Evidence-Based Treatment and Cultural Competence in American Indian Behavioral Health

Evidenced-based interventions are usually not available for American Indians and Alaska Natives (AIANs) obtaining treatment for behavioral health problems. The reasons for this are multifaceted, but include community objections to many forms of "western" psychosocial treatment on cultural grounds. Specifically, these interventions are seen as too alien to benfit many tribal members, leading to advocacy for greater inclusion of indigenous tradition in the therapeutic endeavor. That is, as culturally competent alternative, traditional indigenous practices - especially traditional therapeutic practices - might be intergrated with (or even substituted for) mainstream behavioral health interventions to ensure grater cultural relevance for indigenous communities. And yet, tribal leaders, policy makers, and funding agencies will want assurances that such therapeutic innovations actually work, which requires evidenc of beneficial outcomes that will stand up to skeptical scrutiny. In this presentation, I will reveiw these issues, and describe the collaborative development of an Indigenous intervention designed to bridge evidence-based practice and cultural competence in AIAN behavioral health services.