Integrative Approaches

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Integrative Approaches

• LEARN Model
• Native American Teachings/Medicine

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LEARN MODEL

• Most powerful transcultural barriers are
  different explanatory models of disease/illness
• Providers must first become aware of their own
  cultural biases

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Starts in communication

• Verbal
• Non-verbal
• Handshakes smiles
• Signs of warmth and caring to a Hispanic patient
• Indication of frivolity and immaturity to Soviet
  emigres

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LEARN Model

• L - Listen with empathy understanding (active
  listening)

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LEARN Model

• L Listen with empathy understanding
• E Explain your perception of the problem/need

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LEARN Model

• L Listen with empathy understanding
• E Explain your perception of the problem/need
• A Acknowledge discuss differences in
  client/provider perceptions

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LEARN Model

• L Listen with empathy understanding
• E Explain your perception of the problem/need
• A Acknowledge discuss differences as well as
  similarities in client/provider perceptions
• R Recommend treatment or action plans

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LEARN Model

• L Listen with empathy understanding
• E Explain your perception of the problem/need
• A Acknowledge discuss differences/similarities
  in client/provider perceptions
• R Recommend treatment or action plans
• N Negotiate treatment or action plans
  (Involvement Action)
• Berlin Fowkes (1983) Modified Tafoya Wirth
  (1992)

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the disconnect

• Patients ask why theyre ill, and having told
  them how they became ill, physicians think
  theyve answered the question.
• Dr Margaret Clark

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mending/preventing the disconnect

• Because of alternate views of the causative
  factors of disease, there are also alternative
  methods of treatment.

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Asian Latino American Cultures

• Believe in a humoral concept of disease and
  treatment
• Based upon opposition or balance of hot cold
  qualities

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What happens to clients?
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Integrating Native American Teaching

• to develop effective, culturally relevant
  approaches to HIV/AIDS treatment, services, case
  mgt, and prevention programs.

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Smudging Sacred Smokes

• To cleanse and purify both the physical and
  spiritual bodies with smoke from sacred herbs
• Sage Cedar
• Every Nation has its own specific teachings
  practices

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Sweat Lodge

• Ceremony of preparation
• Means of physical and/or spiritual renewal
• No fire hot rocks produce heat create steamy
  mist

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Apache Tears

• Obsidian
• Smoking Mirror
• Knives, spearpoints arrowheads
• Paul Ortega, Apache Medicine Man
• Put sorrow in stone
• Once youve learned what you needed to know,
  release it / let it go

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Storytelling

• Internalization of the meaning of the story
• Telling elaborating stories as opposed to telling
  directly this is what the story means

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Talking Circles

• Provide group members w/ structure and support
• Help to deal with pause time issues
• 1st generation responsibilities of teaching
  sharing

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Drumming Dancing
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Drumming Dancing

• Entire cosmos moves in constant rhythm
• All of life pulses to the cosmic dance
• Music is a healing force all living spirits sing

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Drumming Dancing

• Drumming dancing are expressions of
• inter-dependence,
• healing,
• medicine
• rebalances energy

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Drumming Dancing

• Can be a holy act, a religious act or an act of
  great power

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Sacred Herbs
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Medicine People