• Alaska pretrial project proposal: organizational structure change to incorporate a mental health focus

      Gabriel, Anna (2018)
      The Pretrial Enforcement Division (PED) for the Alaska Department of Corrections (DOC) came into operation on January 1, 2018. PED emerged out of senate bill ninety-one (91) in hopes to reduce incarceration population, and the overall costs of corrections to the state. In response to the new division, a closer look at how this may or may not affect the prison population with behavioral health needs is analyzed. DOC is the number one mental health provider in the state, and often individuals with behavioral health needs are incarcerated longer than those without. With the proposal of assessing all defendants prior to initial arraignment for behavioral health needs, and making referrals to identified community providers, it is hopeful that this can be mitigated. Pretrial supervision for those with identified needs will include Pretrial Enforcement Officers (PEO) to handle specialized caseloads, Crisis Intervention Training (CIT), community behavioral health services, and access to social services.
    • Assisting adolesecents transitioning from residential treatment to public school

      Church, Sylvia; Cook, Christine; Morotti, Allan; Simpson, Joni (2017-05)
      This research project aims to aid residential treatment facilities and school personnel in recognizing the importance of transition planning, developing strategies to assist a successful transition from inpatient residential treatment centers to the students next school, while also taking into account adolescent perspectives on their needs during this transition. This paper introduces the importance of addressing education while in treatment and explores barriers to aftercare and current aftercare models using an ecological model to recognize how multiple systems interact in shaping the experiences of students. Included in this paper is a small pilot study of three students that attended a residential treatment program at the Boys and Girls Home of Alaska. It is important to note that since interviews were conducted, the Boys and Girls Home of Alaska no longer operates in the State of Alaska and is now under new ownership. The application resulting from this project is a presentation for both treatment and school staff.
    • Factors that contribute to rural provider retention, service utilization, and engagement in mentorship by cultural experts

      Gifford, Valerie M.; Rivkin, Inna; Lower, Timothy; Koverola, Catherine; Brems, Christiane (2012-05)
      A substantial amount of time, money, and other resources are expended on recruiting behavioral health providers to fill vacant positions in rural Alaska. This exhaustive drain on resources is perpetual due to the high turnover rates of providers. This exploratory qualitative study utilized grounded theory methodology to investigate personal qualities of providers and other factors contributing to long-term retention of providers relocating to Alaska's Bering Strait Region from elsewhere, community members utilizing the provider's services, and the provider's engagement in cultural mentorship to facilitate the integration of culture into their practice. Furthermore, factors contributing to local provider retention were examined. Key informant interviews were conducted with 21 healthcare providers living and working in the region long-term. A theory emerged that connected provider retention to community member service utilization and cultural mentorship. Results indicated that providers who are open, willing to learn, good listeners, calm, friendly, respectful, flexible, compassionate, genuine and possess a sense of humor, humility, and ability to refrain from imposing personal values, beliefs and worldviews upon others are a good fit for living and work in rural Alaska. Such qualities facilitate a provider achieving professional and personal satisfaction through building relationships and creating opportunities for cultural mentorship, professional support, and social support. These opportunities enhance the delivery of quality services that are culturally appropriate and well-utilized by community members, which, in turn, increase provider satisfaction and retention. Recommendations are made to healthcare organizations regarding recruitment and retention strategies. Recruitment strategies include careful screening of potential applications for specific qualities and enlisting local community members and students into the healthcare field. Retention strategies include professional support by way of a comprehensive orientation program, clinical supervision, cultural mentorship, and continuing education training opportunities that focus on cultural competency. Recommendations for retention of local providers include professional development incentives and opportunities that qualify local providers for positions typically held by outside providers.
    • Historical trauma and approaches to healing among Choctaw American Indians

      Woods, Ashley; Rivkin, Inna; Gifford, Valerie; Lardon, Ce'cile; David, E.J.R. (2018-08)
      Native Americans have experienced a number of historically traumatic events that are believed to contribute to the development of behavioral health symptoms that negatively affect Native American quality of life across generations. Despite the trajectory of trauma experienced in some Native American communities, Native Americans exhibit extraordinary resilience and cultural strengths. Stress and coping models have been developed to explain how historical trauma is related to current health disparities among Native Americans and how enculturation may serve as a buffer against the negative effects of historical trauma. However, these models apply meta-theories to understanding historical trauma rather than tribally specific conceptualizations of historical trauma and historical trauma responses. Therefore, it is important to understand tribally specific manifestations of historical trauma so that intervention and prevention efforts are culturally appropriate. Choctaws are one of the largest Native American groups in the United States. They have experienced a history of forced removal and relocation from traditional homelands, yet the Choctaw Nation itself exhibits continuous growth and success as a tribe. This study used a qualitative, phenomenological, and community based participatory research (CBPR) approach to explore how Oklahoma Choctaw American Indians experience historical trauma and define well-being and enculturation. Interviews and focus groups were conducted with Choctaw American Indians in three different age categories 18-29; 30-49; and 50 and over to examine generational differences in how concepts of historical trauma, enculturation, and well-being are conceptualized. The theoretical construct of historical trauma was informed by themes of assimilation and colonization; resurgence of the Choctaw identity; awareness of historical losses and affective responses; forms of coping; current barriers to accessing Choctaw Nation services; and varying degrees of cultural involvement among tribal members. The theoretical construct of well-being was described in terms of physical health, faith, family, and culture. The theoretical construct of enculturation included pride in heritage, having Choctaw blood, being involved, and social connectedness. Choctaw participants reported social problems related to substance abuse and a sense of diminishing social connectedness to other tribal members. Recommendations on how to upscale behavioral health treatment and strengthen community ties are described. Adapted measures of historical trauma and enculturation for use in future research endeavors with Oklahoma Choctaw American Indians are also provided.
    • Resilient spirits

      Apok, Charlene Renee; Brooks, Cathy; Carroll, Jennifer L. L.; Jones, Jenny Bell; Carothers, Courtney; Ramos, Judith (2016-05)
      The following is a report of a project, "Resilient Spirits", which took place in Nome, Alaska. This project aimed to highlight stories of healing through survivorship. This work focuses on the assets within Alaska Native culture, community, and people. Development of strategies to address violence need to include healing. The project selected a mixed methodology of talking circles and photovoice to highlight the themes of healing, strength, and resilience. These methods served to engage participants in a culturally appropriate manner, in a safe space, and could be utilized at their comfort level. The first phase of the project was the introductory talking circle. It was used to discuss the themes and set up the photo activity. The second phase, photovoice, was chosen as a project activity to assist in sharing stories. Participants used digital cameras in their everyday lives to represent what healing and strength looked like from their perspective. The final third phase was another talking circle. It was a time to reflect on the first talking circle and the process of photovoice. From the unique combination of talking circles and photovoice, stories emerged on healing where there is often silence. Photographs provided a rich illustration of a sense of holistic healing and strength. Knowledge on healing and strength can be found within our Alaska Native communities. Healing is a renewable resource and experienced inter-generationally.
    • Spiritual coping in counseling with trauma survivors

      Bronson, Damaris; Renes, Susan; Gifford, Valerie; Swisher, Kimberly (2016)
      Instances of past trauma are common in clients who are seeking help working through feelings of anxiety and depression. This research project will investigate the use of spiritual coping with clients who have experienced trauma involving intimate partner violence. The literature will identify areas that are important to consider when working with this population. Spirituality will be explored and along with Existentialism serve as the framework for working with trauma survivors. Due to the concentration of Alaska Native and American Indian individuals in Alaska, culture specific interventions are described. The application for this project, based on a review of the literature, is a training for master's level counseling students designed to educate future counselors about spiritual coping.
    • A treatment planner for severely emotionally disturbed (SED) youth in residential treatment programs

      Lotze, Brian; Renes, Susan; Gifford, Valerie; Morotti, Allan (2016)
      Writing treatment plans is a necessary but time-consuming step for busy counselors and mental health workers. Treatment plans are an important way of documenting and showing (a) the need for treatment, (b) the goals or objectives of treatment, and (c) how progress in treatment is measured. A well-written plan is critical to successfully treating clients, but must also allow agencies and counselors to document their work. Treatment planners assist counselors and other mental health workers when developing treatment plans, but existing planners are broadly focused to appeal to a wide audience. A review of the literature, and data from a residential treatment program for Severely Emotionally Disturbed (SED) youth was used to create a more narrowly focused treatment planner.