Section 3
Examples Rooted in Our Principles
When developing or expanding programs, there are modalities or methods of practice which align with the principles of harm reduction, cultural care and belief in the inherent value of our community members who use drugs. Dignity, respect, and an understanding of the ways trauma may shape and influence our behavioral health as Native people are central components to care. The modalities reviewed in this section are either from our communities, or are external modalities compatible with these foundational beliefs. For the non-Native modalities, many of these originated from or were heavily inspired by tribal practices and repackaged within a western context.
Low-Barrier Care
This is the practice of removing as many potential obstacles as possible between a person and the care they seek. While we’ve discussed some of the potential obstacles people may face in accessing care – namely, transportation, lack of housing, and stigma – low-barrier treatment is a direct response of continuous process of internally reviewing existing policies, and developing new programming with barrier reduction in mind. For our community members who are currently using drugs and in various stages of connectivity to resources, low-barrier care can be the difference between someone staying connected and someone falling through the cracks.
The foundational principles of low-barrier treatment are >
-
Ensuring programs and expectations are flexible for the needs of the person in front of us. Someone’s needs, circumstances, past history or lack thereof with services, or even just their preferences should shape the options available and inform how these options are offered. This isn’t the same as having no boundaries, but instead understanding that a person’s situation must be considered in order for care to be effective and empowering.
-
Being able to offer a wide and comprehensive variety of care options which can address people’s needs as an entire system is another factor that decreases barriers. Responsiveness means that services reflect the wide variety of factors that can influence a person’s life and the services they are able to access. Responsive care can include things like offering childcare, having ceremony or cultural practices for people in transitional phases of life, incorporating meals or grocery options, or allowing family members or loved ones to attend clinic appointments.
-
Working in relationship with other groups, organizations, or people involved in the community is necessary to ensure that care for one another is an all-in effort. A cook in the Native community might consider offering brown bag lunches for street-based outreach. A grandma might teach her grandkid about their traditional medicines by preparing bundles for community use. A culture-keeper might lead ceremony for someone coming home after a decade in prison. As a thriving, sovereign Native community – and all the programs by and for us – are stronger when everyone comes together to build a circle of healing.
-
Continuing to learn about different care options, continuing to learn about people’s experiences and challenges, and coming to care for one another from a humble position supports everyone in the process.
Examples of Programs:
-
Talking circles are a style of facilitated peer support in a community setting and done through a cultural lens. While there are many structures and styles to talking circles, the standard principles of non-hierarchy, that everyone has an equally important voice, and that everyone has the capacity to both learn and teach are shared across styles. Talking circles can be used for storytelling, for processing grief, for unburdening guilt or shame, for building connection on a deeper level, and for creating a safe space for people to open up. Talking circles are generally facilitated by someone who holds a respected role in the community, but every group is different. Rotating facilitation, so long as it’s done with support, can empower people who haven’t had the opportunity before. Talking circles can also be lighthearted – it is simply a structure that allows for people to share, whether its focused on a certain topic or prompt, or if its open to anyone to share about anything. Incorporating this modality into your program can support people from all walks of life.
-
Cultural events are any workshop, larger-scale event, or program which focus on cultural ways or teachings. While culture is involved in all aspects of our work, this category is about activites which are focused first and foremost on cultural knowledge or activities. This includes anything from a community Powwow or Big Time, a workshop like canoe or tule-house building, to things like language workshops or traditional foods events. Cultural events are one of the most resources to offer as a Native organization or project. Cultural involvement is a protective health factor, meaning people’s connection to culture is directly related to their physical health, emotional and spiritual wellness, and their capacity to participate in healthy behaviors and healthy choices choices. Cultural events bring people together and introduce people to the other services you have to offer: someone who attends a clapper stick workshop can learn about the counseling or Red Road to Wellbriety groups that you offer, and can then become even more involved in your program.
-
Wellbriety/Red Road to Wellbriety is considered to be a cultural alternative to the non-Native AA or NA model. While people do benefit from access to things like AA or NA, Wellbriety is a facilitated wellness model that is specifically by-and-for the Native community, and centers spiritual wellness and cultural connection rather than focusing on western models of recovery. While Wellbriety is an abstinence-focused model, the environment tends to be more welcoming of people in all stages of their life, so long as they are interested in learning about the culturally-centered healing process. Rather than AA or NA which focus on active steps towards ceasing certain behaviors, Wellbriety focuses on active steps towards spiritual wellness and connection to Creator – the differences in emphasis between these two models, and the groundedness in spirituality, make Wellbriety more approachable and relevant to our Native community. Offering Wellbriety or Red Road meetings are excellent options to create a variety of services for people to engage in.
-
Motivational interviewing and related modalities are about empowerment as a tool for behavioral change. These are styles of interacting with people that help support them in identifying their goals and/or the next steps they would like to take related to them. Motivational interviewing’s core is based on OARS: open questions, affirmation of strengths, reflections based on empathetic listening, and summarizing the key points.
Motivational interviewing places the power of the conversation in the person’s hands, and helps break down the power differential between provider-client. It can help reinforce the autonomy of community members who often are denied theirs, and creates the space for people to explore their desires without judgment.