A brief Introduction and Conclusion
The Family Wellness Warriors Initiative (FWWI) program was developed in 1996 to serve the Alaskan Native (AN) population. The program has as its stated goal, to bring an “end to domestic violence, child sexual abuse and child neglect in the State of Alaska in this generation.” (Ray et al., 2019, p.42). The genesis of FWWI was inspired to address the historic trauma that has become intergenerational among the native people of Alaska, and has been traced as the root cause of domestic violence (Kelly & Small, 2020). One of the main principles of intergenerational trauma theory is that the historic agony felt by ancestors from a lifetime of trauma, forms the basis for various negative health outcomes of the present generation, and needs to be addressed (Beltran et al., 2018). Research has conclusively proven that there are negative impacts to historic transmission of parental and ancestral trauma that manifests in the lives of the successive offspring (Felsen, 2021).
For centuries ANs as well as Native Americans (NAs) experienced unimaginable oppression and discrimination at the hands of the majority White dominant population in America. Families were separated, children were stripped from their parents, heritage, culture and language. The Native Americans’ family unit was broken apart and with it, the family values which were pivotal to the traditions of these indigenous people (Brave Heart et al., 2011). After several failed attempts to address the issues of interfamily violence, sexual abuse of minors and maltreatment of children using westernize treatment and interventions, administered by “outsiders” (non-Alaskan Natives or indigenous people), FWWI was born as a means to address the problems using a more culturally sensitive and traditional indigenous approach. As FWWI developed their program, they sought to first investigate its efficaciousness by recruiting 80% local or indigenous people with the same or similar historic experiences as the target population.
This initiative is a culturally sensitive program that uses traditional AN/NA principles. Ray and colleagues (2019) explained that the program includes a 5-day intensive training, in a nonclinical environment. The activities were all traditional based and unlike Western type interventions, emphasized a feeling of oneness and inclusiveness. According to Ray et al., (2019) key aspects of the program focused on the natives’ ethnic and traditional power, using such major principles as: “Storytelling, Listening and Responding, Relationships Building, and Facilitator Participation” (p. 43). These themes were used to investigate the effects caused by the trauma, as a precursor to offering methods of healing, resilience, and self-esteem. At the conclusion of the training, all participants reported positive outcomes and said that they experienced changes at every phase of the program. Specifically, participants pointed out that they felt healing from their pain and shame, and as a result, were empowered to heal familial rifts, improve their self-esteem, and build stronger family bonds and a better overall transformative life experience.
A Summary of the Intervention/Program
In summary, FWWI is a 5-day intensive outpatient program created in 1996 and offered primarily in a casual (nonclinical) setting rooted in Alaskan Native or Native American traditional cultures. The treatment initiative was tribally-created, owned and directed by ANs as a subsidiary of the not-for- profit Southcentral Foundation (SCF). The SCF uses a traditional in-person holistic approach that provides mental health, medica, and dental services for over 65,000 indigenous people across the United States. In creating the Wellness Initiative, SCF has expanded their program to meet the historic intergenerational trauma needs of the American indigenous populations. Ray et al., (2019) explains that the in-person program has a very successful track record, and provides positive short-term outcomes and good long-term results with follow-up treatments. The most enduring strength of FWWI, and the primary reason why it differs from most programs is because it is Alaskan Native-led, and has as its focus the reintroduction of traditional culture and spirituality to its people, instead of Westernized clinical protocols.
The Good Road of Life Program
A brief Introduction and Conclusion
This program is called the Good Road of Life (GRL) training which was developed in 2007 by Dr. Clayton Small. GRL is an American Indian non-profit organization that was developed by “Native Prevention Research Intervention Development Education” (PRIDE). The aim of PRIDE is to introduce culturally sensitive programs designed to encourage positive mental healthcare, healing and behavioral changes in individuals and families (Kelley et al., 2019). Trainings conducted by PRIDE is inclusive and readily available, which is compatible with its native traditional values of generosity; the trainings are offered to primarily to native indigenous people in rural, frontier and urban areas, as well as to non-Native groups. Currently, the GRL program has been implemented in almost half of the 50 states and has positively impacted more than 15,000 participants.
Treatment provided by GRL is primarily aimed at the original Native American population who have experienced significant struggles due to historic discriminatory, and oppressive practices of the American White establishment population. Due to systematic historic oppression, this minority population have lost their spiritual and ethnic connections to their land and traditions due to American colonization strategies. The GRL training program consists of 6-hour daily sessions for a period of 3-days, covering such topics as: “colonization and racism, multigenerational trauma and breaking unhealthy cycles” (Kelley et al., 2019, p. 63).
At the conclusion of the training, results were assessed based on a 14-point survey that evaluated the recorded changes in participants’ strengths at the beginning and end of the program. Out of a total 77 overall participants across various Native American tribes, there was a daily assessment response rate of 85.2%. The evaluation assessment responses were as follows: 1. Community focused culturally sensitive therapy benefits the clients as well as the mental healthcare professionals; 2. Clinicians cannot “give what we do not have”, and as such, GRL training offers an opportunity for native clinicians to receive personal healing (Kelley et al., 2019, p. 71); 3. The power of forgiveness is an effective antidote against oppression and historic trauma. Portions of the GRL program focused on forgiveness, and results show that individuals struggled with forgiving themselves more than forgiving others. Several sessions of the training therefore focused on self-forgiveness, and cultivating self-love as effective mental health tools, particularly among clinical professionals; 4. The assessments concluded with the need for follow-up programs and interventions to meet the need to continued enhancement and building coping skills.
A Summary of the Intervention/Program
GRL training programs were built on a multicultural model similar to that of the Gathering of Native Americans (GONA). At its core, the GRL curriculum trainings is open and adaptable to all age groups, to promote coping skills, positive relationship bonding, community independence, upliftment and hope as the underpinning for Native peoples’ solidarity and advocacy. The training materials consist of a robust manual which all participants receive, that includes a program outline, in addition to such topics as: norms, and tribal evolution (Kelley et al., 2019). Research conducted by Laurence Kirmayer and colleagues (2003) which focused on the healing traditions, culture, community and mental health of North American aboriginal populations, reveal heightened levels of suicides, substance use disorders (SUD), multiple mental health and sociological dysfunctions with a direct nexus to historic cultural and racial discrimination. For example, Native Americans underwent family, social and ethnic separation, by means of forced relocation and genocide; and neither those who were relocated nor those left behind were allowed to speak their Native languages (Kelley et al., 2019).
Within the last decade, the vast body of research not only support but advocate the reasoning for utilizing culture as a treatment that reunifies the indigenous people with their traditions, ethnic identity, language, culture and practices (Gone, 2013; Kirmayer et.al, 2003). Treatment, by means of trainings, can be offered online or in-person and is conducted in an out-patient setting. These methods of treatment remove previous treatment barriers like mental health stigmas, shameful emotions or uninsured socio-economic status. Additionally, GRL training eliminates a major treatment barrier among the Native population, which has been a chronic distrust in Western mental healthcare (Hodge et al., 2009). Recent studies confirm that government approved racial discrimination lends credence to the believe that Westernized mental health models would be ineffective with this population, because their traditions and culture is undervalued and not generally respected as they should be (Findling et al., 2019).
At the conclusion of the GRL program the results showed important positive outcomes from all participants. Participants were extremely pleased with the level of training, thoughtful planning of sessions activities, and quality of facilitators. The highest levels of statistical improvements were found in individual confidence to cope with future stress levels and personal triggers, feeling of reconnection with community and tribal culture, better comprehension of historical trauma and racism, ability to utilize learned strengths to conquer SUDs and negative behaviors (Kelley et al., 2019).
Web-Based Second-Best Togetherness: Psychosocial Group Intervention
A brief Introduction and Conclusion
This Web-based Second-best Togetherness psychosocial group intervention program, is based on a qualitative online interactive study of the lived-experiences of over 1,200 adult children of Holocaust survivors, who participated in psychosocial group webinars during the quarantine period of the COVID 19 pandemic in America, in the months of March and April 2020. Most of the biological offspring of Holocaust survivors are now age 60 and older, and according to Center for Disease Control (CDC) (2020) data, individuals over 60 were among the most vulnerable population to the novel coronavirus respiratory disease. All across America, people over 60 years of age were strongly cautioned to shelter in place, wear masks or protective covering over the nose and mouth, and practice social separation of at least 6 feet when in the presence of others. For many people, including senior adults, social quarantine has resulted in negative psychological outcomes (Brooks et al., 2020). Due to the historic intergenerational trauma “second generation Holocaust survivors” underwent various emotions evidenced by hypersensitivity to family separation, food shortages, mass governmental regulations and age trauma, because of what their parents’ suffered during the period of the Holocaust (Felsen, 2021).
Psychology and medical research have long established that parents with post-traumatic stress disorder (PTSD) “may confer psychological vulnerability upon their offspring” (Leen-Feldner et al., 2013, p. 1118), therefore, the issue of epigenetic transference and psychological connections between parents and children is a relatively foreclosed discussion. Parental symptomology of hyper-anxiety, depression, and acute stress are recognized as crucial determinants in assessing the quality and pervasiveness of intergenerational transmission in Holocaust survivor children and other historical trauma survivor groups (Lambert et al., 2014). The Web-based Togetherness program offered first-of- a- kind tools providing targeted culturally sensitive psychosocial intervention methodologies, distinctively designed for remote treatment when no in-person contact is required. The treatment method provided safe group environments where common vulnerabilities were held sacred, and people felt secure in sharing and working through trauma-related dysfunction free from judgment, or misunderstanding.
At the conclusion of the two-month treatment intervention using primarily trauma focused cognitive behavioral therapy (TF-CBT), participants responded in their groups with positive results. A majority of people cited the psychoeducational part of each webinar as most helpful by offering information about trauma and coping, with important strategies to implement during difficult times to help reduce stress and anxiety. There were several meetings structured around interaction where individual private concerns can be addressed, along with peers who share similar trauma. The interactive sessions of the program provided opportunities for others to relate to their peers who share similar pain, and normalize their experience by working through individual and collective trauma.
A Summary of the Intervention/Program
The Web-based Second-best Togetherness program was a group-based intervention offered on line throughout the United States and Canada, to children of Holocaust survivors during the Covid-19 pandemic in 2020. Some of the large group sessions consisted of up to 200 individuals who, electronically sent questions and concerns to the facilitator, prior to the meetings to be addressed during the interactive portion of the sessions. Participants were allowed to attend various sessions on different topics; however, the opening topic was a standard requirement on psychoeducation. Every session was ninety minutes. There were also much smaller group sessions with no more than 25 participants, who were involved with online stand-alone sessions.
Critical information on trauma focused cognitive behavioral therapy (TF- CBT) and coping, was taught during the psychoeducational part of each webinar. In additions to trauma therapy, stress reduction and behavioral coping skills, the larger group meetings included details on a structure for individuals who share similar trauma legacy. The aim here was to allow participants to compare and contrast experiences, and understand that their lived-experiences are normal, so that they can work through personal and collective trauma (Felsen, 2021). The program also addressed trauma triggers during Covid such as: age, food shortages, quarantine from family, loneliness, and helplessness, which are all reminiscent of stories the parents of Holocaust survivors shared with their children and grandchildren, who are now vulnerable to Covid and have internalized intergenerational collective trauma (Scharf & Mayseless, 2011).
Empirical research regarding second and third generation offspring Holocaust survivors dating back to the 1970s, have bolstered similar research in other historical trauma-exposed populations. Consequently, there is now a large body of literature addressing the impacts of intergenerational trauma resulting from the coronavirus pandemic (Felsen, 2021). Of particular notice is the report of one of the participants in the Wed-based program, who shared in one of the larger group sessions that she connected with her grandfather’s fortitude and resilience which became a source of power for her to persevere through the COVID-19 pandemic.
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