Aboriginal and Torres Strait Islander

Question 1

What is Cultural Capability?

Answer 1

Demonstrated capacity to act on cultural knowledge and awareness through a suite of core attributes that are acquired through a dynamic lifelong-learning process 
 Holistic
 Transferable
 Responsive
 Adapted to new and changing contexts

Question 2

5 Capabilities of the Aboriginal and Torres Strait Islander Health Curriculum Framework

Answer 2

Five Capabilities

1. Respect
2. Safety & Quality
3. Reflection
4. Communication
5. Advocacy

Question 3

Aim of Australian Indigenous Psychologists

Association

Answer 3

National body representing Aboriginal and Torres Strait Islander psychologists in Australia
Is committed to improving the social and emotional well-being and mental health of Aboriginal and Torres Strait Islander peoples by leading the change required to deliver equitable, accessible, sustainable, timely and
culturally competent psychological care which respects and promotes their cultural integrity

Question 4

The White Australia Policy 1850s– 1973

Answer 4

Excluded and marginalised groups based on their ethnicity and race

Question 5

Colonisation - 1788–1880

Answer 5

Appropriation of Aboriginal homelands and a process of extermination or domestication, sickness and a loss of Aboriginal law, leadership, traditions and language

Question 6

‘Protection’ through segregation: 1890s –1950s

Answer 6

Perceived inferiority of the Indigenous peoples (Ethnocentrism);
Indigenous peoples would die out (Social Darwinism);
Forced segregation of Aboriginal people from their homelands onto missions and reserves (Trauma)
Provided with poor living conditions, meagre rations of sugar, tea and flour, as well as controlling substances of tobacco and opium (Health)
Forcible removal of children (the stolen generation).
The role of the Chief Protector - control the movement,
speech, marriage, bank accounts, wages, wills, property
and debts of all Aboriginal people (Kidd, 2002).

Question 7

Assimilation: 1950s–1960s

Answer 7

Based on the assumption that Aboriginal Australians would attain the same lifestyle, customs, laws and traditions as other Australians (Broome, 1982).
Later found to be both ‘systemic racial discrimination, and genocide, as defined by international law’ (Human Rights and Equal Opportunity Commission, 1997, p. 266).

Question 8

Integration: 1967–1972

Answer 8

In 1967, the federal government held a constitutional
referendum
 90 per cent of Australians voted in favor
In 1971 Indigenous Australians were included in the
census for the first time.
Placed more emphasis on positive relations (Smith, 2016)

Question 9

Self-determination: 1972–1975

Answer 9

The Federal Department of Aboriginal Affairs (DAA) was
established in 1972.
 Responsible for the development of national policies in consultation with Aboriginal and Torres Strait Islander people, thus restoring power to Aboriginal people and Torres Strait Islanders to make their
own decisions about their own way of life (Smith, 2016).
 The Queensland Government rejected this and continued with assimilation policies until 1982 (Ober et al., 2000).

Question 10

Self-management 1: 1975–1988

Answer 10

Federal Government expected Indigenous Australians to be held accountable for their own decisions and financial management
(Eckermann et al., 2012).
With this came a strong push for land rights and separate legal, health and housing services
Treaty
Reconciliation
World Health Organization (WHO) reported that Aboriginal health was among the worst of any Indigenous group in the world

Question 11

Shared Responsibility: 2004–2014

Answer 11

Coordinate a whole-of-government approach to programs and services for Indigenous Australians
Office of Indigenous Policy Coordination (OIPC)
Department of Immigration, Multicultural and Indigenous Affairs (DIMIA)

Question 12

What is Inter-generational Trauma

Answer 12

A trauma that reoccurs across generations, shared collectively, and is continuously compounded in a cyclic nature.
Destruction of ways of dealing with trauma, suppression of unresolved trauma, collective trauma and cultural trauma are components of Aboriginal and Torres Strait Islander
transgenerational trauma

Question 13

Why does inter-generational trauma exist in Aboriginals?

Answer 13

- Australia being declared Terra Nullus
– Genocide period, violence and killing
– Loss of land, home, hunting grounds, water holes
– Introduction of diseases
– Protectionism, assimilation
– Stolen wages
– Black deaths in custody
– Stolen generation
– Withdrawal of the Racial Discrimination Act (RDA)

Question 14

Definition health for Aboriginals

Answer 14

“Aboriginal health” means not just the physical well-being of an individual but refers to the social, emotional and cultural well-being of the whole Community in which each individual is able to achieve their full potential as a human being thereby bringing about the total well-being of their Community

Question 15

Who is Aboriginal

Answer 15

A descendant of First Australians
Identifies as an Aboriginal and/or Torres Strait Islander person
Accepted by his/her community in which he/she lives

Question 16

What does culture provide for Aboriginals?

Answer 16

Provides Aboriginal and/or Torres Strait Islander people with a strong sense of identity and belonging.
Provides a strong sense of identity
Provides a strong sense of well-being
Strength to be confident

Question 17

Traditional Aboriginal Cultural Practices

Answer 17

 Rituals & Ceremonies
 Traditional Lore
 Bush Medicine
 Food
 Sacred Sites
 Environment
 Spiritual
 Sorry Business
 Traditional Healers

Question 18

Why is it important to study Aboriginals?

Answer 18

High percent of them live in major city areas, not rural as expected (especially in NSW and QLD)
3/10 have high to very high levels of psychological stress
Suicide
- twice the rate compared to non-indigenous
- factors contributing to these rates include
 History of colonisation;
 Inter-generational trauma;
 Ongoing racism;
 The everyday realities in First Peoples communities, such as unemployment, poverty, overcrowding, social marginalisation.

Question 19

What are the social determinants of health?

Answer 19

• Understanding disparities between First Peoples and non-Indigenous peoples, is to understand factors and processes outside traditional domains of health.
• Structures of society and social conditions in which people grow, live, work and age

Question 20

Social determinants of concern for aboriginals?

Answer 20

 Schooling – 55% Year 12 completion rate
 Employment – 4.2 times higher unemployment
 Incarceration – First Peoples 27% of the prisoner population
 Housing – 14 times higher homelessness rate
 Racism – 27% reported experienced regularly

Question 21

Culture as A determinant of Health for Aboriginals

Answer 21

 Protection/ promotion of traditional knowledge and practices;
 Family and kinship;
 Connection to Country/Community;
 Contribute to personal and community resilience and well-being.
The cultural determinants of health originate from and promote a strengths based perspective, acknowledging that stronger connections to culture and country build stronger individual and collective identities, a sense of self-esteem, resilience, and improved outcomes across the other determinants of health including education, economic stability and community safety

Question 22

Clinical considerations for aboriginals social and emotional well-being

Answer 22

• Culturally appropriate screening tools
 Connection to land
 Connection to history
 Connection to community
 Relationships with family
• Prevalence of under diagnosis
• Spirituality
• Interactions between western medicine &
bush medicine
• Holistic approach

Question 23

Promoting Healing in Aboriginals

Answer 23

 ‘Culturally safe’ health care
 Respect difference
 Holistic practices
 Incorporation of concept of SEWB and collectivist worldview
 Flexible
 Working in partnership

Question 24

Strengths Based Approaches

Answer 24

Recognises the importance of
 an individual’s resilience
 builds upon existing strengths and capacities
- Build upon pre-existing negative stereotypes that can be dis-empowering for individuals
Value activity, skills, knowledge, connections and potential in individuals and communities
Focusing on what is going well and identifying what is going on when things are going well

Question 25

Strength based communication does not try to

Answer 25

 avoiding the truth,
 focusing only on the “problems”,
 focusing only on positive things,
 accommodating poor health choices,
 one sided

Question 26

Low Cultural Context (Non indigenous)

Answer 26

Primary purpose of communication is the exchange of information, facts and opinions

Association
• Relationships begin & end quickly. Many people can be inside one’s circle; circle boundary is not clear
• Follows procedures & pays attention to the goal
• One’s identity is in oneself and one’s accomplishments
• Social structure is decentralised; responsibility goes further down
Interaction
• Low use of nonverbal elements.
• Verbal message is explicit
• Verbal message is direct;
• Communication is seen as a way of exchanging information, ideas, and opinions.
• Disagreement is depersonalized. One withdraws from
conflict with another and gets on with the task. Focus
is on rational solutions, not personal ones. One can be
explicit about another’s bothersome behaviour
Territoriality
Space is compartmentalized and privately owned; privacy is important, so people are farther apart.
Temporality
 Things are scheduled to be done at particular times, one thing at a time. What is important is that activity is done efficiently.
 Change is fast. One can make change and see immediate results.
 Time is a commodity to be spent or saved. One’s time is one’s own.
Learning
 Reality is fragmented and compartmentalized.
One source of information is used to develop knowledge
 Learning occurs by following explicit directions and explanations of others.
 An individual orientation is preferred for learning and problem solving.
 Speed is valued. How efficiently something is learned is important.

Question 27

High cultural Context (Aboriginals)

Answer 27

Primary purpose of communication is to form and develop relationships; contextual information is needed
Association
• Depend on trust, build up slowly, are stable. Ones social circle is clearly defined
• Attention to group process.
• One’s identity is rooted in groups (family, kinships, culture, work)
• Social structure & authority are centralised; responsibility is at the top.
Interaction
 High use of nonverbal elements;
 Verbal message is implicit;
 Verbal message is indirect;
 Communication is seen as an art form—a way of engaging someone.
• Disagreement is personalized. One is sensitive to
conflict expressed in another’s nonverbal communication.
• Conflict either must be solved before work can progress or must be avoided because it is personally
Territoriality
 Space is communal; people stand close to each other, share the same space threatening.

Question 28

Things to consider for indigenous communication

Answer 28

Eye contact
Silence
Gender Roles
Kinship Networks
Historical impacts
Diversity
Language
Story telling
Non-verbal
 Environment
 A strong connection to land, country, ancestors and spirits
 Gratuitous concurrence
 The importance of family, family structure & community –
connectedness
 Importance of humour

Question 29

Therapeutic relationships with aboriginals

Answer 29

More likely to access services if:
• communicate respectfully,
• have some understanding of culture,
• build good relationships with Aboriginal &/or Torres Strait Islander
clients, and
• where Aboriginal &/or Torres Strait Islander health workers are part of
the health care team

Question 30

Biomedical Model

Answer 30

 seen as a ‘sick’ body that can be
handled, explored and treated independently from their mind and other external considerations.
 All illness and all symptoms and signs arise from an underlying abnormality within the body, referred to as a disease.
 Health is the absence of disease.
 The patient is a victim of circumstance with little or no responsibility for the presence or cause of the illness.
 The patient is a passive recipient of treatment, although cooperation with treatment is expected

Question 31

Biopsychosocial Model

Answer 31

 Proposed by Engel (1977) implies that behaviours, thoughts and feelings may influence a physical state.
 Psychological and social factors influence biological
functioning and play a role in health and illness.
 Patient seen as a person with an individual lifestyle and not simply as a patient with a disease which has deviated them from normal functioning (McInerney, 2015).