Field Gains Insight into Cumulative Trauma`s Effect on Indigenous Populations

Group trauma rooted in historical oppression continues to have a damaging effect on Native American communities. But a counselor and consultant with expertise in cultural training for helping professionals sees numerous signs of progress in working with these populations.

Yvonne Fortier, MA, LPC, LISAC, who also serves as president of the Arizona Association of Alcoholism and Drug Abuse Counselors, will present the workshop session American Indian Historical Trauma and Cultural Healing on Feb. 20 at the Science and Spirit Summit in Scottsdale, Ariz.

“More research is being done,” Fortier tells Addiction Professional. “Also, there has been more of a focus on resilience factors, with an emphasis on 'How did we survive this?' vs. 'What happened to us?'”

Part of Fortier's talk will address the cumulative group trauma that American Indian populations experience; this trauma differs from the intergenerational trauma that is experienced in an individual family. A better understanding of the trauma gives professionals greater insight regarding disease prevalence in the Native population. Fortier cites, for example, recent National Public Radio coverage of challenges in the Najavo population, where suicide rates far exceed national norms.

In working with the trauma-affected American Indian population, Fortier believes it is important to integrate traditional approaches such as outpatient behavioral health care and peer support with culturally sensitive strategies emphasizing mind/body/spirit.

Much of the national perspective on historical trauma in indigenous populations is derived from the work of Maria Yellow Horse Brave Heart, PhD, who established a model of historical trauma for the Lakota population that has guided other efforts around the country. Fortier cites her work in her trainings.

Diversity within community

Fortier adds that it is important not to see the American Indian population as one group with the same profile. All communities and tribes are different. Native Americans who live in urban communities experience a sort of “dual citizenship,” she says, influenced both on and off reservation.

Stigma remains a potent force in the community, making careful assessment and treatment planning a must. Fortier says that in assessing trauma, she uses a two-question inventory adapted from a tool used to screen for post-traumatic stress disorder (PTSD) in military veterans.

Issue hits home

The challenges encountered by the Native American population received new emphasis this month from the widely discussed encounter between a Native American elder and a group of Kentucky high school youths at a Washington, D.C., rally. Fortier, whose work focuses a great deal on diversity and inclusion, says that while she has not closely examined the dynamics of what became a national news event, her initial impression focused on the respect usually afforded to elders.

“You may be demonstrating your view, but are you doing it in a respectful way?” she says.

Fortier this month received an advocacy award from the Arizona Counselors Association for state policy efforts benefiting the behavioral health profession. Active in the Arizona Board of Behavioral Health Examiners as well as the state's NAADAC affiliate, Fortier was instrumental in helping to beat back legislation that would have done away with some professional credentialing requirements, and in advancing a syringe exchange initiative.

The Feb. 20-22 Science and Spirit Summit will examine new research, evolving treatment concepts and cultural considerations in order to help attendees devise effective treatment plans. Fortier says her session will demonstrate to attendees the many commonalities among programs working with Native Americans, and will place more experienced clinicians in a position to share insight with others in their organizations.