cross cultural communication terry l. cross, msw, national indian child welfare association alaska...

Cross Cultural Communication

Terry L. Cross, MSW, National Indian Child Welfare Association

Alaska Statewide CINA Conference,

Anchorage, Alaska October 2012

For Colonialism to Succeed

• Take Territory – Land

• Take Natural Resources – Energy/Food

• Take Sovereignty – Disrupt Leadership and Governance

• Take Away the Legitimacy of Thought – Worldview, Language, Spirituality, Healing

• Take the Children

Historical Context by Eras

• Pre-Columbian

• Military Balance 1492-1832 (340 years)

• Removal and Annihilation (1832-1870)

• Assimilation (1870-1970)

• Self-Determination ( 1968-Present)

Boarding Schools

Church and Federal

Historical Background

• Tribal governments disrupted

• Traditional land and economies taken away

• Generations of children forced into residential schools

• Children taken from families for adoption outside their cultures

Manifestations of Colonialism

• Limits on tribal jurisdiction

• Inequity of funding

• Superiority of thought

• Removal of children

• White privilege/resentment

• Paternalistic policy making

• Disparities (structural risk factors)

Messages of Colonialism• Indigenous people can’t be trusted to know

or do what’s best for them.

• Indigenous people are not significant enough to count.

• Services can only be done by Indigenous people if provided as prescribed by the colonial power.

• Colonial power policies are the “right” way and can’t be modified even when they do harm.

• Know your place (we defeated you—get over it); “Cowboy up” – Michael Bloomberg

Symptoms of Post-colonialism

• Intergenerational Trauma

• Lateral Oppression and Violence

• Internalized Racism—Self-Blame

• Identity Politics

• Dismembered Social Norms

• Adverse Childhood Experiences

• Blaming the Victim

Post-colonial Reality• Disparities – Racial inequity in

economic security, health, education, social conditions

• Disproportionate representation in systems (over and under)

• Poor outcomes for AI/AN children in state services

• Barriers to self-determination – funding • ICWA not fully implemented

Disparities vs. Disproportionality

• “Disparities” refers to the variation in rates at which persons of different groups experience social conditions

• “Disproportionality” refers to the over representation of specific groups in child welfare, particularly placement

Child Well-Being, 2007/2008

National Average

White (Non-Hispanic)

Black/African American

Asian & Pacific Islander

American Indian & Alaska Native

Hispanic/ Latino

Infant Mortality Rate

6.7 5.6 13.2 3.7 8.8 5.7

Teen Death Rate 62 58 83 33 87 58Teen Birth Rate 43 27 64 17 59 82

% of teens 16-19 not in school/not graduates

6 5 8 2 13 11

% of Children in Poverty

18 11 34 12 31 28

Suicide Rates by Race/Gender Age 10-18, 2006

1.74

0.65 1.35

1.15

9.73

6.09

3.43

3.23 3.77

19.9

8

0

5

10

15

20

25W

hite

Af. Am

./Blac

k

Hispan

ic/Lat

ino

Asian A

m/ P

ac. I

s.

AI/AN

Female

Male

Source: U.S. Department of Health and Human Services, Administration for Children and Families: Children’s Bureau (2010) The AFCARS Report Preliminary FY 2009 Estimates as of July 2010. Available at http://www.acf.hhs.gov/programs/cb/stats_research/afcars/tar/report17.htm.

2009 % of Total Foster Care Population

2010 % of Total Population

White 39.2 72.4Black/ African American 30.2 12.6American Indian/ Alaska Native

2 (2.6*) .9

Asian American .6 4.8Hispanic/Latino 20.4 16.5

Source: U.S. Census Bureau (2011) Overview of Race and Hispanic Origin: 2010 Census Brief. Available at http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf

* estimate by NICWA which includes AI/AN children in tribal welfare programs

Foster Care Placement, 2009 (compared to 2010 census percentage of

total population)

Maltreatment Decision Path

White Children

100Reported

25Substantiated

8 Placed

Decision Path to Disparity

• American Indian Children

100Reported50

Substantiated

Juvenile delinquency risk for Indian children increases

25 Placed

Overrepresentation of AI/AN

children in care is related to

poverty, poor housing, poor

education, untreated

mental health issues, and caregiver substance misuse.

Child

Family

Basic Principles of Child Protection

Safety and Well being Paramount

Assumes the Family has the Tools to Ensure Safety and Well Being

STATE steps in when family

fails to ensure safety and well

beingBlackstock & Trocme, 2004

Psychological Parent Model

Extended Family Model

What is an Adverse Childhood Experience (ACE)?

The experience of “significant abuse or household dysfunction during childhood”

Specific Indicators:

• Someone who is chronically depressed, mentally ill, institutionalized, or suicidal in the household

• Mother is treated violently• One or no parents• Emotional or physical

neglect

• Recurrent physical abuse• Recurrent emotional

abuse• Contact sexual abuse• An alcohol and/or drug

abuser in the household

• An incarcerated household member

(Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, 2010)

RISK FACTORS

ACE Study Model

(CDC, 2010)

(Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, 2010)

The ACE Study

• The ACE Score is a count of the total number of ACE indicators for an individual.

• The score ranges from 1 (low trauma) to 9 (high trauma).

• In the mainstream population, as an ACE score increases, the risk for numerous health problems increases.

(Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, 2010)

American Indian Youth Victimization and Delinquency Outcomes Study (AIYVDOS)

• Used a participatory research model:

– Culturally sensitive and scientifically sound

– Involving community members as partners and owners throughout the research process

Final Sample

• 110 young adults, aged 18-25• 82% Enrolled Tribal Members• 58% Female, 42% Male• Grew up:

– On the Reservation: 46%– Rural: 5%– Small Town: 21%– Suburbs: 10%– Urban: 18%

AIYVDOS and ACEs

The percent of youth in our study with four or more ACEs is almost TWICE the rate in the mainstream population.

In mainstream culture, adults who had experienced four or more ACEs compared to those who had experienced none had at least four times higher risk of – Alcoholism/drug use– Depression– Suicide attempts

# of ACEs % of AIYVDOS Participants

% ACEs study

(CDC, 2010)

0 30% 36%

4+ 25% 13%

The good news…

ACE Study Model

Prote

ctive

Chi

ldho

od E

xper

ienc

es

(Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, 2010)

What is a Protective Childhood Experience (PCE)?

Positive relationships and experiences while growing up that protect young people from negative influences and behaviors.

Specific Indicators:

• Spiritual/Religious Connection

• Connection with Tribal Elders, Learning a Tribal Language

• Safe and Strong Community

• Supportive Adults• Positive Peer Groups• School Activities• Family Resources

PROTECTIVE FACTORS

ACE scores, PCE scores, and Juvenile Delinquency

We examined how ACEs and PCEs relate to delinquency by grouping people according to both ACEs and PCEs

• The group with low ACEs and high PCEs had the lowest delinquency (14%)

• The group with high ACEs and low PCEs had the highest delinquency (67%)

• Even when ACEs were high, the group with high PCEs had lower delinquency (39%) than the group with low ACEs and low PCEs (46%)

ACE scores, PCE scores and Depression

We also examined how ACEs and PCEs relate to depression.

Depression was related to the following:• Gender (female)• Higher Sexual abuse (ACE)• Lower Safe and strong community (PCE)• Lower Spirituality (PCE)

Decolonization

“Colonization dismembered our culture, our people, and our families. Our job is Re-membering.”

Theda Newbreast, Blackfeet

Relationship of NAYA-identified outcomes to existing evidence

Community-mindedness

Positive cultural identity

School belongingness

Reduced perceived discrimination

Hope

Spirituality

Positive relationships with adults

Lower depressionLower alcohol useLower antisocial behaviorLower levels of internalizing behaviorsReduced suicideSchool successIncreased school belongingnessAnti-drug adherenceHigher self-esteemHigher social functioningIncreased resilienceBetter physical healthBetter psychological healthBetter health practicesIncreased physical activityConsistent use birth controlLower gang involvementPerception of less neighborhood disorderBetter athletic performanceIncreased hopefulnessHigher levels of employmentDecreased likelihood of hurting someone

Outcomes in red are NAYA-identified outcomes; all items in right column are outcomes from the research literature.

Touchstones of Hope

• Self-Determination

• Culture and Language

• Holistic Approach

• Structural Interventions

• Non-Discrimination

Self Determination

•Development of community visions of child safety•Embracing what hurts – taking ownership•Linking economic development/lands to child safety•Reconciliation in child welfare program for leaders

Culture and Language

•Clarity of what community child caring knowledge is •Acknowledging mainstream child welfare is culturally loaded •Caution around adapting mainstream programs – center community knowledge and values

Holistic Approach

•Do community planning with child wellbeing playing a central role •Engage children/youth in community visioning exercises•Be cautious about the risk of doing community development based on what government will fund versus on community need•Engage the non-profit sector

Structural Interventions

•Ensuring Alaska Native children have equal access to resources•Child welfare addressing poverty, substance abuse, mental health, and housing

Non discrimination

•Ensuring Indigenous children have equal access to resources•Ensuring Indigenous knowledge is on equal footing with non Aboriginal knowledge in child welfare•Promoting respectful relationship building across cultures

Background of WPIC Project• 16 Alaska Native tribal partners.

• Developed in response to the disproportionate rate of out-of-home placement of Alaska Native children in Alaska.

• Increase tribal capacity in several areas.• Approaching systems change in tribal-state

relationships through knowledge and education of historical trauma.

Purpose of the TIHSM Template

• Standards based on the State of Alaska Safety model.

• Development and Implementation of 8 core elements.

• System of Care model.

• Cross system collaboration.

Tribal In Home ServicesTribal In Home Services

Safety

Model

Core Elements

System of Care

Local Practice Model

Purpose of the TIHSM Template

• Standards based on the State of Alaska Safety model.

• Development and Implementation of 8 core elements.

• System of Care model.

• Cross system collaboration.

43

Development of TIHSM On-Site

Step 1:Providing a Foundation, Overview,

Materials to discuss the

TIHSM

Development of TIHSM On-Site

Step 2:Discussion,

Brainstorming,Group

Dialogue

Development of TIHSM On-Site

Step 3:Case staffing

to reveal services

Development of TIHSM On-Site

Step 4:Incorporation

of Tribal Principles and

Values on Safety

On-Site TA successes with the TIHSM Development

Utilized the 8 core elements to staff the case.•Case staffing indicated the level of services and resources available in villages.•Allowed tribal staff to fully see what they do for families but also the level of collaboration that exists or can exist.

Other uses of the TIHSM

• To develop an assessment.

• To staff and problem solve.

• To document services provided to families and children.

• To develop court reports.

Other uses of the TIHSM

• Service mapping,•Case planning,•Team staffing•Individualized MOA’s

Other uses of the TIHSM

• This document assisted the tribal child welfare worker to think of each 8 core element and how they could either provide the service or collaborate to provide the service.

Let’s remember why we are really here today…

Healthy Native Children

National Indian Child Welfare AssociationProtecting our Children

Preserving our Culture

www.nicwa.org