Alaska Natives view aging from a holistic perspective, an approach not typically found in the existing literature on successful aging. There is little research on Alaska Native (AN) Elders and how they subjectively define a successful older age. The lack of a culturally specific definition often results in the use of a generic definition that portrays AN Elders as aging less successfully than their non-Native counterparts. This research explores the concept of successful aging from an AN perspective and what it means to age well in AN communities. An Explanatory Model (EM) approach was used and adapted to focus on the health and well-being of AN Elders and to gain a sense of their beliefs about aging. Qualitative, in-depth interviews were conducted with 26 Elders in six participating communities to explore the concept of successful aging and the role of their community in the aging process. Focus groups were held in specific communities to present the findings and receive feedback; this ensured the findings and report would be reflective of the unique perspectives of the communities and region. This study highlights four domains of successful aging, or "Eldership": emotion, spirituality, community engagement, and physical health. One aspect of successful aging seen in each of these four domains is optimism, or having a positive outlook on life. These four domains serve as the foundation of how communities define who is an Elder and what is important when considering whether someone has aged successfully or not. Research findings also indicate that aging successfully is based on local understandings about personal responsibility and making the conscious decision to live a clean and healthy life. Most Elders stated that Elder status is not determined by reaching a certain age (e.g., 65 years), but instead is designated when an individual has demonstrated wisdom because of the experiences he or she has gained throughout life. This research seeks to inform future studies on rural aging that will prioritize the perspectives of Elders to impact positively on the delivery of health care services and programs in rural Alaska.

In order to facilitate greater cultural competency, a study regarding the use of the Orthogonal Cultural Identification Scale (OCIS) in a sample of Asian Indian exchange students was conducted. The specific research questions to be answered were: (a) what meanings would participants ascribe to key terms and phrases on the OCIS, (b) what meanings would participants apply to differences in categorical placement on the OCIS, and (c) what themes would the participants associate with cultural identification? To answer these questions, 47 participants completed the OCIS and a demographic questionnaire, while 8 of these participants also participated in a semi-structured individual interview and group feedback interview. A phenomenological method and participant feedback were used to analyze and summarize the data. Internal consistency of the OCIS subscales was good, while the White American or Anglo and the Asian Indian subscales correlated positively to a significant extent. The OCIS term, "traditions," was associated with festivals, family, puja, and special foods. The OCIS phrase, "way of life," connoted Hinduism, family-centered, day-to-day activities, gender differences, and intra-cultural variation. Finally, the term, "success," connoted karma, family life, education/knowledge, social life, and practical considerations. Because no previous study has investigated the meanings of key terms or phrases on the OCIS, this study adds to the literature by providing: (a) an initial indication of the meanings ascribed by Asian Indian exchange students to items on the OCIS, and (b) a model for similar investigations in other cultures.

Alaska's older adults are growing faster in proportion to the overall population creating concern regarding how adequate care will be provided in the coming years. Statewide, rural community members are looking for innovative, culturally appropriate ways to promote successful aging for their growing population of elders, allowing them to age in their home communities. This qualitative, phenomenological study sought to establish a deeper understanding of how Alaska Native Elders in Northwest Alaska understand and experience successful aging to inform program development and service delivery. The present project was embedded within a larger community-based participatory research study and conducted in collaboration with community members and an Alaska Native Elder Advisory Committee. The 14 community-nominated Elder participants universally identified engagement with family and community, self-awareness and care, and a sense of gratitude as essential elements of successful aging. Elders who age successfully listened to and learned from their Elders, enact their traditional values and practices, and pass their wisdom and knowledge to future generations. The results provide a culture and context specific understanding of successful aging that will help communities develop Elder-centered programs and service delivery and contributes to field of successful aging by presenting a perspective of successful aging that is not currently represented in the literature. Finally, by recording the Elders' knowledge and stories of successful aging this project also helped preserve some of the traditional cultural knowledge held by Elders in this region to be shared with generations to come.

Alaska Native college students are less likely to graduate within a four year time span, have higher drop-out rates, and have lower grade point averages compared to other students. In addition to the typical life adjustments, challenges, and stressors that come along with college life, Alaska Native college students also commonly face conflicts between their heritage culture and the Westernized systems of colleges and universities, which might make it more difficult for Alaska Native college students to successfully adjust to college life, perform well academically, and remain committed to completing their education. Thus, this study used an experimental design to compare two similar student support groups (Talking Circles or TC and Mainstream Support Groups or MSG) that were administered during an academic semester to determine which works better with Alaska Native college students for facilitating their adjustment to college life, academic performance, and commitment to completing college. Using an experimental, pre-/post-test comparison group design with 24 Alaska Native college students (TC n=10; MSG n=14), the results revealed that neither TCs nor MSGs increased levels of adjustment to college life and commitment to completing college. Furthermore, although the results showed that students who participated in TCs felt more satisfied and felt that they were heard better by their group compared to students in the MSGs., no evidence was found to support the effectiveness of TCs in improving adjustment to college life, academic success, and commitment to college. Along with the study limitations, future research and service implications regarding the use of TCs among Alaska Native college students -- and among Alaska Native Peoples more generally -- are discussed.

Psychotherapy has repeatedly been shown to be an acceptable form of treatment for a variety of psychiatric conditions. However, despite the success of psychotherapy, not all patients improve during a course of treatment. In fact, research has suggested that some patients actually become worse while engaged in psychotherapy. Thus, it becomes important to identify patient deterioration and provide this information back to therapists. Additionally, the ability to detect patient deterioration cannot be solely the result of clinician judgment. Research has shown that utilizing actuarial methods of identifying patient non-responders is superior to that of clinician judgment alone. In turn, the field has moved toward implementing routine outcome monitoring tools/management systems to assist in the process of identifying patients who are failing to respond to treatment. The present study explored potential relationships between routine outcome monitoring, deliberate practice, and routine clinical supervision. Results suggest that the vast majority of practicing therapists do not utilize routine outcome monitoring tools/management systems as part of their daily practices of psychotherapy, and most do not incorporate feedback results into their personal clinical supervision experiences. Additionally, results suggest that therapists who have received formalized training with routine outcome monitoring tools and/or are required to engage in weekly supervision, are more likely to monitor their patient outcome as part of their daily practices of psychotherapy. Moreover, self-assessment bias seems to be present within the sample in regards to identifying patient improvement, non-response, and deterioration. Implications for clinical practice and research are discussed, along with limitations and future directions.

The purpose of this study was to look at factors involved in the process of women leaving abusive relationships. In two interviews of one to two hours each, each of the three women told the story of her abusive relationship. Study findings indicate that these women began abusive relationships during unstable or chaotic periods of their lives, when they were more vulnerable to manipulation. The abuse caused a distortion of reality for these women, but as soon as they were able to gain a clear view of reality, they immediately left their relationships.

Worldwide, the burden of cancer continues to grow and impact the quality of life of patients, their families, and caregivers. Aside from the physical effects and financial costs of cancer and its treatment, a significant portion of cancer patients and their caregivers experience emotional, social, and psychological distress throughout the trajectory of their illness and extending to long-term survivorship. Despite medical advances in cancer treatment, a cancer diagnosis is still often considered to be synonymous with death, pain, and suffering. It has been established that engaging in the creative arts could promote quality of life (QOL) especially for those suffering from chronic illnesses such as cancer. Specifically, studies on dance/movement therapy (DMT) have indicated its efficacy as a complementary and holistic intervention in providing social support, decreasing fatigue and stress, increasing mobility, and enhancing overall wellbeing of cancer survivors. Results from a pilot DMT study that explored the cultural suitability, feasibility, and benefits of using DMT in the post-treatment QOL of Alaska Native cancer survivors indicated positive impacts on participants' mobility, body awareness, emotional expression, self-care, and wellbeing. Participants from the pilot study highlighted the need for providing DMT in the community and opening the DMT group to both cancer survivors and caregivers. This suggestion was in consideration of the lack of support groups available to both cancer survivors and caregivers that focus on cancer survivorship and promotion of quality of life. Existing locally available cancer support groups emphasize cancer education but are limited in meeting the psycho-social, emotional and physical needs of both cancer survivors and caregivers. The encouraging results and feedback from participants not only supported existing studies on DMT's cross-cultural benefits in promoting QOL among cancer survivors but also provided the rationale for a larger dissertation study for survivors and caregivers in Fairbanks, Alaska. It was in this context that DMT's significance in increased survivorship and QOL among cancer survivors and caregivers in Alaska was examined. The study employed a sequential, mixed methods small-N design in investigating the therapeutic benefits of DMT among cancer survivors and caregivers (N = 16) in a practice-based setting in Fairbanks, Alaska. Adhering to the principles of community-based partnership research (CBPR), the study established a collaborative partnership with the Fairbanks Memorial Hospital as it piloted a 12- week, open DMT group intervention for cancer survivors and caregivers. The study was conducted in two phases: Phase 1: DMT Intervention (12 weeks) and Phase 2: Follow-up and Findings Meeting (3 months after the last offered DMT session), which assessed DMT’s lasting effects on participants. Quantitative and qualitative data were employed to examine DMT’s effects on participant’s mental health functioning, body awareness, subjective QOL, and sense of group cohesiveness and engagement with the DMT group. Quantitative findings indicated significant improvements in participants’ mental health functioning with a moderate effect size after participation in the DMT program. Although no significant pre- to post-change was found on participants’ subjective QOL, cancer survivors reported significantly better QOL (social, emotional and functional wellbeing) at the three-month follow-up, suggesting that DMT can offer late, but possibly lasting, positive changes. Additionally, participants’ ability for selfregulation and use of avoidance as a coping tool for pain were found to increase after their DMT participation. No significant changes were noted in participants’ level of cohesion with the DMT group. However, qualitative findings indicate that participants found that the DMT program was extremely beneficial in promoting their physical, psychological, social and spiritual wellbeing and expressed overall strong positive feelings toward their DMT group. Implications for research and clinic practice were discussed as informed by the study’s strengths and limitations. One the study’s strengths is its adherence to the principles of community-based participatory research (CBPR) as an over-arching framework in guiding all aspects of the research process. By establishing a collaborative partnership between the UAF academic community and the local community hospital (Fairbanks Memorial Hospital), this study was able to build on the community’s strengths and resources in an effort to help promote cancer survivorship for cancer survivors and caregivers. Future recommendations include further strengthening collaborative community partnerships with a larger, DMT confirmatory study using a Randomized Control Trial (RCT) design, while integrating a mixed-methods approach. Implementing these strategies would help establish DMT’s efficacy as a holistic and ecologically valid intervention for cancer survivors and caregivers in Fairbanks, Alaska.

This thesis presents the results of a formative process evaluation of the Fairbanks Native Association Women and Children's Residential Treatment Center abuse program using interviews, participant observation, and grounded theory methods of qualitative research. Eight clients and eight staff were interviewed across the domains of culture, spirituality and family. A theory of program operation emanated from and was grounded in the data: program functioning was significantly affected by the relationship perceived by the clients to exist between themselves, (their needs, values, desires, goals and world view) and the program's goals and priorities.

Drinking in Alaska has almost reached epidemic proportions in some subcultures. Alaska Natives have the highest number of FAS cases as compared to non-Natives. Nationally, youth drinking has been correlated to parental drinking. This study addressed the issue of whether there is a difference between the perceived drinking of people in treatment by gender, age, and ethnicity. The parental drinking of one hundred and thirty-four people diagnosed as alcohol dependent or alcohol abusers and in treatment was examined. Significant differences were found between the perceived parental drinking by age, gender, and ethnicity. In addition, many of the subjects did not have a parental drinking model, which could indicate that parental problematic drinking is not a significant causation factor in adult alcohol dependence or alcohol abuse.

This thesis studies Alaska Native Vietnam veterans using archival data and grounded theory methods of qualitative analysis. It discusses the impact of cultural and individual beliefs, expectations and experiences on Alaska Native veterans during and since the Vietnam War. Theories developed from and grounded in the narratives of the 11 participants posit that reconciliation with community is a critical factor in healing from the traumas of war.