EVIDENCE-BASED AND EXPERIENCE-BASED PRACTICES

National American Indian and Alaska Native Addiction Technology Transfer Center . University of Iowa . 1207 Westlawn . Iowa City, IA 52242 Phone: 319-335-5564 . Fax: 319-335-6068 . Email: [email protected] . Website: attcnetwork.org/americanindian

I am delighted to welcome you to the second issue of our newsletter. The year 2013 was very busy for all of us, because our main goal for this year has been to listen and learn as much as we can about what American Indian and Alaska Native behavioral health providers identify as their most important needs for training and technical assistance. During this “listening year” we have travelled to as many tribal communities as possible to make sure we understand the needs for

training and technical assistance across the 12 Indian Health Service regions. By the end of 2013, we were able to visit 11 of the 12 IHS regions and were able to meet with both urban and tribal programs, as well as with colleagues in IHS institutions. If you want to know about the specifics of our travel program, please visit our website and click on Travel Log

under the Center News menu. We are in the

process of developing a systematic overview of our findings so we can share them with you in a later issue of this newsletter. We have heard loud and clear that providers want us to assist them in adopting evidence-based practices and assist them in making these practices culturally informed. In addition, we have learned that tribal and urban providers want assistance in using experience-based practices systematically in their programming. This newsletter has been dedicated to providing overviews of a few evidence-based and experience-based practices.

By listening to behavioral health providers, we have also heard the need for leadership development within the behavioral health workforce in American Indian and Alaska Native communities. Hence, we are in the process of finalizing our leadership

development program and starting to recruit mentors and mentees for this program. Please see the article on page 7 of this newsletter.

We have also been told that tribal providers have experienced more and more restrictions

on their ability to travel to training events and conferences so we

would like to make sure that we offer training

opportunities close to home by using local trainers. We have identified many potential trainers across the country who will be invited to participate in a Training-of-Trainer (TOT) event later this spring. After this TOT we will facilitate regular training opportunities using local trainers in different IHS regions. Our goals are to offer our own culturally-informed training programs across the country on a regular basis, and also provide support for our trainers after the TOT is completed. Our Center supports the concept of

Training Without Travel by offering our two

webinar series: The American Indian and Alaska Native Behavioral Health series the first Wednesday of every month, and our Essential Substance Abuse Skills series every third Wednesday of the month. We also offer on-line courses through our National ATTC Coordinating Center in Kansas City, Missouri.

The Center has completed the

strategic planning process and the Advisory Council unanimously voted to approve the plan on October 17, 2013. The Strategic Plan document is available on our website’s homepage.

Finally, I want to tell you about our First Annual Symposium, which took place in Iowa City on October 18, 2013. We had many wonderful presentations that were videotaped and will be made available on our webpage soon. These presentations will also be included in a proceedings document to be published by early 2015. We have already started planning the Second Annual Symposium for Fall 2014. The dates and location for this symposium will be announced in the near future.

We have been busy, and have loved working with our behavioral health providers across Indian country. We would like to thank you all for trusting us with the information you shared during our travel in the past year. We look forward to future collaborations and hope you enjoy this update.

Regards,

Anne Helene Skinstad

NEWSLETTER

SPRING 2014 / VOL 1 ISSUE 2

DIRECTOR’S CORNER

_{EVIDENCE-BASED AND}

EXPERIENCE-BASED

PRACTICES

A. INTRODUCTION

It is now an accepted standard – and in some instances a requirement - for communities to utilize either an

evidence-based treatment (EBT) or employ an evidence-evidence-based practice (EBP). An EBP is defined as a clinical activity that is “informed by evidence about interventions, clinical expertise, and patient needs, values, and preferences” (Kazdin, 2008), whereas EBT refer to specific “interventions or techniques that have produced therapeutic change in controlled trials” (Kazdin, 2008). An emerging consensus among practitioners in the drug treatment field is that EBPs and EBTs should be the norm rather than the exception within the continuum of primary treatment and continuing care services.

However, a major critique of EBP/EBTs is that they typically represent mainstream recovery approaches influenced by Western life experiences which may, as a consequence, be quite culturally alienating (Gone, 2009) and fail to take into account “indigenous traditional knowledge” (Gone, 2012). Whereas there is recognition that some traditional aspects of healing are important in substance abuse recovery for American Indian & Alaska Native (AI & AN) clients (Donovan, 2010), there is widespread recognition that culturally-informed interventions renew pride in Native cultural heritage and promote recovery (Donovan, 2010; Manson, 2009; Sue, Zane, Hall, and Berger, 2009).

B. PROFILES OF EXEMPLARY

CULTURE-BASED PROGRAMS AND INITIATIVES

Introduction

CULTURALLY

COMPETENT RECOVERY

SERVICES

AND THE AI & AN COMMUNITY

By Ken Winters, PhD, and Kate Winters, MA

Photo: Buffalo Nickel Creative

As aptly described by Eva Petoskey, the Director of the Anishnaabek Healing Circle, a strong tradition exists that promotes the

development of recovery services that are adapted for indigenous people (White, 2012). Also, there is a sizeable body of research literature on drug treatment for AI & AN clients. In Greenfield and Venner’s (2012) review of the literature, they concluded that “the research has improved across the decades, as has the inclusion of cultural adaptations” (p. 483).

We provide below a summary of exemplary efforts to develop and evaluate culture-based recovery services for AI & AN communities. All of them offer alternative, culturally appropriate treatments to address substance use disorders for Native individuals. The list is provided in alphabetical order.

Building Research Infrastructure for Dissemination, Goals, and Education (BRIDGE)

The BRIDGE is one of several NIH-funded programs as part of the Centers for American Indian and Alaskan Native Health at the

University of Colorado (www.ucdenver.edu/CAIANH). BRIDGE involves a partnership between Center staff and a local tribe in order to empower the tribe to acquire important funding for prevention and other health related program development and implementation. The partnership addresses four specific aims:

1. To bring together Native community and academic partners to review the tribe’s public health needs and priorities and develop a research agenda;

2. To develop mechanisms for training a research workforce within the tribe in order to gain the skills necessary to pursue the research agenda;

3. To cultivate effective dissemination methods for returning research findings to the local community, to provide the tribe, other researchers, service providers and policy makers with the best available information about health;

4. To systematize procedures developed by the project in order to establish templates for building sustainable research infrastructure in Native and other communities.

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A noteworthy feature of this project is its bi-directional philosophy. The project seeks to develop an extensive and targeted training program that will enhance the cultural competence of the researchers coming into the reservation community, as well as to enhance the research skills of the Native community members who will actively participate in implementing the research.

Drum-Assisted Recovery Therapy for Native Americans (DARTNA)

The drum is a sacred instrument within American Indian culture. Drums are used in ceremonies, social dances, feasts, in preparation for hunting, and as a way of bringing people together. Drums are used in nearly every aspect of American Indian culture, from births to funerals.

There is also a long tradition of the use of drums for therapeutic effects. Several studies have demonstrated physical and psychological effects associated with drumming (Winkelman, 2003). Rhythmic auditory stimuli, including drumming, singing, and chanting, may facilitate auditory drive, leading to increased alpha and theta wave production, and such wave changes can promote meditative states (Wright, 1991).

DARTNA is a treatment program that relies heavily on drumming as part of the therapeutic effects (Dickerson et al., 2012). Developed with assistance from a series of focus groups with

AI & AN clients with a substance use disorder, treatment providers and a tribal community advisory board (Dickerson et al.,

2012), the program also includes the concepts of the Medicine Wheel and

the 12 Step Program developed by

Don Coyhis and White Bison, Inc. (White Bison, Inc., 2007). A pilot study of the program revealed promising results, including improvement in the participants’ depression, anxiety, and fatigue, as well as enhanced spirituality (Dickerson, 2013 presentation).

Evidence-Based Practices and Substance Abuse Treatment for Native Americans

The emergence of evidence-based treatments is populated by Euro-American approaches to substance abuse treatment, and these approaches

may conflict with both American Indian and Alaska Native and 12-step healing traditions. In an effort to address this issue, the Centers for American Indian and Alaskan Native Health at the University of Colorado initiated the Evidence-Based Practices and Substance Abuse Treatment for Native Americans program. This project has three aims: 1) to describe the use of specific evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities; 2) to describe the factors associated with the implementation of evidence-based treatments in these programs;

and 3) to identify methods for more effective dissemination of evidence-based treatments to substance abuse treatment programs serving American Indian and Alaska Native communities.

The project’s Advisory Board reflects its high priority for diversity and inclusiveness; board members include clinicians and administrators from substance abuse treatment programs serving American Indian and Alaska Native communities, program evaluators, and researchers.

Immersion Camp

This novel alternative drug treatment approach involves a seasonal cultural immersion camp designed to approximate the day-to-day experiences of pre-reservation ancestors (Gone and Calf Looking, 2011). Designed for use in conjunction with adult clients referred for residential treatment on the Blackfeet Indian reservation, this program is inspired by the survival camps of the Red Power movement. The program is implemented during the summer months in multiple four-week cycles. Clients and staff reside in gender-segregated tepees pitched well away from settled areas of the reservation for the duration of the treatment cycle. Camp life involves “living off the land” while participating in a variety of associated Blackfeet traditional activities (e.g., hunting or fishing for food; making an individual pipe for personal prayer).

Red Road Approach

The Red Road approach is a holistic healing journey based on Lakota/Nakota/Dakota world views. Several tribal

treatment programs in the Upper Midwest have based their programming on these values. The Red Road

approach is in the process of being manualized by Gene Thin Elk, who together with Wayne Evans

and Rick Thomson developed this approach. Tribal members gather annually to celebrate

the Red Road, which is based upon the “wopila” ceremony. The wopila ceremony involves giving (something) back for (something) that was received. What is given and received depends on the participants of the ceremony. Thanksgiving ceremonies are integral parts of lifeway teachings of Indigenous people. People come from many parts of the world to participate in the Wase Wakpa community gathering to network, share resources, and participate in recovery experiences for holistic healing opportunities. It is a time for healing and renewal, and an opportunity to gain the energy and insight to stay physically, mentally, emotionally, and spiritually healthy. This spiritual gathering is a self-initiated individual healing experience enhanced through powerful group interactions, utilizing the talents, expertise, and resources of the participants. The Gathering evolved from the Red Road Approach Enterprises of Medicine Wheel Inc., a partnership of the Student Counseling Center, University of South Dakota, and members of the Wase Wakpa community. The 25th Red Road Gathering will be held in Vermillion, South Dakota, at the National Guard Armory September 18 & 19, 2014. This year’s theme is “Forgiveness is Medicine for the Human and Natural for our Soul”.

Medicine Wheel and 12 Steps

This culturally adapted 12 Step program for Native clients was developed by Don Coyhis and White Bison, Inc. (White Bison, Inc., 2007). Key components include teachings of the Medicine Wheel, the Cycle of Life, and the Four Laws of Change. The program consists of a series of modules, which include watching a video that explains Medicine Wheel teachings, and the sharing of insights in talking circles regarding how to apply these principles to daily life. The Medicine Wheel is an ancient method for teaching important concepts about truth and life. Many Native American communities use a Medicine Wheel, although the colors and the symbols differ depending upon the culture. The 12 Steps of the program center on personal character and values (e.g., Step 1: Honesty; Step 2: Hope; Step 3: Faith).

One Sky Center

The One Sky Center is a national initiative to bring culturally relevant EBP/EBTs to Native communities (www.oneskycenter.org). The Center, which is located at Oregon Health & Science University in Portland, Oregon, is the first American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services. The overarching aim of the Center is to advance the development of culture-based interventions by applying existing scientific knowledge to the treatment for suicide, violence, and substance abuse. The Center’s many projects and resources include the following: 1) a research review on practices proven to work in Indian Country; 2) the development of a framework for describing culture-based practices; 3) initiatives to facilitate communication between scientifically oriented professional organizations and government agencies in order to foster research and service

collaborative projects; and 4) the hosting of conferences that combine science, practice, and culture-based knowledge.

Southcentral Foundation

The Southcentral Foundation, based in Anchorage, Alaska, is a health provider for approximately 55,000 indigenous people. The foundation’s health care model is organized around a Nuka Model of Care (Nuka is an Alaska Native word used for strong, giant structures and living things). The core principles of this model are the following:

1. SCF’s focus is the needs, goals, and values of its customers. In this light, the customer is given a great deal of personal responsibility for his or her health decisions.

2. Given the rural nature of Alaska, the healthcare team is integrated and built on a home model, rather than the traditional clinic-based setting.

3. The medical teams promote customer compliance by offering same-day access and addressing medical issues over the phone whenever possible.

4. Regular feedback is given to the medical teams in the form of process and outcome data. Employees’ salaries are based on the team’s overall performance.

5. All new employees receive a multi-day orientation to the Nuka Model of Care, with a heavy emphasis on the culture of Alaska Native people.

With respect to addiction recovery services, the SCF principles are key ingredients to the diverse services provided, which include an outpatient program, a family wellness program (grassroots effort to bring wellness to the Alaska Native community by strengthening the family), and a program that introduces clients to activities that support lifelong recovery from drug addiction. These programs typically employ Native traditions (e.g., sweat lodge and talking circle).

C. THE ROLE OF RESEARCH IN

CULTURALLY COMPETENT SERVICES

A common theme among many of the recovery programs and practices summarized above is that they originated from a partnership between researchers and the AI & AN community. Successful, two-way partnerships can be built between researchers and the AI & AN community, and when such joint efforts work well, culturally-informed treatment approaches can be developed for AI & AN clients, and research evidence can be generated to document that the

treatment “works” in its intended cultural context.

Numerous experts have developed culturally-based programs with core involvement from the AI & AN community. The published

literature on this issue (e.g., Burhansstipanov, Christopher & Schumacher, 2005; Dickerson et al., 2012; Donovan, 2010; Gone,

2012; Whitbeck, 2006) provides keys to building a successful collaborative research program. Following is a synthesis of common themes that emerged from this literature identifying essential ingredients for researchers when engaging in collaborative projects with AI & AN communities.

Point 1: Create a strong partnership team.Native American communities have concerns that they may be exploited by researchers. Yet a strong and fruitful partnership can be cultivated between researchers and the tribal community.

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However, this involves building trust and taking time to do so. Here are suggested procedures and practices that promote a mutually-satisfying partnership: treat tribal leaders with respect; meet regularly to discuss the planning and progress of the project; give the leaders a meaningful role in decision-making; and share the data and include tribal community partners on publications. It is important

to note that often times IRB approval at universities or federal agencies for a project is not sufficient in itself, but needs to be augmented by an approval by tribal IRB boards before research can start.

Point 2: Communicate often and address possible barriers to effective communication.

Many tribal communities are in rural areas and standard communication practices may not always be suitable. Cellular telephone service may be poor or nonexistent, access to email may be limited, and ground mail delivery can be delayed for several weeks in some rural areas. An alternative suggested by Burhansstipanov and colleagues (2005) is to send mail via Federal Express to a local gas station, which allows a community partner to pick up the mail when stopping for gas.

Another key is the need to distribute the scheduling of meeting at the locations among the partners. Important to trust-building is for tribal community members to know that researchers will travel to their community for meetings.

Point 3: Budget allocation needs to be equitable.The budget should be comparably allocated among the partners in the research-community team. A related budget issue is to pay frontline staff who are implementing the project with a competitive wage; do not only pay the research and tribal leaders on the project.

Point 4: Adjust research procedures to be culturally

acceptable and respectful of the local community.Traditional research designs may not always be acceptable for communities involved in the partnership (Burhansstipanov et al., 2005). Evaluation procedures, the content of assessment measures and other research design issues may need to be modified. For example, a randomized

clinical trial in which some individuals would not receive the active or promising treatment condition may need to be avoided. Donovan (2010) recommends first implementing a qualitative study on the role of traditional-based healing practices in order to gain community perspectives.

Point 5: Share data.Data related to the project needs to be shared among members of the partnership

team. Naturally, steps are required to maintain confidentiality and privacy regarding the study

participants. Also, researchers may want to provide an educational training to its tribal

partners on how the data can inform future health needs (Burhansstipanov et al., 2005).

Point 6: Decisions on disseminating and publishing the findings need to include members of the tribal community.

Approval of presentations and publications based on partnership research work may need to come from the tribal community. Also, the findings from the research should be communicated to tribal media, such as newsletters and local tribal radio shows.

D. SUMMARY

Numerous recovery programs and practices which serve AI & AN communities are informed by a variety of approaches based on Native culture and values. Such recovery services for the AI & AN community not only provide tribal communities with more culturally relevant and acceptable treatments and help to decrease overall substance abuse rates among Native Americans, they also add knowledge to the body of work on implementing research-community partnerships.

The experience of numerous successful partnerships between researchers and AI & AN communities provides a blueprint for how traditional aspects of recovery and cultural heritage can be blended to create a continuum of culturally competent services. As the field moves forward, incremental improvements and evaluation can further enhance the delivery of effective health care in the tribal community.

Burhansstipanov, L., Christopher, S. & Schumache, S.A. (2005). Lessons learned from community-based participatory research in Indian country. Cancer Control, 12 (Suppl 2), 70-76.

Dickerson, D., Robichaud, F., Teruya, C., Nagaran, K., & Hser, Y.I. (2012). Utilizing drumming for American Indians/Alaska Natives with substance use disorders: A focus group study. The American Journal of Drug and Alcohol Abuse, 38, 505-510.

Dickerson, D. (online presentation, August 14, 2013). Drum Assisted Recovery Therapy for Native Americans (DARTNA): Research and Practice Implications for Native Americans with Addictions. Donovan, D.M. (October, 2010). Substance abuse research in Indian Country: Building a science that meets the need. Presented at Building Bridges: Advancing American Indian/Alaska Native Substance Abuse Research. State of the Science and Grant Development Workshop. Rockville, MD

Gone, J. P. (2009). A community-based treatment for Native American historical trauma: Prospects for evidence=based practice. Journal of Consulting & Clinical Psychology, 77, 751-762.

Gone, J.P. (2012). Indigenous traditional knowledge and substance abuse treatment outcomes: the problem of efficacy evaluation. American Journal of Drug and Alcohol Abuse, 38, 493-497. Gone, J. P., & Calf Looking, P. E. (2011). American Indian culture as substance abuse treatment: Pursuing evidence for a local intervention. Journal of Psychoactive Drugs, 43, 291-296.

Greenfield, B.L., & Venner, K.L. (2012). Review of substance use disorder treatment research in Indian Country: Future directions to strive toward health equity. The American Journal of Drug and Alcohol Abuse, 38, 483-492.

Kazdin, A.E. (2008). Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63, 146-159.

Manson, S.M. (2009). Personal journeys, professional paths: Persistence in navigating the crossroads of a research career. American Journal of Public Health, 99(Suppl 1), 20-25. Sue, S., Zane, n., Hall, G.C.N., & Berger, L.K. (2009). The case for cultural competency in psychotherapeutic interventions. Annual Review of Psychology, 60, 525-548.

White, W. (2012). Interview with Eva Petoskey, the Director of the Anishnaabek Healing Circle. Winkelman, M. (2003). Complementary therapy for addiction: “Drumming Out Drugs”. American Journal of Public Health, 93, 647-651.

Whitbeck, L.B. (2006). Some guiding assumptions and a theoretical model for developing culturally specific preventions with Native American people. Journal of Community Psychology, 34, 183-192. White Bison, Inc. (2007). www.whitebison.org/2007pdf/7TrainingsMN.pdf

References

Too much focus on deficits and not assets in the majority of research programs to date.

Clyde B. McCoy, PhD,

Professor of Epidemiology, University of Miami, member of the Eastern Band of the Cherokee Nation

One of the more valuable things that we can accomplish is looking as hard as possible to find what is most positive in any of the research that we do. So much of the research among our peoples emphasizes the negatives because of the great disparities that are evident and because of the extreme challenges found in our history. But, as this article already shows, we are striving for the positives within cultural translations and adaptations, and possibly more than anything else we need to emphasize the positive cultural values, particularly

for the next generations that should be in the forefront of our thinking. As I think further, the work that we have done in international areas particularly have outlined our work on the guidelines and principles for international research in case any of these have positive parallels for work among our peoples. Good job for everyone who has contributed to this document.

Doing research in Indian communities

Dennis Norman, PhD, Faculty Chair,

Harvard University Native American Program, Chief of Psychology,

Massachusetts General Hospital, member of the Southern Cheyenne Nation

Doing research with American Indians and Alaska Natives and their communities needs to be based on the principles of Community Based Participatory Research (CBPR). The AI & AN communities need to be involved from the beginning of the research process; in planning the project, implementing the project, and interpreting and publishing the results for the research to have any scientific value. Furthermore, the majority of tribal communities and Indian Health Service Regions have their individual Internal Review Boards (IRB), which means that approval from institutional IRBs at different institutions and universities is not enough. The protocol needs to be approved by their own tribal IRB boards.

It is felt by many members of tribal communities that institutional IRB boards are not adequate protection for risk and informed consent. If they do not have their own IRB, consent at the Tribal level is necessary in addition to the researchers’ host institution. Best case study where this went wrong is the Havasupai case, but it has also been a long-standing concern, which has been fueled by distrust of researchers.

Difficult to differentiate between prevention and treatment

Dolores Subia Big Foot, PhD, Caddo Nation; Associate Professor,

Center for Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center; Director, Indian Country Child Trauma Center

Indian Country Child Trauma Center (ICCTC)

Childhood abuse, neglect and trauma is one of the strongest predictors of early onset and chronic alcohol abuse in women, according to Sharon Wilsnack (1979). Furthermore, a person with substance use disorders often suffers from co-occurring mental disorders. Treating young children and adolescents for trauma-related issues can serve as both prevention and early intervention of substance related disorders.

The ICCTC was established to develop trauma-related treatment protocols, outreach materials, and service delivery guidelines

specifically designed for American Indian and Alaska Native (AI & AN) children and their families. The Indian

Country Child Trauma Center is part of the National Child Traumatic Stress Network

funded by the Substance Abuse Mental Health Services Administration

(SAMHSA) under the National Child Traumatic Stress Initiative. It is housed

at the University of Oklahoma Health Sciences Center in the Center on Child Abuse and Neglect. A

current program includes Project Making Medicine (PMM). This program is:

1. Evidence-based interventions for culturally appropriate treatment for American Indian and Alaska Native children

2. The program Honoring Children,

Making Relatives incorporates American

Indian and Alaska Native philosophies into the basic concepts of parent-child interaction therapy. This model combines trauma-sensitive interventions with elements of cognitive behavioral therapy into a treatment designed to address the unique needs of children with post-traumatic stress disorder and other problems related to post-traumatic life experiences.

3. Another part of the treatment includes a focus on treatment of sexual abuse though Honoring Children, Respectful Ways - cultural

adaptation of treatment for children with sexual behavior problems, a treatment approach that is appropriate for children between the ages of 3 and 12 years.

4. The fourth component of this program is framed as Honoring Children, Honoring the Future - American Indian life skills

development curriculum, a suicide prevention curriculum for middle and high school students. ICCTC has assisted the author to modify the curriculum for middle schools students and Boys and Girls Clubs in Indian Country.

Photo: iStock

COMMENTS ON

THE ARTICLE

Phone: 319-335-5564 . Fax: 319-335-6068 . Email: [email protected] . Website: attcnetwork.org/americanindian

The National AI & AN ATTC will initiate a Training-of-Trainer (TOT) program in June. This first initiative is focused on developing trainers to offer Alcohol and Drug Review Courses in different parts of the country. This program has been developed to assist tribal and urban Indian providers to pass certification and licensure exams. The passing of the Affordable Care Act has made it even more important to be licensed or certified in order to receive third party reimbursement. Many tribal and urban Indian providers have expressed a need for this kind of support and preparation. If you are interested in becoming a trainer for us, please contact us, and we will share with you the requirements and expectations involved.

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THE DR. DUANE MACKEY “WAKTAYA NAJI”

AWARD

The Dr. Duane Mackey “Waktaya Naji” Award was established to acknowledge individuals who, in their addiction study careers, have made significant contributions in education, research, mentoring,

and service among American Indian and/or Alaska Native peoples. The award signifies the promise of continued success of an individual and serves to inspire others to make contributions to the addiction treatment field for AI and/or AN people. The award is also designed to recognize individuals who, through their concerted efforts, have untiringly promoted and espoused the ideals of equality and justice for all peoples.

The award winner will be announced at the Red Road Gathering in Vermillion, South Dakota in September 18-19, 2014. Nominations for the 2014 award must be submitted to National American Indian and Alaska Native ATTC by June 15, 2014. For more information on the award and requirements for nomination, please visit our website, attcnetwork.org/americanindian, and click on Awards.

When our Center was the Prairielands ATTC (1998 – 2012), serving as a regional center, we offered a Leadership Institute (LI) annually. However, we did not have many American Indians signing up for this program until we, in collaboration with Mountain West ATTC, offered a culturally specific Leadership Institute for American Indians in our respective regions. Northwest Frontier ATTC has also offered a culturally specific LI, and Great Lakes ATTC offered a training program for Trainers of Color: Training of Leaders. These three initiatives were very well received by our tribal participants. Furthermore, on our travels and in our communications with tribal leaders, we heard their concerns about succession planning and leadership development.

The National American Indian and Alaska Native ATTC convened a task force consisting of participants from these three ATTC LI programs as well as the two AI & AN providers who had graduated from the ATTC Advanced Leadership Institute offered in 2011. The task force met for the first time in Iowa City on October 25, 2013 to discuss the leadership development initiative, and how to tailor this initiative to American Indian and Alaska Native behavioral health providers’ needs. Members of the Advisory Council were involved in this task force

as well. Pam Waters, MA, previous director of the Southern Coast ATTC and the primary author of the LI curriculum, facilitated the two-day meeting. Please see the picture of the participants to the right.

The task force is diligently working to finalize the program and develop advertising and recruitment materials for mentees and mentors. The recruitment process started in March, 2014. Please stay tuned for future announcements coming soon. This LI program is different from Project LIFT, also funded by SAMHSA, in that there will be more face-to-face training and the program will extend over nine months.

Pictured from left to right: Lisa Brunk, Anne Helene Skinstad, Clyde McCoy, Linda Woods, Jacki Bock, Marilyn Spoon, Terra Hamblin, Pam Waters, Lenore Myers, and Julie Cain.

Not pictured: Mandy Conrad, Arlene Kashata, William Martin, Richard Moreno, Dale Walker, and Kellie Webb.

NATIONAL AMERICAN

INDIAN & ALASKA

NATIVE LEADERSHIP

DEVELOPMENT

PROGRAM

TRAINING OF

TRAINER

PROGRAMS

Newsletter Editorial Board and Contributors

Anne Helene Skinstad, PhD, Managing Editor Peter Nathan, PhD, Copy Editor

Kate Thrams, BA, Editor

Kate Winters, MA, Contributing Editor Ken Winters, PhD, Contributor

Ryan Red Corn, Buffalo Nickel Creative, Design

*Webinars require advance registration. Go to our website at attcnetwork.org /americanindian and click on Trainings & Events to see a full list of

upcoming webinars and registration information. Questions? Contact Kate Thrams at [email protected] or 319-335-5362.

MAY

Date

5/7/2014

12 noon - 1 pm Central

Title

Behavioral Health webinar series: Overview of Fetal Alcohol Spectrum Disorders (FASD)

Location/Registration information

Online, see registration information below*

5/12-14/2014 Spirit of Communication: Motivational Interviewing and American Indian

Teachings: Program Pilot Tama, IA; to register, contact Jacki Bock: [email protected]; 319-335-5564

5/20-22/2014 Integrating Native Culture into Clinical Practices Conference: Center

staff will present at this conference Rapid City, SD

UPCOMING TRAININGS, EVENTS and OPPORTUNITIES:

5/13-15/2014 South Dakota Native American Curriculum Training Rapid City, SD; to register, contact Jacki

Bock: [email protected]; 319-335-5564

JUNE

6/1-5/2014 25th Anniversary Native Health Research Conference: Center staff

will present at this conference Phoenix, AZ

JULY

7/2/2014

12 noon - 1 pm Central Behavioral Health webinar series: Motivational Interviewing for Prevention Among Native Urban AdolescentsCombining Traditional Healing and Online, see registration information below*

7/18-19/2014 Alcohol and Drug Exam Review Training Rapid City, SD; to register, contact Jacki

Bock: [email protected]; 319-335-5564

University of Iowa 1207 Westlawn Iowa City, IA 52245

5/21/2014

12 noon - 1:30 pm Central Essential Substance Abuse Skills webinar series: Treatment Planning Clinical Evaluation: Online, see registration information below*

6/17-20/2014 Training of Trainers (TOT): Alcohol and Drug Exam Review

Training Lookup

7/18-19/2014 Alcohol and Drug Exam Review Training Rapid City, SD; to register, contact Jacki

Bock: [email protected]; 319-335-5564 7/16/2014

12 noon - 1:30 pm Central Essential Substance Abuse Skills webinar series: Group Counseling Online, see registration information below* 6/4/2014

12 noon - 1 pm Central Behavioral Health webinar series: Interviewing with Native American AdaptationsAn Introduction to Motivational Online, see registration information below*

6/18/2014