1. The Healing Circle

2. Presented by the
Supha Phonchiangkwang Substance
Tracey Neal Triggers
Amardeep Saini Intolerance
Lara Blanks Generational
Lois Hyatt Metis
Aboriginals
COALITION
Group Project - PSYN 205-3 Substance Use/Misuse Psychiatric Nursing Practice - Theory.

3. The Healing Circle highlights substance abuse issues and culturally sensitive holistic treatment for North American Aboriginals.
Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional
approaches. The use of alcohol, illicit drugs and solvents is a serious problem among First Nations, Inuit and Métis. This project
explores the distinct aspects of Aboriginal generational issues, women and youth, impact & resources for families as well as
contemporary and traditional healing methods to facilitate patient, family and community substance abuse education.
Psychiatric Nursing values all aspects of health. The profession recognizes the complex relationships between emotional,
developmental, physical, and mental health; the influence of social factors on physical and mental health and on illness; and
the role of culture and spirituality in health promotion, illness prevention, and recovery. Psychiatric Nursing values equality
and believes that persons with mental health and developmental challenges deserve access to high quality health services
(Registered Psychiatric Nurses of Canada, 2010).

4. Background
Knowledge of the European imposition of colonization is imperative to fully comprehend the resultant social dysfunction and
destructive behaviours that plague many Indigenous communities in Canada. Along with European contact came the introduction of
alcohol. It is notable that alcohol was one of the most important commodities in the fur trade and was also utilized as a negotiation
tool which contributed to the downfall of the Native nation.
Through the creation of the Dominion of Canada in 1867, “Section 91(24) of the British North America Act established that the federal
government of Canada was responsible for Indians and Lands reserved for Indians” (Government of Canada, 2013). The Indian Act of 1876
introduced policy decisions across the board such as determining who was an Indian, managing Indian lands, resources and moneys,
controlling the access to intoxicants and promoting "civilization." Amendments to the Indian Act became increasingly restrictive and
imposed ever greater controls upon the lives of First Nations peoples including taking full responsibility for educating their children.

5. and disconnection
roles among the residential school survivors
i.e. lack of skills, knowledge, or emotional strength to parent their children
Subsequent generation raised in families with chaos, substance abuse, and
violence
in children (they turn to alcohol, drugs or acting out as
this is how they see their parent cope)

6. with higher
levels of hopelessness and more prone
to depressive symptoms which in turn
predispose them to drinking to cope
and ultimately makes them
to excessive drinking (“First Nations
Alcohol Policies”, 2012, p. 11)

7. This emotional vulnerability is termed as
It is essentially different from drinking for a social motive
such as conformity and enhancement.
It reveals a pattern of drinking with stress, anger,
frustration and depression; implying that “alcohol abuse
is used as an escape from reality” (Mushquash, Stewart,
Comeau, & McGrath, 2008, p. 46)

8. When one is emotionally competent, one is
demonstrating one’s self-efficacy in emotionally-
eliciting transactions, which are invariably social in
nature. And emotional literacy is in turn related
with moral competency.

10. This program derives from traditional Aboriginal values
“The male population within our communities is asking
for change and tools to make the change. It is the
warrior that is standing up and declaring that he
wants to contribute towards the solution”

12. Prior to contact with European culture, First
Nations people had tribal customary
practices for providing mentor-like
guidance for children and youth.
The whole community contributed to
raising children; everyone had a role to play
in teaching the young.
“Children were regarded as a gift from the
Creator and members of the community
shared responsibility for their upbringing”
(Klinck, Cardinal, Edwards, Gibson, Bisanz &
da Costa, n.d.).

13. Far too many Aboriginal youth experience a sense of
hopelessness for the future because of the barriers and
discrimination they face including cultural and social
alienation, often existing in a world characterized by
violence and racism.
The rate of morbidity resulting from the use of illicit drugs is three
times higher for Aboriginals than for the general population. For
many the belief is that using drugs will alleviate the pain they
experience in areas of their life that seem unbearable, which may
ultimately make them more vulnerable to becoming high risk for
suicide. Suicide rates are five to seven times higher for First
Nations youth than for non-Aboriginal youth. Suicide rates among
Inuit youth are among the highest in the world, at 11 times the
national average (Health Canada, 2013).
Suicide prevention generally involves finding ways to
reduce risk factors, such as eliminating substance abuse, in
promoting protective and preventive factors against
suicide.

14. High levels of substance abuse in Aboriginal communities are most often generational. As a direct result children of parents
who have a drug and alcohol addiction are almost three times more likely to be physically or sexually assaulted, and more than
four times more likely to be neglected than children of parents who are not substance abusers. Children of substance-abusing
parents suffer low self-esteem, depression, self-mutilation, suicide, panic attacks, truancy, and sexual promiscuity, and will
replicate later in life the drug and alcohol abuse problems they witnessed in their parents
(National Centre on Addiction and Substance Abuse, 1999).

15. Aboriginal youth are at a significant risk of becoming involved in substance abuse. Studies have shown that youth
of First Nations, Métis and Inuit descent are of the highest abusers of illicit drug use in Canada. This population is
also over represented in courts concerning charges relating to drug possession and drug trafficking. In Canada
there were approximately 7,500 Aboriginal youth admitted to either custody or probation in 2005/2006 (Tangient
LLC., 2014). High crime rates in youth are frequently linked to substance abuse and a marginalized position in
society. Other factors that may play a role in affecting a youth’s choice to abuse drugs are low levels of education,
poor school attendance, family breakdown, lack of parental involvement and support in their daily lives.

16. The most important thing to me is to teach the children, so that our culture never dies
Blackhawk SanCarlos, Mohawk and Apache
Having identified some of the major issues affecting youth, the question is how to foster a
more constructive dynamic for Aboriginal youth? Preventing substance abuse is a constant
battle and without strong efforts from local communities and organizations that focus on
substance abuse prevention nothing will change.
As a community, everyone must work together to make changes by providing strong cultural
and family supports. The main goal is to reconnect youth with cultural identity and regain a
sense of belonging. In this environment the issue of substance abuse prevention can be more
readily addressed.

17. As a substance abuse
preventative measure,
graphic recording is a
holistic method that
increases youth
engagement and may be
implemented by trained
mentors, possibly with the
inclusion of participants if
so desired.
During an event drawings
are produced that parallel
the discussion so as to
allow visualization of the
factors that make up a
health promotion
framework.
It keeps participants
focused, gives them a
chance to reflect on what’s
happened, and helps them
to remember and care
about the ideas discussed.
Delivered by mentors as a
youth teaching strategy it is
productive as well as an
effective therapy disguised
as fun.

18. During an event
participants;
See connections
Highlight keynote
speakers
Focus participants
Engage visual
learners
Gain a deeper
understanding of
the issues
Give young people
a space to
congregate, engage
with the visuals and
each other (Bradd,
2014).

19. *According to Canadian Women’s Health Network (2005), injection drug use
is the main path of HIV transmission for Aboriginal women and that 65%
reported AIDS cases caused by exposure to injection drug use (Prentice,
2005).
* The rate of new HIV infection among Aboriginal women in Canada has
been increased over the last two decades.
* Aboriginal women account for 50% of all new HIV positive when compare
with their non-Aboriginal people which is only 16%. The HIV infection occurs
in Aboriginal women between age 15-29 years old (Prentice, 2005).

20. Aboriginal women are vulnerable gender and are twice as likely to be poorer than non-aboriginal women.
They live to an environment where substance use and domestic violence are widespread.
They are most likely to be using substances which place them at the highest risk for contracting HIV/ AIDS and
hepatitis C (Prentice, 2005).
Due to poor living environment and their vulnerability, Aboriginal women are more like to migrate from rural
area to urban area, become homelessness, work in sex trade, and abuse alcohol and substances (Prentice,
2005).
Aboriginal women who have been sexually and physically abused have low-self-esteem, have little access to
education, are poor due to lack employment and they often abuse alcohol and illicit drugs as coping strategies
and pain after the traumatic incidence(Prentice, 2005).

22. .

24. Substance abuse in some aboriginal
communities is a complex problem
requiring culturally appropriate,
multidimensional approaches.
Violence, abuse and harm to children are
among the effects of abuse, the cost of
which is paid by the community as a
whole year after year (Jiwa, Kelly &
Pierre-Hansen, 2008).
The effects of colonization, residential
schools, First Nations and Métis land
appropriation, Indian hospitals and child
welfare intrusion continue to ripple
through generations.

25. These effects include learned violence, loss of language, loss of emotional
security and family connections, and a loss of respect for First Nations
and Aboriginal culture.
Many children of parents who attended residential school did not
experience healthy role modeling and as a result, parenting capacity was
often diminished over generations.
Beyond the colonial experience, there are other more general risk factors
for mental wellness among First Nations and Aboriginal people, such as
family problems, unstable housing, school stress, or workplace pressures
and substance abuse (NAHO, 2011). Efforts to decrease drug
dependencies begin at the community level.

26. Community-based care:
Community-based treatment emphasizes prevention, treatment, and
after-care taking place in one’s home community.
The immediate benefit of community-based programs is that they
might overcome many of the barriers to off-reserve residential
programs. These barriers include fears of unknown larger centres and
being away from work or family.
A community-based approach to prevention, treatment, and aftercare
programs attempts to address these factors by extending healing to the
community level.

27. Honoring cultural relevance in community-based addictions treatment can allow
individuals to be treated in familiar environments where they are surrounded by
family and friends, thus promoting understanding of their illnesses within the
communities they will rely on for post treatment support.
These programs ideally cover prevention, harm reduction,
treatment, and aftercare.

28. Community Mobile Treatment
The community mobile treatment (CMT) model, developed in 1984, views
substance abuse as “a local problem that requires community-based
solutions. The goal of CMT is to mobilize the community in order to heal
the group as a whole. Changes in values and social structures require a
cohesive understanding of what is deemed acceptable behaviour in the
belief system of the community.

29. The program requires that a community first
identify a need for intervention as well as a belief
that change is possible.
This approach often eliminates the need for
people to leave their remote communities.
They become focuses of community development,
as the communities become the treatment
facilities. Success requires solutions developed
within communities, strong community interest
and engagement, leadership, and sustainable
funding

30. Prevention Education and Harm Reduction
• Cultural relevance is important in educational and harm reduction
programs. Early approaches to prevention often included the belief
that people informed of the risks of their behaviour would choose not
to participate in activities with known harm.
• Strategies suggested include the following: sobering-up shelters,
which provide a dignified alternative to placing intoxicated people in
police custody, and night patrols and personal injury prevention
initiatives. These types of policies in the county led to a reduction in
motor vehicle collisions and a reduction in mortalities from both
suicide and homicide (Homestead Schools, n.d.).

31. Family Therapy
Substance use affects all family members. Family counselling can provide tools which
assist the family to give up the enabling behavior patterns that abetted the client's
substance dependence.
Acknowledging the pain of family members can be empowering through addressing
family interaction patterns that revolve around denying the problem, avoiding conflict,
rationalizing abuse, and protecting the abuser.
Relearning effective ways to communicate, express feelings, problem solve, and set
limits is essential in order to create safe boundaries which address the issues that could
escalate into a crisis.
Family therapy will also address the needs of all family members, especially children
who struggle with guilt, low self-esteem; fear, distorted perceptions, double messages,
identity confusion, all-or-none thinking, and rules of don't think and don't feel.
Overall culturally sensitive family therapy can empower the family to reformulate roles
and responsibilities (Jiwa, Kelly & Pierre-Hansen, 2008).

32. Government programs:
• The Government of Canada’s Aboriginal Portal has resources dealing
with addictions. The Partnership for a Drug Free Canada is also
running a nationwide drug prevention campaign. Additionally, Health
Canada provides helpful information on drug prevention strategies for
all Canadians.
• Focusing on prevention to address the sixty percent of illicit drug
users who are 15 to 24 years old, the Canadian Centre on Substance
abused has developed a five-year, $10-million national drug
prevention initiative, A Drug Prevention Strategy for Canada’s Youth.
This Strategy—which is part of the federal government’s National
Anti-Drug Strategy—aims to reduce illicit drug use by Canadian youth
between the ages of 10 to 24 (Health Canada, 2012).

33. Aftercare
Connectedness to one’s cultural group helps in health and recovery.
Post treatment success is highly dependent on the individual’s
environment after addictions treatment.
The purpose of aftercare is to help people and their families or other
loved ones along their healing journey and to return to positive
community life.
Successful aftercare in communities requires a long-term focus.

34. In order to design a sustainable program, capacity building and
community ownership are crucial (NAHO, 2011).
Support from family, peer networks, and friends, as well as access to
housing, education, work, and opportunities to celebrate cultural
identity, help support a person to be productive and connected to their
community.
Effective aftercare strategies include follow up by treatment providers;
additional supports for people with co-existing mental health
conditions; safe living conditions to support recovery; and support for
people moving to urban centres or other communities (FNAAP, 2011).

35. Aboriginals believe that mind, body, emotions and spirit need to be in
balance in order to have a healthy life (McCabe, 2008).
Community contexts changed with colonization and omitted many of their
healing traditions (Kirmayer, Simpson & Cargo, 2003).
One example of changes in community context is residential schools (Kondro,
1998).
Prisons is also another imposed idea that could be looked at as isolation from the
community which may only increase negative self-talk and anxiety.
Western culture has neglected the need for spiritual and emotional balance and
practices to the point of some have disappeared altogether (McCabe, 2008).
Traditional healing practices have been shown to rapidly reverse the effects of
historical trauma (Schiff & Moore, 2006).
Some practices aboriginals use in order to heal the mind, body, emotion and spirit
are: medicine wheel, sweat lodges and story-telling
(McCabe, 2008).

36. Healing Wheel
The healing wheel consists of four directions of North, South, East and West in which each is
connected to an aspect of the person and their condition:
North is the mind/ receiving, South is the body/holding,
East is the spirit / determining West is emotions/ giving.
Each aspect of the wheel are the essential ingredients for activating the healing process
(McCabe, 2008).
McCabe (2008) gives an example in which we are not just people moving around through life
reacting to impulses and hormonal signals, watching this presentation but also a more
profound interaction with all mind, body and the dialogue of our spirit and emotions are
also taking place.
The Medicine Wheel can address the issues Aboriginal faces such as damage
of their self-concept by colonization and oppression (McCabe, 2008).

38. Sweat Lodge
The sweat Lodge is made in a dome shape to block out light and keep in heat.
The sweat lodge is for physical and spiritual cleansing while some may also
experience deep emotion, visions and may bring clarity (McCabe, 2008).
Water and heat are universally known for their cleansing properties (Schiff &
Moore, 2006).
The sweat lodge is an experience that allows inner dialogue also a connection
with the spirit/emotional dialogue. The sweat lodge encourages letting go of
negative self-talk and feelings of anxiety (McCabe, 2008).
“Spiritual and emotional well-being of participants was directly attributable to
the ceremony.”(Schiff & Moore, 2006).

39. Story Telling
“Telling of stories became an expression of the healing itself. The
healing was the story and the story became part of the healing
“(McCabe, 2008).
Story telling can help make sense of our inner dialogue that helps
remove blockages and integrate emotions with thoughts, especially
the ones that about self. When someone tells a story, they are living it,
or reliving it as a whole and not just partially.
The expression of the event allows not only for releasing of negative
thoughts but also allows listeners to be sympathetic or even
empathetic to their experience (McCabe, 2008).

41. References
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