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
5. As a spiritual leader, how does the healing affect anyone, in a positive or
negative manner?
a. Mrs. Haag replied that she “has heard from other individuals,
acquaintances, family members attest to what the healing does to them
but a lot of times they don’t understand from just one sweat lodge
ceremony…you have to keep going until you begin to understand from
sitting still, being quiet, listening … and there’s a time when you also get
to express yourself. Whether it physical, mental, psychological, emotional
pain that they need healing from, how it affects them is just a sense of how
they perceive… the healing or how somebody can help them. For
example, she explains that a person with arthritis could use the heat from
the sweat lodge as a type of physical healing and if a person were suffering
emotionally they might cry in a sweat lodge.” (L. Haag, personal interview,
September 21, 2011)
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
5. As a spiritual leader, how does the healing affect anyone, in a positive or negative
manner?
b.
Ms. Webster said to “work with your heart, body and mind [it] will make
you well. It is up to the individual, if you are open if you want that
healing it will happen…if you send out positive energy it will come back
and if you send out negative energy it is going to come back. Some
people have [selective] hearing or selective thought. It is also up to that
person wanting to receive that healing, if they want it or not to get to the
place to get better” (M. Webster, personal interview, September 16,
2011).
c. Mrs. Merrill’s reply to the question was that “It is all positive” (A. Merrill,
personal interview, September 22, 2011).
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
6. As a spiritual leader do you feel that your efforts in Native Healing have
had any effectiveness on people you serve?
a. Mrs. Haag replied that “yes, and that’s just from the individuals that have
come to me prior to a healing ceremony… and saying I really need this or
I really want to do this and they actually come and then have that
experience and they get there and get to benefit from the ceremony.
After that they come back to you and say I really slept good last night or
they say I figured something out while you were talking… or say I really
feel good. There’s always something somebody says and appreciates these
types of events and ceremonies. She further acknowledges that [she] gets
to feel the positive effects of the things that we do as Indian people and
the tools that were left here for us that were given to us by the creator.”
(L. Haag, personal interview, September 21, 2011)
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
6. As a spiritual leader do you feel that your efforts in Native Healing have had any
effectiveness on people you serve?
b. Ms. Webster replied by saying that “I rely on my spirituality [and] I rely on the
Creator to direct me ... [to] help me say something to somebody today that
[is]going to help them.” She also goes onto comment that she “[gets] direction
from my higher power…it is not of the ego it is of the heart. When you have the
mind and the heart to work together it is a good place, ego doesn’t exist.” Ms.
Webster feels happy when she has been able to help someone “in the healing
process” (M. Webster, personal interview, September 16, 2011).
c. Ms. Merrill replied that “Getting the advice of an elder, spiritual leader or healer
has positive effects on those who walk in the Traditional way… she agrees with
the concept of the mind-body-spirit connection, and that you cannot neglect one
part of that, because we are all mind-body and spiritual people.” (A. Merrill,
personal interview, September 22, 2011)
Native American Vocational
Rehabilitation~Spiritual Leaders/Helpers
• A positive outcome that came about as a result of this
interview was that Ms. Webster had asked Ms. Waubanascum
“to start having a resource for Spiritual communication,
because there are people in our community that are looking
for what clan they are, where to go for sweat lodge, and who
they are” (M. Webster, personal interview, September 16,
2011).
Traditional Values
• The ceremonies offered and practices for Traditional
Healing are as varied as the Tribes, Bands, Nations.
• Most have Medicine Men that can be called upon for
healing.
• Most have sweat lodges or some form of hot house
used for healing and harmony of mind-body-spirit.
Traditional Values
• Carey’s helper (healer) was very open and asked her to help
get a resource list together for Natives who are looking for
their healing or path.
• Dawn’s leader was open and gave us a lot of good
information and understanding of the Traditional ways and
reasons behind different ceremonies.
• Mollie’s leader was reserved in her information – many things
are taboo to speak of in regard to Traditional Spirituality for
this Tribe.
Results
• Conducted a survey to the 9 Regional TVRs, with 5
responses returned.
• Data was for the 2010 and 2011 fiscal years. Surveys
were received from:
•
•
•
•
•
Great Lakes Inter Tribal Council-Pat Lerch
Inupiat Community-Dallas Lee Drower
Menominee Nation-Norman Shawanokasic
Oneida Nation-Micah Nickey
Yakama Nation-Leah Smartlowit.
Spiritual Healing-Findings
1. How many consumers total were served under an
Individualized Plan for Employment (IPE)? 701
2. How many of these consumers were closed as
successful (employed)? 227
3. How many of these consumers were closed as
unsuccessful (not employed or other)? 123
IEP
Successful
Unsuccessful
TVR Survey 1, 2, 3
0
100
200
300
400
500
600
700
800
Spiritual Healing-Findings
4. How many of these consumers had as their primary
disability:
a) Substance dependency 340
b) Mental Health Disorder 278
c) Physical Disability
160
Substance Dependency
Mental Health Disorder
Physical Disability
TVR Survey Question 4
0
50
100
150
200
250
300
350
Spiritual Healing-Findings
5. Of these consumers, how many received Traditional healing as a service?
A. For those consumers who did receive Traditional healing as a service, how many
were:
• 18-40 years old 42
• 41-70 years old 29
B. For those consumers who did receive traditional healing as a service, how many
were:
• Closed as successful (employed) 24
• Closed as unsuccessful (other) 4
18-40
41-70
Successful
Unsuccessful
TVR Survey Question 5
0
10
20
30
40
50
Spiritual Healing-Findings
6. Of these consumers, how many did not receive Traditional Healing as a service?
A. For those consumers who did not receive Traditional healing as a service, how
many were:
•
•
18-40 years old
41-70 years old
227
264
B. For those consumers who did not receive Traditional healing as a service, how
many were:
•
•
Closed as successful (employed)
Closed as unsuccessful (other)
201
109
18-40
41-70
Successful
Unsuccessful
TVR Survey Question 6
0
100
200
300
Results
Consumers who have received traditional healing:
10%
Consumers who have not received traditional healing: 70%
Successful closures that did receive traditional healing service:
Successful closures did not receive traditional healing service:
33%
40%
Discussion and
Recommendations
• In developing this paper the researchers have
discovered that most, if not all TVR application
paperwork does not ask the consumer if he or she
has or needs religion and spirituality (r/s) or
Traditional Healing in his or her life.
• The researchers believe that our results could have
had a different outcome if r/s and/or traditional
healing was addressed on the application or during
the introduction of VR services.
Discussion and
Recommendations
• Furthermore, the interviews with the spiritual
leaders and helper indicated that the role they play in
their communities is important and they all felt that
traditional healing has made positive effects in the
lives of those they serve.
• Are traditional healing practices not addressed
during the VR process? This was indicated by Mrs.
Haag’s response when she said that in her
experience that it is not addressed and that it is only
a suggestion.
Discussion and
Recommendations
• Another reason why r/s may not be addressed
during the VR process is that rehabilitation
counselors historically do not discuss this with their
consumers, because it is seen as a private matter and
some counselors may be fearful of imposing their
own beliefs and values on consumers (Green,
Benshoff, and Harris-Forbes 2001).
Conclusion
• Though our survey results did not support our
hypothesis, through the research and interviews the
researchers feel that r/s are very important to
Native people and to AIVR.
• Future studies may wish to address the question of
whether spirituality is uniformly addressed during the
application, intake, or when developing a plan for
employment, and whether or not this may have
some significance in successful outcomes.
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•
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•
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