SAMHSA Meeting – January 2013

1. SAMHSA Meeting – January 2013 Rodney C. Haring, PhD, LMSW (Seneca) One Feather Consulting - (Cattaraugus Indian Reservation) University of Arizona Department of Family and Community Medicine Tucson, Arizona

2. Relationship building for a healthy future: Indigenous youth pathways for resiliency and recovery • Research Question: Why Indigenous youth decide to abstain from substance abuse • (Native Hawaiians, Pacific Islanders, Native American, American Indian, First Nations, and Alaska Natives) • Mixed Methods: qualitative (grounded theory) and quantitative (exploratory factor analysis) • Aggregate data from Global Appraisal of Individual Needs (GAIN) intakes • Results: • Maintaining relationships is a driving factor in the quit process • Maintaining a healthy lifestyle and having strong self-will, and addiction-free were resiliency factors in the path to recovery • Perceived future plans (school and career) • Past experiences with the legal system as a means of support • Theoretical name - Relationship building for a healthy future and better life control • Conclusions:Voices from participants provide a means for future Indigenous-relevant curriculum and social work related intervention development. • Support: SAMHSA/CSAT Contract 270-07-0191 • This project was based on the guiding principles set forth by a tribally relevant research code.

3. Theory: Relationship Building for a Healthy Future and Better Life Control

4. Increasing the Knowledge Base: Utilizing the GAIN in Culturally Sensitive Landscapes • Background: Assessment instruments used in human services settings are often normed for mainstream populations. The importance of increasing the evidence-based validity of assessment tools in unique populations is essential to providing relevant evaluation, successful treatment, and, ultimately, individual and societal wellness. The Global Appraisal of Individual Needs (GAIN) is an assessment used with both adolescents and adults in outpatient, intensive outpatient, partial hospitalization, methadone, short-term residential, long-term residential, therapeutic community, and correctional programs. GAIN has been adopted by hundreds of agencies and systems of care in communities ranging from large urban areas to moderate-sized and small urban communities, rural areas, and Indian reservations. • Methods: Using qualitative methods based in grounded theory, the project discovered the commonalities, themes, processes, experiences, and perceptions represented by the multiple diverse workgroups sharing their “in the field” knowledge of the GAIN process from a cultural utilization standpoint. • Results: Findings suggested the importance of assessment flexibility, the use of storytelling to improve communication-style differences, the importance of ongoing diversity trainings and respectful community relationship building to increase acceptance and utilization. • Conclusions: The findings help provide multi-cultural settings with meaningful information that can be useful in the field and providing action steps for using the GAIN in culturally sensitive landscapes. • Sub-contract funds from CSAT/SAMHSA

5. Using the GAIN in Culturally Diverse Landscapes: Recommendations from the Field • Adapting the Administration Environment of the GAIN (Category) • Flexibility During Assessment (Property) • Understanding and Improving Terminology (Category) • Identity Questions (Dimension) • Taboo Questions (Dimension) • Resiliency Questions (Dimension) • Communication Styles (Category) • Storytelling (Property) • Trainings (Category) • Emphasizing Community Process (Core Category) • Historical Traumas (Subcategory of Community): Trust & Mistrust • Spirituality (Property) • Multi-Cultural Advisory Council (Property) • “Listening to the Children” (Dimension) • Involving Families & Collaterals (Property) • Confidentiality (Property): “There Is a Strong Grapevine”

6. Implementation in Indian Country • Consistency of trained staff through out time; • Working with Native consulting firms, NFPs, and others with a stable and consistent history providing consistent direct service care for tribal health systems as collaborators. • Collaborating with Native organizations, institutes, and universities at a macro-level (coordinating partners): • Native Research Network, Inc • National Congress of American Indians • University of Arizona, Native American Research and Training Center • Practice as usual; Evidenced Based Practice; Practice Based Evidence Scenarios.