Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
DSpace
UBCV
McCormick, Roderick Michael
Doctor of Philosophy - PhD
University of British Columbia
This study explores the facilitation of healing for First Nations people living in the province of British Columbia. The purpose of the study is to develop a reasonably comprehensive scheme of categories that will describe, from the perspective of First Nations people, what facilitates healing. The research method involved interviews with 50 adult First Nations volunteers who were long-term residents of British Columbia and also in a position to observe what facilitated their own healing for them . The Critical Incident Technique (Flanagan, 1954) was utilized to elicit 437 incidents from 50 participants. Fourteen categories emerged from an analysis of the incidents reported. Several procedures were used to examine the soundness and trustworthiness of the categories. The results indicate that healing can be facilitated in the following ways: participation in ceremony, expression of emotion, learning from a role model, establishing a connection with nature, exercise, involvement in challenging activities, establishing a social connection, gaining an understanding of the problem, establishing spiritual connection, obtaining help/support from others, self care, setting goals, anchoring self in tradition, and in helping others. A preliminary examination of the healing outcomes of these facilitating events suggests that an effective healing program for First Nations people would invoke empowerment, cleansing, balance, discipline, and belonging. Narrative accounts were analyzed for the purpose of revealing an organization for the categories. Four divisions of categories emerged as a result of this analysis: separating from an unhealthy life, obtaining social support and resources, experiencing a healthy life and living a healthy life. Further analysis of the narratives revealed five overall themes which serve to enhance the categories and outcomes presented in this research. Those themes entail: A broad spectrum of healing resources are available to First Nations people, First Nations people have a different way of seeing the world which has to be understood before effective counselling services can be provided, First Nations people expect that whatever is healing should help them to attain and/or maintain balance, self transcendence followed by connectedness is a common route to healing for First Nations people, and First Nations people are seen to act as agents of their own healing. The findings of this study contribute to the field of counselling psychology by providing a reasonably comprehensive scheme of categories and themes that describe, from the perspective of First Nations people, what facilitates healing. This study suggests promising developments in First Nations healing that have implications for both research and practice.
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THE FACILITATION OF HEALING FOR THE FIRST NATIONS PEOPLE OFBRITISH COLUMBIAbyRODERICK MICHAEL MCCORMICKBA., Carleton University, 1980B.Ed., Queens University, 1981M.A., University of Victoria, 1986A THESIS SUBMITTED IN PARTIAL FULFILLMENT OFTHE REQUIREMENTS FOR THE DEGREE OFDOCTOR OF PHILOSOPHYinTHE FACULTY OF GRADUATE STUDIES(Department of Counselling Psychology)We accept this thesis as conformingto the required standardTHE UNIVERSITY OF BRITISH COLUMBIA@ Roderick Michael McCormick, 1994In presenting this thesis in partial fulfilment of the requirements for an advanceddegree at the University of British Columbia, I agree that the Library shall make itfreely available for reference and study. I further agree that permission for extensivecopying of this thesis for scholarly purposes may be granted by the head of mydepartment or by his or her representatives. It is understood that copying orpublication of this thesis for financial gain shall not be allowed without my writtenpermission.(Signature)Department of qJ IThe University of British ColumbiaVancouver, CanadaDate i%e Z/ //DE-6 (2188)ABSTRACTThis study explores the facilitation of healing for First Nations people livingin the province of British Columbia. The purpose of the study is to develop areasonably comprehensive scheme of categories that will describe, from theperspective of First Nations people, what facilitates healing.The research method involved interviews with 50 adult First Nationsvolunteers who were long-term residents of British Columbia and also in aposition to observe what facilitated their own healing for them . The CriticalIncident Technique (Flanagan, 1954) was utilized to elicit 437 incidents from 50participants. Fourteen categories emerged from an analysis of the incidentsreported. Several procedures were used to examine the soundness andtrustworthiness of the categories. The results indicate that healing can befacilitated in the following ways: participation in ceremony, expression ofemotion, learning from a role model, establishing a connection with nature,exercise, involvement in challenging activities, establishing a social connection,gaining an understanding of the problem, establishing spiritual connection,obtaining help/support from others, self care, setting goals, anchoring self intradition, and in helping others. A preliminary examination of the healingoutcomes of these facilitating events suggests that an effective healing program forFirst Nations people would invoke empowerment, cleansing, balance, discipline,and belonging.11Narrative accounts were analyzed for the purpose of revealing anorganization for the categories. Four divisions of categories emerged as a resultof this analysis: separating from an unhealthy life, obtaining social support andresources, experiencing a healthy life and living a healthy life. Further analysis ofthe narratives revealed five overall themes which serve to enhance the categoriesand outcomes presented in this research. Those themes entail: A broad spectrumof healing resources are available to First Nations people, First Nations peoplehave a different way of seeing the world which has to be understood beforeeffective counselling services can be provided, First Nations people expect thatwhatever is healing should help them to attain and/or maintain balance, selftranscendence followed by connectedness is a common route to healing for FirstNations people, and First Nations people are seen to act as agents of their ownhealing.The findings of this study contribute to the field of counselling psychologyby providing a reasonably comprehensive scheme of categories and themes thatdescribe, from the perspective of First Nations people, what facilitates healing.This study suggests promising developments in First Nations healing that haveimplications for both research and practice.111TABLE OF CONTENTSEgeABSTRACT.TABLE OF CONTENTSLIST OF TABLESACKNOWLEDGEMENTSUivviviiFOREWORD viiiCHAPTER II: REVIEW OF THE LITERATURE 6First Nations mental health problems 19WHAT FACILITATES HEALING FOR FIRST NATIONS PEOPLE?SummaryCHAPTER III: METHODOLOGYCritical Incident TechniqueParticipantsCritical Incident InterviewOrientationElicitation of eventsProcedureCHAPTER I: INTRODUCTIONPurpose of the studyRationale of the studyApproach to the Study1225BACKGROUNDIntercultural CounsellingIndigenous PsychologiesFIRST NATIONS CULTURE AND MENTALFirst Nations WoridviewInterconnectednessSpiritualityCeremonyTradition/cultureHEALTH668101013161718232729293031323435ivTABLE OF CONTENTS, CONTINUED:CHAPTER IV: RESULTSDESCRIPTION OF THE CATEGORIESVALIDATION OF THE CATEGORIESReliability of Categorizing IncidentsComprehensiveness of CategoriesParticipation Rate for CategoriesExpert CommentarySupport of Related LiteratureEXAMINATION OF THE OUTCOMESSUMMARYCHAPTER V: ORGANIZATION AND ANALYSIS OF THE HEALINGCATEGORIESNarrative AccountsEXAMINATION OF THE NARRATIVESDivision of the healing categoriesExamination of the healing themesPage9393126127130CHAPTER VI: DISCUSSIONSummary of ResultsLimitationsImplications for theory and researchImplications for PracticeImplications for further researchSummaryREFERENCES 148APPENDIX A 156APPENDIX B 159ANALYSIS OF OF THE INCIDENTS 36Extraction of the incidents 36Process of forming categories 37VALIDATION PROCEDURES 4044446767697072738291134134135136142144146vLIST OF TABLESPageTABLE 1: RELIABILiTY OF CATEGORY SCHEMES. 68TABLE 2: PARTICIPATION RATE IN EACH CATEGORY 71viACKNOWLEDGEMENTSI would like to thank Dr. Larry Cochran, my thesis supervisor, for hisinsight, support, and guidance in the research and writing of this thesis.Thanks are also owing to my other committee members, Dr. MarvinWestwood and Dr. Wendy Wickwire for their guidance.Thanks to my colleagues and the many people who helped as judges,expert witnesses, and proof readers.Special thanks to my wife Liane for her constant support , encouragement,and incredible patience.Most importantly, I would like to thank the fifty participants whosewisdom and strength made this research possible.viiFOREWORDThe idea for this research came to me as a result of my experiencecounselling First Nations people in both British Columbia and the YukonTerritory. As a First Nations person myself, I have been able to combine mygrowing knowledge of aboriginal culture and healing with the training I havereceived in counselling psychology. I refer to my knowledge of First Nationsculture as‘tgrowing” because I did not grow up with my people ( Mohawk ofKahnawake) and only started on the path to learn my culture in 1986.After completing my M.A. in counselling psychology, I utilized traditionalWestern therapeutic approaches with First Nations people often to find that theywere only moderately effective. For the five years (1986 to 1991) I lived intheYukon Territory I worked as both a counsellor with Indian Affairs and as aHigh School counsellor in Whitehorse. This work enabled me to travel to all ofthe First Nations communities in the Yukon and to provide counselling tohundreds of First Nations people in the North. While working on my PhD incounselling at the University of British Columbia I had the privilege of working asthe counsellor at the First Nations Lorighouse and later, as the Director of theNative Indian Teacher Education Program. It was during this period that I beganto utilize culturally specific ways of counselling First Nations people in additionto more conventional Western approaches. On observing the success of theculturally specific methods I became interested in discovering other indigenousviiipaths to healing. From my own experience it was apparent that the mostrevealing source of such information was from First Nations people themselves.This study was, therefore, designed to provide First Nations perspectives whichcan inform helping professionals as to what works to facilitate healing for them.Please note that although I have attempted to use the contemporary term“First Nations” in the text, you may occasionally see the term “Native”, “Metis,”“Indian” or “Aboriginal”. These terms are used interchangeably and refer to thesame people.ix1CHAPTER IINTRODUCTIONResearchers in the field of intercultural counselling recognize that sometherapeutic approaches might be ineffective or even harmful when appliedwithout regard to the cultural background of the client (Sue & Sue, 1990). Onecultural group that seems to be affected by a lack of cultural sensitivity incounselling is the First Nations population. Despite this population’sdisproportionately high level of suicide, drug and alcohol abuse, and other mentalhealth problems (Nelson & McCoy, 1992), First Nations people tend not to utilizethe counselling services provided by the majority culture, and of those FirstNations people who do use such services, approximately half drop out after thefirst counselling session (Sue, 1981). In an effort to address this problem,researchers in First Nations mental health (York, 1990; Lafromboise, 1988; Darou,1987) have stressed the need for mental health theorists and practitioners toquestion the appropriateness of counselling methods presently being used in thetreatment of First Nations people, and to become familiar with mental healthhealing processes that might be more appropriate for First Nations people. Asmuch of the theory and practice relating to the provision of mental health servicesfor First Nations people is based on opinion and conjecture, it is important thatFirst Nations people themselves be provided with an opportunity to provideinformation as to what facilitated healing for them. In response to this need to2understand what First Nations people report as helpful, the research question forthis study was: What facilitates mental healing among First Nations people ofBritish Columbia?Purpose of the studyThrough gathering reports from First Nations people, the aim of this studywas to develop a set of categories that describe what facilitates healing. Thecategories are intended to further the development of a theoretical framework thatis more in keeping with a First Nations woridview. An investigation of this kindis intended to contribute to the larger field of intercultural counselling byproviding data and information of culturally appropriate ways to facilitate healingfor a First Nations population.Rationale of the studyThere are several reasons for conducting a study of healing among FirstNations people of British Columbia. First, there is a high incidence of mentalhealth problems amongst First Nations people in British Columbia and the rest ofCanada (York, 1990). In British Columbia alone, the suicide rate for First Nationsteens is seven times higher than the national average (Bellett, 1994). Othermental health problems such as depression and substance abuse are also3significantly higher (Nelson & McCoy, 1992). It is therefore critical that moreresearch on First Nations mental health be undertaken so that mental healthprofessionals can design culturally appropriate interventions.Second, the field of intercultural counselling has paid little attention to theways in which various cultural groups have organized their own means forobtaining help. These traditions are apt to define what is effective or sensible. Ina study of the history of traditional Native healing, Katz & Rolde (1981) argue thathelping networks have been in operation for many years. As Sue & Sue (1990)explain, some of these methods of healing have been dismissed as “unscientific,unprofessional, and supernatural”. They argue that the mental health professionneeds to examine the viability of traditional methods of healing and determinehow they might be combined with Western healing (Sue & Sue, 1990, p. 187).Several researchers have stated the need for an understanding of effective andineffective mental health interventions for First Nations people. York (1990)argues that we urgently need to examine the appropriateness of the mental healthservices presently being offered to Native people. Neligh (1990) states thatbecause psychotherapy for Native people has received so little study, there clearlyexists a need for the development of a uniquely aboriginal field of psychotherapy.Lafromboise (1988) recommends that psychologists become familiar withtraditional Native mental health practices before they impose their own values onNative people. Everett & Proctor (1983) also believe that therapists cannot offerculturally appropriate mental health services until they understand the cultural4values of Native people that pertain to healing. This study begins to address theserecommendations by providing a broad set of categories that describe whatfacilitates healing for First Nations people.Third, many of the programs and initiatives used by the majority culture to“assist” First Nations people have been unsuccessful. The residential school policyand the policy of assimilation are better known examples of “assistance” that werecounterproductive (Anderson, 1993; Herring, 1989). These initiatives wereconsidered to be a solution to what was seen as the First Nations problem ofretaining a way of life and culture that was considered inferior to that of themajority culture (Haig-Brown, 1989). On a different scale, Atkinson, Morton &Sue (1989) point out that therapeutic approaches such as client-centered therapyhave also been unsuccessful when used with First Nations populations. In mostcases the program or initiative used to assist First Nations people has not beenbased on research conducted with them.Fourth, the present study was also undertaken as a way of addressing thelack of research attention given to understanding First Nations mental health. Inan extensive review of multicultural counselling research, Ponterotto & Casas(1991) noted that very few studies focused on mental health strengths of minoritycultures. They emphasized the need for research that examined positive copingstrategies used by minority groups.This study is intended to fill the gap by providing mental healthpractitioners and researchers with an initial understanding of the healing5processes that reportedly work for First Nations people so that culturallyappropriate programs and initiatives can be developed to assist them effectively.Approach to the StudyThe methodological approach used in this study is based on the need togive First Nations people a voice in identifying what can help them in healing.First Nations traditions of healing have not been given enough seriousconsideration by the mental health profession (Lafromboise, 1988). It is thereforeappropriate to bring these traditions forth so they can be examined. There is agreat deal of knowledge available to mental health service providers through theprocess of speaking directly with First Nations peoples about what worked or didnot work for them in the healing process. The Critical Incident Technique wasused in this study because it allowed First Nations people to share their ownknowledge and voice their own experiences. In addition, the Critical IncidentTechnique provided a reasonable approach to addressing the research question.6CHAPTER IIREVIEW OF THE LITERATURELiterature relevant to the question of what facilitates healing for FirstNations people will be reviewed in this chapter. The concept of interculturalcounselling and indigenous counselling will be presented by way of backgroundfollowed by a review of First Nations culture and First Nations mental healthproblems. The remainder of the chapter will focus on the factors that contributeto healing for First Nations people.BACKGROUNDIntercultural CounsellingThe most straightforward definition of intercultural counselling is anycounselling encounter in which two or more of the participants are culturallydifferentt’(Atkinson, Morton, & Sue, 1989, p.9). Intercultural counselling or crosscultural counselling was said to have been developed in response to the humanrights movement and the attention given to the needs of women, ethnic minoritiesand the disabled (Margolis, 1986). Counsellors and other mental healthpractitioners were concerned that the culturally bound approaches they wereusing were causing great harm to the culturally different (Ponterotto & Benesch,71988; Sue & Sue, 1990; Ponterotto & Casas, 1991). Counselling is seen as beingculturally bound because approaches and theories are composed of culturallybound philosophical assumptions regarding the nature of humanity (Sue, 1989).The techniques used in counselling and psychotherapy also tend to be closely tiedto culture (Torrey, 1972).To work effectively in a cross cultural capacity a counsellor must, accordingto Cormier & Hackney (1987), “choose approaches and strategies that pace ormatch both the personal and cultural background of the client and avoid relyingon just their favorite or typical unimodal approach” (p. 117). Sue & Sue (1990)concur, stating that an effective cross cultural counsellor must have a sensitivity toand appreciation of cultural differences. The cross cultural counsellor listens andlearns from the client to gain an understanding of the client’s assumptionsregarding the nature of humanity. This knowledge provides the counsellor withan understanding of what motivates the clients, how problems occur for them,how healing occurs for them, and what the client and counsellor role is in thehealing process. After obtaining this knowledge the counsellor can then developnew concepts, services and methods that are appropriate to the life experiences ofthe culturally diverse client.A recent development in intercultural counselling is to view it as the‘fourth force’ in counselling. This is to view multicultural counselling from abroad perspective so that it is seen as a generic approach to counselling(Pederson, 1991). According to this broad definition, the multicultural perspective8would.apply to all counselling relationships. This perspective would enable thecounsellor to better match a client’s culturally-learned expectations with theclient’s behavior and to help the counsellor become more aware of how his/herown culturally-learned perspective and expectations affects the counsellingrelationship (Pederson, 1991). The culture-centered or “cross-eyed” approach tointercultural counselling has also been advocated as it recommends thatcounsellors attend to both the ways in which people are similar, and the waysthat they are different at the same time. Mistakes are often made by focusing toostrongly on the universal or culture free aspects of humanity or by focusing toonarrowly on the isolated or culture pure aspects of humanity (Pederson, 1991). Tobe “cross-eyed” a counsellor must focus one eye on the differences and one eyeon the similarities (Pederson, 1993)Indigenous PsychologiesLike intercultural counselling, the field of indigenous counselling hasexperienced an increased interest among members of the mental healthprofession. This interest has been sparked by the realization that generalpsychology tends to be both culture blind and culture bound (Kim & Berry, 1993).Indigenous psychologies have been described as generally accepted psychologicalclaims that are “culturally pervasive and not invented” (Heelas & Lock, 1981).Heelas & Lock (1981) state that indigenous psychologies seek to interpret reality,9whereas scientific psychologies seek to transform it. As the term ‘indigenous’implies, these psychologies are about people and their relationship to the world.They are also characteristic of the region or culture that they originated in and arenot intended to apply to other cultures. Heelas & Lock (1981) thought thatindigenous psychologies are necessary with respect to three functions: ‘sustainingthe inner self, sustaining the self with respect to the sociocultural, and enablingsociocultural institutions to operate” (p. 13). Indigenous psychologies exist in orderto help people of one culture/community to understand their lives in the contextof that culture or community. Healing from an indigenous psychologicalperspective means that illnesses are locally understood, treated, managed, andclassified (Gaines, 1992). This differs from the type of cross cultural psychologythat, in its attempts to examine local variation, uses Western categories andclassifications assuming that such practices are universally acceptable (Gaines,1992). One of the findings of research on intercultural counselling and indigenouspsychologies is that Western psychologists have gained a greater awareness of theculture-bound quality of the categories and models that drive Westernpsychological theory building (Schwartz, White & Lutz, 1992).10FIRST NATIONS CULTURE AND MENTAL HEALTHFirst Nations WoridviewEthnopsychiatrists such as Torrey (1972) make a strong case thatcounselling cannot take place without communication, and that we cannotcommunicate with someone unless we have a shared language and woridview. Inorder to communicate and counsel First Nations people, counselling serviceproviders must understand the traditional woridview of First Nations people.Despite the working assumption of some non Native counsellors that many formsof therapy are “value free,” all counselling nevertheless makes inherentassumptions. These assumptions are rooted in philosophical views of humannature and people’s place in the world (Wachtel, 1977). Mental healthprofessionals, like most members of a community, lack insight into their ownculturally learned ideas and values (Torrey, 1972).It is estimated that there are approximately 250 systems of psychotherapyin existence (Corsini, 1984). Most of these models of counselling are based on thebelief system and values of the “accepted” majority point of view (Ibrahim, 1984).This point of view or worldview inevitably affects our belief systems, decisionmaking, assumptions, and modes of problem solving (Ibrahim, 1984). Peoplecomprehend worldview to mean the understanding that an individual has abouthow things and people relate to one another. An understanding of a client’s11woridview is, therefore, essential to being an effective cross-cultural counsellor(Ibrahim, 1984, 1985). Lafromboise, Trimble, and Mohatt, (1990) state:Knowledge of and respect for an Indian woridview and valuesystem-which varies according to the client’s tribe, level ofacculturation, and other personal characteristics - is fundamental notonly for creating the trusting counselor-client relationship vital to thehelping process but also for defining the counselling style orapproach most appropriate for each client. (p. 629)An important point in this statement concerns the need to recognize the diversityamong First Nations people. If this statement is correct how, then, can counsellorsassess worldview? Based on a scheme developed by Kluckhohn and Strodtbeck(1961), Ibrahim (1984) has developed a scale for assessing woridview acrosscultures. The common themes are: 1) People - nature orientation, 2) Timeorientation, 3) Activity orientation, 4) Relational orientation, and 5) Modality ofhuman nature. An examination of these schemes would further ourunderstanding of any culture’s or individual’s world view. Although this scalehas not been utilized in this study, it is one of the few instruments designed torecognize differences in the ways people see their world.The First Nations Medicine Wheel informs a philosophy of healing thatapproximates a traditional First Nations Worldview as it pertains to healing. TheMedicine Wheel shows the separate entities : mental, physical, emotional andspiritual as being equal and as part of a larger whole. This reinforces the concept12of interconnectedness and the belief that one part cannot be the center but mustinstead learn to work in harmony with all of the other parts. The Medicine Wheeltherefore represents the balance that exists between all things. The First Nationsworldview as represented by the Medicine Wheel has balance as one of the basictenets of healthy living. The Medicine Wheel is viewed as “movements in thecycle of human development from our birth to our unity with the whole ofcreation” (Bopp, Bopp, Brown & Lane, 1984).Traditional First Nations healing incorporates the physical, social,psychological, and spiritual being. It is difficult to isolate any one aspect(Primeaux, 1977). It is thought that First Nations people become ill when theylive in an unbalanced way (Medicine Eagle, 1989). Balance then is essential forthe First Nations person because the world itself is seen as a balance oftranscendental forces, human beings, and the natural environment(Hammerschlag, 1988). An appropriate description of First Nations health can befound in a recent report on Aboriginal health and healing in Canada:Throughout the history of First Nations people- the definition ofhealth evolved around the whole being of each person- the physical,emotional, mental and spiritual aspects of a person being in balanceand harmony with each other as well as with the environment andother beings. This has clashed with the Western medical modelwhich, until very recently, has perpetuated the concept of health asbeing ‘the absence of disease’ (Favel-King, 1993, p.125).13InterconnectednessIn this context interconnectedness can be viewed as the individual’sconnection to the world outside the self. Practically, this means to becomeconnected or reconnected to friends, family, community, and culture. LeadingFirst Nations mental health researchers have continuously stressed the collectiveorientation of First Nations people (Trimble & Hayes, 1984; Lafromboise et aL,1990). This philosophy is well described by Ross (1992) when he states thatinterconnectedness means:That we are not alone, nor can we go it alone. We are here not toassert our dominion or to rise above the rest, but to make acontribution to the rest. The successful man is the one whounderstands his role as the conduit of sustenance for all componentsof creation and who dedicates his efforts towards maintainingharmony and balance within all creation. (p182).This theme of interconnectedness is prevalent throughout most First Nationscultures and has been aptly described as a series of relationships, starting with thefamily, that reaches further and further out so that it encompasses the universe(Epes-Brown, 1989). The emphasis on interconnectedness is often in conflict withthe modern western emphasis on individuality. Some First Nations people evensee mental illness as result of excessively individualistic behavior that is besttreated by utilizing the power of the community (Lafromboise, 1988). Counsellors14who tend to stress the role of individual client responsibility need to be awarethat it may not be appropriate to do so with all clients.The role of healing in traditional First Nations society has been not only toreaffirm cultural values but also to consider the individual in the context of thecommunity (Trimble & Hayes, 1984; Lafromboise et al., 1990). Tn some FirstNations cultures, establishing harmony within the community and improvinginterpersonal relationships amongst members of the community is seen bymembers of the community as the goal of therapy (Torrey, 1972). Healing is oftenin the form of a community-sanctioned and community-run cleansing ceremonythat involved the whole community (Ross, 1992; Torrey, 1972). Katz and Rolde(1981) found that the goal of traditional Native healing was not to strengthen theclient’s ego as in non-Native counselling, but to encourage the client to transcendthe ego by considering him/herself as imbedded in and expressive of community.Like family therapy, systems therapy, and community psychiatry, First Nationshealing promotes the idea of bringing together many forces to best utilize thepowers that promote health (Hammerschlag, 1988). Traditional First Nationsceremonies such as the Vision Quest and Sweat Lodge reinforce adherence tocultural values and help to remind people of the importance of keeping familyand community networks strong (Lafromboise et al., 1990). Traditional FirstNations therapeutic approaches, unlike many Western approaches, usually involvemore than just the therapist and client. Relatives and community members areoften asked to be part of the healing process. Numerous researchers such as15LaBarre (1964), Trimble (1976), Blue (1977), Redhorse, Lewis, Feit & Decker (1978),More (1985), Guilmet & Whited (1987), and Herring, (1989) found that FirstNations people will inevitably turn to relatives and community members whenthey experience personal problems. This finding raises doubts as to theusefulness of using Western approaches such as Psychodynamic therapy or PersonCentered therapy with First Nations clients. The one-on-one interactioncharacteristic of many Western counselling approaches is isolated outside of thecontext of the community and family and must, therefore, be questioned as avalid means of dealing with First Nation client problems (Dauphinais, Dauphinais& Rowe, 1981).One approach that takes the First Nations collective orientation into accountis called “Network therapy”. The network approach utilizes family, friends andrelatives as a network and social support system to help the person in need. Thecounsellor’s role in Network therapy is to act as a facilitator and catalyst(Lafromboise et al., 1990). Crouse (1982) recommends that counsellors takeadvantage of the power of the network in either an advisory or a supportivecapacity.The traditional First Nations person is more likely to receive help fromfamily, friends, and traditional healers because they are not accustomed to talkingto strangers about their problems (Paterson, 1990; Wohi, 1989). Blue (1977) foundthat First Nations students saw elders for cultural and spiritual problems and notthe university counsellors who were more likely utilized for educational problems.16For problems that arise within the First Nations community, it is thought that thebest place to develop and initiate programs to deal with such problems is in thecommunity itself (Nelson, 1992).SpiritualityTraditional First Nations people believe that mental health is much morespiritual and holistic than Western Psychology would suggest (Locust, 1988). ForFirst Nations people, spirit plays as big a role in sickness and wellness as themind and body does (Hammerschlag, 1988). In a First Nations conducted studythat examined the development of a culturally sensitive framework for counsellingwith First Nations people, the healing process combined with spirituality wasfound to be one of the major themes that emerged (Anderson, 1993). It is notsurprising that there exists a close association between illness and the spirit formost indigenous people around the world (Torrey, 1972). Many of the FirstNations healing ceremonies emphasize the spiritual aspect of healing. “It is to theGreat Spirit, perceived everywhere, that the Native turns to in times of need”(Dugan, 1985). Different First Nation ceremonies stressed the need forreconnection with one’s spirituality. In the Vision Quest ceremony the FirstNations person makes contact with his/her spiritual identity (Hodgson & Kothare,1990). The Medicine Wheel symbolized by the circle represents spiritual ties thatbind human beings to one another and to the natural world (Bell, 1991). This17spirituality or holiness is seen as the essence of healing for native people(Medicine Eagle, 1989).Non-native counselling approaches rarely deal with the spiritual aspect ofpeople. In talking of the spiritually bereft, materialistic North American culture ofthe 1990’s, Hammerschlag (1993) recalls that the Hopi people of the southwesternUnited States believe that civilization will come to an impoverished end when thespirit, or its symbols, are owned, not felt. If Western counselling is to be effectivewith Native people, “then it must re-examine religion and transcendental ways ofunderstanding the world” (Lafromboise et al., 1990). In doing so, Westerncounsellors might find they become more effective with non-native clients as well.CeremonyMental health professionals who have worked with First Nations peoplehave found that ritual and ceremony allow First Nations people to give expressionto personal experience while at the same time connecting people with theircommunity (Hammerschlag, 1993). Ceremonies such as the Spirit dances, theSweatlodge and the Pipe ceremonies are tools to maintain and deepen theindividual’s sense of connectedness to all things (Ross, 1992). The Vision Questceremony is said to help a person to realize the vastness of the universe, and byenabling the person to transcend himself, to realize ultimately his oneness withnature (McGaa, 1989). Although there has not been empirical research conducted18on the efficacy of traditional healing ceremonies such as those mentioned,anecdotal evidence exists within the literature to attest to their effectiveness inhealing (Torrey, 1972; Jilek, 1982; Hammerschlag, 1988).Tradition/cultureResearchers have found that one of the roles of therapy for traditional FirstNations society has been to reaffirm cultural values (Lafromboise et al., 1990). Ina study examining Aboriginal drug and alcohol counselling in British Columbia, asuggested culturally sensitive counselling framework for First Nations peopleincluded the theme of importance of personal and cultural identity (Anderson,1993). In a study conducted to determine the characteristics of recovery ofpersonal meaning for First Nations people, one of the major themes orcharacteristics that emerged was that individuals valued knowledge of traditionalFirst Nations culture (More, 1985). Another characteristic of personal recovery inthat same study was that the First Nations language was maintained or relearned.It is not surprising then, that the teaching of traditional culture has been found tobe a successful way to facilitate healing in First Nations people. In one FirstNations community it was possible to reduce dramatically the teen suicide rate byhaving tribal elders teach traditional culture to the teens in a group setting(Neligh, 1990). By providing First Nations people with culture through storiesand shared cultural activities, elders were able to provide community members19with guidance, direction, and self understanding (Halfe, 1993). This incorporationof self, or identity with traditional ideology also provides First Nations peoplewith strength for coping in the mainstream environment (Axelson, 1985). Thismovement towards reconnecting with cultural beliefs, tradition, and ceremony asa way of overcoming problems has been referred to as “retraditionalization’(Lafromboise et al., 1990).First Nations mental health problemsFirst Nations people suffer from many of the same mental health problemsas members of the general population. The incidence of suicide, family violence,and drug and alcohol abuse however, is much higher among First Nations people.For Canada as a whole, the suicide rate for First Nations people under the age of25 is six times higher than the rate for non First Nations in the same age group.Violent deaths account for 36% of all deaths for First Nations people in Canada(York, 1990). In British Columbia the suicide rate for First Nations teens is seventimes higher among the 10-to-19 -year old group then among the generalpopulation (Bellett, 1994). For all First Nations people, mental health problemssuch as suicide, depression, substance abuse, and domestic violence, all seem tobe significantly higher (Nelson & McCoy, 1992). In a recent study examining theneed for a Native health workforce, Beadle & Lee-Son (1992) state that:20Current health information for First Nations people within BritishColumbia shows an alarming increase in chronic health conditions aswell as mental health problems. In addition, there is a frequentlyexpressed need for health professionals who understand the culturaland social issues affecting these people (p 6).It is thought that many of the mental health problems of First Nationspeople can be attributed to rapid cultural change and loss (More, 1985, York,1990). The tremendous loss and change within First Nations culture in BritishColumbia suggests that people have lost a sense of personal meaning and purposein their lives (More, 1985). Interaction with European cultures has involved botha cultural decline and a population decline for the First Nations people of BritishColumbia (Fisher, 1977). Ross (1992) argues that the “assistance measures” takenby the majority culture to assist First Nations people have been, and remaintoday, misguided and counterproductive. Neither were the issues perceivedaccurately nor the remedies designed appropriately. The residential schoolstrategy is one of the better known examples of counterproductive “assistancet. Itis thought that many of the problems facing First Nations people today resultfrom the cultural, spiritual, physical and sexual abuse that occurred in theresidential schools (Anderson, 1993).Despite the profusion of mental health problems suffered by First Nationspeople, they generally, across North America, tend not to use the mental healthservices provided by the majority culture, and of those who do, approximately21half drop out after the first session (Sue, 1981). Studies examining First Nationsuse of Western mental health services have found that besides under-utilization,First Nations people have a higher therapy dropout rate than ethnic minorities,and are less likely to respond to treatment (Trimble & Fleming 1990, More, 1985).It is thought that differences in value orientations between First Nations peopleand counsellors contribute to the under-utilization of services as well as differingbeliefs as to the causes and solutions to mental health problems (Wohl, 1989;Darou, 1987; Trimble, 1981; Redhorse, Lewis, Feit and Decker, 1978). Even thoughthere is an apparent lack of interest by First Nations people in the servicesprovided by Western therapists, Western psychologists continue to apply thesame, perhaps, inappropriate methods of healing. Dinges, Trimble, Manson, andPasquale (1986) describe the situation as follows:The hurried introduction of Western mental health theory andpractices among Indian cultures may contribute to the wholesalesubstitution of Western cultural functions and dysfunctions for thatof the host culture. As the problems which arise among Indiangroups partly as a result of the patterns of behaviors and explanationencouraged by Western mental health theory became progressivelymore Western in nature and etiology, practitioners would be able torespond to the problems which they shaped over time to fit theirown therapeutic concepts and techniques.22Although it undoubtedly makes the task of the mental health professionaleasier, diagnostic systems such as the Diagnostic and Statistical Manual of MentalDisorders (DSM) used by the American Psychiatric Association should not beexpected to apply in all ways to members of another culture (Neligh, 1990).Despite good intentions on behalf of the mental health professions, one cultureshould not impose its concepts of causation or systems of classification on anotherculture (Torrey, 1972).Several mental health researchers have pointed out the need to understandthe cultural background and values of their First Nation clients so they canprovide appropriate mental health services to them (Heinrich & Corbine, 1990,Wohi, 1989, Everett & Proctor, 1983). Lafromboise (1988) suggests thatpsychologists need to become familiar with mental health prevention processesthat work for First Nations people. What is clearly needed is an understandingof what facilitates healing for First Nations people through the study ofpsychotherapy for First Nations people and the development of a uniquely FirstNations psychotherapy literature (Neligh, 1990). It is also argued that there is anurgent and critical need for an understanding of the appropriateness of variouscounselling methods presently being used in the treatment of First Nation clients(York, 1990). As with cross cultural counselling research with other culturalgroups, the research literature does not address the philosophical assumptionsthat people hold (Ibrahim, 1984; Casas, 1985; Ponterotto & Casas, 1991). What isneeded is a theoretical framework incorporating First Nations worldview and23values that can also incorporate recommendations made by the research literature.It will be the purpose of this study to further the development of a theoreticalframework that is more in keeping with the First Nations worldview bydetermining what actually facilitates healing for First Nations people, from theirpoint of view.WHAT FACILITATES HEALING FOR FIRST NATIONS PEOPLE?The major part of the literature that examines healing for First Nationspeople tends to be based on opinion and conjecture and not on research. In thefield of counselling, the literature often provides advice to counsellors so that theycan be more effective with First Nation clients but does not provide empiricalevidence to support such advice. Several researchers (Dauphinais, Dauphinais &Rowe, 1981; Wohi, 1989) refer to the lack of empirical studies that examine theeffectiveness of specific counselling approaches with First Nations people. Havingnoted the lack of research in this field, I will briefly examine the research andwriting that does exist in an effort to identify the key factors that facilitate healingfor First Nations people. It should be noted that Native people favour an oraltradition over the written word as a way of transmitting knowledge. While I amrelying on written accounts of First Nations culture, it must be understood thatwritten accounts are not regarded as full and accurate accounts by First Nationspeople and scholars.24Knowledge of First Nations culture and traditions is one of the factors thatfacilitates healing for First Nations people. In a study conducted to determine thecharacteristics of recovery of personal meaning for First Nations people, one of themajor themes or characteristics that emerged was that individuals valuedknowledge of traditional First Nations culture (More, 1985). Another characteristicof personal recovery discussed in that same study was that the First Nationslanguage be maintained or relearned. It is not surprising then, that the teachingof traditional culture has been found to be a successful way to facilitate healing inFirst Nations people. In one First Nations community it was possible to reducedramatically the teen suicide rate by having tribal elders teach traditional cultureto the teens in a group setting (Neligh, 1990). By providing First Nations peoplewith culture through stories and shared cultural activities, elders were able toprovide community members with guidance, direction, and self understanding(Halfe, 1993). This incorporation of self, or identity with traditional ideology alsoprovides First Nations people with strength for coping in the mainstreamenvironment (Axelson, 1985).Some First Nations people believe that not maintaining one’s culturalvalues and community respect is one of the reasons for psychological and physicalproblems (Lafromboise, Trimble, & Mohatt, 1990). It is therefore thought that oneof the roles of therapy for traditional First Nations society has been to reaffirmcultural values. A culturally sensitive counselling framework for First Nations25people must therefore include the theme of the importance of personal andcultural identity (Anderson, 1993).Another key factor in the facilitation of healing for First Nations people isthe process of dealing with problems with the assistance of others and not byoneself. Assistance can be obtained from friends, the family, the community, andin the context of group counselling or on a social basis. For traditional FirstNations people, healing is often in the form of a community sanctioned andcommunity run cleansing ceremony that involves the whole community (Ross,1992; Torrey, 1972). According to a traditional First Nation’s view, a person’spsychological welfare must be considered in the context of the community(Trimble & Hayes, 1984). Similarly, therapy for First Nations people shouldencourage the client to transcend him/herself by conceptualizing the self asbeing imbedded in and expressive of community (Katz & Rolde, 1981).Intercorinectedness is considered a dominant theme in all First Nations cultures.It is thought of as a series of relationships that reach further and further out (Epes-Brown, 1989). Some First Nations people see improving interpersonal and socialrelationships as one of the goals of traditional therapy (Torrey, 1972). Socialconnection is therefore seen as an important element in healing for First Nationspeople. Support was also seen as one of the themes of the model of culturallysensitive counselling for First Nations people as suggested by Anderson (1993).For First Nations people there exists a focus on family and communityresponsibility for the emotional, mental, physical, and spiritual health of one26another (Ross, 1992). Guilmet and Whited (1987), also found that the extendedfamily was of paramount importance to most First Nations clients in terms ofemotional support. Much has been said earlier on the strength of group orcollective forms of therapy with First Nations people. Neligh (1990) found severalforms of group therapy to be effective with First Nations people, particularlysupport groups such as Alcoholics Anonymous. Network therapy has beenmentioned as a culturally relevant way of using the collective power of theextended family and community (Lafromboise, Trimble, & Mohatt, 1990;Reclhorse, 1982). Neligh (1990) mentions the description of network therapy asthe grand opera of psychotherapy, because the therapist draws forth from thegroup the definition of the problem in terms satisfactory to all and facilitates thesolution of the problem in terms satisfactory to all. Sue & Sue (1990); Crouse,(1982) ; Attneave (1983) also recommend that counsellors take advantage of thecommunicative power of the network by utilizing processes that involve thefamily and extended family. It is to the family that First Nations people often gowhen they are in need of help (Paterson, 1990).Another factor in the facilitation of healing for First Nations people is theinclusion of spirituality in the healing process. Spirituality is seen as the essenceof healing for many First Nations people (Medicine Eagle, 1989). It is thought thatif Western counselling is to be effective with First Nations people, then it must reexamine spirituality and transcendental ways of understanding the world(Lafromboise et al., 1990). For First Nations people, spirit plays as major a role in27weliness and sickness as does the mind and body (Hammerschlag, 1988). It isthought that in times of need, the First Nations person will turn to the Great Spiritwhich is perceived everywhere (Dugan, 1985).SummaryMost of the First Nations counselling research up to the present time canbe described as descriptions of ways in which First Nations cultural valuesinterface with Western counselling practice (Dauphinais, Dauphinais & Rowe,1981; Ponterotto & Casas, 1991). Despite a very high level of mental healthproblems among First Nations people (Nelson & McCoy, 1992), and theobservation that First Nations people tend not to use the mental health servicesprovided by the majority culture (Sue, 1981; Trimble & Fleming, 1990),researchers have all but ignored the successful healing strategies used by FirstNations people themselves. Although there is evidence that spirituality,connection to culture, interconnectedness and balance play an important role inFirst Nations healing, such evidence is largely based on informed opinion andconjecture and not on empirical research. Several researchers have mentioned theneed for an understanding of effective mental health interventions for FirstNations people (Everett & Proctor, 1983; Lafromboise, 1988; York, 1990; Neligh,1990). It therefore seems clear that this research question must be approachedin a way that includes the input of First Nations people who have been healed.28Such research would explore healing processes that work as reported by FirstNations people themselves. It is not sufficient to rely upon informed butunsubstantiated opinions to base theory and practice on. Researchers need toexplore the insights and experiences of First Nations people in order to obtaininformation to determine the best way to facilitate healing. This is the purpose ofthe present study.29CHAPTER IIIMETHODOLOGYThe major considerations in selecting a design for the present study weretwofold. First, rather than focus upon one factor or set of factors, I wanted toprovide a reasonably comprehensive map of what facilitates healing among FirstNations persons of British Columbia. Secondly, I wanted to give First Nationspeople a voice, to consider what facilitates healing from their perspective. Onemethod that fulfills these considerations is the Critical Incident Technique(Flanagan, 1954). Tn this chapter, the general nature of this technique is presentedfirst, followed by a description of the sample, interview procedures, andprocedures for making use of the information gathered.Critical Incident TechniqueThe Critical Incident Technique (Flanagan, 1954) is a form of interviewresearch in which participants provide descriptive accounts of events thatfacilitated or hindered a particular aim. Participants are selected for a study whohave been in an a position to observe or experience relevant facilitation orhindrance and who are capable of articulating their experiences. Upon completionof interviews, critical incidents are extracted from accounts and then grouped bysimilarity to form a set of categories that encompass the events. The category30system provides a map of what facilitates or hinders a given aim. This categoricalmap can be used for the development of theory, for test construction, for practicalprograms, and for further research to refine, extend, or revise the categories.Since Flanagan’s initial formulation of this approach to research, it has beensuccessfully used in hundreds of studies in a variety of fields.ParticipantsThrough posters and my network of contacts as the counsellor at the FirstNations House of Learning, potential participants who were in the Vancouverarea were made aware of the study. Interested volunteers were provided with aninformation package that contained a letter describing the study in more detail(Appendix A) and a card describing my background (Appendix B). Participationin the study involved three criteria. First, the participant had to be identified as aFirst Nations member of British Columbia. Second, the participant had to be ableto recall a time when he or she required healing. Third, the person had to be ableto articulate events in a clear way in the English language.The participants in this study ranged in age from the early twenties to theearly fifties. The mean age was 35. Geographically, the 50 participants camefrom approximately 40 different communities in British Columbia. The location ofthese communities ranged from the interior of the province to the west coast ofVancouver Island, to as far north as Fort Nelson and as far south as the31Musqueam reservation in Vancouver. Fifteen of the participants were male andthirty-five were female. Four of the participants originally came from anotherprovince but had been living in British Columbia for at least 5 years. Nineteen ofthe participants were university students while thirty-one were employed in awide variety of occupations such as housewife, administrator, secretary, andlabourer. Problems presented by participants involved issues such as dealingwith separation, loss, childhood abuse, substance abuse, and issues concerningcultural identity. It should be noted that Aboriginal people do not necessarilyregard something as a problem in the same way as non-Aboriginals. Definitionsof illness between cultures can be different as can methods of healing. In thisresearch it was therefore necessary to leave the problem open by not specifying tothe participants the type of problem that should be presented.Critical Incident InterviewIn this study, the Critical Incident interview involved two parts, anorientation and an elicitation of incidents. The orientation clarified the nature ofthe study and provided time to establish rapport. In particular, the orientationwas an attempt to communicate the aim or nature of events to be reported. Carewas taken to make sure that the aim was phrased in a way that members of FirstNations would readily understand (aim of healing rather than one of selfactualization). The second part of this interview was an attempt to elicit events32that facilitated or hindered healing. Participants were encouraged to describeevents clearly and completely. My role as the interviewer was to listen carefullyto ensure that the events were complete and accurate. It was necessary to learnwhat led up to the incident, what actually happened, and what the resultingoutcome was. As the interviewer, I utilized active listening skills by providingoccsasional comments, reflections, and summary statements to ensure that Iaccurately understood the speaker. An example of this form of dialogue is asfollows:Interviewee - After that I went home for a couple of weeks.Interviewer - Did you find that helpful in your healing?Interviewee - Definitely. Just being there with my parents wholoved me made me feel like it was going to be okay.Interviewer - You felt reassured, comforted?Interviewee- Exactly. I knew that I was going to recover once Icalmed down and was able to think straight.OrientationParticipants were oriented to the study by being informed by the researcherof the purpose of the study. The following statement was used by the researcherto accomplish this:33Thank you for agreeing to speak with me about healing. Thepurpose of the study is to find out what helps and hinders healingfor First Nations people of British Columbia. I am meeting withpeople to find out what has actually worked to help you with yourhealing and what has hindered or caused things to get worse.In addition to explaining the purpose of the study, the confidential nature of thestudy and the participant’s option to withdraw from the study at any time werealso explained. An explanation was provided concerning the term “healing” in aneffort to reduce ambiguity that might exist concerning this term. The statementused by the researcher to accomplish this was as follows:Although I used the term “mental healing” in the information letterand consent form, its all right just to consider healing in the holisticform for the purpose of this study. By that I mean healing can referto the mental, physical, emotional or spiritual and does not have torefer just to the mental part of a person.It was thought that this holistic definition of healing already provided by theFirst Nations model of the medicine wheel would be more appropriate becauseit incorporates the mental with the physical, spiritual, and emotional parts of theself.34Elicitation of eventsInterviews took approximately one hour to complete and were taperecorded with an audio recorder. With the exception of four interviews that tookplace in the participant’s place of work, the remaining 46 interviews took place inthe researcher’s office. The interview commenced with the researcher asking thefollowing question:Think back to a time in your life that you were in need of healing.What happened that facilitated or helped or hindered you with thishealing?Time was allowed for the participants to remember when they were in need ofhealing. The researcher repeated the question when necessary. The participant’sinitial response was usually sufficient to provide a sense of the problem that theyneeded healing for. After clarifying what the problem was it was then theresearcher’s task to elicit information about that which facilitated healing. Astatement made at this point was “Now, think back to when something happenedthat helped you to heal”. It was acceptable for the participant to ask questions forclarification during the interview. The researcher also was free to ask questionsto obtain further clarification concerning responses made by the participants.Throughout the interview care was taken by the researcher to ensure that leadingquestions or hints were not given to the participant. Clarification questionsfrequently asked by the researcher during the interview were questions such as:35What exactly happened that was helpful? or How did you know that it washelpful? After the participant recalled an event that was helpful, the researcherrepeated the process by asking him/her to think about other events that facilitatedhealing. This process was continued until the participant could not think of anynew events. The participant was also asked to think of events that hinderedhealing. This question was asked to obtain additional information that mighthave added to the validity of the study. Very few participants were able to recallevents or incidents that hindered healing.ProcedureA pilot study consisting of field tests with three different participants wasconducted in the winter of 1992-93. The results of the pilot study were used torefine the interview procedures. Participants in the study were recruited throughposters and by my network of contacts in the lower mainland of British Columbia.An information package was provided to interested volunteers who wereencouraged to phone the researcher to obtain more information or arrange aninterview time if they wished to participate in the study. The time and location ofthe interviews were arranged at the convenience of the participants. Most of theparticipants found it convenient to be interviewed at the First Nations Longhouseat the university. Before the start of each interview, the participants signed anindividual consent form (see Appendix A). The interviews were conducted over a36seven month period during the spring and summer of 1993. Each interview lastedapproximately one hour and was tape recorded on an audio recorder. Once theinterviews were completed, events were extracted and worked on according to thecriteria specified below until I was able to develop a set of categories. Thecategories were then validated in a number of ways.ANALYSIS OF OF THE INCIDENTSAnalysis of the incidents involved three steps. First, from audio-tapes,events were extracted and recorded on cards, with one incident per card. Second,incident cards were grouped according to similarity to form categories. Third,these categories were subjected to several tests to examine reliability and validity.Extraction of the incidentsAll 50 of the interviews were tape recorded and each was assigned a codenumber. The incidents were then typed out in the words used by theparticipants. Each transcript and statement was carefully studied by theresearcher in order that the full meaning of the statement was understood beforethe event was initially extracted. The researcher initially recorded everythingresembling an event. The initial list of events was then subjected to an intenseexamination by the researcher and the research supervisor. In this examination37the following criteria were applied: (1) was there a source for the event? ; (2) canthe story be stated with reasonable completeness?; and (3) was there an outcomebearing on the aim? By ensuring that these criteria were followed, it was possibleto delete vague statements and sharpen the occasionally rambling language ofparticipants. Examples of incidents that were cast aside are as follows:Hiking has helped me because you walk in a straight linebecause the trails are narrow, so you have lots of time where youcan’t really talk to one another. I know I’m with people but I couldalso have my own thoughts.Being outside is an important healing tool for me.In these two examples it is not clear what happened to facilitate the healing nordoes there seem to be a discernible outcome. In the second example it is also notclear who the source of help was. After this process of extracting, 437 completeincidents were obtained. It should be noted that the incidents varied in clarityand format; some were in detailed and narrative form while others were vague intheir wording. The process of extracting incidents was straightforward aftersuitable criteria were established.Process of forming categories38After the incidents were extracted and placed on cards, each of theincidents was then divided into the three component parts: source, action taken,and outcome. This facilitated the sorting of incidents into categories. The threeparts- source, action taken, and outcome were then typed onto index cards foreach of the 437 incidents. The researcher had to exercise judgment in recordingthe events because participants tend to speak with varying degrees of clarity. Itwas therefore necessary to paraphrase occasionally an event to convey fully theintent of the speaker’s message. In such cases, the researcher went back to theoriginal transcripts to confirm that what was recorded on the card was accurate.Whenever possible the words of the participant were left unchanged. Thefollowing examples illustrate this point.(Source)Self(What happened)I wrote letters to the nuns that were abusive to me as a way to getout my anger.(Outcome)It got out the anger that I had been keeping in for years. I couldthen forgive and felt much better.39(Source)Traditional healer(What happened)The healer told me what the cause of the problem was.(Outcome)I would feel at ease because I was able then to put a label on it.(Source)Treatment Center(What happened)They made us tell our story over and over again because of all thedifferent groups we were in.(Outcome)It was slowly cleansing to keep telling my story. I felt better eachtime.The next step in the process was to divide incidents into groups thatseemed similar. The focus of sorting was on the second component part: action40taken (what happened). It was found that some of the events tended to beambiguous and were therefore considered borderline. As a result, it wasnecessary to use prototypes that emerged as guideposts for the sorting. Aprototypical event was an event that best described the group in question as itcontained the greatest number of defining characteristics. These prototypesserved as models for the purposes of sorting. Ambiguous or borderline eventswere placed to the side to use as challengers for the first scheme of categoriesdeveloped. The categorization was then subjected to the research supervisor’sreview and, as a result, refined and revised. The ambiguous events were utilizedin the second round of categorization when or where they were introduced to thechallenger. This resulted in further refinement of the categories. This process ofchallenge and consultation continued until stability was achieved. Two cycles ofcorrection were necessary to make changes to the placement of the events intocategories in order to ensure accuracy. It was also necessary to rename some ofthe categories so that the name accurately represented the contents of thecategory. In the end, 14 categories emerged that accommodated all of theincidents.VALIDATION PROCEDURESThe categories were assessed in five different ways answering five differenttypes of questions regarding the soundness and trustworthiness of the category41system. First, can different people use the categories in a consistent way? Toanswer this question, two independent judges were asked to participate. Bothjudges were doctoral students in the Department of Counselling Psychology,University of British Columbia. On separate occasions, each judge was providedwith a brief description of the categories and then asked to place a sample of 54incidents under appropriate categories. By comparing the placement of incidentsby judges with the original placement of incidents while forming categories, thenumber of hits and misses could be summarized statistically as a percentage ofagreement. For example, if a judge had 54 hits out of 54 placements, thepercentage of agreement would be 100%. Flanagan (1954) recommends a 75%level of agreement or more to consider a category system to be sufficiently reliablefor use. A high level of agreement indicates that different persons can use thecategories to categorize incidents in a consistent or reliable way.Second, is the category system reasonably complete or comprehensive?Following Andersson and Nilsson (1964), approximately ten percent of theincidents (50) were withdrawn and not examined until the categories wereformed. When category formation was finished, these incidents were examinedand classified. The test involves whether or not the incidents can be easily andreasonably placed within the existing category system. If not, new categorieswould have to be formed. If the incidents can be placed reasonably with existingcategories, it suggests that the category system is comprehensive, at leastprovisionally.42Third, are categories sound or well founded? To form a category, theresearcher must identify a significant similarity among a group of incidentsreported by different people. Participants independently report the same kind ofevent. If only one person or a few persons reported a category of event, it mightbe dismissed. For example, one person might have distorted or fabricated anevent. However, when many people report about the same kind of event, suchpossibilities as distortion or fabrication begin to lose force. Agreement amongindependent persons is one criterion for the objectivity of an event. Certainly,there are other ways to assess the soundness of a category (e.g., the clarity andplausibility of events within it), but interpersonal agreement remains a basic testof soundness. Agreement is gauged by participation rate for each category (thenumber of participants reporting a category of event divided by the total numberof participants).Fourth, the soundness of categories can also be assessed by judgments fromindividuals who are highly qualified to judge the relevance and usefulness of acategory of event for facilitating or hindering a particular aim. In this study twoFirst Nations Mental health professionals were asked to determine whether or notthese categories were useful to them. Both individuals were First Nations,possessed Masters degrees in the helping professions, and had approximately 25years combined experience in facilitating healing for First Nations people withinBritish Columbia. The directions given to these qualified and experienced43practitioners were to examine each of the 14 categories and provide their opinionas to whether each one was relevant or useful.Last, the soundness of a category can be assessed through agreement withprevious research. If a category of event disagreed with previous research, therewould be a good reason to question its validity. It could not be automaticallydismissed, but it would be more questionable because it contradicts prior evidencefrom other studies. If a category of event agreed with previous research, therewould be good reason to be more confident that it is sound. If a category ofevent was novel, neither confirmed or disconfirmed by previous research, itwould stand alone as a possibility to be confirmed or disconfirmed by futureresearch. To assess agreement, the categories formed were compared withprevious research and informed opinion.44CHAPTER IVRESULTSThrough interviews with 50 First Nations adults (15 men, 35 women), 437critical incidents were elicited concerning what facilitated mental healing in thispopulation. An attempt was also made to obtain critical incidents that reportedthe hindrance of mental healing, but so few hindering incidents were reported itwas determined that no new knowledge would be added by their inclusion in thisstudy.The 437 critical incidents were organized into 14 categories. In this chapter,these categories are first described. Secondly, methods used to establish thereliability and validity of the categories are reported. Finally, a framework ofhealing beliefs is provided based on an analysis of the healing outcomes of thecritical incidents.DESCRIPTION OF THE CATEGORIESThis section will present each of the 14 categories by providing a briefdescription of the category, examples of incidents in the category, and anindication of the range or variation within each category. Categories arepresented in random order as there was no attempt to rank them in order ofimportance. All of the incidents describe what has facilitated healing for the First45Nations people who participated in the study. The generic term 11healing” wasused in this study as no attempt was made to define healing in terms of one partof the person, be it physical, mental, emotional or spiritual. First Nations peopletend to see healing from a holistic perspective (Medicine Eagle, 1989), and anyeffort to differentiate one from another would contradict the belief in theinterconnectedness of these different dimensions of the self.Established Social Connection (16 incidents)This category involves getting beyond one’s own world and connectingwith other people. Establishing a social connection means that the individual isable to facilitate healing by getting socially involved. This category does notinclude incidents that involved getting direct help or support from others, butincidents in which the individual was socially involved with other people. Manyof the participants saw their tendency to withdraw from people as problematic.Participants described feelings of loneliness, anxiety, feeling left out, and of notbeing accepted. Those participants felt that it was necessary to go out and dothings with people and to have fun. Examples range from going to Friday nightdances to learning activities involving other people.46ExamplesAfter my separation one of the things I did that helped in healingwas to get involved in extra-curricular activities like ceramics andball room dancing. They helped me to get out of my shell and tobuild self confidence. I’m still not a good dancer but I went forthree years because it helped me to feel more in control andconfident in myself. These activities helped me to feel OK to bemyself in a social situation and that helped me in my healing.Making new friends at school and building a community helped alot. I wasn’t home and I didn’t have a community or connections.The sense of belonging is really important to me. Having peoplearound me made me feel like I could connect with this place andeven though they are not my family, they care about what I have tosay.Making friends was very healing. I forced myself to get to knowpeople. Initially it was just at school and school related activities butthen we would later invite them over for dinner or we would dothings socially as well. This definitely helped me to get over theloneliness.47Anchoring oneself in tradition (32 incidents)This category refers to the individual’s learning about and participating inFirst Nations culture and traditions. It does not include the participation intraditional ceremonies but does include all other aspects of traditional culture andknowledge. These events ranged from involvement in traditional events such asPow Wows to participating in traditional crafts such as beadwork. Manyparticipants considered gaining knowledge of their culture to be an important stepin becoming healthy. Cultural confusion and lack of connection to traditionalculture and values were often identified as reasons for anxiety and pain. Inaddition to cultural alienation, participants reported a personal lack of identityand a need for roots and tradition. Activities that reconnected people withtradition and strengthened cultural identity were seen as healing.ExamplesPow Wows and other cultural activities are healing for me. Once thedrumming and singing starts and the masks come out I feel anenergy. It’s a spirit feeling that makes you feel good. I feel goodbecause of the energy. This sort of event gives me positive energy.48Finding out who I was again helped me a lot. I left residentialschool not knowing who I was. I was like a shattered person.Reconnecting with my culture and with spirituality gave me backmy identity. I knew who I was again.I left home and hitchhiked back to my reserve and that helped a lotwith the healing because I stayed there until I learned about myNative culture. It was a learning quest and that was very healing forme. My grandparents and relatives taught me about my culture sonow I feel like I can fit into both cultures.Exercise (20 incidents)This category means that participants engaged in some form of physicalexercise such as running, hiking, or cycling. It does not include activities that arespecifically directed towards self care. Participants often saw exercise as a way ofensuring that the physical dimension of the self was in balance. The significanceof the interconnectedness between the physical, the emotional, the mental and thespiritual was frequently mentioned. Exercise helped participants to feel betterabout themselves because they were able to feel stronger and more capable.Examples49Running helps me because I feel better about myself when I run. Ithas also helped me to reduce stress. One of the best things about itis I can do it whenever I want. Running also helps me to be bymyself but I’m not alone because I see lots of new things.Physical fitness, specifically running, helped me a lot. It gives me ahigh and it does something for my self esteem. Doing something formy self makes me feel good about myself. I feel better and lookbetter and feel a sense of accomplishment. Running calms me toobecause I am in another state I don’t think about anything and don’tfeel any stress.Exercise helped me. One of the elders told me that exercise wouldbe good for me and would relieve tension. I found that after Iwould go to the gym I would be relaxed and energetic. Exercisehelps to put everything into perspective for me it really relievesstress.Self Care (3 incidents)This category includes forms of looking after oneself and doing somethingspecifically for oneself. It does not include exercise. In this category, the person50does something for himself in order to feel better. To practice self care seemed toaffirm self-worth. The issue of respect was mentioned as an important value forFirst Nations people. In this category, respect is extended to respect for self.ExamplesI didn’t use to take care of myself. I’m learning. Like my body. I’mtaking care of my body and it’s neat to realize that I’m doing that.It’s good for my self esteem.I started doing traditional crafts again when I was sick. This hasmade me feel good again because it’s something that used to be abig part of me and it’s something that I do just for me. It’s helpedme to be myself again and to feel good about myself.Doing things that are good for my self esteem has helped a lot.Even if it just getting my hair done or buying some new clothes.Involvement in challenging activities (7 incidents)This category includes doing something difficult in the form of a selfdirected challenge. It does not include self care or exercise. Incidents ranged51from public speaking to finishing grade 10 algebra. By exercising self disciplineand perseverance through challenging activities, participants were able to feelbetter about themselves.ExamplesStanding up to my ex husband was healing for me. Even though itwas really difficult I knew it was something I had to do and I feltmuch better afterwards. Being able to do it was good for my selfesteem and that is good for my healing.Going back to school was really challenging, but it was somethingthat helped a lot. I worked really hard and it helped me to feel goodabout myself.Expressing oneself (55 incidents)This category included the expression of feelings and emotions throughvarying channels such as talking, crying, laughing, and screaming. Participantsalso utilized many creative ways to get feelings out such as by listening to musicor going into the woods and screaming. Several participants mentioned the52significance of keeping this emotional dimension of themselves in balance throughthe expression of emotion. By learning how to identify and express emotion,participants were able to build up their emotional dimension. In learning how toexpress emotions in an appropriate manner, participants reported that they gainedstrength and balance in this aspect of their lives. Anger towards an abuser, forexample, could be expressed in an effective, non-destructive manner and notturned inwards against oneself. An important aspect of learning how to identifyemotions is that such action provided people with an awareness of the problemwhich facilitated problem-solving. This is a large category and indicates both theneed and tremendous healing benefit derived from expression of emotion.ExamplesWhen I first moved to Vancouver and was attending a downtowncollege, I lived down in the skids in a Hotel room in the East side.One night before Christmas the loneliness really hit. I had been inmy room and it was around 11 o’clock and I had been crying. Iremembered the wolf and how it goes out and howls until its mateanswers or its family group answers. I went down to the waterfrontlate at night and I did exactly that - I screamed and hollered andcried my eyeballs out until I let people know back home that I reallymissed them. This felt good to do this. The next day I got a letter53from back home and I thought that the Creator is right. I just haveto go out and express myself like the wolf. It may have been acoincidence but I saw it as a sign. Going out and screaming wasgood. If I did it in public it would have created tension for people.Wolves howl when they are lonely so it’s alright to be sad andlonely and let people know so the wolf really helped me.Crying helped a lot. I was hurt so I cried and that was important ingetting over it. If I didn’t cry the hurt could have turned to angerwhich I may have taken out on my children. Crying recognized thatit was hurt which was OK so I was able to get it out. Crying justflushes it all out.Crying helped me a lot to get rid of emotions that I had beenkeeping inside. I needed that because all those years of hurt neededto get out. It was encouraged in the treatment center and that partreally helped with my healingObtaining help/support from others (91 incidents)This category included incidents in which the individual obtainedhelp / support through encouragement, acceptance, validation and/or reassurance54from another person. This category does not include incidents such as socialinvolvement with others, but incidents in which the individual obtained directhelp or support from others. This help was obtained through both professionaland non -professional sources and ranged from supportive parents to encouragingcounsellors. This is a large category and illustrates the collective orientation ofmany First Nations people. The extended family, friends, and members of thecommunity are seen as a natural support for First Nations people and aretherefore turned to in times of need.ExamplesTalking to people helped, especially talking to my sister. I told herwhat I would like to do and I got reassurance from her that it waspossible to survive this. She would question me about myrelationship. We talked about coping skills and she showed me howshe was coping. That’s what I was looking for. Because she workedin the band office she knew the routes to go for help. She was also amodel for me. The ways that she coped made her a role model forme to follow. My sister knew me and knew strengths in me that Ididn’t see and she told me these things. I felt better about myselfand my abilities to face this problem.55My friend helped me because she is trustworthy. There are only afew people in the world that I count on and she is one of them. Sheis non threatening in the way that she talks and I know that shereally cares for me. When she listens she doesn’t say anything for along time. She doesn’t try to change my feelings like some peopledo. When I finished talking she said she felt bad that I was feelingthat way and she encouraged me to get help and to tell my Mom.Participation in ceremony (33 incidents)This category included traditional First Nations ceremonies. Examplesranged from the Sweat Lodge Ceremony to the Pipe Ceremony. This category didnot include the more general category of learning about and participating in FirstNations culture and traditions, but dealt specifically with traditional ceremony.There are many different ceremonies in First Nations culture, and ceremonies varyfrom nation to nation. Many of the incidents obtained overlap with ‘expressionof emotion” and “ anchoring oneself in tradition”, but were chosen because theywere identified specifically as participation in ceremony. Participation inceremony is a traditional form of healing used by First Nations people forthousands of years and is still recognized as an important form of healing today.Certain ceremonies such as the Sweat Lodge Ceremony and the SmudgeCeremony were mentioned numerous times. The Sweat Lodge Ceremony, for56example, is often considered to be a cleansing or rebirthing ceremony. Elementsof this ceremony such as the darkness and the drumbeat are likened to theexperience of being in the womb of Mother Earth. The process of sweating canrepresent the intermingling of the participant’s life fluids with that of motherearth’s. Powerful images such as these help to facilitate healing for those whoparticipate in the Sweat Lodge Ceremony and other First Nations ceremonies.ExamplesI was having a hard time going to work because I was drinking a lotto avoid thinking. I was given the option of going to a treatmentcenter or being fired. I went to Roundlake Treatment Center forFirst Nations people. It was there that I went to a Sweat LodgeCeremony. It was explained to me that it was like going into themother’s womb again. I really benefited from this ceremony.I went in thinking about being reborn again. I was given anotheropportunity to get a new start to life. In the sweat an image came tome of my dead grandfather. He told me to keep going with life andnot towards death like many of our people were doing. That stuckwith me and helped me to stay away from drugs and alcohol for 10years straight. Seeing that image of my grandfather stuck with me.57The smudge helped me because whenever I smudge I feel centeredand grounded. When wild things happen in my life I getungrounded very easily and need to get grounded with a smudge.Other times going to the sweat lodge helped me with not drinking.Being encased in darkness with the heat and the sound of the drummade me feel like I was being held without really being held byanyone. It made me feel like being an infant again and seeing thingslike a child rather than someone who has been through a lot ofhorrible things. Coming out and cleaning in cold water was likerebirth. This is concrete and not really part of the thought process.It gives me comfort and security. The experience of the sweat stayswith me and comforts me.Sweats are an intense powerful healing method for me. Its’ cleansingand it opens my mind. I tend to shut off my mind but when I was ina sweat the visions that I saw and what I heard opened me up sothat my whole world was wide open. I walked out a lighter personand whatever burdens I had weren’t there any more or if they werethere they weren’t as heavy anymore. When it expands you itconnects you with the spiritual world. It opened me up to a spiritual58dimension. The process of bringing the rocks and water into thesweat is peaceful and calming. It’s also like I was the only one there,it doesn’t matter how many people are actually in the sweat. I wasthe only one there in connection with the spirits.Setting Goals (15 incidents)This self-explanatory category is distinct from involvement in challengingactivities in that the goal need not be difficult or self directed. Examples rangedfrom setting career goals to goals of improving one aspect of the person’s life.Before setting goals, many reported feeling depressed and powerless because oflack of options and direction. The action of setting a goal resulted in participants’feeling more optimistic and empowered.ExamplesHaving established some career goals helped me in my healing.Making the plans was something that I could do for myself and thatmade me feel good. It was like respecting myself. This got me outof drinking and got me thinking about the future. I started sleepingbetter because I knew I had something to work towards. I startedlooking after myself better physically.59I have the goal to set up my own shop and that has really helpedme. Having that goal has given me the feeling that I have analternative to the job I’m doing now. This gives me a sense ofconfidence and takes away some of my anxiety.Helping others (21 incidents)This category includes any form of the participant helping another person,ranging from volunteering with a First Nations organization to helping someoneto get home safely. This category is distinct from obtaining help/support fromothers. The concept of helping others or of community service is a traditionalvalue among many First Nations cultures and is seen as a healthy activity.Participants reported that they felt empowered through this activity.ExamplesI received a general message from my elders that I should go beyondmyself to help others with their healing. In doing this I helpedmyself because I felt that I could do something useful and it helpedme to not worry as much about my own problems.60Gaining an understanding of the problem (22 incidents)In this category individuals obtained an understanding of their problem bylearning to identify, clarify, and make sense of the problem. This category isdistinct from simply obtaining help from others because it focuses specifically onidentification and understanding of the problem as opposed to a more generalcategory of obtaining help from others. Incidents ranged from gainingunderstanding through dreams to obtaining understanding through a treatmentprogram. Participants reported that understanding their problem wasempowering because it gave them optimism and self confidence to deal with it.ExamplesI was involved in a women’s survivors of family violence group. Itwas really good as I learned a lot about the cycle of violence and theroles that people play. To be with other women and to learn wherethey are at really helped me to see where I was at. That was apowerful experience to be in that group and it gave me power. Iknew that I could start to do something about my problem.Reading this book called the “Grieving Indian” helped me because it putinto perspective what I had been going through. It helped me to61understand the stages of grieving and where I was. It explained theseparation and the impact and the losses. It helped me to understand theloneliness I felt from being separated and from the later withdrawal. Inunderstanding it I was able to start dealing with it.Establishing a spiritual connection (34 incidents)This category encompassed prayer and other forms of connection andcommunication with the Creator, Great Spirit, God. This category did not includeparticipation in ceremony but focused more specifically on the spiritualconnectedness. Spirituality was identified as an important component in FirstNations healing. Many participants pointed out that they could not heal untilthey developed the spiritual dimension of themselves. The concept of balancewas mentioned as it pertains to keeping the various parts of the self equal and inbalance. For many participants, it was necessary to develop the spiritualdimension of themselves to attain the necessary balance with the physical, mental,and emotional side.ExamplesI go to high spots to help with my healing. This past summer in anoutdoor job, I had planned to bring my kids to be with me but I62didn’t know if I could do it. To calm my doubts I climbed thismountain and sat up there and prayed and things became clearer. Iwas able to see through some of the problems that I didn’t thinkcould be solved. Sitting up there thinking things through helped meto come up with a game plan. Being on the mountain andconnecting spiritually, helped me to see further. When I canphysically see farther it helps me to see farther within myself.I guess what helped me the most was learning about Nativespirituality. I was raised with the Catholic faith but it did not fulfillmy spiritual needs. All of the ceremonies and teachings I receivedhelped me to get in touch with my spiritual side because this is theway that Native people develop their spirituality. Spiritually I wasdead before that. I would never have finished University withoutthis reconnection.Learning from a role model (16 incidents)In this category the participant obtained guidance, instruction or examplefrom someone whom he/she had established as a role model. The role model issomeone specifically chosen as such and therefore is distinguished from theperson who helps in the more general category of obtaining help from others.63Examples ranged from learning from others who were successfully coping withsimilar problems, to following the example of a respected elder.ExamplesI always used my grandmother as a model in coping with problem sbecause I felt that she was strong and she was independent and Icould use her as a role model. If she could do it then I would do ittoo.This old woman helped me because she was so strong in her faith.She seemed so patient to others and kind. I didn’t have thosequalities in my own life because of what had happened to me. Herexample got me to relearn to be a human being again. A humanbeing has trust for others and accepts others. She was a role modelfor me because she was like I wanted to be.Establishing a connection with nature (72 incidents)This category includes being in or with nature and in using the naturalworld for self-healing. This category does not focus on spiritual connection buton the many ways that nature is used. For many First Nations people, there is a64spiritual connection that exists between nature and humans in that humans areseen as part of nature. All of creation is seen as being equal and part of thewhole, and is therefore equal in the eyes of the Creator. Some participantsreported feeling further away from creation and the Creator because of theinfluence of living in the mechanistic, material world of the city. Connection withnature was sometimes seen as getting back to creation and the Creator. Many ofthe incidents obtained could overlap with ‘Establishing a spiritual connection” butwere chosen because they specifically dealt with nature. Examples ranged fromthe use of water in healing to the healing benefits of being in the forest amongsttrees. This is a large category, perhaps indicating the significance First Nationspeople place upon the role of nature in healing. Nature helped participants to feelrelaxed, cleansed, calmed, and stronger.ExamplesSomething that helped me was the noise of the water. Rivers slowme down. I can sit and go the same pace as the river and enjoy itand the sound. In the ocean it’s the sound of the waves hitting theboat. Those noises are much more relaxing than the noises in thecity. The water helped to calm me inside and it gave me strength.65The thing that helped a lot was water. I would go to the river or tothe lake or something. I would just sit by the river and watch thewater flow. The water was continuously flowing whateverhappened even if there was a snag or something it would just flowaround it. If a rock was sticking out of the surface the water wouldflow around it. It made me feel that’s how I should be and that Ishould carry on.With bad feelings the wind would help. It felt like the wind justblew them away. It just dissipated because it felt like creation wasso big it would just disappear and be absorbed. It was like thewhole of creation was absorbing my bad feelings. The wind couldtake away my problems only if I threw them into the wind. In mymind I had gathered problems and feelings up and threw them intothe wind. If you don’t throw them up into the wind it won’t work.I used to take a walk in the bush where it was isolated. During thetime that I was depressed I would walk along the power linesbehind my village. One day I was sifting in a favorite spot therethinking about what I should do about the pain that I am carryingaround when just then a bear came crashing out of the bush, crossedthe clearing, and went crashing back into the bush on the other side.66When I walk through the bush it is really tangled and tough to walkthrough. Watching the bear encouraged me to go straight forwardand not be afraid of sobriety. At that time everybody else waspoking fun at me and saying that I must have thought I was betterthen them because I stopped drinking. Thinking and acting like thatbear taught me that it was OK to take big steps. This helped me tofeel a lot better about not using alcohol but in finding straighterpaths to deal with my problem. My grandfather’s guardian spiritswere the wolf and the bear and I think that they are for me now too.Nature helps me in healing. I go where there are trees. I’ve gone tothe middle of Stanley Park where it’s quiet and I can absorb mysurroundings. It makes me feel part of reality. When I’m in themiddle of all the cement everything seems unreal. I feel I’m aspectator instead of a participant. When I am in nature I feel like Iam a part of my existence of being. I feel like I’m absorbingeverything and everything is absorbing me and I’m a part of it.I used to go out to the woods and walk up a hill. From beingaround all of that nature my spirit used to get soothed to the pointthat nothing could bother me. because it’s so calm you can hear allof the life in the woods and it’s all peaceful and soothes my inside.67VALIDATION OF THE CATEGORIESIn developing a scheme of categories it is important to determine if thecategory scheme developed is one that can be used confidently. Are thecategories sound and are they trustworthy? The question of validity of thecategories concerns the extent to which the categories are sound or well-founded.Although it is not possible to attain absolute certainty as to the soundness andtrustworthiness of any category scheme, it is necessary to ensure that thecategory scheme is reasonably certain if it is to be used in practice. The user mustbe assured that the incidents gathered and the categories formed are notincomplete, inaccurate, or impractical. Several measures have been taken by theresearcher to assure the user of an acceptable level of soundness andtrustworthiness.Reliability of Categorizing IncidentsA good indication of trustworthiness is reliability. According to Anderssonand Nilsson (1964), one way to determine reliability is by the degree of agreementof independent judges using the category scheme. Can different people use thecategories in a consistent way? The relevant statistic for such a test is percentageagreement. Flanagan (1954) suggested that a category scheme should attain ascore exceeding 75% agreement. In this study a sample of 54 incidents were68drawn from the pooi of 457. The sample size of 54 was used because itrepresented 4 incidents from each of the 14 categories. l’his sample size alsoconstituted approximately 10% of the incidents reported. A smaller sample size of2 incidents was used for the category Self Care because of the small number ofincidents in this category.The two independent judges who participated in this procedure weredoctoral students in the Department of Counselling Psychology at the Universityof British Columbia. The judges were provided with a brief description of thecategories by the researcher and asked to place the random sample of 54 incidentsin the categories. The incidents provided to the judges were typed on 54 separateindex cards. The judges were directed to place the incidents in the categories thatthey felt were most appropriate. Both judges took approximately 45 minutes toplace the incidents. Table 1 represents the percentage of agreement between theresearcher’s and the judges’ placement of incidents in the category scheme.TABLE 1: RELIABILITY OF CATEGORY SCHEMESJudges Percentage AgreementDoctoral student #1 100%Doctoral student #2 92%Average Inter-rater reliability 96%69To make best use of the results, the researcher conducted an interview withthe second judge who did not attain 100% agreement to determine if the reasonswarranted the need for changes in the category scheme. An examination of thefour incidents incorrectly placed by the second judge revealed that the judge hadfocused on a trigger word without focusing on the whole incident. Thisinconsistency can be attributed to haste and as such does not warrant changes tothe category scheme.The high percentage agreement obtained by the independent judges meansthat other people can use the categories to categorize incidents in a consistent orreliable way.Comprehensiveness of CategoriesAn important way of determining the soundness of a category scheme is todetermine whether or not the category scheme is reasonably complete orcomprehensive (Andersson and Nilsson, 1964). One test used to check forcomprehensiveness or completeness in this study involved the procedure ofwithholding 50 incidents (approximately 10%) until the categories had beenformed. When category formation was finished, the withheld incidents were thenbrought back and classified. All withheld incidents were easily placed within thecategories. Were this not the case, it would have been necessary to form newcategories until all of the withheld incidents had been placed. Therefore, it is70reasonable to say that the categories are provisionally comprehensive. It isnecessary to make this claim provisional because there is always the possibilitythat a new category could be discovered.Participation Rate for CategoriesAnother method to determine whether a category is sound or well foundedis to examine the level of agreement amongst the participants in the study inreporting the same thing. To form a category, the researcher must identify asignificant similarity amongst a group of incidents reported by different people.Participants independently report the same kind of event. If only one person or afew persons reported a category of event, it might be dismissed. For example,one person might have distorted or fabricated an event. However, when manypeople report about the same kind of event, such possibilities as distortion orfabrication begin to lose force. Agreement among independent observers is animportant test of soundness. Agreement is gauged by the participation rate foreach category (the number of participants reporting a category of events dividedby the total number of participants - see table 2). The categories with the highestparticipation rate are therefore those with the highest level of agreement. Theparticipation rates ranged from a low of 6% (Self care) to a high of 70%(Expressing oneself). Other categories with a participation rate of 50% or higherare: Anchoring self in tradition, Obtaining help/support from others,71TABLE 2: PARTICIPATION RATE IN EACH CATEGORYEstablished social connection 8 16%Anchoring self in tradition 25 50%Exercise 16 32%Self care 3 6%Involvement in challenging ativities 6 12%Expressing oneself 35 70%Obtained help/support from others 32 64%Participation in ceremony 25 50%Setting goals 12 24%Helping others 15 30%Gaining an understanding of the problem 19 38%Establishing spiritual connection 18 36%Learning from a role model 11 22%Establishing a connection with nature 33 66%n=50Note: Frequency indicates the number of participants reporting an incident in acategory, while participation rate indicates the percentage of participants reportingan incident in a category.Participation in ceremony, and Establishing connection with nature. Althoughmost categories received a high participation rate, the category of Self Care had alow participation rate of 6%. Though only 3 people reported events in thiscategory, the category is not necessarily ill-founded. When this event was reexamined to see if the incidents in the category could fit elsewhere, it was72determined that the category should be preserved due to the vividness and clarityof events. The incidents and the category were sufficiently clear and distinct toremain intact.Expert CommentaryAnother test for soundness used in this study was expert validation. Thisanalysis puts research into the context of the field by asking people who areexperts in the field to determine whether or not these categories are valid anduseful to them. Experts are asked to bring their relevant experience to bear(Cronbach, 1971) by explaining whether or not the findings of a particular studyare consistent with what they have found from their own experience. Expertvalidation is an important test for soundness because experts have experiencewitnessing events that the average person would not see. Experts are able toprovide collaborative evidence and content validity to the results of aninvestigation. In this study, the researcher asked two First Nations mental healthprofessionals who are considered experts at helping First Nations people withmental healing to determine whether or not these categories are useful to them.The two First Nations mental health professionals possessed magistral degrees inthe helping professions, and had approximately 25 years’ combined experience infacilitating healing for First Nations people within British Columbia. Theresearcher conducted an interview with each of the two experts and after73describing each of the categories, asked the experts to go through each categoryand assess their usefulness. The instructions were simply to consider eachcategory and state whether or not they had used the category to facilitate healingand if so, comment on its usefulness. The results of interviews with expertsconfirmed that each of the 14 categories in the category scheme were useful andvalid to their practices. Comments made by these experts conveyed the messagethat all of these categories can lead to healing and have been used at one time oranother by them to facilitate healing. Comments made to me by the experts suchas “this is the way the elders taught us” and “we must never lose our connectionwith Mother Earth” reinforced the significance of the healing approachesdescribed by the participants. This analysis adds further strength to thesoundness or validity of the categories and the category scheme.Support of Related LiteratureAnother method used to check for the soundness of the categories isagreement with previous research. If a category disagreed with previousresearch, there would be a good reason to question its validity. It could not beautomatically dismissed, but it would be more questionable because it contradictsprior evidence from other studies. If a category of event agreed with previousresearch, there would be good reason to be more confident that it is sound. If acategory of event was novel, neither confirmed nor disconfirmed by previous74research, it would stand alone as a possibility to be confirmed or disconfirmed byfuture research. To assess agreement, the categories formed were compared withprevious research and informed opinion. In this analysis twelve of the fourteencategories agreed with previous research and informed opinion. This finding cantherefore increase our confidence that these categories are well founded. As nomention could be found for the remaining two novel categories (self care andhelping others), they stand alone as a possibility to be confirmed or disconfirmedby future research. Reference to relevant research and informed opinion for thetwelve supported categories are as follows:Established social connectionBecoming socially connected with other people is one of the keys to healingfor First Nations people. Lafromboise, Trimble & Mohatt (1990) state:It is clear that the role of therapy in traditional American Indiansociety has been to reaffirm cultural values and consider theindividual in the context of the community (p. 633).Seeing the individual in the context of the community is an importantconcept in First Nations woridview as pertains to healing. Western psychologyoften strives to strengthen the client as an individual, whereas First Nationspsychology encourages the client to transcend the self for the purpose ofbecoming connected to the people and world beyond the self (Katz & Rolde,751981). One of the goals of healing must therefore be to establish and maintain asocial connection with others.Anchoring oneself in traditionThis category is also supported by other studies in the literature. Anderson(1993) found that personal and cultural identification is an important theme in thefoundation of a culturally sensitive counselling framework for First Nationspeople. For over one hundred years the majority culture attempted to separateFirst Nations people from their culture and traditions. Understandably, thisaction has adversely affected the cultural identification of generations of FirstNations people.Many American Indians attribute their psychological or physicalproblems to human weaknesses and the propensity to avoid thepersonal discipline necessary for the maintenance of cultural valuesand human respect (Lafromboise et. al., 1990, p.630).Those who have found the strength and discipline to become reconnected andanchored in tradition and culture have found it to be an effective path to healing.76ExerciseExercise is mentioned in the context of the Medicine Wheel model whichstresses the importance of keeping the physical dimension of the self in balance(Bopp et aL,1984). In a broader context, exercise is seen as facilitative to healingparticularly as it pertains to its role in the reduction of stress (Long & Flood,1993).Involvement in challenging activitiesMany of the ceremonies and rituals described by McGaa (1989) in his bookon Native American healing mention the beneficial effects of challenging the selfby exercising patience and self-discipline. These are challenging activities thatreward the person with improved self esteem and mental health. In a differentcultural context, this finding is similar to the studies showing the psychologicalbenefits derived from self encounter and self challenge (Reser & Soherl, 1988).Expressing oneselfThe ability to express oneself and to do so symbolically is something thatFirst Nations people have maintained (Hammerschlag, 1993). It might seemstrange to a non- aboriginal person to believe that healing can occur by going into77the forest for the purpose of crying or screaming, but many First Nations usetechniques such as this because of the recognition of the need to cleansethemselves of bad emotions. This teaching is also included in the traditionalteachings of the Medicine Wheel. The Medicine Wheel stresses the need forkeeping the emotional self in balance (Bopp et al., 1984). Western counselling isalso finding that the psychological and physiological effects of the expression ofemotion is a key element for change (Hess & Kapas, 1992; Moreno, 1946).Obtaining help/support from othersThe theme of obtaining help/support from others is prominent in theliterature. Lafromboise, Trimble & Mohatt (1990) state:When problems arise in Indian communities they become not onlyproblems of the individual but problems of the community. The family,kin, and friends coalesce into an interlocking framework to observe theindividual, find comprehensible reasons for the individual’s behavior, drawthe individual out of isolation, and integrate the individual back into thesocial life of the group (p. 630).This approach to healing ensures that individuals need not cope with theirproblems alone but do so with the help of friends, extended family, andcommunity. Ross (1992) mentions the following value as an aspect of First78Nations culture that should not only survive, but should be adopted by themajority culture:An insistence on family and community responsibility for the mental,emotional, spiritual, and physical health of each member (p. 98).Participation in ceremonyHealing through participation in ceremony has frequently been mentionedin the literature. In reflecting on the importance of ceremony and ritualHammerschlag (1993) states:The enduring gift of Native Americans is the importance of ritual. Theyinvest our lives with meaning. They illuminate and ultimately define ourrealities because they mark the milestones by which we define ourselves asindividuals and participants in a community.One of the more prominent ceremonies or rituals described in the healingliterature is the Sweat Lodge ceremony. This ceremony is often considered to be acleansing or rebirthing ceremony. Elements of this ceremony such as the darknessand the drumbeat are likened to the experience of being in the womb of MotherEarth. The process of sweating can represent the intermingling of theparticipant’s life fluids with that of Mother Earth’s. Powerful images such asthese help to facilitate healing for those who participate in the Sweat Lodgeceremony and other First Nations ceremonies.79Setting goalsSetting goals was stressed in the literature concerning the Medicine Wheel.The Medicine Wheel is considered a framework for stressing the development ofgoals (Bopp et al., 1989). The process of setting goals is seen as an importantstep in most counselling approaches. In a broader sense, goals can have amotivational, educational, and evaluative function in the counselling process(Cormier & Hackney, 1987).Gaining an understanding of the problemThe act of naming what is wrong with a person has a therapeutic andhealing effect for the person (Torrey, 1972). Understanding relieves anxiety andprovides a person with hope that he or she can deal with the problems.Establishing a Spiritual ConnectionHealing through establishing a spiritual connection was mentioned in theresearch literature. As Dugan (1985) states: “It is to the great spirit, perceivedeverywhere,that the Indian turns to in times of need’ (p. 93). The inclusion ofspirituality in the process of healing adds that fourth element to the humandimension that is often neglected in Western counselling, which tends to focus80only on the mental, physical, and emotional. For First Nations people spiritualityis seen as a universal aspect to healing that overlaps with all dimensions ofeveryday life.Spirituality or holiness is seen as the essence of healing for Native people.This means to manifest wholeness in spirit and bring it into our bodies, ourfamilies, our communities and our world (Medicine Eagle, 1989. p.60).Learning from a role modelRole modeling is seen as one of the themes that form the foundation for aculturally sensitive counselling framework as suggested by Anderson (1993). TheWestern practice of mentoring also draws strongly on the principle of rolemodeling as it is an important component in mentoring others.Establishing a connection with natureThe First Nations philosophy concerning nature has traditionally been oneof accommodation and respect. In talking of the majority culture’s relationship tonature Ross (1992) states: We must modify our insistence of manipulation andmastery in the direction of accommodation and respect” (p. 67). In respectingnature, First Nations people see nature as providing a sort of blueprint of how to81live a healthy life. Nature is another important resource in the facilitation ofhealing for First Nations people.In summary, the tests employed in this study support the soundness andtrustworthiness of the category system. It is therefore possible to say that thecategories can be used confidently. Soundness and trustworthiness weresupported by virtue of a high percentage of agreement obtain ed by independentjudges in using the category scheme to consistently place the incidents. Thesoundness of the category scheme was also supported by the test of introducingwithheld incidents to the established scheme. This test of comprehensiveness orcompleteness did not result in any new categories being formed, therebysupporting the soundness of the category scheme. The soundness andtrustworthiness of the categories was also supported by testing the participationrate, validation by experts, and the agreement of previous literature. Theparticipation rate was determined by checking for the agreement among theparticipants in reporting the same thing. In all categories a number ofparticipants reported the same thing, with 5 categories showing a participationrate of 50% or higher. Expert validation was obtained when two First Nationsmental health experts were able to report that all 14 categories would be valid anduseful to them in their work. An examination of related literature demonstratedthat 12 of the 14 categories dovetailed with other research found in the literature.82This agreement of previous literature also supports the soundness of thecategories.EXAMINATION OF THE OUTCOMESThis study has addressed the question of what has facilitated healing forthe First Nations people of British Columbia. The focus has been on what wasdone to facilitate healing. Participants in the study provided 437 critical incidentsof what was done and what action was taken to facilitate healing. A scheme ofcategories was established to organize this data so that it could be of use to boththeorists and practitioners. This section will briefly discuss the outcomes orresults of those actions taken to facilitate healing. The reason for examiningoutcomes along with the facilitating events is to attempt to discern a general trendconcerning the beliefs about healing held by First Nations people. From anethnopsychiatric perspective, knowledge of these beliefs is an essential key tounderstanding what is apt to work in facilitating healing for any group of people.For one to be an effective healer, it is necessary to share some of the person’sworidview, especially that part of the woridview concerning illness and healing(Torrey, 1972). By examining the sorts of things that people stressed in the 437events, and by organizing these outcomes into categories, it has been possible toconstruct a framework of principles or beliefs held by the First Nations people ofBritish Columbia concerning healing. Five categories have emerged as a result of83this process. It should be noted that these categories are not conclusive findingsof the study but are still exploratory and serve only to provide a tentativeorganization of the outcomes. There is, therefore, a certain degree of overlapbetween the categories. These five categories will be presented by providing abrief description of the category and an indication of the type of events withineach category.Empowerment (227 incidents)This large category refers to the individual being empowered in some way.This category includes outcomes in which the person was provided withoptimism, motivation, strength, self-confidence, self- respect, self-esteem, in whichhe/she was assisted in helping to solve a problem. Empowerment is broughtabout by the participant obtaining strength or a sense of power through his/herown actions or the actions of others.ExamplesWhen I do something for someone else it makes me feel goodbecause it gives me power.84I was recognized by another clan because of the service I provided tothem. This was a tremendous honour and really did something forme. To be held in such esteem by another group of people wasgood for my self esteem.The counsellor taught me how to make my own decisions. Hedidn’t tell me what to do but told me what my options were and Ihad to make the decisions. This gave me more personal power thanI had before.Cleansing (72 incidents)This category refers to eliminating or getting rid of bad energy, spirits, oremotions, and includes outcomes such as elimination, purging, relieving pressure,and releasing emotions. Cleansing can occur through a wide variety of meansand can apply to physical, emotional, mental, and spiritual cleansing. Often whatleads to cleansing is the expression of emotion such as pain, anger, or fear. Beliefin the healing powers of cleansing are prevalent among First Nations people, butthis belief is not prominent in Western approaches to healing and can, therefore,be considered an important contribution of First Nations culture. Much of thepractice of cleansing for First Nations people is expressed in a symbolic way andmay not be clearly visible or understood by non-Native people.85ExamplesI cleanse myself with water. In my culture you cleanse yourself withwater, your eyes, your face, your ears, your hands. Instead of goingto the river you can go to a tap and use the cold water and cleanseyourself. You would say prayers while you are doing this as it is athank you for all that we are given. I have done this regularly likepraying and it has helped me to be strong and to heal.Bathing helped me because it was a cleansing time. Whatever it wasthat I wanted removed I could cover my body with mud or sandand then go into the river and wash it away. I did this for a month.This helped because I had to put a name to what it was that Iwanted to get rid of and then washed it away. The physical washingaffected the emotional and spiritual by washing and cleansing themas well. I would do this bathing the first thing before the sun wasup and the last thing before the sun was down. In the city I can dothis by washing with just water from the tap.We had to tell our story over and over again because of all thedifferent groups we were in. Each and every time that I told my86story I remembered something else and then that comes out and Ican deal with it. It was slowly cleansing to keep telling my story.I sit by the water when I’m really upset. The river behind our housewas really rough. I imagined the troubled water just taking all ofmy problems away. The rougher the water the calmer I felt becauseit pulls the problems away faster.Balance (105 incidents)This category refers to having attained balance in one’s life. This categoryincludes outcomes such as attaining harmony, centering and grounding of oneself.The individual attained perspective, meaning in their life, calmness orpeacefulness. The individual may also have managed to develop a certain part ofhim/herself such as the emotional or spiritual dimension. Balance is an importantconcept presented in the First Nations model of the Medicine Wheel; it isthought that to live life in a healthy way a person must keep the four parts of theself in balance. It is like the four legs of a table: If a table has only 3 legs insteadof four, or has one or more legs that are shorter than the others, the table willwobble and will be unable to support any weight. Similarly, if a person has thephysical, spiritual, mental or emotional dimension of the self missing orundeveloped then he/she too will not be able to function properly. This belief is87not prominent in Western approaches to healing but could be considered animportant contribution of First Nations knowledge. The following examplesillustrate some of the ways in which participants attained such balance.ExamplesI have obtained balance by looking at creation. Forests for exampleare very important in my healing because they have everything andthey are all interconnected. There are all different elements but theyare living in harmony and are interconnected. So many parts ofmyself have been like loose ends going off in different directions. Tobe able to bring all of these things together has been very importantto me. I am striving for this more within myself. Plants don’t growexactly side by side but it all fits and it all works. I am learning tokeep the parts of myself in balance.I took a program at College that helped me to realize what mycareer/life options were and that I could start to take care of myself.I learned that I could also look after myself in a balanced way. Ibecame more in tune with my body and my emotions. I realized thebalance and the connection between my emotional state and myphysical state. Physical symptoms became warnings that I wasn’t88attending to emotional problems. This realization was very helpful tome in my healing.Discipline (11 incidents)Through obtaining and exercising discipline, participants reported thatthey were more in control of their lives. Participants felt more self-control and feltproud of their accomplishments in obtaining discipline. This provided peoplewith optimism and confidence in their abilities to deal with future problems.Although discipline was often represented as physical challenge, it was alsomanifested in spiritual, mental, and emotional ways. This concept of disciplineas a key to healthy living has been a traditional value of First Nations people inthe past and may eventually gain greater recognition as healing for contemporarypeople as well.ExamplesExercise in general helps a lot because it teaches you about dealingwith problems the right way. Exercise is hard and dealing withproblems is hard. There are steps on how to do them but sometimesI would get caught up in doing them the wrong way and not getanything out of them. I had to learn to do exercise right and this89taught me to deal with problems properly. I guess what I learnedwas discipline in dealing with things.Cold water helped me a lot either by swimming in a cold river orby using cold water at the end of a shower. It teaches a persondiscipline and it also bring things to base existence and calms me.It’s like it helps me face the cold hard facts. It would remind methat I was the only one who could make the decision not to drink.No one else is going to be able to stop me. Cold water grounds meand reminds me of my responsibility.Fasting - not eating for 24 hours has helped me. This is when it iscombined with lots of prayer. I’m not exactly sure why it works butit does work. Church leaders have told me that if you fast -whatever you are praying for will happen if it is a worthwhile cause.It has added strength to my request and helped me to be morespiritually disciplined.Belonging (22 incidents)li-i this category the person achieved a sense of belonging or connectednessto something or someone. This category includes outcomes such as belonging to90family, community, culture, traditions, and all of creation. This desired outcomeillustrates the collective orientation of many First Nations people. The extendedfamily, friends, and members of the community are seen as a natural support forFirst Nations people and illustrate the importance of belonging. Similarly, it isseen as desirable for many First Nations people to be connected or to belong withnature and with spirituality, and ultimately, to be a part of and belong to all ofcreation. This belief touches on a broader cultural issue for First Nations peoplebecause of the historical events of the past 200 years. The Federal Government’spolicy of assimilation has had devastating effects on the unity and sense ofbelonging for the First Nations people of Canada. The Government and Churchwere successful at separating First Nations people from their culture, language,religion, families, communities, and land. First Nations people have recognizedthe overwhelming need to be reconnected and to reclaim that which was taken,and are now acting to reconnect and strengthen those bondsExamplesGetting together with my birth Mom was healing in knowing whomy people are and knowing where I belong and who my relationsare. Its been healing in that I belong somewhere. Belonging in afamily and community has been very healing because in the nonnative environment I didn’t belong. I can be proud of who I am as a91native person and everything that we have gone through. Despiteour differences we are still family and we are still strong. I ran awaywhen I was 6 and my adopted family said that I should wait until Igraduated and then they would help me to find my birth family.They did help me but it was three years after graduation before Iwas ready to have them help me.Getting in touch with my culture has really helped in healing. It hasgiven me a sense of belonging to something, a purpose.Based on the results of this analysis we can say that an effective healingprogram for First Nations people would invoke empowerment, elimination,balance, discipline, and belonging.SUMMARYIn response to the question adressed to First Nations people of BritishColumbia: What facilitates healing for you?, participants responded with 437critical incidents. The 437 critical incidents were organized into 14 categorieswhich are described in this chapter. Tests were employed in the study tosupport the soundness and trustworthiness of the category system. It wasdetermined that the category system can be used confidently. Finally, aframework of healing beliefs was provided based on an analysis of the healingoutcomes of the critical incidents.9293CHAPTER VORGANIZATION AND ANALYSIS OF THE HEALING CATEGORIESThe previous chapter introduced fourteen categories of incidents thatfacilitated healing for First Nations people along with a preliminary presentationof healing outcomes. This chapter examines four complete narratives in an effortto provide meaning and action to the categories by showing them in context. Apreliminary organization of the categories is presented based upon this,examination as well as a list of themes that emerge in successful First Nationshealing.Narrative AccountsThe following healing stories told by the participants are presented asmuch as possible in the words of the participants. It was necessary to edit someof the transcripts for the sake of clarity. I provide a running commentary on thenarratives to highlight and summarize key concepts necessary to understand theanalysis at the end.94Narrative account # 1Four or five years ago when my wife and I separated was the mostdevastating time in my life so far. One Christmas in my secondyear of University she told me it was over between us and we couldnot go any further. There was a lot of hurt for me that I had to gothrough. My wife and I separated and I was feeling devastated,depressed and hurt.This participant’s separation from his spouse left him feeling devastated.Moving home helped me. I moved home to be with my family, toget rid of the hurt, and to phase it out of my life. I talked to myparents about it and to my brothers and friends to find out how togo about healing and how you handle something like that. Theirsupport made me feel more confident about solving my problem.In moving home this participant was able to talk with relatives about hisproblems and express his emotions. This gave him the social support he neededto help him understand his problem.95I started getting involved with my elders at home. I went to theirmeetings whenever they got together. I spent time with them andasked them questions about why things were done a certain way.Through not being idle and by spending time with them and inlearning traditional ways, I began healing and feeling good aboutmyself again. I started working the things out that needed to beworked out.He had a breakthrough when he began to learn and practice his traditional waysunder the guidance of his elders.I was always able to speak our language. The time I was able tospend with the elders (2 1/2 years), I learned that there is somethingelse besides being fluent in a language and that is knowing how touse it. Even though it is the same language you can use it in somany different ways to achieve different ends. I guess the wholeprocess helped me to become whole again inside. I knew what itwas like to be traditional, to get up at a traditional feast and be ableto speak and I think that was the healing process for me to get outand do what my elders did. In a round about way they counselledme through my hurt by learning traditional ways.96By learning how to use his Native language he reinforced his connection withtradition. In doing this he obtained a sense of belonging and direction. He statedthat “the whole process helped him to become whole again inside”. Heexperienced a new and healthier life by becoming whole and balanced.The elders told me that when I speak to them I am never wrong andthat anything I have to say has some good to it. When I wrotespeeches they told me that something was a good idea and this ishow it could be improved. They showed me how I could add to myspeeches. They would never say that this is what you forgot or thatsomething was wrong. This really helped me to feel good aboutmyself and what I had done. By the end of the second year I wasfeeling good about myself. I spent enough time with them that Iwas no longer moping or feeling bad about the thing that happenedto me in my life.It was his elders’ unique way of constructive teaching, counselling,encouragement without overt criticism that really impressed this intervieweeOne of the things that the elders did for me that helped me was thatthey taught me that my hurt was not the only hurt that anyone hasever gone through. A lot of people have gone through that hurt.97Everyone has experienced a lot of hurt and you can’t keep it withinyou and you can’t just forget about it. You have to get it out.The elders encouraged him to look beyond himself to see that his pain was notthe only hurt in the world. He felt reassured by this and motivated to deal withthe hurt.I learned from the elders that in everything that you do the Creatorwill be present. This helped me because it made me think aboutmyself, because even though I was hurting I can go to the Creator tohelp me. They didn’t just tell me to go to the church and straightenmy life out there - that’s not what they did. They taught me byexample. As a result of spending time with them I was able to buildup my spiritual self to a point where I was able to reach thatsuperior being to help me with the healing process. They did thisindirectly. They did it by example.This participant learned a great deal from the elders’ way of teaching by example.Through this he learned the importance of establishing a spiritual connection withthe Creator.98I received a general message from the elders that I should go beyondmyself to help others with their healing. In doing this I helpedmyself because I felt that I could do something useful and it helpedme to not worry as much about my own problems.The elders once again encouraged this person to transcend or “go beyond theself’. In this case the purpose or means was in helping others with their healing.This activity signified a new and healthy change for the participant.Doing the community speeches helped me to put my problem intoperspective. The break-up with my wife wasn’t the end of theworld. Life goes on. There were things that I was expected to do inthe village. If I sat around and moped and worried about myproblem and kept to myself, I would not be considered an asset tothe community. I had to get out and face the music that mymarriage was done with. I had to go on with my life. I was avalued member of that community and I had a role to serve andcould not stay within myself.Again the participant was encouraged to “not stay within myself” but to get outand establish a social connection with people in the community.99Something that really helped in those 2 1/2 years was that I neverheard anyone say after a speech that I had made that I was wrong.That was a big sign to me. At the end their encouragement wasgetting stronger and they said that one day I would be wise. Thiswas quite a compliment coming from elders. I knew then I didn’thave to worry about the breakup. This role gave me a new purposeand meaning and I didn’t have to worry about the loss in mymarriage.In addition to the absence of any criticism, this participant benefited from theencouragement he received from the elders. He derived new purpose andmeaning in life from his role as a community spokesperson.Those 2 1/2 years with the elders helped to tie things in for me.Those 12 years of public school and many years of university wereyears gaining knowledge. Those 2 1/2 years helped me to put thisknowledge into proper perspective. At any one time and on any oneday I can only spend 5-6 years in the classroom passing onknowledge as a public school teacher. The rest of the time I am alsoliving a life that is meaningful to my community and to me. That iswhere the wisdom comes in by using that knowledge in proper100perspective. That to me helped me more than anything I everlearned.The participant was able to live a healthier more meaningful life by extending hisknowledge outward to others.Something that helped with my healing was in learning that there isalways someone there that cares. There are a lot of people who careand there is always someone who has the answer that you don’thave and that you only need to reach out for that answer to get thathealing.This participant found it reassuring to know that he could get help/support fromothers.Knowing that the elders cared was healing. I worried about beingsocially accepted after the marriage break -up. At the wedding thereare big speeches that you have to do everything in your power tokeep that marriage together. It’s up to you and if you don’t thenyou are a failure and that stuck out in my mind. I was afraid that Iwouldn’t be accepted after the break -up. I was accepted and they101even started depending on me. They told me I could do the job so Imust have been on the right track to be called upon.It was healing and comforting for the participant to feel accepted by hiscommunity.Something that helped me was solitude. Out in the open ocean inmy boat or drifting down the river or sitting on the bank I wouldfind peace. This settles my heart down when I’m hurting a lot.Nothing is threatening me. I would sit there until I had to go home.There is a difference between solitude and loneliness. Loneliness isbeing alone. With solitude you are not alone. Animals wouldn’tinterfere with my life the way things would in the city- telephonesringing, cars going by.This participant found solitude and comfort in nature which served to take thehurt away.Something that helped me was the noise of the water. Rivers slowme down. I can sit and go the same pace as the river and enjoy itand the sound. In the ocean it’s the sound of the waves hitting the102boat. Those noises are much more relaxing then the noises in thecity. The water helped to calm me inside and it gave me strength.The participant obtained comfort and strength from water and nature.Learning to open up my heart to nature helped. The elders have aname for that which means heart opened up. When I opened upmy heart to the beauty and peace of nature it made me feel good.Problems aren’t that great that you can’t solve them once you havereached that level where you can go with the flow of nature.The participant was able to put his problems into perspective as a result of theinsight he obtained through his connection with nature.The Northern Lights helped me in my healing. In the city it’sdifficult, especially in winter. Up north in the winter times I wouldlie down on the living room floor. I had windows that were high sothat I can lie down and watch the Northern Lights in the sky. Thisgoes on for hours and is really soothing. It calmed me down andgave me strength.Again he obtained comfort and strength from nature.103Narrative account #2The hardest time was when I broke up with my wife. I had beendrinking and doing drugs. My homelife had collapsed. I tried todeal with problems on my own and it wasn’t working. One nightmy wife and I decided our marriage was over and I should leave.In the beginning this participant felt angry, lonely and had a low sense of selfesteemGoing home was probably the thing that saved me. When we brokeup I jumped into my truck and was planning on ramming it intosomething and killing myself. While I was driving I recalled that Iused to go to my Mom and tell her what was wrong so that’s what Idid. When I got there I couldn’t say anything to her I just huggedher and she hugged me. I went outside and my sister seemed toknow what was wrong and she hugged me and I cried for the firsttime. Just knowing that someone loved me made me feel that it wasworth living. After that I was able to put the pieces back totogether and start to look at alternatives. Mom didn’t reallyunderstand why we were breaking up but just her being there andknowing that she cared for me and would look after me when I104couldn’t be alone helped a lot. This is what I needed because myself esteem was so low and I just felt like a total failure. I had failedthe kids and I had failed my wife. Knowing my family still lovedme helped to pull me through that.This participant obtained social support as a result of going home. He found hewas able to express his emotions there and still feel loved and accepted. With hissense of self affirmed in this way, he began to reverse his way of life.The thing that helped a lot was water. I would go to the river or tothe lake or something. I would just sit by the river and watch thewater flow. The water was continuously flowing whateverhappened even if there was a snag or something it would just flowaround it. If a rock was sticking out of the surface the water wouldflow around it. It made me feel that’s how I should be and that Ishould carry on.From nature/water the participant learned to ‘flow around obstacles”. There is aFirst Nation’s belief that nature can provide people with directions on how to livea healthy life. This symbolic interpretation of natural phenomena is a powerfulhealing resource for First Nations people.105I used to go out to the trapline with my Dad and he said that theIndian people would thank the water for letting them cross it safelyby giving it an offering of tobacco. I also did this to help in myhealing. When I sat by the water I would throw some tobacco in thewater as a type of prayer. At this stage in my life I was verydisappointed with organized religion. The Roman Catholic faith Ihad been brought up with didn’t appeal to me. I didn’t know muchabout Native spirituality. I had thought it was quaint and no longerapplied to people but when my faith in the church was gone, myfaith in nature was stifi there and putting the tobacco in the waterhelped me to realize this. I think in a way it strengthened myNative spirituality again.This participant made a strong spiritual connection with nature and water in away that he had not been able to do with Roman Catholicism.When I went into the bush I was able to think about what I haddone to bring this on. I didn’t feel good about myself but beingoutside and not having anyone to judge me made me realize that Iwasn’t all that bad. I had screwed up but I wasn’t a total sinner orfailure or other stuff I had thought about. Nature was forgiving andaccepting. It made me feel that I was part of the whole thing and I106had a right to be there. Knowing that I had the right to be theregave me the feeling that I was OK. I was part of it and it was OK tobe me. This helped me to heal a lot.He felt a strong sense of acceptance in his new spiritualityRocks helped me in my healing in different ways. Rocks that stickout of the water seem to be strong. They have a power. Sometimesa rock had a positive force so I would put it into my pocket and thenlater put it down somewhere calm. I wouldn’t chuck it like I wouldsome rocks. It would be like a sponge because it could absorb myprayers and I could leave it somewhere. I put all of my force in therock and it was good energy. I was putting some of myself backinto creation. Giving back something that I had received felt veryhealing.This participant believed that rocks have a power and “positive force” that helpedhim in his healing. Empowered by the rocks, he began to live a healthier life by“giving back something” and “putting some of myself back into creation”.With bad feelings the wind would help. It felt like the wind justblew them away. It just dissipated because it felt like creation was107so big my problems would just disappear and be absorbed. It waslike the whole of creation was absorbing my bad feelings. The windcould take away my problems only if I threw them into the wind. Inmy mind I had gathered problems and feelings up and threw theminto the wind. If you don’t throw them up into the wind it won’twork.This participant also believed that the wind and creation itself could cleanse badfeelings. He saw the wind as a positive helping force.At times I felt confusion and I didn’t have a clue what I would dowith my life. Once I was driving down the Liard Highway and Iwas really troubled. I felt like dying because there was nothing thatI could do and I had no plans for my life. I parked the truck anddecided to walk up this hill. On top of the hill there was a clearpond filled with clear water. It was a sunny day with blue skies andthe water seemed as clear as glass. The aspen trees had turnedyellow, a beautiful gold colour. The water was so clear I could see abig rock at the bottom that was sort of drawing me to it. I thoughtabout just jumping in the water and drowning. The water wasdrawing me into it. I could see that if I wanted to end my life itwould be so easy. I stood there for 5-10 minutes just staring into thewater. Then I looked down on the ground and there was a big rock108beside me. I picked up that rock and threw it into the water. Thatwas what the water wanted. It wanted something added to it. Thatrock must have weighed about as much as I did because when Ithrew it in to the water it made a huge splash. At the same timethat feeling of wanting to jump in there disappeared. It was like thatwater had got its wish and had something in it now. I walked awayfrom there and got back in the truck and went home. As I drovehome I realized that I had to do something about my problem withaddictions first or I wouldn’t go anywhere. Throwing the rock inthere was like the turning of a page. It was like things just seemedto fall into place after that. The water wanted my energy or forcebut when I saw this rock beside me I realized that it had the samekind of force so I threw that rock in there and the water was happy.I didn’t have to put my life into the water so now I could put mylife’s energy into something else. I could go on living.The participant felt a positive helping force in the rock and water. When hethrew the large rock into the water. He realized suddenly that: I didn’t have toput my life into the water so now I could put my life’s energies into somethingelse. Until then that something had been alcohol. This man attributed his newawareness to the spirits of the rock and water.109I go to high spots to help with my healing. This past summer Iworked for B.C. Parks. I had planned to bring my kids to be withme but I didn’t know if I could do it. To calm my doubts I climbedthis mountain and sat up there and prayed and things becameclearer. I was able to see through some of the problems that I didn’tthink could be solved. Sitting up there thinking things throughhelped me to come up with a game plan. Being on the mountainand connecting spiritually helped me to see farther. When I canphysically see farther it helps me to see farther within myself.This participant obtained further spiritual guidance by praying on the mountain.One of the things about going to a treatment center that helped a lotwas that it stressed the AA program and going to meetings andtalking about feelings. I never did talk about feelings before becauseI didn’t think it was of any use and it wasn’t manly or something.Talking about my feelings helps but it’s still difficult to do.In the treatment center & AA, he found an appropriate outlet for expressing hisspirituality. Overall he felt a much stronger sense of self-worth and acceptancethan ever before.110The AA helped a lot. I can put it in my own interpretation. AA justmakes suggestions but it is spiritually based. It has put me in touchwith what I call the Creator. It reinforces the idea that God loves meno matter what I do. Because before I didn’t feel that I was worthbeing loved.The participant was also able to strengthen his spiritual connection and feeling ofself acceptance through his involvement with AA.Narrative Account # 3A bad time was when I was 21 and all of my childhood problemsand painful memories began affecting me. It affected my mentalhealth and my view of life and how I should cope with it in anegative way. I was very depressed during this time and wasseriously considering suicide.In his early 20’s this participant was quite depressed and often suicidal.My grandmother thought it would help me if I learned to lookaround and see how other people deal with their problems. I startedto pay attention to things around me so from this I started seeing111other people drinking and using drugs and being violent and dyingfrom it. This made me more determined to do something about myown drinking problem and to deal with things differently.The participant obtained direction and guidance from his grandmother.I was having a hard time going to work because I was drinking a lotto avoid thinking. I was given the option of going to a treatmentcenter or being fired. I went to Roundlake Treatment Center forFirst Nations people. It was there that I went to a Sweat LodgeCeremony. It was explained to me that it was like going into themother’s womb again. I really benefited from this ceremony. I wentin thinking about being reborn again. I was given anotheropportunity to get a new start to life. In the sweat an image came tome it was of my dead grandfather. He told me to keep going withlife and not towards death like many of our people were doing.That stuck with me and helped me to stay away from drugs andalcohol for 10 years straight. Seeing that image of my grandfatherstuck with me.In the Ceremony the participant felt a sense of being reborn from the image of thespirit of his grandfather who told him to continue on the path of life.112I had this recurring dream of a bear and a wolf. In the bear dreamthe bear chases me up a tree. I had run half way down a hillsideand it chased me up a tree. A curved tree like you see growing on ahillside with a curved trunk. As I run I can see the bear behind meeven onto the tree where it was pushing on the trunk to try to knockme out of the tree. This happens again and again that I keptdreaming about this bear and then in one dream I just decided todrop out of the tree and face the bear. The bear just smelled methat’s all it did and then it turned around and went back up that hill.I realized that this had to do with my fear. That bear was an imageof fear to me and that there were a lot of things I was afraid of that Iwasn’t ready to confront yet but when I finally did it wasn’t as hardas I thought it was going to be. This realization helped me to getpast the fear and to start doing the things I needed to do to dealwith my problems. I learned not to be afraid of transition.He looked to his dreams for guidance. For example, when he finally confronted abear who had been pursuing him in recurring dreams, he found he could confrontmore issues in his actual life. This helped him overcome his fears and graduallysee through his real problems.113I was looking for positive helping images in my life because mygrandmother told me to look for them. In one dream I was runningand running and running and I couldn’t seem to stop running.Every time I looked over beside me there was a wolf runningalongside me just keeping pace with me. It made me feel moreconfident to face my problems to know that the wolf was alwaysbeside me.Dreams were a powerful force in his life. After the bear, the wolf began to appearin his dreams.I used to take a walk in the bush where it was isolated. During thetime that I was depressed I would walk along the power linesbehind my village. One day I was sitting in a favorite spot therethinking about what I should do about pain that I am carryingaround when just then a bear came crashing out of the bush,crossed the clearing, and went crashing back into the bush on theother side. When I walk through the bush it is really tangled andtough to walk through. Watching the bear encouraged me to gostraight forward and not be afraid of sobriety. At that timeeverybody else was poking fun at me and saying that I must havethought I was better than them because I stopped drinking.114Thinking and acting like that bear taught me that it was okay to takebig steps. This helped me to feel a lot better about not using alcoholbut in finding straighter paths to deal with my problem. Mygrandfather’s guardian spirits were the wolf and the bear and I thinkthat they are for me now too.He felt a major transformation occur when he watched the bear crash straightthrough the tangled bush. He suddenly realized that he needed to do the samething with his own life and that alcohol had been his major obstacle. Like thebear, he needed to find the straighter path.Other times going to the sweat lodge helped me with not drinking.Being encased in darkness with the heat and the sound of the drummade me feel like I was being held without really being held byanyone. It made me feel like being an infant again and seeing thingslike a child rather than someone who has been through a lot ofhorrible things. Coming out and cleaning in cold water was likerebirth. This is concrete and not really part of the thought process itgives me comfort and security. The experience of the sweat stayswith me and comforts me.115His experience in the Sweat Lodge ceremony enabled him to feel a sense ofrenewal and optimism.When I was being ridiculed for being sober I had a regimentedexercise routine. I would run hills and I would look at the hills asbeing problems. As I got to the hill I would think that this hill is aproblem and I’m going to climb it bit by bit. When I got to the top Iwould often have a solution to the problem or at least a betterunderstanding of ways of dealing with it. It was always hard goingup but going down was easy. I would usually go to small hillsaround my village but if I had big problems I would find a big hillwhich I could then run up, walk up or crawl up if it was reallysteep. I would build good energy doing the hills by exercising andtaking the toxins out of my body. It helped me to look at problemsthat way. I used it as a metaphor because if I can climb hills I canface problems the same way. Climbing hills like facing thoseproblems would made me stronger in mind, body and spirit.The participant began to feel stronger by exercising and meeting challenges he setfor himself.116Exercise in general helps a lot because it teaches you about dealingwith problems the right way. Exercise is hard and dealing withproblems is hard. There are steps on how to do them but sometimesI would get caught up in doing them the wrong way and not getanything out of them. I had to learn to do exercise right and thistaught me to deal with problems properly. Just exercising doesn’treally help because I have to exercise with metaphors for gettingover the problem. That’s what really helped me. Once in mycommunity there was this police officer who was giving me a hardtime. I had received a weight set for Christmas. I was so angry atthis cop I went down and I pushed weights for 2 hours. My angerwas so powerful that I still felt angry even after those 2 hours. Thisdidn’t work because all that I was doing was just straight physicalexercise.He found that exercise made him feel strong in his mind, body, and spirit.Cold water helped me a lot either by swimming in a cold river orby using cold water at the end of a shower. It bring things to baseexistence and calms me. It’s like it helps me face the cold hard facts.It would remind me that I was the only one who could make the117decision not to drink. No one else is going to be able to stop me.Cold water grounds me and reminds me of my responsibility.The participant used cold water to calm himself down so that he could thinkclearly.In my first year of sobriety in the late spring, I really wanted to goback to drinking again because everybody else was doing it. I wasrocking the boat by not drinking. I talked to my Uncle who hadbeen sober for 7 years and he told me to go to this small riverbehind our village and pick a spot that I liked and sit there. He saidto ask myself the question that I needed to find the answer to andthen wait for the answer. I watched that river and saw how it runsand how it goes over rocks and around rocks. The water wouldbehave differently all the time. As I sat there and heard the soundof the water it made things peaceful because it hushed the air. Ithought about drinking. In looking at the river I saw that I couldtake a sip of the river or I could drink the whole river but itwouldn’t matter because that water will keep flowing. I thought ifyou got all of our people lined up on the bank and if they tried todrink they wouldn’t be able to because that river would keep onflowing. With alcohol one drink is too much and one million is not118enough. This is what kept going through my mind. But if we linedup our people on either side of the river and had them drink thewater and bathe in the water and fish in the water that’s a lot better.The question of going back to drinking again was answered when Ithought of that river being all liquor. Trying to drink up the riverwouldn’t accomplish anything because the river is too powerful.He resolved himself not to drink after obtaining valuable insights from the river.Water can fill any capacity. You can move water any way you wantbut it always goes to the bottom line. It looks for the easiest routedown and that’s right down to earth. That’s what it has done forme. Its brought me back to the earth again. I want to be like waterand be connected with the earth because it gives me strength andhelps me to lead a good life.He obtained strength and direction through his connection with water/nature.When I first moved to Vancouver and was attending the NativeEducation Center I lived down in the skids in a hotel room in theEast side. One night before Christmas the loneliness really hit. I119had been in my room and it was around 11 o’clock and I had beencrying. I remembered the wolf and how it goes out and howls untilits mate answers or its family group answers. I went down to thewaterfront late at night and I did exactly that - I screamed andhollered and cried my eyeballs out until I let people know backhome that I really missed them. This felt good to do this. The nextday I got a letter from back home and I thought that the Creator isright. I just have to go out and express myself like the wolf. It mayhave been a coincidence but I saw it as a sign. Going out andscreaming was good. If I did it in public it would have createdtension for people. Wolf howl when they are lonely so its airight tobe sad and lonely and let people know so the wolf really helped me.The participant experienced a breakthrough when he was able to express hisloneliness and sadness by crying like a wolf. Realizing that he could express hisemotions and call out for help allowed him to feel connected with his distantfamily.Mountains have helped me. One time I was really anxious inremembering the sexual abuse I had experienced as a kid. I was atmy Dad’s house and feeling sad and I looked out the window at thissnow capped mountain. It was beautiful and it was solid and it had120been there a long time. At different times of the year it looksdifferent, sometimes it is mostly snow and other times it is mostlygreen. That helped me that day to think about that mountain thatwas put there by the Creator. Sometimes we are given a hugeproblem to deal with for a reason. Without seeing that mountain Idon’t think I would have survived that day. I wanted to be like thatmountain. The mountain will always be there, it doesn’t goanywhere but it changes how it looks. It has strength and beauty.The problem I have with those memories will always be there butsome days it will look a lot better than other days. I am learning tobe like that mountain.The participant obtained a sense of strength from the mountain.Narrative Account # 4My problem was deciding what I should do whether to continueliving with my husband or to leave him and to go to school. Thiswas very hard on me and I was very stressed because my husbandwasn’t there and my family wasn’t there for me. I had no one tolean on and I felt overwhelmed. I didn’t have any skills of my ownto support myself or my kids.121When this participant, a woman, was alone and in the city, she felt a great senseof isolation and lack of confidence.Talking to people helped, especially talking to my sister. I told herwhat I would like to do and I got reassurance from her that it waspossible to survive this. She would question me about myrelationship. We talked about coping skills and she showed me howshe was coping. That’s what I was looking for. Because she workedin the band office she knew the routes to go for help. She was also amodel for me. The ways that she coped made her a role model forme to follow. My sister knew me and knew strengths in me that Ididn’t see and she told me these things. I felt better about myselfand my abilities to face this problem.Fortunately, she was able to turn to a sister who also helped her to understandher problem and served as a role model for her.My aunts and uncle provided me with guidance in different ways.They let me talk about my emotions which was good. They alsogave me directions as to what I should do with the kids. That washelpful and reassuring to me. The most important thing that theydid for me was to give their permission and approval for me to122leave my husband and to go to school. I felt I had to get thispermission for my sake, my husbands’ sake and the kid’s sake. Thisreally relieved anxiety for me. They also went and spoke to myhusband about this. This was helpful to me because I felt relief thathe knew that they knew why we split up.Her relatives, especially an aunt and uncle were also extremely helpful to her.I asked my aunt and uncle for stories about things that happened inthe past that would relate to my life situation and would help me toreduce the stresses. They gave me examples of other person’s lives -parts of legends. The example of another person’s life made meaware that this wasn’t an original problem. It had happened beforeand had been dealt with before. This released the stress of thinkingthat I was the only one struggling. It also gave me confidence that Icould make it through. This lifted my depression. It was not asheavy as I was before.When she listened to her traditional legends and learned her traditional ways sherealized that she was not alone in experiencing difficulties and was able to put herproblem into perspective.123Something that helped was taking a walk and looking at nature. Mysister and aunts looked after the kids and this gave me time to getout into nature. When I looked at nature it released me fromthinking about what was bothering me. It released me fromeveryday life and showed me that there is also life out there. Lifegoes on and it never stops, it doesn’t all stop just because you do. IfI left my husband life would continue and it doesn’t really matterhow we think about it life goes on.Like participants #1 and #2, she also gained strength by establishing a connectionwith nature. She claimed that it set her on a path to a healthier lifestyle.Walking in the woods helped me to get out of myself. Getting outof myself made me realize that things happen on their own. Thingsdon’t happen all together. I was getting all of my problems andputting them all together and trying to deal with them that way.The result was that I couldn’t think of how to do anything because itwas all mixed up. By getting outside of myself I was able to look atthem differently and separately. I was then able to feel better aboutmoving ahead and dealing with them.124As a result of getting beyond herself, she felt she could better understand herproblem and set goals for her future.In nature it doesn’t matter what you do or what you say, because noone will judge you. I could holler, cry or whatever I wanted. Thiswas really good, because it helped me to get my emotions out andthat relieved stress.Nature helped her express her emotions, because she felt that it would neverjudge her or reject her.The biggest attraction in nature is water. I grew up near water soany time I hear water in any way it attracts me. When I get close toa river or a stream it affects me spiritually because it is a cleansingelement. You can wash physically, spiritually, mentally oremotionally. Listening to water would release me emotionally byletting me cry or laugh or let out whatever emotion needed to beexpressed. I remember walking by water and feeling release bycrying. I feel better afterwards.The participant attained cleansing and balance from the river by washing herselfmentally, physically, emotionally and spiritually.125I always used my grandmother as a model in coping with problemsbecause I felt that she was strong and she was independent and Iused her as a role model. If she could do it then I would do it too.The participant saw her grandmother as a role model for inspiration.I went to resources in the community who were leaders. The schooladministrator encouraged me to get an education because inbettering my education I could better my childrens education. Hewent to University too and he was also a role model for me. He hadinformation about programs and funding. He also told me what toexpect. Talking to him was very helpful because he gave meinformation and motivation that made it easier to go to University.The participant used a community leader as a positive role model.After my separation one of the things I did that helped in myhealing was to get involved in extra-curricular activities like ceramicsand ball room dancing. They helped me to get out of my shell andto build self confidence. I’m still not a good dancer, but I went forthree years because it helped me to feel more in control and126confident in myself. These activities helped me to feel OK to bemyself in a social situation and that helped me in my healing.The participant was able to “get out of her shell” and grow as a result ofinvolvement in social activities.The Peer Support training I took helped because it showed me howfar I had come and what I had been through. Helping others helpsme to know that I have learned a lot. I didn’t know how to ask forhelp before. The Peer program showed me that I can do it now, Istill hesitate, but I can do it.In helping others, the participant learned how to ask for help and feel better abouther own accomplishments.EXAMINATION OF THE NARRATIVESAn examination of the four narratives provides information that adds detailto what is known about the facilitation of healing for First Nations people. Firstly,the fourteen categories previously presented are seen in action as methods ofhealing utilized and described by the participants. It is also possible to see a logicor division in the healing process when the process is examined from beginning to127end. Lastly, an examination of themes that emerge in the narratives provides newinsights that further describe what facilitates healing for the participants.Division of the healing categoriesThere is a division and logic to the healing process of the four narratives.In the beginning of the healing process, most participants described themselves aswithdrawn, self confined, disconnected, out of balance, angry, hurt, and sad. Bythe end of the healing process, participants described themselves as feelingconnected, accepted, balanced, and generally positive. A study of the stories ofthe participants reveals four divisions of categories in the healing process. Thosefour divisions can be described as: separating from the unhealthy life; obtainingsocial support and resources; experiencing a healthy life; and living a healthy life.This organization of categories is by no means exhaustive, nor is it intended torepresent a strict chronological sequence. As demonstrated by the narratives, it isnot necessary for someone to progress through these divisions in the orderpresented.Separating from the unhealthy lifeIn this division an individual first identifies the problem, and expresseshis/her emotions. The individual learns to determine, clarify, and make sense ofthe problem by talking with others about it, or through observing other people or128even something in nature that helped them to understand the problem. He/sheexpresses emotion by various means such as talking, crying, singing or screaming.He/she also feels a need to keep parts of himself/herself in balance. At thisstage, understanding the problem is separate from the expression of emotionabout it. The former is the cognitive aspect of the self, while the latter is theemotional part of the person. An example of the division of separating from theunhealthy life can be seen in the first two narratives when, after recognizing thatthey were in need of healing, the two participants each returned home where theywere able to talk about their problem, understand it and express their emotions.Being able to separate from the unhealthy life is an important first step in thehealing process for all four participants.Obtaining social support and resourcesIn this division the individual seeks help/support from others, andestablishes social connections with others. This support takes the form ofencouragement, motivation, acceptance, validation and reassurance. Theindividual feels socially connected when he/she is able to get beyond his/herown world through social interaction. This transition can be seen in the accountsof all four participants who sought out friends, family, and community membersfor help and support as well as the need to ‘get beyond themselves”.129Experiencing a healthy lifeIn this division the individual is able to live a fuller life doing many or allof the following: participating in ceremony, learning from a role model,establishing a spiritual connection, establishing a connection with nature, andanchoring oneself in tradition. Participation in ceremonies such as the SweatLodge Ceremony helps individuals to feel grounded and connected to a healthierlife. Role models provide guidance and instruction about healthier ways to livetheir lives. Finding some spiritual connection gives individuals an additionalsense of balance. Often Nature offers calmness, strength, and guidance. Thefeeling of integration with one’s culture provides a strong sense of direction andbelonging. For example, the first participant experienced a healthier life throughknowledge of traditional ways. The second participant experienced a healthier lifethrough reconnecting with his spirituality. The third participant experienced ahealthier life through participation in a Sweat Lodge ceremony and from thehelping images he derived from it. The fourth particpant experienced a healthierlife through observing role models who showed her how to live.Living a healthy lifeIn this final division, the individual moves on to goal seffing and becomesinvolved in challenging activities, exercise, engaging in self care and helpingothers. He/she also takes steps to ensure that he/she is able to live and maintainthe new life experienced in the previous stage. Many feel optimistic and130empowered by this new involvement in challenging activities and in a new senseof discipline. Exercise ensures that one feels a stronger physical being. Thisoverall self care affirms self worth and reinforces respect for self as well as forothers. Helping others provides individuals with an opportunity to reach out tothe larger community and to feel empowered in doing so. There are severalexamples of how the participant started living a healthy life. The first intervieweestarted living a healthy life by “going beyond himself and helping others”. Thesecond participant challenged himself by learning to express his emotions to otherpeople. The third participant established a regular exercise regime where he wasable to balance the physical aspect of himself and acquire discipline. The fourthparticipant continued to challenge herself through extra curricular activities andgoal setting.Examination of the healing themesAn examination of themes that emerge in the narratives provides newinformation that further describe what facilitates healing for the participants. Thefirst observation or theme derived from the four narratives is that there is a broadspectrum of healing resources available to First Nations people. For example,within the category of Nature, participants obtained healing from animals, rocks,water, mountains, the wind, the earth, and the sky. Within the category ofceremonies, the Sweat Lodge ceremony alone can provide participants with131cleansing, catharsis, spiritual connection and empowerment. This multitude ofhealing resources contrasts with the limited mental health approaches provided toFirst Nations people by the majority culture. Relative to the variety of approachesthat are used by First Nations people, Western mental health approaches are aptto be viewed as restrictive in what they have to offer for healing.A second observation derived from an examination of the narratives is thatFirst Nations people have a different way of seeing the world. As was describedin the background of this paper, a different set of cultural beliefs or worldviewhas implications for the provision of healing services. For example, the ability tosee nature as being capable of speaking to you about your problem and providingdirection and guidance in healing is a view that would be foreign to most Westernmental health practitioners. Participants range from believing that they wereliterally in contact with the spirit of a rock, to a more general belief that natureprovides them with healing images, symbols and metaphors. There is acommonly accepted belief amongst First Nations people that the natural worldcontains the blueprint for how we should live our lives. Such differencesreinforce the belief that healing practices are culturally bound.A third observation or theme is that the participants seem to expect thatwhatever is healing should help to put them in balance. This is a conceptinherent in the Medicine Wheel. The First Nations Medicine Wheel teaches thatthe separate entities of the self mental, physical, emotional, and spiritual, areequal and part of a larger whole. It is necessary to keep all four parts of the self132in balance in order to become healthy and remain healthy. It is therefore expectedthat any therapy or healing approach should ultimately address all four areas ofthe person. If an approach does not accomplish this the client might well feelincomplete. When people with this cultural expectation encounter Westerntherapies, a conflict emerges. Because most Western therapies tend to focus on asingle dimension of the person, such as the case with affective therapies such asRogerian therapy, the First Nations client often leaves feeling that only one part ofthe self has been attended to.A fourth observation is that self transcendence followed by connectednessseems to be a desired route by which participants gained the necessary insightinto the nature of their problems and the direction for how to live their lives.Participants were often urged by elders and family to “get out of their self” inorder that they might find the peace, understanding, strength and guidancenecessary to find and follow the path to a healthy life. In transcending the self,the participants would then connect with healing resources such as family, nature,community and spirituality. When participants state that “It made me feel that Iwas part of the whole thing” and ‘1 was part of it” they are referring to thisphenomena. To feel connected it is necessary to become part of something suchas nature, the spiritual world, the family, the community, the culture. This is notpossible if the individual does not first go beyond his/her own self. If the personis self absorbed and confined within the self then he/she will not find healing.This view of self transcendence contrasts with western mental health approaches133which often stresses the need to strengthen the self or the ego so that theindividual can master their environment.A final observation is that throughout these incidents we can observe thatthe participant acts as an agent of his or her own healing. They are not acting asa patient or victim but as an agent on their own behalf. It is also significant thatother people treat them as their own agents. This is exemplified by statementsmade to participants such as:I received a general message from the elders that I should go beyongmyself and help others with their healing. In doing this I helpedmyself...In summary, through examining the accounts of healing as told by fourindividuals, it was possible to develop general categories or divisions thatencompass the specific categories. The discussion of five themes that emergedfrom the narratives also provided new information about the features whichfacilitate healing for First Nations people. As well, this discussion served tosharpen several differences in healing approaches used by First Nations peopleand Western mental health practitioners.134CHAPTER VIDISCUSSIONSummary of ResultsThrough interviews with 50 participants, 437 critical incidents were elicitedreporting what facilitated healing for First Nations people of British Columbia.The 437 critical incidents were placed into 14 categories that were found to bereasonably reliable. These categories are: participation in ceremony, expression ofemotion, learning from a role model, establishing a connection with nature,exercise, involvement in challenging activities, establishing a social connection,gaining an understanding of the problem, establishing a spiritual connection,obtaining help/support from others, self care, setting goals, anchoring self intradition, and helping others. These categories were organized into four divisionsseparating from an unhealthy life, obtaining social support and resources,experiencing a healthy life and living a healthy life. A preliminary examination ofthe healing outcomes for First Nations people was thought to invokeempowerment, cleansing, balance, discipline, and belonging. Distinct themes inFirst Nations healing were also developed as a result of analyzing narrativeaccounts of participants. These themes are: a broad spectrum of healingresources are available to First Nations people; First Nations people have adifferent way of seeing the world which has to be understood before effective135counselling services can be provided; First Nations people expect that whatever ishealing should help them to attain and/or maintain balance; self transcendencefollowed by connectedness is a common route to healing for First Nations people,and First Nations people act as agents for their own healing.LimitationsThere are a number of factors that limit this investigation. A primarylimitation of the study is that the results cannot easily be generalized at this time.In addition to only interviewing First Nations people from British Columbia itshould be noted that a high percentage of participants in the study wereuniversity students (38%). This could also be described as a delimitation becauseit was known at the onset that this study would only provide an initial set ofcategories that describe healing and not a definitive description of effective andineffective healing techniques for all First Nations people of British Columbia.Future studies will be needed to determine generalizability of the categories andto begin to utilize the categories to further develop theory and practice. Anotherlimitation of the study is that the categories were derived from self reportingrather than by observation. Critical incidents obtained through self reporting arelimited to the events that people are able to remember during the interview. It islikely that some events were not mentioned because they had been forgotten bythe participant. Another limitation of the use of self reporting is that participants136could only report what they could articulate. This may have excluded someevents from being revealed. The focus on healing events as opposed to healingrelationships is also a limitation of the study because relationships are moreenduring than events. This study did not focus on the question of who washelpful in facilitating healing but on the action taken to facilitate healing for theparticipant.Implications for theory and researchThe results of this study confirm and extend the research pertaining to thefacilitation of healing for First Nations people as described in the review of theliterature. The most important implication is that it provides an empirical basisfor what has previously amounted to opinions from researchers. Previousscholars have stressed a number of factors that they believed facilitated healingfor First Nations people. Those factors are: knowledge of First Nations cultureand traditions, obtaining help from others in dealing with problems,interconnectedness, spirituality, exercise, expressing oneself, healing ceremonies,gaining an understanding of the problem, role models, and nature. These factorswere empirically supported in this research by the following categories:anchoring self in tradition, establishing a social connection, establishing a spiritualconnection, exercise, setting goals, obtaining help from others, engaging inchallenging activities, expression of emotion, participation in ceremony, gaining an137understanding of the problem, learning from a role model, and establishing aconnection with nature. This research has gone beyond the twelve existingcategories by providing two new categories: self care, and helping others. Allfourteen categories therefore represent ways to facilitate healing for First Nationspeople. This study addresses the criticism of cross-cultural counselling research ingeneral, and First Nations counselling research in particular, that states that mostof the research in these fields is merely speculation with little or no empirical datato support it (Dauphinais, Dauphinais, & Rowe, 1981; Casas, 1985; Ponterotto &Casas, 1991).Mental health services provided to First Nations people have been based onthe wholesale adoption of Western approaches without regard to their efficacywith First Nations people. This research does not advocate abandonment ofWestern theory and therapeutic approaches, as they can be successfully utilizedwith First Nations people. Although this research supports the use of someWestern approaches, it also does not advocate that such approaches be utilizedin a wholesale manner as they tend to assist with just one part of the healingprocess. Western approaches/techniques can instead be used to assist with andsupplement the First Nation practices described in this study. Westernapproaches can provide helpful tools in healing if they are integrated in aninformed manner. Rogerian therapy might, for example, be helpful to facilitateexpression of emotion. It would not, however, be suitable as the entire approachto healing as it only focuses on one aspect of the person. Behavioural therapy138might be used to facilitate action for a client but it again should not constitute theentire approach to healing.The findings of this research indicate that the view of the means and endsof counselling for First Nations people differs from Western therapeuticapproaches. The aim of healing for First Nations people, for example, isconcerned with attaining and maintaining balance between the four dimensions ofthe person: physical, mental, emotional, and spiritual. Western therapeuticapproaches could be seen as imbalanced as they overemphasize one dimension ofthe person by focusing, for example, on feeling or on cognitive modification.Another difference in the view of the means and ends of counselling is thateffective healing for First Nations people focuses on interconnectedness ratherthan on autonomy which is a more common goal for Western therapy. For FirstNations people, connecting with family, community, culture, nature, andspirituality all seem important in successful healing. Similarly, First Nationshealing requires the individual to transcend the ego rather than strengthen it asWestern counselling aims to do. These three differences are ingredients of thehealing process that require further theoretical research. This study serves toopen up theoretical debate over the differences in the means and ends ofcounselling.The results of this study suggest that it is necessary to understand thebelief system and woridview of a culture before applying theories and techniquesof healing. Belief systems, decision making strategies, models of problem solving,139assumptions about how problems arise, and how change occurs are all connectedto how we see the world (Torrey, 1972; Ibrahim, 1984). Lack of knowledge ofFirst Nations values, belief systems, and worldview can, for example, lead tofaulty assumptions concerning the diagnosis of the problem, and the strategy usedin solving the problem. This lack of knowledge can also mean that both therapistand client will overlook the wonderful variety of healing methods available toFirst Nations people. Nwachuku & Ivey (1991) in their promotion of culture-specific counselling, argue that counselling research must first start with anexploration of the natural helping styles of a culture before developing theoriesand approaches for it. This is contrasted with the belief that Western counsellingtheory can be adapted to fit any specific culture (Gaines, 1992). There clearlyexists a value in mobilizing the belief system and healing resources of participantsto facilitate healing for them. To ignore these belief systems or to impose acontrary one is to potentially overlook important healing resources and underminethe working relationship between counsellor and client.Some of the healing practices utilized by First Nations people warrantfurther research. One example is the importance First Nations people place onthe mobilization of social support. For many of the participants, the healingprocess started when the individual started making contact with family andfriends. This practice needs to be explored and applied to a broader theory to seehow it works for other populations.140Another implication for theory is that the categorical map presented in thisresearch supports a form of healing that resembles a rite of passage. The conceptof “rite of passage” originally presented by van Gennep (1960) is a process oftransition whereby the individual moves from one state of being to a new state ofbeing. Based on an extensive analysis of ceremonies and the content and order ofthe activities associated with these ceremonies, van Gennep was able to discernthree phases of transition: separation, transition, and incorporation. Separationmeans to separate from the present life or way of being. Transition required thedying of the old life and the birth of a new one. Incorporation means that theindividual is incorporated or reincorporated into the community in his/her newstate and new way of being. These three phases developed by van Gennepparallel the four divisions of healing categories presented in the present study.Further, within the incidents under the categories, there are numerous referencesto content that are similar to images of a rite of passage. For example, the phaseof separation from the present life or present way of being is very similar to thedivision described as “ separating from an unhealthy life”. A healing practiceassociated with separation from an unhealthy life is expression of emotion. Theindividual learns to rid himself of the old unhealthy life or “bad spirits” by suchmeans as ritual cleansing in water. Transcending or “getting outside the self” isan important component to this process. The phase of transition is similar to thedivision of “obtaining social support and resources” combined with “experiencinga healthy life”. The practice of participation in ceremony is characteristic of this141phase. Ceremonies such as the Sweat Lodge ceremony described by some as“returning to the womb” symbolize a transition for participants. The last phase,incorporation, signifies the incorporation or reincorporation of individuals intotheir new way of being. This phase is very similar to the division “living ahealthy life”. The category of helping others, for example, provides individualswith an opportunity to reach outward to the larger community and to connectwith it in a new way that is empowering and affirming. Healing images utilizedby First Nations people such as “washing away bad spirits” or “returning to thewomb” provide a promising resemblance to the phases described in “rite ofpassage”. It is possible that rite of passage may be an expected part of healing forFirst Nations people. A preliminary examination of First Nations ceremonies suchas the Sweat Lodge Ceremony or the Vision Quest Ceremony reveals that thephases of separation, transition, and incorporation provide a relevant frameworkto these ceremonies. It is possible that the structure of First Nations ceremonieswhich developed over thousands of years provide the individual with ametaphor or framework to describe other effective healing practices. Thesedivisions or phases of healing therefore suggest a promising framework fromwhich further research and theoretical development can take place.142Implications for PracticeThere are two key points concerning this study that have implications forpractice. Firstly, this research presents a map of what facilitates healing for FirstNations people. This map describes categories of healing and does so in aninterpreted form that depicts how individuals go through the healing process. Asthis map did not exist previous to this research, it is now possible for practitionersto utilize this map in their practice of facilitating hea1ing. This practical map hasimplications for counselling, counsellor training, program development, andcommunity based initiatives.Secondly, the map of healing presented in this research indicates that anabundance of healing resources exist for First Nations people. This finding has thepotential to change significantly the way First Nations communities view thenature and source of mental health services provided to them. It also has thepotential to change the way mental health professionals from the majority cultureview the scope and nature of the delivery of services they provide to FirstNations people.Counsellors could utilize the findings of this study to develop techniques orinterventions to help First Nations clients. A counsellor who is unfamiliar withFirst Nations culture could assist in mobilizing healing resources for their clientby referring them to culturally appropriate sources of help. A counsellor withmore knowledge might make more concrete suggestions such as encouraging the143client to watch a river flow for a few hours or attend a Pow Wow. AU fourteencategories would provide areas about which counsellors could obtain knowledgein order to help facilitate healing for their clients, either directly or throughreferrals. These categories could also be of benefit in assessing the effectiveness ofindividual counsellors in working with First Nations clients or in sensitizingcounsellors to the factors involved in facilitating healing for First Nations people.A formal training program could be established to train First Nationscounsellors that would use as its curriculum this categorical map of whatfacilitates and hinders mental healing amongst First Nations people. Counsellorsmight, for example, receive training in how to assist/encourage clients to attendhealing ceremonies, learn how to express themselves, set goals, help others, orreconnect with their tradition and culture.Upon the basis of this practical map it would be possible to design aculturally relevant program to assist First Nations people to attain healing.Programs could be developed to include some or all of the fourteen categoriesthat facilitate healing. A treatment program, for example, might provide optionsfor participants based on individual needs and preferences. Opportunities mightbe provided for participants to participate in healing ceremonies, for example.Another participant in the same program might work on establishing aconnection with nature or on expression of emotion.This research suggests some promising approaches to healing that might befacilitated by members within a community setting. Community leaders might,144for example, organize members to recognize, make available, and encouragevarious paths of healing. This might mean setting aside undeveloped areas ofland so that community members would have the opportunity to utilize naturein healing. Ceremonies could be made available to members of the community.Elders and families could be recognized and supported in their role as care giversto community members. Initiatives such as these would strengthen communitypurpose and provide access to healing resources.Implications for further researchAdditional research needs to be done if counsellors and programs wish toutilize the map of healing presented in this study. It will be necessary to examinethe effectiveness of such practice and programs to see if the map can be revised,refined or extended.A primary limitation of this study is that the results cannot be easilygeneralized at this time. Future studies could be conducted to determinegeneralizability, perhaps utilizing a survey instrument which could be developedfor that purpose. A survey instrument based on the categories would allow alarge number of First Nations people to be surveyed to determine if the categoriesare applicable. This could be used with First Nations people throughout BritishColumbia as well as other parts of Canada. Future research might also examine ifcategories of healing events differ with age, gender, geographical location, and145education. The ethnic identity development of participants in the sample couldalso be examined as another possible source of variation in reported events.Future research might involve replicating this study to determine if newinformation and healing categories could be obtained. Replication might help torefine, extend, or revise these categories to further our understanding of healingfor First Nations people.Future research might utilize results of this study to develop a test tomeasure the working alliance that can be developed between First Nations peopleand non First Nations counsellors and facilitators. Such a test could increasecounsellor awareness of the needs of the client and provide the counsellor withdirection to improve the working alliance. For example, a difference on thecounsellor/client score about the importance of ‘establishing a spiritualconnection’ might indicate that the client needs to work more on this method ofhealing while the counsellor, in addition to recognizing the importance of thismethod for the client, might help the client by suggesting ways to meet this need.Such a test might also indicate to a client that although he/she places considerableimportance on the healing powers of expression of emotion, he/she is notutilizing this method. Such awareness would hopefully lead to a negotiationbetween counsellor and client followed by an appropriate plan of action to utilizethis method of healing.A further examination of the healing stories related by the participantscould be initiated to further develop the concept of a First Nations plot for146healing. Similar to the phases developed by van Gennep, and the divisions ofhealing presented in this research, further examination of a First Nations plot forhealing should prove extremely useful to both research and practice.SummaryThis study explored the facilitation of healing for First Nations peopleliving in the province of British Columbia. The purpose of the study was todevelop a reasonably comprehensive scheme of categories that would describe,from the perspective of First Nations people, what facilitates healing.The research method involved interviews with First Nations people whowere in a position to observe what facilitated their own healing for them. TheCritical Incident Technique (Flanagan, 1954) was utilized to elicit 437 incidentsfrom 50 participants. Fourteen categories emerged from an analysis of theincidents reported. Several procedures were used to examine the soundness andtrustworthiness of the categories. The results indicate that healing can befacilitated in the following ways: participation in ceremony, expression ofemotion, learning from a role model, establishing a connection with nature,exercise, involvement in challenging activities, establishing a social connection,gaining an understanding of the problem, establishing spiritual connection,obtaining help/support from others, self care, setting goals, anchoring self intradition, and in helping others. A preliminary examination of the healing147outcomes of these facilitating events suggests that an effective healing program forFirst Nations people would invoke empowerment, cleansing, balance, discipline,and belonging.Narrative accounts were analyzed for the purpose of revealing anorganization for the categories. Four divisions of categories emerged as a resultof this analysis: separating from an unhealthy life, obtaining social support andresources, experiencing a healthy life and living a healthy life. Further analysis ofthe narratives revealed five overall themes which serve to enhance the categoriesand outcomes presented in this research. Those themes entail: A broad spectrumof healing resources are available to First Nations people, First Nations peoplehave a different way of seeing the world which has to be understood beforeeffective counselling services can be provided, First Nations people expect thatwhatever is healing should help them to attain and/or maintain balance, selftranscendence followed by connectedness is a common route to healing for FirstNations people, and First Nations people are observed to act as agents of theirown healing.The findings of this study contribute to the field of counselling psychologyby providing a reasonably comprehensive scheme of categories and themes thatdescribe, from the perspective of First Nations people, what facilitates healing.This study suggests promising developments in First Nations healing that haveimplications for both research and practice.148REFERENCESAnderson, B.M. (1993). 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Canada V6T 1L2Tel: (604) 822-5259Fax: (604) 822-2328Dear______________________________________You are being asked by a mutual contact to participate in my doctoral study. Thisresearch is being conducted to determine what helps and does not help mentalhealing to occur for First nations people of British Columbia.Participation will involve a 45-60 minute interview. In the interview, you will beasked to recall a time in which you have required mental healing. You will thenbe asked to identify the factors that either helped or hindered this healing process.Interviews will be tape recorded, transcribed and given a number code to ensureconfidentiality. The tapes will be erased upon completion of the study. The totalamount of time that will be required of you will not exceed one hour. You willreceive a $20 honorarium upon completion of the interview.The purpose of these interviews is to develop a categorical framework of whatfacilitates and hinders mental healing for First Nations people of British Columbia.The development of such a framework may have an indirect benefit to you. Inaddition to impacting upon the theory of counselling First nations people, it couldalso impact upon the practice and training of counsellors who work with FirstNations people.Your involvement is entirely voluntary and you may withdraw from the study atany time. All responses will be kept strictly confidential. A dummy number willbe the only means of identification once the interview is completed.If you would like to participate in this study, please complete and return theattached consent form to me in the self addressed! stamped envelope and I willcontact you to arrange a suitable interview time.Thank you for your time and interest.Respectfully,158THE UNIVERSITY OF BRITISH COLUMBIADepartment of Counselling PsychologyFaculty of Education5780 Toronto RoadVancouver, B.C. Canada V6T 1L2Tel: (604) 822-5259Fax: (604) 822-2328STUDY: THE FACILITATION AND HINDRANCE OF MENTAL HEALING FORFIRST NATIONS PEOPLE OF BRITISH COLUMBIAINVESTIGATOR: Rod McCormick (Tel: 822-4685)SUPERVISOR OF RESEARCH: Dr. Larry Cochran (Tel: 822-6139)This research is being conducted as one of the requirements for Rod McCormickfor the doctoral degree in Counselling Psychology. The research is to determinewhat helps and does not help mental healing to occur for First Nations people ofBritish Columbia. Participants are asked in a 60 minute interview to recall anincident in which they have required mental healing. Participants will then beasked to identify the factors that either helped or hindered this healing process.Interviews will be tape recorded, transcribed and given a number code to ensureconfidentiality. The tapes will be erased upon completion of the study. The totalamount of time that will be required of each participant will not exceed one hour.Each participant will receive a $20.00 honorarium upon completion of theinterview.The research investigator will be happy to answer any questions you might haveconcerning the study either before or after the interview. It is important to notethat your participation is voluntary and that you have the right to withdraw fromthe study at any time without prejudice of any kind.I HAVE READ AND UNDERSTOOD THE ABOVE AND CONSENT TO BE APARTICIPANT IN THIS RESEARCH.I ACKNOWLEDGE RECEIPT OF A COPY OF THE CONSENT FORM.Name of Participant:Address:Telephone Number:Signature_________________________DateResearcher: Rod McCormick (822-4685)159APPENDIX BCARD DESCRIBING RESEARCHER’SBACKGROUND160“Saygo”, Greetings,My name is Rod McCormick and I am investigating the facilitation and hindranceof healing for the First Nations people of British Columbia. This research is partof my doctoral work in counselling psychology at UBC. I am First Nations and amember of the Mohawk Nation (Kahnawake Band). For the past year I have beenworking in the First Nations Longhouse as the counsellor for First Nationsstudents at UBC. I have 5 years experience working as a counsellor with FirstNations people.
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