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Winter 2007/08 | Vol 11 No 2

Q & A

Strengthening Aboriginal families through prevention

By Lesley Young

Strengthening Families for the Future (SFF) is a psychoeducational prevention program focusing on family strengths. Founded by Dr. Karol Kumpfer in 1988 at the University of Utah, the program targets families with children from ages 7 to 11 at risk for substance use problems, depression, violence, delinquency and school failure.

During 14 consecutive weekly sessions, parents and children enjoy a meal together, break apart for separate skills development sessions and come back to practise their learning together. Outcome studies have found the program to improve stress and anger management skills and to reduce substance use among youth.

The program has a definite structure, but it also recognizes the need to adapt to the needs of the communities it serves. To this end, initiatives are underway to adapt SFF to Aboriginal communities across North America. To learn more, CrossCurrents interviewed Ceceilia Tso, an American Indian trainer of trainers for the Strengthening Families Program (SFP – the U.S. equivalent of SFF), who provides training throughout the United States and Canada. Also interviewed was Daniel Manitowabi, a social worker and clinical manager for the mental health program at M’Nendamowin Health Services on Manitoulin Island in Ontario, who was trained by Tso. Along with the two other Manitoulin-area health services, Manitowabi’s program received funding for SFF through the National Youth Suicide Prevention Strategy of the Ontario-region First Nations and Inuit Health branch of Health Canada. Thirty-four frontline staff have been trained to tailor SFF to their communities’ cultural needs. The program is expected to be launched at three locations for up to 30 families with 12- to 16-year-olds this year.

What are the unique issues of Aboriginal communities that can be addressed through Strengthening Families?

Manitowabi: The poor health status of Aboriginal peoples is clear. There are higher rates of illness and poverty and lower life expectancy than the rest of the population. We also have high rates of substance use and suicide. Suicide among youth is particularly high. Poor health, social and economic conditions put Aboriginal families and individuals at higher risk for substance use, mental health issues and problem behaviours, all of which can be targeted through a program like Strengthening Families if it is adapted to the specific needs and culture of Aboriginals. We felt that delivering this culturally appropriate program to First Nations families would strengthen protective factors and reduce risk factors.

Why is it important to tailor programs like Strengthening Families to a specific culture?

Tso: By bringing in cultural elements, the program resonates with more families. They are more receptive to learning from their own people and relate better to cultural elements, even if it is a simple thing like using a talking stick (an implement used in Aboriginal culture to indicate that someone is speaking and everyone must listen). When someone uses that symbolic item, it hits close to home and has more meaning for families. In the same way, if someone presents an eagle feather, it will garner instant respect, which could not be as easily attained without the impact of cultural meaning.

Manitowabi: The community and family values of Strengthening Families are in line with the strong Aboriginal traditional of taking care of one another. That is why we include extended family in the program – grandparents are quite involved with kids in Aboriginal culture. We build on the family aspect of SFF to make it reflect the Aboriginal emphasis on family.

How can the program be tailored to the needs of Aboriginal communities?

Tso: It’s a good idea to make sure group leaders are Aboriginal. The program requires a minimum of two leaders for the parent group, two for the child group and a site coordinator. It is also incredibly effective to have a medicine man attend at least the first session. We also suggest having both a male and female leader so everyone feels comfortable discussing topics or concerns with at least one leader.

Elders should be invited to join the group. Many of the ties that bind Aboriginals with their traditions, such as elders, have been broken and this is a way to help mend them. When I was going through a difficult divorce, I went through Strengthening Families myself (which gave me a new perspective and practical experience as a trainer) with my young daughter and son, and my aunts and grandmother. At graduation, the elders conducted a ceremony and gave each child a baby blanket they had had made. I had no idea the effect it would have on my kids. My son, who is now 11, still sleeps with the blanket! Given how much respect they have in the Aboriginal community, elders have a big impact, especially on children, if they join a group.

Why is the communal meal particularly important for Aboriginal people?

Tso: The meal component of Strengthening Families helps families bond. We recommend including extending family like grandparents, aunts and uncles and foster parents. Having a meal together is a very traditional aspect of Aboriginal families. Yet few at-risk families do. The dinner is also an opportunity to meet with group leaders in a relaxed atmosphere, as well as to network with other families, so families realize they are not alone.

How can the meal be adapted culturally?

Tso: Potlucks should be avoided. That creates too much work for the families; the meal is supposed to be an incentive for families to attend. We suggest providing a traditional Aboriginal meal. The dinner is also an opportunity to bring a guest speaker to talk about nutrition, provide prevention education or expose families to more traditions during the meal. One tribe I worked with held a bear dance, which an elder attended and explained to the families.

Manitowabi: I agree that incorporating traditional food is an excellent idea. Addressing proper nutrition is important, given the high incidence of diabetes in our community. We hope to bring in a dietitian to do a short prevention session as part of the program.

How can Strengthening Families skills training be tailored to meet the needs of Aboriginal communities?

Tso: First, it’s important to point out that adapting Strengthening Families to a particular culture does not mean changing the actual material. Cultural adaptation means adding a cultural element to help demonstrate a particular life skill from the program, rather than actually modifying the material, which essentially removes part of the lesson or the skill.

My favourite example is on the lesson on dealing with stress. We ask the children and the parents in their separate groups what kind of stresses they think our ancient ancestors faced. It is important that the kids themselves come up the answers. They may answer war, sickness or disease. Then we talk about some of the stressors we deal with today, such as crime, divorce and poverty in rural or urban areas. Then we ask the kids to come up with some strategies our ancestors may have used to help them deal with the stress. This may include prayers, sweat lodges, ceremonies, pow-wows and beading. We then talk about how the kids and their families can use these strategies themselves when they feel stressed.

During this lesson, another adaptation is to make little medicine bags at the same time, filled with sage and what is called an animal fetish – the animal you see yourself as. These can be used during prayer or quiet time.

Manitowabi: We plan to incorporate some of the Seven Grandfathers Teachings, which are Aboriginal ethics relating to truth, honesty, bravery, love, humility, respect and wisdom into the program.

How can at-risk Aboriginal families be recruited to the program?

Tso: Recruitment should target areas with many high-risk families. Get the word out at tribal courts, social service facilities and at local pow-wow and cultural events. Once you’ve run one session, word spreads about how much fun or how useful the program is. This breaks down a lot of misconceptions that the program is therapy or incredibly difficult work. Fliers are a great tool, too, but nothing works like word of mouth.

What are some key challenges to implementing Strengthening Families in Aboriginal communities?

Tso: There are a lot of barriers to the program in Aboriginal communities, including poverty. Even something as seemingly simple as not having money for gas can prevent some families from attending. So you need to take transportation into account. Car pooling may be one answer. One agency had a van that drove people to the program. Language can also be a barrier and part of the reason why we prefer Aboriginal group leaders. However, a translator may still be necessary sometimes. There is also a range of literacy levels, so leaders need to be aware that they may need to give instructions orally, not written.

Manitowabi: Distance is a challenge for us. Some of the communities are an hour or more apart, so we are establishing three different locations for the program. Funding is quite challenging as well. We are very excited to be running the program, and depending on whether we get renewed funding, we hope to run the program for at least one more year.

For more information about the American Indian Strengthening Families two-day training workshop, available across Canada and the United States, contact the LutraGroup at lutragroup@att.net.