• Explorations of intergenerational healing, resilience, and post-traumatic growth by helpers and healers on the Blackfeet Nation

      Hoyt, Tyler J.; Gifford, Valerie M.; Whipple, Jason; Topkok, Sean; David, Eric John (2019-12)
      This project explored intergenerational healing, resilience, and post-traumatic growth within the context of the Blackfeet Nation in Montana, the roles of helpers and healers in this setting, and community experiences of familial trauma and the idiosyncratic healing and resilience processes according to their worldview. The central goal of this study was to provide a contemporary public narrative surrounding healing and resilience as these topics related to historical and intergenerational trauma in this specific community. This exploratory study was composed of the narratives of 14 co-participants working as helpers and healers on the Blackfeet Nation. Indigenous narrative and a cosmic relationality were honored and a phenomenological method of Gadamerian hermeneutics was utilized. Seven central themes arose in the process of data analysis including Spirituality, Trauma, Healing, Resilience, Helping Role, Community, and Blackfeet Worldview. Co-participants explored contemporary experiences of collective intergenerational trauma of those they served as well as personal and familial processes of healing and resilience. The centrality of spirituality, cultural immersion and personal cultural identity were discussed as aspects of intergenerational healing and resilience. A holistic and culturally idiosyncratic understanding of personal and intergenerational healing was emphasized including spiritual, emotional, mental, and physical modes of healing. Patterns of healing experienced collectively and synergistically within family systems and between community members were also identified.
    • A humble guest: a phenomenological exploration of success and competence in rural Alaskan mental health care

      Herman, Daniel John; Gifford, Valerie M.; Whipple, Jason; David, Eric John; Swift, Joshua (2018-12)
      Objective: Rural communities in Alaska face a long list of mental health disparities that are exacerbated by the other challenging factors inherent within the rural context. Rural Alaskan mental health care providers are faced with the tremendous task of providing clinically and culturally competent care to underserved and marginalized populations, with limited personal and professional resources, all while balancing the needs of the community, their own personal boundaries, and the pressure of remaining accountable to the larger system of professional ethics and guidelines. The aim of this study was to explore, identify, and understand from the perspective of rural Alaskan providers what it means to be successful and competent mental health care providers in rural Alaska. The ultimate goal of this study was to develop a deeper understanding of what being successful and competent means from the perspective of providers who have been successful in rural Alaskan practice. Methods: This study utilized an exploratory qualitative methodology grounded in the interpretive/constructivist paradigm. Semi-structured interviews were used to explore the perspectives of 12 mental health providers who have practiced successfully and competently with rural Alaskan patients. Furthermore, a phenomenological-hermeneutic approach was applied in order to work collaboratively with participants to reach a deeper understanding of mental health care success and competence in a rural Alaskan context. Results: Ten contextual themes and 27 subthemes emerged from the interviews that illuminate the experience of success and competence as experienced by rural Alaskan mental health care providers. The implications of this study serve to deepen the current understanding of what it means to practice in rural Alaska with communities and Indigenous people. Furthermore, the findings provide a culture and context specific understanding of success and competence that will help current providers, employers, and communities to better serve rural Alaskan people. The findings contribute to the literature by promoting a salient perspective of practice that is within a context of mental health that is generally disregarded, overlooked, and rarely considered.
    • Moderators of bicultural self-efficacy and mental health among Asian Americans

      Shah, Dhara; David, E.J.R.; Lopez, Ellen; Campbell, Kendra; Buckingham, Sarah (2019-08)
      The relationship between acculturation and mental health among Asian Americans has been established. For example, the integration strategy, often associated with bicultural competence, has been shown to positively predict well-being and self-esteem, and negatively predict various indicators of distress (Nguyen, Messe, & Stollak, 1999; Oh, Koeske, & Sales, 2002; Yoon, Lee, & Goh, 2008). Further, biculturalism (Chen, Benet-Martinez, & Bond, 2008) and bicultural self-efficacy (David, Okazaki, & Saw, 2009) have been associated with positive mental health outcomes among Asian Americans. That is, perceiving oneself as capable of navigating various domains (e.g., values, behaviors) within two cultures is associated with better mental health. Little is known, however, regarding the factors that may influence the strength of this relationship. Thus, the present study aimed to identify some moderating factors of the relationship between bicultural self-efficacy and mental health among Asian Americans. Considering previous research examining the factors associated with acculturation and mental health (Berry, 1980; Nguyen & Benet-Martinez, 2007; Padilla, 2006), it was hypothesized that bicultural identity integration, cognitive flexibility, psychological flexibility, and resilience would each moderate the relationship between bicultural self-efficacy and satisfaction with life, and between bicultural self-efficacy and psychological distress. Results indicated that bicultural identity integration approached significance, indicating that of all the hypotheses presented in this study, it may be the only moderator of the relationship between bicultural self-efficacy and life satisfaction. Thus, viewing two cultures as compatible may act as a protective factor, or buffer, against the negative effects of low bicultural self-efficacy on some aspects of mental health. Further, the null findings suggest that the relationships between the measured variables may be more complex than simple moderation. It is recommended that future research continue to explore and test moderation and mediation models, while considering alternative measures and specific subscales. Recommended service implications for Asian Americans include interventions geared to increase one's level of bicultural identity integration or bicultural selfefficacy, as well as to encourage systems or communities to provide the appropriate resources needed to do so.
    • Quality of life for Alaskan individuals with FASD and their families

      Dow, Brenda S.; Ehrlander, Mary; Boylan, Brandon; Anahita, Sine; Rivkin, Inna (2019-05)
      Fetal alcohol spectrum disorder (FASD) is a lifelong disability caused by prenatal exposure to alcohol. The effects of FASD include a range of physical, mental, behavioral, and learning disabilities. These disabilities impact quality of life, not only for the affected individual, but for family members. The effects from FASD ripple into schools, the correctional system, and throughout rural and urban communities. Although there are no reliable statistics available on FASD in Alaska, many professionals in the field believe Alaska to have the highest rate of FASD in the United States. This research has explored the ways in which prenatal exposure to alcohol affects quality of life for Alaskan individuals and their families. For this study, I have defined quality of life as the multi-faceted evaluation of the individual's personal experiences and life satisfaction, including health, psychological and social indicators. Since the identification of fetal alcohol syndrome (FAS) and FASD, many studies have analyzed the effects of prenatal alcohol exposure, as well as possible interventions. Few studies have investigated how prenatal alcohol exposure affects the individual's quality of life and even fewer studies have analyzed how raising one or more children with FASD affects the family. To address the gap in the literature, this research applied social constructivist theory and employed a qualitative design, using semi-structured interviews to explore individuals' and parents' life stories and perceptions on how FASD has affected their lives. I interviewed eight individuals with FASD and 14 adoptive or long-term foster parents. Findings indicate that FASD impacts almost every facet of the lives of both the individuals affected and their families. All individuals with FASD interviewed for this project suffered serious adverse childhood experiences in addition to their prenatal exposure to alcohol. All encountered academic and social difficulties at school. Individuals struggled in their transitions to adulthood, with some individuals needing assistance from parents or social services throughout their lifespan. Parents expressed their ongoing need for structure within the home and the continual need to advocate for suitable services for their children. They described how the ongoing stress of raising their child(ren) with FASD affected their social lives, employment and even their marriages. The perspectives and insight of these individuals with FASD and their parents can provide other family members, service providers and legislators a better understanding of how FASD affects quality of life and assist decision makers in making informed choices on how to best provide expanded or improved supportive services to these individuals and families whose everyday struggles go largely unrecognized by the general public.