Incorporation of a Compassionate Schools Program in the Makah and Hoh Tribes, two Native American Communities in the Pacific Northwest area of the United States Lauren May PHC6937

Abstract:

Native American communities in the United States have disproportionately high rates of health disparities such as post-traumatic stress, depression, violence and substance abuse, especially when compared to other demographic groups in the United States¹.  These communities also disproportionately experience adverse childhood experiences (ACEs) with up to 40.3 percent experiencing 2 or more ACEs³ including childhood physical and sexual abuse, witnessing violence, poverty, racism and parental alcohol and drug abuse¹. These can result in adverse health effects leading to lower life expectancies². This proposal aims to develop a resilient schools program in the communities of the Hoh and Makah tribes in the Pacific Northwest and is modeled after a successful program implemented in rural Buncombe County, North Carolina. This program will focus on developing trauma informed strategies specifically for the Hoh and Makah population that focuses on students, parents and the community and will incorporate native arts and language to develop resiliency in ACE effected children and parents.

Level(s) of the Social Ecological Model

We will utilize the intervention program based on the CDC’s social ecological⁴ model which emphasizes the link between the Individual, their close Relationships, and the Community and Society in which they live. Our primary focus will be on the individual, their relationships and the community to evaluate and address ACEs and promote resilience in the Makah and Hoh community. The home environment or the relationship level has the most immediate impact on the individual as the trauma source often originates from the parents or another caregiver⁵. Teaching resilience in the individual in these communities can lessen the impact of the immediate stresses of the home⁶. Additionally, we will address the ACEs associated with the caregiver and provide coping tools to mitigate the repeat of ACEs in future generations. We are aware we need to involve the Native American community as this level of the SEM can have a significant impact on ACEs in children as this is where they live and can help the individual find resilience through discovery of their history and culture. Through addressing these our aims are long-term, positive effects to break the chain of trauma, neglect, substance abuse, violence, and re-victimization and work toward multi-generational resiliency building.

Trauma Informed Principles Utilized ⁷

The safety principle will be addressed by creating a safe environment where individuals can openly discuss ACE’s experienced. Classroom exercises or a smaller groups will be created with a trusted adult or a trauma informed teacher.

Trustworthiness and transparency will be essential in allowing for a productive and continual dialogue between the child and the teacher or the counselor and the parents. This will be addressed by ensuring that there are councilors that are either very familiar with the Hoh and Makah community or are a current member of this community.

The peer support approach for children will involve family members or close friends of the family who can best understand the specific ACEs to which the child has been exposed. The same approach would be utilized for counseling parents as this will be an important continuation of the mitigation of further trauma in families.

Collaboration and mutuality will be addressed by working with individuals that have experienced ACEs in this community and staff, administrators and clients will work towards creating an individualized program for the client or survivor.

Empowerment, voice and choice will be addressed by creating awareness of the programs’ purpose and providing a choice to participate. When participating they will have a voice in their program and the program can be altered to best suit their needs.

Cultural, Historical and Gender issues will be addressed by training all staff in the cultural and historical trauma of that community and how it applies to either gender.

Public Health Framework

The incorporation of a compassionate schools program in the Makah and Hoh tribes will be based on the CDCs public health framework for prevention ⁴. This approach will primarily focus on primary and secondary prevention measures. The primary approach will be initiated by creating a general awareness among staff members of the personal history of the students attending the schools, including the family history if known. This will be necessary in creating strategies toward primary prevention of trauma and will promote resilience and alternative attitudes of the students. This will be facilitated by introducing techniques promoting: self-respect, the ability to self-calm, the recognition of a trusted adult(s) and the ability to make constructive choices both now and in the future.

The secondary prevention measures will focus on the relationships of students with close family members and the influence and impact these can have on children. Strategies would be emphasized to reduce the impact of negative family interactions by employing family-focused prevention programs, parental mentoring and programs involving positive peer or role models. Programs would be designed to best fit the individual(s) and their specific needs with an emphasis on developing problem-solving skills that focus on building healthy relationships.

The tertiary level of the framework will focus on counseling and the mitigation of long term effects trauma can have on older students and their positive interactions with the community including school, workplaces and neighborhoods.

References:

1. Brockie TN, Heinzelmann M, and Gill J. A framework to examine the role of epigenetics in health disparities among Native Americans. Nursing Research and Practice. 2013. http://dx.doi.org/10.1155/2013/410395
2. Dankovchik J, Hoopes MJ, Warren-Mears V and Knaster E. Disparities in life expectancy of Pacific Northwest American Indians and Alaska Native: Analysis of linkage-corrected life tables. Public Health Reports. 2015. Vol 130; 71-80.
3. https://www.pcaaz.org/wp-conte...merican-Families.pdf
4. https://www.cdc.gov/violencepr...chealthapproach.html
5. Bruskas D, and Tessin DH Adverse childhood experiences and psychosocial well-being of women who were in foster care as children. http://dx.doi.org/10.7812/TPP/12-121
6. LaFromboise TD, Hoyt DR, Oliver L, et al. Family, community and school influences on resilience among American Indians adolescents in the upper Midwest. J Community Psychol. 2006 Mar;34(2);193-209.
7. SAMHSA’s Concept of trauma and guidance for a trauma informed approach. Prepared by SAMHSA’s Trauma and Justice Strategic Initiative. July 2014. www.samhsa.gov