Cross Cultural Communication

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• Cross Cultural Communication

Terry L. Cross, MSW, National Indian Child
Welfare Association
Alaska Statewide CINA Conference, Anchorage,
Alaska October 2012
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For Colonialism to Succeed

• Take Territory Land
• Take Natural Resources Energy/Food
• Take Sovereignty Disrupt Leadership and
  Governance
• Take Away the Legitimacy of Thought Worldview,
  Language, Spirituality, Healing
• Take the Children

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Historical Context by Eras

• Pre-Columbian
• Military Balance 1492-1832 (340 years)
• Removal and Annihilation (1832-1870)
• Assimilation (1870-1970)
• Self-Determination ( 1968-Present)

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Boarding Schools
Church and Federal
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Historical Background

• Tribal governments disrupted
• Traditional land and economies taken away
• Generations of children forced into residential
  schools
• Children taken from families for adoption outside
  their cultures

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Manifestations of Colonialism

• Limits on tribal jurisdiction
• Inequity of funding
• Superiority of thought
• Removal of children
• White privilege/resentment
• Paternalistic policy making
• Disparities (structural risk factors)

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Messages of Colonialism

• Indigenous people cant be trusted to know or do
  whats best for them.
• Indigenous people are not significant enough to
  count.
• Services can only be done by Indigenous people if
  provided as prescribed by the colonial power.
• Colonial power policies are the right way and
  cant be modified even when they do harm.
• Know your place (we defeated youget over it)
  Cowboy up Michael Bloomberg

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Symptoms of Post-colonialism

• Intergenerational Trauma
• Lateral Oppression and Violence
• Internalized RacismSelf-Blame
• Identity Politics
• Dismembered Social Norms
• Adverse Childhood Experiences
• Blaming the Victim

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Post-colonial Reality

• Disparities Racial inequity in economic
  security, health, education, social conditions
• Disproportionate representation in systems (over
  and under)
• Poor outcomes for AI/AN children in state
  services
• Barriers to self-determination
• funding
• ICWA not fully implemented

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Disparities vs. Disproportionality

• Disparities refers to the variation in rates at
  which persons of different groups experience
  social conditions
• Disproportionality refers to the over
  representation of specific groups in child
  welfare, particularly placement

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Child Well-Being, 2007/2008
National Average White (Non-Hispanic) Black/African American Asian Pacific Islander American Indian Alaska Native Hispanic/ Latino
Infant Mortality Rate 6.7 5.6 13.2 3.7 8.8 5.7
Teen Death Rate 62 58 83 33 87 58
Teen Birth Rate 43 27 64 17 59 82
of teens 16-19 not in school/not graduates 6 5 8 2 13 11
of Children in Poverty 18 11 34 12 31 28
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Suicide Rates by Race/Gender Age 10-18, 2006
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Foster Care Placement, 2009 (compared to 2010
census percentage of total population)
2009 of Total Foster Care Population 2010 of Total Population
White 39.2 72.4
Black/ African American 30.2 12.6
American Indian/ Alaska Native 2 (2.6) .9
Asian American .6 4.8
Hispanic/Latino 20.4 16.5
estimate by NICWA which includes AI/AN children
in tribal welfare programs
Source U.S. Census Bureau (2011) Overview of
Race and Hispanic Origin 2010 Census Brief.
Available at http//www.census.gov/prod/cen2010/br
iefs/c2010br-02.pdf
Source U.S. Department of Health and Human
Services, Administration for Children and
Families Childrens Bureau (2010) The AFCARS
Report Preliminary FY 2009 Estimates as of July
2010. Available at http//www.acf.hhs.gov/programs
/cb/stats_research/afcars/tar/report17.htm.
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Maltreatment Decision Path

• White Children

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Decision Path to Disparity

• American Indian Children

Juvenile delinquency risk for Indian children
increases
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• Overrepresentation of AI/AN children in care is
  related to poverty, poor housing, poor education,
  untreated mental health issues, and caregiver
  substance misuse.

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Basic Principles of Child Protection
Assumes the Family has the Tools to Ensure Safety
and Well Being
Family
Child
Safety and Well being Paramount
STATE steps in when family fails to ensure safety
and well being
Blackstock Trocme, 2004
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Psychological Parent Model
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Extended Family Model
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What is an Adverse Childhood Experience (ACE)?
RISK FACTORS

• The experience of significant abuse or household
  dysfunction during childhood
• Specific Indicators

• Someone who is chronically depressed, mentally
  ill, institutionalized, or suicidal in the
  household
• Mother is treated violently
• One or no parents
• Emotional or physical neglect

• Recurrent physical abuse
• Recurrent emotional abuse
• Contact sexual abuse
• An alcohol and/or drug abuser in the household
• An incarcerated household member

(Division of Adult and Community Health, National
Center for Chronic Disease Prevention and Health
Promotion, CDC, 2010)
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ACE Study Model
(Division of Adult and Community Health, National
Center for Chronic Disease Prevention and Health
Promotion, CDC, 2010)
(CDC, 2010)
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The ACE Study

• The ACE Score is a count of the total number of
  ACE indicators for an individual.
• The score ranges from 1 (low trauma) to 9 (high
  trauma).
• In the mainstream population, as an ACE score
  increases, the risk for numerous health problems
  increases.

(Division of Adult and Community Health, National
Center for Chronic Disease Prevention and Health
Promotion, CDC, 2010)
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American Indian Youth Victimization and
Delinquency Outcomes Study (AIYVDOS)

• Used a participatory research model
• Culturally sensitive and scientifically sound
• Involving community members as partners and
  owners throughout the research process

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Final Sample

• 110 young adults, aged 18-25
• 82 Enrolled Tribal Members
• 58 Female, 42 Male
• Grew up
• On the Reservation 46
• Rural 5
• Small Town 21
• Suburbs 10
• Urban 18

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AIYVDOS and ACEs

• The percent of youth in our study with four or
  more ACEs is almost TWICE the rate in the
  mainstream population.
• In mainstream culture, adults who had experienced
  four or more ACEs compared to those who had
  experienced none had at least four times higher
  risk of
• Alcoholism/drug use
• Depression
• Suicide attempts

of ACEs of AIYVDOS Participants ACEs study (CDC, 2010)
0 30 36
4 25 13
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• The good news

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ACE Study Model
(Division of Adult and Community Health, National
Center for Chronic Disease Prevention and Health
Promotion, CDC, 2010)
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What is a Protective Childhood Experience (PCE)?
PROTECTIVE FACTORS

• Positive relationships and experiences while
  growing up that protect young people from
  negative influences and behaviors.
• Specific Indicators

• Supportive Adults
• Positive Peer Groups
• School Activities
• Family Resources

• Spiritual/Religious Connection
• Connection with Tribal Elders, Learning a Tribal
  Language
• Safe and Strong Community

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ACE scores, PCE scores, and Juvenile Delinquency

• We examined how ACEs and PCEs relate to
  delinquency by grouping people according to both
  ACEs and PCEs
• The group with low ACEs and high PCEs had the
  lowest delinquency (14)
• The group with high ACEs and low PCEs had the
  highest delinquency (67)
• Even when ACEs were high, the group with high
  PCEs had lower delinquency (39) than the group
  with low ACEs and low PCEs (46)

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ACE scores, PCE scores and Depression

• We also examined how ACEs and PCEs relate to
  depression.
• Depression was related to the following
• Gender (female)
• Higher Sexual abuse (ACE)
• Lower Safe and strong community (PCE)
• Lower Spirituality (PCE)

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Decolonization

• Colonization dismembered our culture, our
  people, and our families. Our job is
  Re-membering.
• Theda Newbreast, Blackfeet

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Relationship of NAYA-identified outcomes to
existing evidence

• Community-mindedness
• Positive cultural identity
• School belongingness
• Reduced perceived discrimination
• Hope
• Spirituality

• Lower depression
• Lower alcohol use
• Lower antisocial behavior
• Lower levels of internalizing behaviors
• Reduced suicide
• School success
• Increased school belongingness
• Anti-drug adherence
• Higher self-esteem
• Higher social functioning
• Increased resilience
• Better physical health
• Better psychological health
• Better health practices
• Increased physical activity
• Consistent use birth control
• Lower gang involvement
• Perception of less neighborhood disorder
• Better athletic performance

Outcomes in red are NAYA-identified outcomes all
items in right column are outcomes from the
research literature.
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Touchstones of Hope

• Self-Determination
• Culture and Language
• Holistic Approach
• Structural Interventions
• Non-Discrimination

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• Self Determination
• Development of community visions of child safety
• Embracing what hurts taking ownership
• Linking economic development/lands to child
  safety
• Reconciliation in child welfare program for
  leaders

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• Culture and Language
• Clarity of what community child caring knowledge
  is
• Acknowledging mainstream child welfare is
  culturally loaded
• Caution around adapting mainstream programs
  center community knowledge and values

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• Holistic Approach
• Do community planning with child wellbeing
  playing a central role
• Engage children/youth in community visioning
  exercises
• Be cautious about the risk of doing community
  development based on what government will fund
  versus on community need
• Engage the non-profit sector

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• Structural Interventions
• Ensuring Alaska Native children have equal access
  to resources
• Child welfare addressing poverty, substance
  abuse, mental health, and housing

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• Non discrimination
• Ensuring Indigenous children have equal access to
  resources
• Ensuring Indigenous knowledge is on equal footing
  with non Aboriginal knowledge in child welfare
• Promoting respectful relationship building across
  cultures

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Background of WPIC Project

• 16 Alaska Native tribal partners.
• Developed in response to the disproportionate
  rate of out-of-home placement of Alaska Native
  children in Alaska.
• Increase tribal capacity in several areas.
• Approaching systems change in tribal-state
  relationships through knowledge and education of
  historical trauma.

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Purpose of the TIHSM Template

• Standards based on the State of Alaska Safety
  model.
• Development and Implementation of 8 core
  elements.
• System of Care model.
• Cross system collaboration.

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Tribal In Home Services
System of Care
Local Practice Model
Core Elements
Safety Model
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Purpose of the TIHSM Template

• Standards based on the State of Alaska Safety
  model.
• Development and Implementation of 8 core
  elements.
• System of Care model.
• Cross system collaboration.

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Development of TIHSM On-Site
Step 1 Providing a Foundation, Overview,
Materials to discuss the TIHSM
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Development of TIHSM On-Site
Step 2 Discussion, Brainstorming, Group Dialogue
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Development of TIHSM On-Site
Step 3 Case staffing to reveal services
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Development of TIHSM On-Site
Step 4 Incorporation of Tribal Principles and
Values on Safety
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On-Site TA successes with the TIHSM Development

• Utilized the 8 core elements to staff the case.
• Case staffing indicated the level of services and
  resources available in villages.
• Allowed tribal staff to fully see what they do
  for families but also the level of collaboration
  that exists or can exist.

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Other uses of the TIHSM

• To develop an assessment.
• To staff and problem solve.
• To document services provided to families and
  children.
• To develop court reports.

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Other uses of the TIHSM

• Service mapping,
• Case planning,
• Team staffing
• Individualized MOAs

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Other uses of the TIHSM

• This document assisted the tribal child welfare
  worker to think of each 8 core element and how
  they could either provide the service or
  collaborate to provide the service.

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Lets remember why we are really here today
Healthy Native Children
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National Indian Child Welfare Association
www.nicwa.org
Protecting our Children Preserving our Culture