Integrative Approaches

1. Integrative Approaches LEARN Model & Native American Teachings/Medicine

2. LEARN MODEL • Most powerful transcultural barriers are different explanatory models of disease/illness • Providers must first become aware of their own cultural biases

3. Starts in communication … • Verbal • Non-verbal • Handshakes & smiles • Signs of warmth and caring to a Hispanic patient • Indication of frivolity and immaturity to Soviet emigres

4. LEARN Model • L - Listen with empathy & understanding (active listening)

5. LEARN Model • L – Listen with empathy & understanding • E – Explain your perception of the problem/need

6. LEARN Model • L – Listen with empathy & understanding • E – Explain your perception of the problem/need • A – Acknowledge & discuss differences in client/provider perceptions

7. LEARN Model • L – Listen with empathy & understanding • E – Explain your perception of the problem/need • A – Acknowledge & discuss differences as well as similarities in client/provider perceptions • R – Recommend treatment or action plans

8. LEARN Model • L – Listen with empathy & understanding • E – Explain your perception of the problem/need • A – Acknowledge & discuss differences/similarities in client/provider perceptions • R – Recommend treatment or action plans • N – Negotiate treatment or action plans (Involvement = Action) Berlin & Fowkes (1983); Modified Tafoya & Wirth (1992)

9. … the disconnect “Patients ask why they’re ill, and having told them how they became ill, physicians think they’ve answered the question.” Dr Margaret Clark

10. … mending/preventing the disconnect … “Because of alternate views of the causative factors of disease, there are also alternative methods of treatment.

11. Asian & Latino American Cultures • Believe in a humoral concept of disease and treatment • Based upon opposition or balance of hot & cold qualities

12. What happens to clients?

13. Integrating Native American Teaching • … to develop effective, culturally relevant approaches to HIV/AIDS treatment, services, case mgt, and prevention programs.

14. Smudging & Sacred Smokes • To cleanse and purify both the physical and spiritual bodies with smoke from sacred herbs • Sage & Cedar • Every Nation has its own specific teachings & practices

15. Sweat Lodge • Ceremony of preparation • Means of physical and/or spiritual renewal • No fire – hot rocks produce heat & create steamy mist

16. Apache Tears • Obsidian • Smoking Mirror • Knives, spearpoints & arrowheads • Paul Ortega, Apache Medicine Man • Put “sorrow” in stone • Once you’ve learned what you needed to know, release it / let it go

17. Storytelling • Internalization of the meaning of the story • Telling elaborating stories as opposed to telling directly … “this is what the story means”

18. Talking Circles • Provide group members w/ structure and support • Help to deal with “pause time” issues • 1st generation responsibilities of “teaching” & “sharing”

19. Drumming & Dancing

20. Drumming & Dancing • Entire cosmos moves in constant rhythm • All of life pulses to the cosmic dance • Music is a healing force – all living spirits sing

21. Drumming & Dancing • Drumming & dancing are expressions of: • inter-dependence, • healing, • medicine & • rebalances energy

22. Drumming & Dancing • Can be a holy act, a religious act or an act of great power

23. Sacred Herbs

24. Medicine People