Treatment and Recovery Best Practices
Description: The Medicine Wheel and 12 Step interpretations were developed by White Bison, based on the Teachings of the Medicine Wheel, the Cycle of Life and the Four Laws of Change. The basic premises are:
- All native cultures believe in a Supreme Being.
- We believe in the Elders as a guiding force.
- We believe all tribal nations are different from each other.
- We believe that alcohol is destroying us and we want to recover.
- We believe there is a natural order running the Universe.
- We believe our traditional ways were knowledgeable about the natural order.
- A spiritual person is one who screws up every day and keeps coming back to the Creator.
- Those who walk this road will find that our thoughts must change to the way Warriors think.
Tribes Using Practice: Toiyabe Indian Health Project MSPI
Description: ACT is a contextually focused form of cognitive behavioral psychotherapy that uses mindfulness and behavioral activation to increase clients' psychological flexibility—their ability to engage in values-based, positive behaviors while experiencing difficult thoughts, emotions, or sensations. ACT has been shown to increase effective action; reduce dysfunctional thoughts, feelings, and behaviors; and alleviate psychological distress for individuals with a broad range of mental health issues, including substance abuse.
Tribes Using Practice: Indian Medical Center MSPI; Pueblo of Sandia MSPI
ACT (Assertive Community Treatment) Team, Modified
Description: The purpose of ACT is to deliver comprehensive and effective services to individuals who are diagnosed with severe mental illness and whose needs have not been well met by traditional service delivery approaches.
Treatment history of individuals who will be served is characterized by frequent use of psychiatric hospitals and emergency rooms, involvement with the criminal justice system, and alcohol/substance abuse.
The ACT program is a recovery/oriented and client-driven treatment model. Services provided by the ACT team seek to address all aspects of a person’s functioning and to nurture their life goals and integration into the community. ACT is a total team effort involving a prescribing provider, nurses, social work, therapists, substance abuse specialist, peer support specialist, and case managers with the emphasis on home visits and other interventions to promote recovery in the community.
Tribes Using Practice: Phoenix Indian Medical Center MSPI
Description: NADA (Acudetox or the NADA protocol was developed in 1974 by Dr. Michael Smith and is currently in use in many of the rehabilitation centers throughout the United States) acudetox is a five-point auricular (outer portion of the ear) acupuncture method that applies fine gauged, sterilized, one-time-use stainless steel needles just below the skin, where they remain for up to an hour while the patient relaxes in a comfortable environment. … Basically the stimulation of ear acupuncture points appears to cause the systemic release of endorphins. Comprehensive rehabilitation programs are used in conjunction to acudetox offering the basic therapeutic elements of family therapy and involvement, in addition to intensive counseling, education and 12 step forums.
Tribes Using Practice: Taos Pueblo MSPI
Adolescent Community Reinforcement Approach (A-CRA) and Assertive Continuing Care (ACC)
Description: A-CRA has been adapted for use with Assertive Continuing Care (ACC), which provides home visits to youth following residential treatment for alcohol and/or other substance dependence. It also has been adapted for use in a drop-in center for street-living, homeless youth to reduce substance use, increase social stability, and improve physical and mental health.
Tribes Using Practice: Pyramid Lake MSPI.
Description: Excerpt from the website: A fellowship of relatives and friends of alcoholics who believe their lives have been affected by someone else’s drinking.
- A mutual support recovery program based on the Twelve Steps of Alcoholics Anonymous.
- A nonprofessional fellowship where members share their experience, strength, and hope to solve their common problems.
- A program with the anonymity of all Al-Anon and AA members protected.
- A spiritual program that is compatible with all religious beliefs or none.
- A program with the single purpose of helping families and friends of alcoholics, whether the alcoholic is still drinking or not
Tribes Using Practice: Pawnee Nation MSPI
Co-Dependent No More
Description: Codependency causes a cycle of destructive behavior between manipulators and enablers that helps no one and can destroy relationships and lives. Substance abuse can make codependent relationships even worse. Codependency treatment helps participants learn to have healthier relationships and is associated with better outcomes for drug abuse treatment.
Tribes Using Practice: Fort Belknap Tribal Health Family Violence Prevention DVPI
Description: A form of psychotherapy in which the therapist and the client work together as a team to identify and solve problems. Therapists use the Cognitive Model to help clients overcome their difficulties by changing their thinking, behavior, and emotional responses.
Tribes Using Practice: Many
Description: The community-reinforcement approach (CRA) is an alcoholism treatment approach that aims to achieve abstinence by eliminating positive reinforcement for drinking and enhancing positive reinforcement for sobriety. CRA integrates several treatment components, including building the client’s motivation to quit drinking, helping the client initiate sobriety, analyzing the client’s drinking pattern, increasing positive reinforcement, learning new coping behaviors, and involving significant others in the recovery process. These components can be adjusted to the individual client’s needs to achieve optimal treatment outcome. In addition, treatment outcome can be influenced by factors such as therapist style and initial treatment intensity. Several studies have provided evidence for CRA’s effectiveness in achieving abstinence. Furthermore, CRA has been successfully integrated with a variety of other treatment approaches, such as family therapy and motivational interviewing, and has been tested in the treatment of other drug abuse.
Connect Program(“Postvention”), aka "New Hampshire Connect" or "NAMI Connect"
Description: This nationally recognized suicide response and prevention EBP uses a public health approach and best practice protocols. Customized to meet training and service needs of audiences, additional culturally appropriate components are included. Connect cross-training relies on collaboration between service providers.
Tribes Using Practice: Cheyenne River Sioux Tribe MSPI
Description: This approach uses a behavioral, problem-solving focus blended with acceptance-based strategies that emphasizes dialectical processes. ("Dialectical" refers to issues involved in treating people with multiple disorders and to the type of thought processes and behavioral styles used in treatment.) Foci include balancing behavioral change, problem-solving, emotional regulation with validation, mindfulness, and acceptance.
Tribes Using Practice: Many
Description: Harm reduction and substance abuse is a practical, empathic, and respectful way to manage drug and alcohol use. The advantage of harm reduction and substance abuse is that it respects and empowers the individual in a therapeutic relationship. The individual and therapist work together in an open, communicative relationship to discuss how to reduce negative effects of substance abuse, without necessarily having to abstain from using entirely … This does not eliminate abstinence as an effective option should the individual and therapist decide that it is the best choice. However, in harm reduction and drug abuse, treatment centers understand that in not everyone is ready to get completely abstinent at the same time, and in these cases reducing the risks of substance abuse may be more helpful than no treatment at all.
Tribes Using Practice: San Manuel Band MSPI
Living In Balance Curriculum
Description: Moving From a Life of Addiction to a Life of Recovery is a manual-based, comprehensive addiction treatment program that emphasizes relapse prevention. LIB consists of a series of 1.5- to 2-hour psychoeducational and experiential training sessions. The manual includes 12 core and 21 supplemental sessions. LIB can be delivered on an individual basis or in group settings with relaxation exercises, role-play exercises, discussions, and workbook exercises. The psychoeducational sessions cover topics such as drug education, relapse prevention, available self-help groups, and sexually transmitted diseases (STDs). Interactive sessions are designed to enhance level of functioning in certain key life areas that are often neglected with prolonged drug use: physical, emotional, and social well-being, adult education opportunities, vocational development, daily living skills, spirituality/recovery, sexuality, and recreation/leisure. These sessions include a large amount of role-play with time to actively process personal issues and learn how to cope with everyday stressors.
Description: An outpatient drug and alcohol treatment program that focuses on lifestyle changes, training in relapse prevention, education about dependencies and family involvement. Includes culturally relevant components and relies on interviewing techniques that motivate rather than confront people, so youth don’t feel they are being judged or attacked. Projects also report use of a ‘Modified Matrix’ model that incorporates cultural components into the model activities that reflect specific communities’ Tribal affiliation(s).
Tribes Using Practice: Many
Description: Medication assisted treatment (MAT) is the use of pharmacological medications, in combination with counseling and behavioral therapies, to provide a ‘whole patient' approach to the treatment of substance use disorders. Research indicates that a combination of medication and behavioral therapies can successfully treat substance use disorders, and for some people struggling with addiction, MAT can help sustain recovery.
Tribes Using Practice: Penobscot MSPI
Men’s Full Medicine Wheel [PDF - 638 KB]
Description: Provides a culturally appropriate 12 Step program for Native American men. Based upon Teachings of the Medicine Wheel, the Cycle of Life, and the Four Laws of Change(Similar to 12 Step Wisdom Program, reviewed above.)
Tribes Using Practice: Narragansett Indian Health Center
Meth 360 is a methamphetamine prevention program uniting law enforcement, treatment professionals and prevention professionals to deliver meth prevention education presentations to local communities. The audience learns about all aspects of meth from experts with diverse perspectives on the issue–a true "360-degree" view. Informative and motivational, Meth360 also challenges concerned citizens to educate themselves about the dangers of meth and take action to stop the spread of this dangerous drug.
Motivational Enhancement Therapy (MET)
Description: An adaptation of motivational interviewing (MI) that includes one or more client feedback sessions in which normative feedback is presented and discussed in an explicitly non-confrontational manner. Feedback is intended to strengthen and consolidate commitment to change and promote self-efficacy.
Tribes Using Practice: Several
Description: A goal-directed, client-centered counseling style for eliciting behavioral change by helping clients explore and resolve ambivalence.
Tribes Using Practice: Most
Multisystemic Therapy (MST) for Juvenile Offenders
Description: MST for Juvenile Offenders addresses the multidimensional nature of behavior problems in troubled youth. Treatment focuses on those factors in each youth's social network that are contributing to his or her antisocial behavior. The primary goals of MST programs are to decrease rates of antisocial behavior and other clinical problems, improve functioning (e.g., family relations, school performance), and achieve these outcomes at a cost savings by reducing the use of out-of-home placements such as incarceration, residential treatment, and hospitalization. The ultimate goal of MST is to empower families to build a healthier environment through the mobilization of existing child, family, and community resources.
Tribes Using Practice: Southern Ute MSPI
Parenting with Love and Limits
Description: Parenting with Love and Limits (PLL) combines group therapy and family therapy to treat children and adolescents aged 10-18 who have severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, attention deficit/hyperactivity disorder) and frequently co-occurring problems such as depression, alcohol or drug use, chronic truancy, destruction of property, domestic violence, or suicidal ideation. PLL teaches families how to reestablish adult authority through consistent limits while reclaiming a loving relationship. It includes six multifamily sessions, conducted by two facilitators that employ group discussions, videotapes, age-specific breakout sessions, and role-play. Individual families also receive intensive 1- to 2-hour therapy sessions in an outpatient or home-based setting to practice the skills learned in the group setting.
Tribes Using Practice: Kodiak Native Health Association
Description: A component of peer recovery support services that are designed and delivered by people who have experienced both substance use disorder and recovery. Peer recovery support services help people enter and stay engaged in the recovery process and so reduce the likelihood of relapse. They are designed and delivered by peers who have been successful in the recovery process and embody a powerful message of hope and a wealth of experiential knowledge. The services effectively extend the reach of treatment beyond clinical settings into the everyday environment of those seeking to achieve or sustain recovery.
Tribes Using Practice: Utah Navajo Health System, Inc. Navajo
Peer-mentoring, Sources of Strength
Description: At-risk youth with adults and peer mentors trained in the Sources of Strength Youth Suicide Prevention program (see SOS description, below). Trained peer leaders use their network of friends to:
- Have one-on-one conversations
- Develop a Hope, Help, Strength poster and/or PSA program using local faces and voices
- Present peer-to-peer presentations
- Develop video, internet, or texting messages.
The program often starts as 3-6 month project, but is designed as a multi-year project with ongoing peer messaging and contacts growing over time.
Tribes Using Practice: Turtle Mountain Band of Chippewa DVPI
Peer-to-peer services [PPs]
Description: Peers provide group supports; system navigation assistance; and follow-up/follow-along contacts.
Tribes Using Practice: Winslow Indian Health Care Center, Inc. MSPI
Red Road Approach to Wellness and Healing integrates Native American healing methodologies, philosophy and values with contemporary methods of chemical awareness, education and chemical addiction therapy processes. The Red Road Gathering evolved from the Red Road Approach enterprises of Medicine Wheel Inc., a partnership with the Student Counseling Center at the University of South Dakota and members of the Wase Wakpa community. Although the efforts of Medicine Wheel Inc. and its Red Road concepts are still at the foundational sharing of the conference, it has grown to be a globally diversified approach to recovery, health and healing.
Tribes Using Practice: N/A
Description: The signature, evidence-based Screening, Brief Intervention, and Referral to Treatment model developed by SAMHSA.
Tribes Using Practice: Components are widely used across projects.
Twelve Step Facilitation Therapy (TSF) is a brief, structured, and manual-driven approach to facilitating early recovery from alcohol abuse, alcoholism, and other drug abuse and addiction problems. TSF is implemented with individual clients or groups over 12-15 sessions. The intervention is based on the behavioral, spiritual, and cognitive principles of 12-step fellowships such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). These principles include acknowledging that willpower alone cannot achieve sustained sobriety, that reaching out to others must replace self-centeredness, and that long-term recovery consists of a process of spiritual renewal. Therapy focuses on two general goals: (1) acceptance of the need for abstinence from alcohol and other drug use and (2) surrender, or the willingness to participate actively in 12-step fellowships as a means of sustaining sobriety. The TSF counselor assesses the client's alcohol or drug use, advocates abstinence, explains the basic 12-step concepts, and actively supports and facilitates initial involvement and ongoing participation in AA.
The Wellbriety Movement is a multi-dimensional program created and designed by White Bison, Inc. Wellbriety teaches that we must find sobriety from addictions to alcohol and other drugs and recover from the harmful effects of drugs and alcohol on individuals, families and whole communities. The "well" part of Wellbriety is the inspiration to go on beyond sobriety and recovery, committing to a life of wellness and healing every day. Wellbriety resources and events include conferences, specialized community training events, Wellbriety coalitions, and the popular grassroots Firestarters circles of recovery groups across the nation.
Tribes Using Practice: N/A
Description: This is a peer-to-peer program that is designed to equip Native Americans in recovery to provide recovery support and community referrals for others in recovery. Provides a relapse prevention and recovery support program for Native Americans who are completing treatment, returning to the community from incarceration, or who have been working on their recovery journey using traditional method or 12 Step methods and who wish to provide support to others experiencing the same issues.
Tribes Using Practice: Toiyabe Indian Health Center
Wellness Recovery Action Plan (WRAP)
Description: Wellness Recovery Action Plan (WRAP) is a manualized group intervention for adults with mental illness. WRAP guides participants through the process of identifying and understanding their personal wellness resources ("wellness tools") and then helps them develop an individualized plan to use these resources on a daily basis to manage their mental illness.
Tribes Using Practice: United Indian Health Services MSPI
Wild Rice Camp, Medicine Gathering (traditional subsistence activities) (Local PP)
Description: Practices are facilitated for youth participating in suicide prevention group and to those in treatment for suicide intervention or methamphetamine (and other drugs or alcohol) abuse. Designed to increase connections to culture and community and help youth develop healthy alternatives to risky behaviors.
Tribes Using Practice: Fond Du Lac MSPI
Women's Full Medicine Wheel [PDF - 642 KB]
Description: Medicine Wheel and 12-Steps for Women provides a culturally appropriate 12 Step program for AI/AN women. Based upon Teachings of the Medicine Wheel, the Cycle of Life, and the Four Laws of Change.
Yes You Can! 16 Steps for Discovery and Empowerment
Description: The 16-step empowerment model is a holistic approach to overcoming addiction that views people in their wholeness—mind, body and spirit. Based on Dr. Charlotte Kasl’s “Yes, You Can!” book and model, the therapeutic group is called Women’s Path to Recovery.
Tribes Using Practice: Pueblo of Isleta BH Services (IBHS)