native american cultural sensitivity trainingattcnetwork.org/userfiles/file/nfa-aian/handouts aug...

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Behavioral Health is Essential to Health Prevention Works | Treatment is Effective | People Recover

Native American Cultural Sensitivity TrainingEd Parsells, BS, LAC, Cheyenne River Sioux Tribe

American Indian & Alaska Native Behavioral Health Webinar Series

This webinar is provided by the National American Indian & Alaska Native ATTC, a program funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment (CSAT).

For more information on the ATTC Network, visit: attcnetwork.orgTo find your regional center, visit: attcnetwork.org/findregcenter.asp

For more information on the National American Indian & Alaska Native ATTC, visit: attcnetwork.org/americanindian, or call 319-335-5564

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Upcoming webinars from the National American Indian & Alaska Native ATTC

Clinical Evaluation: Assessmentpresented by: Sean Bear I, BA, CADC, Meskwaki Tribal Nation

For more information about our webinar series, contact Kate Thrams at [email protected] or 319-335-5362

Issues of Suicide and Response in Indian Countrypresented by: Jacque Gray, PhD, Choctaw & Cherokee Nation

Treatment Knowledgepresented by: Robert Rohret, MPH

Historical and Intergenerational Trauma: The Impact on the Two Spirit and Native LGBTQ Communitypresented by: Lenny Hayes, MA, LADC, Sisseton Wahpeton-Oyate

Webinar Follow-Up

CEHs are available upon request for $15 per session. • This session has been approved for 1.0 CEH’s by:

• NAADAC: The National American Indian & Alaska Native ATTC is a NAADAC (The Association for Addiction Professionals) certified educational provider, and this webinar has been pre-approved for 1.0 CEH.

• To obtain CEHs for this session, submit a CEH Request Form and payment to the National AI & AN ATTC. A request form is available for download in the “Files” pod in the webinar screen. If you choose to download a file, a new tab will be opened in your browser, and you will have to click on the webinar window to return to view the webinar.

• Participants are responsible for submitting state specific requests under the guidelines of their individual state.

Presentation handouts:• A handout of this slideshow presentation is also available by download.

If you are unable to download the documents from the webinar, please contact Kate Thrams at [email protected] or 319-335-5362

Continuing Education Hours (CEH)

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Webinar Follow-Up

This webinar is provided by the National American Indian & Alaska Native ATTC, a program funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment (CSAT), and is evaluated in accordance with the Government Performance and Results Act (GPRA).

Participation in our evaluation lets SAMHSA know:

• How many people attended our webinar

• How satisfied you are with our webinar

• How useful our webinars are to you

Immediately following this webinar, you will be redirected to a customer satisfaction survey. Please take a few minutes to give us your feedback on this webinar. . You can skip any questions that you do not want to answer, and your participation in this survey is voluntary. Through the use of a coding system, your responses will be kept confidential and it will not be possible to link your responses to you.

We appreciate your response and look forward to hearing from you.

Evaluation: SAMHSA’s GPRA

Adobe Connect Overview

• To alternate between full screen mode, please click on the full screen button on the top right of the presentation pod. (It looks like 4 arrows pointing out)

• To ask questions or share comments, please type them into the Q&A pod and hit “Enter.”

Participation instructions:

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Adobe Connect Overview

• The webinar system records participant attention time.

• If you have other windows open and active, or have the webinar minimized, the system will deem you as inattentive, which may be reflected in the number of CEHs received.

Please note:

Disclaimer

• The National American Indian & Alaska Native Addiction Technology Transfer Center is supported by a grant from SAMHSA

• The content of this publication does not necessarily reflect the views or policies of SAMHSA or the Department of Health and Human Services (HHS).

Please note:

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Today’s Speaker

Ed Parsells, BS, LAC, is the Director of Lakota C.A.R.E. located in White River, South Dakota, with four satellite offices on the Rosebud Reservations and one in Pierre. He served as the Clinical Supervisor for the Rosebud Sioux Tribe’s Drug and Alcohol Treatment Program for eight years. Ed received his BS in Behavioral Science from Mid-America University in Oklahoma City, Oklahoma. He is a certified substance abuse counselor and has provided clinical supervision within the Rosebud Sioux Tribal Substance Abuse Programs. Ed has co-authored the South Dakota Statewide Native American Substance Abuse Needs Assessment and administered an Indian Health Services’ grant that developed a substance abuse screening instrument for pregnant women. He is the current South Dakota Native American Curriculum committee chair and is also a master trainer and trainer of the curriculum. Ed is the coordinator for the NARCH prevention research grant focused on developing a program to address adolescence’s who are at high risk in developing Type II diabetes. The exercise and nutritional program is based on traditional Lakota cultural values and diet and includes equine therapy. Ed has developed, implemented and administrated a Lakota Values Equine-Assisted Counseling Model. The primary focus of his adolescent program, Piya Mani Otipi, is to provide substance abuse treatment for Native American adolescents incorporating traditional values and equine therapy.


Building Understanding of American Indian Clients’ Cultural Orientation, Learning Styles,

and Family Relationships:Keys to Understanding Unique Challenges and

Strengths of American Indian Clients in Substance Abuse Treatment

Presented by: Ed Parsells, BA, LAC

Developed by: Sean Bear, 1st. BA, CADC

Dee LeBeau, MSEd Parsells, BA, LAC

Anne Helene Skinstad, PhDPatricia Iron Shell-Hill, PhD

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Overview of the presentationHistory of the Curriculum development

– Historic overview of the traditional values

– Cultural orientation

– Native American Learning styles

– American Indian Family Relations

– Historical trauma

– Red Road Approach


History of the Native American Curriculum for State Accredited

Non-Tribal Substance Abuse Programs in South Dakota

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Curriculum Development

• Duane H. Mackey, EdD, Dakota Isanti– Assistant Professor, Regional Director: Native American Initiatives,

Alcohol and Drug Studies Department, University of South Dakota; Prairielands Addiction Technology Transfer Center in South Dakota

• Mr. Frank Zavadil, MA– Program Specialist, South Dakota Division of Alcohol and Drug Abuse

Agency

Funding for this project development

• Prairielands Addiction Technology Transfer (ATTC)• Anne Helene Skinstad, PhD, supported the project by funding Dr. Mackey’s salary

• South Dakota Division of Alcohol and Drug Abuse Agency secured funding Johnson, Bassin and Shaw (JBS)/ CSAT to support the development of this project

• Director Gilbert “Gib” Sudbeck, was instrumental in initiating and supporting the project statewide

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About the curriculum

• Curriculum consists of 19 modules taught over 3 days• Target Audience

– Non-Native behavioral health providers

– Now, also Native providers

• Curriculum Committee– Chair: Ed Parsells

– Dr. Skinstad appointed the committee after Dr. Mackey passed away

– Goal for the committee: ensure the integrity of the curriculum

About the curriculum

• Developed for Dakota/Lakota/Nakota cultures

• Cultural adaptations– Minnesota

– Billings tribes: under way

• Training-of-trainer program– Only Native trainers

– Rigorous training program

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The new Center will continue the initiatives developed by the Upper

Plains Center of Excellence in NA and Substance Use Disorders, directed by Dr. Duane Mackey, as well as initiate new projects based on expressed needs

from providers, consultants, and member of the Advisory Council

Dr. Duane Mackey, 1998-2010

Dr. Duane Mackey Memorial Award for Excellence in NA Education, Research and Human Rights

• First award given in September 2011 during the Red Road gathering in Vermillion, SD

• Three recipients have received this award thus far:– 2011: Dr. Cecil White Hat

– 2012: Mr. Gib Sudback

– 2013: Mr. Edward Parsells

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Historic Overview: Tribal specific characteristics

Turtle Island before contact with European nations

• All of “Turtle Island” ( the Western Hemisphere) was the homeland of various indigenous nations from coast to coast and border to border.

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Some components of Native American culture

• Language• Dakota/Lakota/Nakota• Oral history

• Belief in– a Creator, spirits and ceremonies– transition from and to the Spirit World– the goodness of humans– relationships with humans, plants, animals and the universe– bringing pride and honor to self, family and nation

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• Customs– Birth

– Naming ceremonies

– Memorials and give-aways

• Values– Provide for the family and the nation

– Learn ways to help the people

– Perpetuate the well-being of the people


• Foods• Buffalo, squash, beans,

berries, turnips, potatoes, corn soup, etc.

• Music• Singing with the drum• Dance• Social dancing (Pow wows)• Dress• Regalia• Arts

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Cultural orientations and some common behaviors

Module 7 Goals and Objectives

• To promote an awareness of traditional, bicultural and assimilated cultural orientations of Native Americans.

• To become aware of behaviors that are associated with each cultural orientation, e.g., verbal and non-verbal communication styles, expressions of emotions, etc.

• To promote an awareness of how these cultural• orientations might relate to substance abuse lifestyles, as well as

alcohol-and drug-free lifestyles.• To become aware of the challenges that Native• Americans might experience integrating into main-stream society.

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Traditional Bi-Cultural Assimilated

Traditional Camp Structures

Independent Nations• Highly structured familial systems• Highly structured governing systems• Belief in the “Sacred Circle”• Economically self-sufficient• Spiritual• Lived in harmony with nature• Developed relationships with all

beings• Free of western diseases

– (small pox, diabetes, diphtheria, TB, etc.)

NO –• Alcohol / Drug Abuse• Poverty• Jails

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Bi-cultural way of life

May –• be challenged daily to live in two

worlds.• experience high levels of stress,

anxiety, anger, rejection, etc. when trying to live in both worlds.

• be confused about their tribal cultural/spiritual identity.

• have feelings of inferiority.• abuse alcohol and/or drugs.


Grandparents Parents Children

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Assimilated way of life

• Knows little about D/L/N cultural and spiritual ways.• May or may not be interested in reconnecting with tribal cultural and spiritual ways.

• The counselor cannot assume that a relative/client is interested in learning about tribal cultural and spiritual ways.

• May or may not use alcohol and/or harmful drugs.• May feel ashamed of being identified as a Native American.

Eye Contact

TraditionalIndirect

Bi-CulturalDirect/Indirect

AssimilatedDirect

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Eye Contact

• Native Americans, who are close to their cultural and spiritual ways, out of respect, may not engage in “direct eye contact” with the teacher/facilitator.

• Lack of direct eye contact does not always mean that the person is not listening.

Handshakes

TraditionalNon-aggressive

Bi-CulturalNon-aggressive/Aggressive

AssimilatedAggressive

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Communication Style

TraditionalVerbal (within culture)

Reserved (outside culture)

Bi-CulturalReserved/Verbal

AssimilatedHighly Verbal

or Verbal

Communication Response Time

TraditionalMore Time Needed…

…While Processing Bilingually

Bi-CulturalMore/Less Time Needed

AssimilatedLess Time Needed

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Emotions

TraditionalNot Usually Exhibited Outwardly

(Reserved)

Bi-CulturalReserved/Outgoing when Exhibiting

Emotions

AssimilatedOutgoing/Reserved

Times of Tears (Crying)

TraditionalResponses from others may

wait until the tears have stopped

Bi-CulturalMay prefer a delayed response, or

may be open to immediate responses

AssimilatedMay be more open to being

comforted immediately

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Anger

TraditionalSuppressed and

Subdued

Bi-CulturalSubdued/Expressed

Adjusts to Both Worlds

AssimilatedExpressed

Showing of Affection

TraditionalPrivate/Modest

Bi-CulturalPrivate/Open

AssimilatedOpen/Private

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Humor/Teasing

TraditionalWithin Culture – Very Humorous

Outside Culture - Reserved

Bi-CulturalTraditional/Assimilated

AssimilatedSimilar to non-natives

Materialism

TraditionalPlaces little value on

accumulating personal possessions

Things are to be used

Bi-CulturalTraditional/Assimilated

AssimilatedSimilar to non-natives

Things are viewed as status symbols

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Time

TraditionalEvent-Oriented

Bi-CulturalEvent/Clock-Oriented

AssimilatedClock-Oriented

Time Orientations and Factors

• In historical times, time was associated with the seasons of the year.– Example: Wolf Moon, Return of Thunder Beings, Sunrise / Sunset

• D/L/N peoples did things according to need, seasons of the year, and the moon.– Example: Sun dances were held in the summer months

• Winter counts recorded significant events from one winter to the next.

• Clocks did not exist.– European peoples brought with them clocks, calendars and a high value

of punctuality.

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“Indian Time” or “Federal Government Time”

• When annuities were to be distributed by the government, tribal groups would be told that the distribution would begin at a certain date/time. However, at times, the distribution of annuities were delayed by several months.

Time Factors Now

• Tribal groups hold ceremonies at certain times of the month and usually before dawn, or after dark. Although a time for a ceremony is announced, the ceremony will begin when it is time –clocks are put away!

• Punctual Events– Tribal council meetings

– School/tribal college schedules

– Other

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Impact of Cultural Orientations

• World Views• Cultural Identity & Belongingness• Self-Esteem• Self-Concept• Self-Confidence• Self-Efficacy

AcceptedRespected

RejectedOppressed

Discrimination(Racial/Social/Other)

Filtration Systems

Dakota/Lakota/NakotaPeoples

MilitaryEmploymentEducation

Other

Mainstream Society of America

Living in Two Worlds

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Other Suicides

Criminal ActivitiesAlcohol/Drug Abuse

Loss of:Self Identity

Ethnic/Cultural Identity

Dakota/Lakota/NakotaPeoples

Living in Mainstream Society: Negative Consequences

Filtration Systems

Feelings of: Inferiority

Being OppressedBeing Rejected by:

Ethnic GroupMainstream Society

D/L/N Cultural and Spiritual Ways and Substance Abuse Treatment

Traditional

Western Bi-Cultural Red Road

Bi-Cultural

Assimilated

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Sample Identity Assessment Questions

• How do you identify yourself –– Traditional?– Bi-Cultural?– Assimilated?

• Do you have other ways that you identify yourself?• Are you okay with how you identify yourself?• How do you think your friends would identify you?• Have you ever experienced any feelings of inferiority related to your

ethnic identity?– If so, how has this affected you?

• Have you ever experienced prejudice from –– Tribal members?– Non-tribal members?


Learning Styles and Native American

Populations

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• To promote awareness and understanding of various learning styles of Native American populations.

• To promote awareness of various teaching strategies for Native American populations in substance abuse treatment settings.

Categories of Learning Styles

• Visual –Learning by seeing• Auditory –Learning by hearing• Kinesthetic –Learning by doing

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Personality Characteristics of Learning Modalities

Visual Auditory Kinesthetic

• Guided imagery

• Demonstrations

• Copying Notes

• Highlighting Key Ideas in Notes

• Flash Cards

• Color Coding

• Mind Maps/Acronyms

• Diagrams/Charts/Graphics

• Photos/Movies/TV

• Auditory Tapes

• Reading Aloud

• Oral Instructions

• Poems/Rhymes/Word Associations

• Lectures

• Repeating Ideas Orally

• Group Discussions

• Music/Lyrics

• TV

• Experiments

• Games

• Problem-solving

• Role Playing/Acting Scenes Out

• Writing Notes

• Making Lists

• Physical Examples

• Associating Emotions with Concepts

Effective Teaching Techniques for each Learning Modality

Visual Auditory Kinesthetic

• Mind wanders during activities

• Has trouble following or remembering verbal instructions

• Doodles

• Prefers to observe rather than actively participate in group activities and discussions

• Likes to read silently

• Has neat handwriting

• Is neat and organized

• Pays attention to detail

• Easily memorizes by seeing pictures and diagrams

• Is usually quiet, shy or reserved

• Is easily distracted

• Quickly looses interest in visual demonstrations

• Enjoys listening activities

• Is active in group activities and discussions

• Enjoys being read to

• Prefers reading aloud to silent reading

• Listens to music while studying or doing homework

• Has sloppy handwriting

• Memorizes lists/sequences easily

• Remembers faces

• Is fairly outgoing

• Taps pencil/foot while thinking, studying or writing

• Enjoys doing experiments

• Enjoys handling objects

• Uses excessive hand gestures, makes physical contact with people when talking to them.

• Tends not to enjoy reading

• Enjoys hands-on activities

• Enjoys problem-solving

• Is unorganized

• May have trouble memorizing lists, etc.

• Is outgoing

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Winter Counts

Beadwork, Quillwork, and Ledger Art

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Instructional Methodologies and Cultural Relevancy

• Learning for Native American populations appears to be enhanced if —– Instructional content is reflective of Native American culture, e.g., stories,

legends, symbols, pictures, audio-video resources, etc.

– Instructor / counselor has some exposure, knowledge and experiences related to Native American cultures.

Motivation to Learn

The results of longitudinal research suggest that an individual’s level of motivation is a very strong predictor of whether the individual’s substance use will change or remain the same.

Cultural Motivation• Returning to the culture (language, singing, dancing, quilt making, beading, etc.)

• Helping oneself to help the people

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A Native American Resource Library

• What would it take to establish and maintain a Native American resource library in substance abuse treatment centers?

Suggested Native American Resources

• Books• DVDs• CDs• Native American published newspapers• Audio tapes• Movies• Other

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American Indian family relations

American Indian Family Relationships

Description:• This module focuses on the structural similarities and differences between traditional Native American families and Western families.

• The impact of alcohol and drug abuse lifestyles on traditional D/L/N families will also be discussed.

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• To enhance participants’ knowledge of the traditional structure of D/L/N families.

• To understand how these family relationships can positively and/or negatively impact the lives of D/L/N clients/relatives.

Native American Societal Structures

Oyate (Nation)

Villages/Camps

Clans/Societies

Bands

Tiospayes

Ti’wa’he (Families)

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Some Male and Female Roles in the Camp Circle

Males FemalesPipe Carrier

Warrior Hunter

Heyoka (Contrary)

Heyeska (Interpreter)

Companion/Husband

Conduct Ceremonies

Father Brother

Grandfather Uncle

Cousin

Horseman

Caretaker of the Home/Lodge

Bearer of Life (Children)

Maker of Clothes

Food Preparer

Companion/Wife

Conduct Ceremonies

Assist with Ceremonies

Grandmother Mother

Cousin Sister Auntie

Provider

Protector

Storyteller

Medicine Person

Caregiver of Children/Others

Teacher

Singer

Other

Loss of roles among Native American males and related consequences

• Traditional Roles– Warrior (Protector) Farmer– Provider (Hunter) Commodities

• Psycho-Social Effects– Anger, Frustration, Shame, Guilt, Etc.– Low Self-Esteem– Identity Issues– Other

• Possible Consequences– Alcohol and/or Drug Abuse– Suicidal Ideations, Attempts, Completions– Homelessness– Incarceration– Other (domestic violence, victimization, etc.)

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Historical and Generational Trauma

Historical and Generational Trauma

Module 10 Description:• This module focuses on specific historical and current traumatic experiences, e.g., boarding school experiences, abandonment and rejection, etc., experienced by some Native Americans, and the possible relationship of these experiences to substance abuse lifestyles.

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“At the beginning of the colonization period in North America, there were approximately 10,000,000 Native Americans

inhabiting the continent.”(Calloway, 1999; Garrett and Pichette, 2000)

"By the year 1900, due to disease, wars, persecution, subjugation, assimilation and attempts at ethnic and cultural genocide, approximately 250,000 Native Americans were left

in the Americas.”(Calloway, 1999; Duran & Duran, 1995)

The Roots of Historical Trauma among American Indians

“After military defeat, American Indians experienced one of the most systematic and successful programs of ethnic cleansing the

world has seen.”(L.B. Whitbeck, G.W. Adams, D.R. Hoyt and

Xiaojin Chen, 2004)

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The Roots of Historical Trauma among American Indians

• American Indians became dependent on the U.S. government for food, shelter and health care.

• All life was under the control of a foreign government.• Leaving the reservation became illegal.• Hunting off the reservation became illegal.• Practicing traditional ways became illegal.

Symptoms of Historical Trauma

• PTSD– (anger, rage, psychic numbing, etc.)

• Major depression• Anxiety disorders• Alcohol and drug abuse• Denial• Agitation• Nightmares• Memory loss• Difficulty in expressing emotions• Survivor guilt• Other

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Daily Reminders related to Historical Trauma

• Rez living• Encroachment of Europeans on Rez lands• Loss of language and culture• Loss and confusion regarding traditional, spiritual ways• Loss of traditional family systems (tiospayes)

Contemporary Sources of Trauma

• Violence• Domestic• Physical• Sexual• Military experiences• Loss of parents, close relatives and friends• Adoption/Foster Care Issues• Other

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Counseling Strategies for Working with Native

Americans

Counseling Strategies with Native American Clients

Module 18 Description:Specific counseling strategies for intake, treatment and after-care are a major focus of this module. Participants will analyze proposed Native American culturally specific assessments. Counseling strategies, such as the use of a genogram/lifeline, identification of some root causes of substance abuse lifestyles, etc. and aftercare goals that include Native American cultural and spiritual components will be discussed. Participants will take part in a Talking Circle at the close of this module.

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Treatment Interventions

Psychotherapies

Alternative Ways of Healing

Red Road Healing

Ceremonies

Self-Empowerment

Medications


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The Red Road Approach

The innate cultural/spiritual resources of an indigenous (Native American) person are a focus of this treatment approach. Cultural and spiritual information are a normal part of the treatment regimen. When and where appropriate, spiritual ceremonies are included in treatment and aftercare plans.


An Integrated Behavioral Health Healing and Recovery Model with Native American

Populations

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An Integrated Behavioral Health Healing and Recovery Model with Native American

Populations

Red Road

Cultural Spiritual

AA

Acupuncture

Alternative Healing

Art Therapy

Behavioral

Cognitive

Emotional

Meditation

Motivational Interviewing

Other

Relative(Client)

Wo’DakotaWo’LakotaWo’Nakota

Western EasternOther

Addiction and Substance Abuse Issues on Reservation Settings

• Abuse of alcohol and harmful drugs

• Prescription drugs• Methamphetamine• Marijuana• Nicotine addiction• Gambling addiction

• Domestic violence• Gang activities• DUIs• Suicide• Other

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Positive Prevention and Intervention Strategies for Reservation Settings

• Youth prevention activities• Juvenile Detention Centers• School and after-school programs• Summer programs• Increasing number of cultural programs:• Learning the language, wacipi dancing, learning songs for various occasions, equine therapy, etc.

• Increasing number of spiritual ceremonies being attended by various age groups

• Other

Building Rapport

Communication & Understanding

Genuine Cultural Interest

Respect Trust

Empathy Compassion

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D/L/N Tribal Cultural and Spiritual Assessment

• Cultural Assessments– Songs– Dances– Dress

• Ethnic Identity• Ethnic Self-esteem• Special Knowledge and Skills

– Stories and legends– Art work– Quill work– Beading

Native American Culturally Specific Assessment Instruments

• Culturally Specific Demographic Information for Native American Clients

• Native American Cultural Comfort Assessment• Native American Cultural Values and Beliefs Scale• Native American Grief Assessment• Native American Identity Assessment

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Genogram

Identifying “Root Causes” of Alcohol/Drug Abuse

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Aftercare/Recovery Goals

• Maintain Sobriety– AA

– Mental Health, Cultural / Spiritual Ways, etc.

• Mental (Behavioral) Health Assistance– Continue to work on mental health issues identified in treatment (anger,

boundaries, stress, grief, trauma, etc.)

– Positive support/reinforcement

– Coping with loneliness, boredom, set backs, etc.

Native American Aftercare

• Goal: Assist interested clients/relatives in identifying aftercare goals that include connecting, or re-connecting with tribal cultural and spiritual ways.

• Tribal enrollment, if needed.

• Participate in spiritual ceremonies.

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Sunka Wakan Assisted Counseling Activities Teach Lakota Values

• Gratitude – The horse is a gift.• Respect and Trust are earned.• Courage is gained by overcoming fear.• Humility – Unpretentious confidence is

developed by negotiating results with horses.• Generosity – The more you give, the more

you get!• Fortitude and Wisdom are developed by

learning to: • Set the goal

• Gain knowledge

• Make the commitment

• Implement a plan

• Evaluate the results

• Earn the rewards of success

How Equine Assisted Counseling Works

• Horses serve as a mirror to reflect emotions and behavior.• Horses are very perceptive, they are acutely in tune with humans.

• How a client interacts with a horse will reveal issues.• The horse will “sense” a client’s thoughts and feelings.• The horse will give instant, honest and objective feedback.• The therapist reads the feedback and observations are shared with the client.

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Discussion Question

• What counseling strategies have you found to be effective with Native American client/relatives?

Contact Information

• Sean Bear, 1st. BA, CADC– [email protected]

• Dee LeBeau, MS– [email protected]

• Ed Parsells, BA– [email protected]

• Patricia Iron Shell-Hill, PhD– [email protected]

• Anne Helene Skinstad, PhD– [email protected]

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Questions and Discussion

Please type your questions or comments for the

presenter in the Q&A pod at this time…

Email Follow-up

Within the next 24 hours, you will receive an email from the National AI & AN ATTC which will include:

• Link to the recording of this webinar

• Link to the survey in case you were unable to access it

• Handouts of the presentation

• CEH request form

We appreciate your participation in our survey, it should take you no more than 10 minutes to complete, and lets SAMHSA know:

• How many people attended our webinar

• How satisfied you are with our webinar

• How useful our webinars are to you

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Upcoming webinars from the National American Indian & Alaska Native ATTC

Clinical Evaluation: Assessmentpresented by: Sean Bear I, BA, CADC, Meskwaki Tribal Nation

For more information about our webinar series, contact Kate Thrams at [email protected] or 319-335-5362

Issues of Suicide and Response in Indian Countrypresented by: Jacque Gray, PhD, Choctaw & Cherokee Nation

Treatment Knowledgepresented by: Robert Rohret, MPH

Historical and Intergenerational Trauma: The Impact on the Two Spirit and Native LGBTQ Communitypresented by: Lenny Hayes, MA, LADC, Sisseton Wahpeton-Oyate


Thank youfor taking time out of your very important

work to ensure quality service through education in collaboration with the persons

you serve

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