Aboriginal and Torres Strait Islander Flashcards
What is Cultural Capability?
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
5 Capabilities of the Aboriginal and Torres Strait Islander Health Curriculum Framework
Five Capabilities
- Respect
- Safety & Quality
- Reflection
- Communication
- Advocacy
Aim of Australian Indigenous Psychologists
Association
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
The White Australia Policy 1850s– 1973
Excluded and marginalised groups based on their ethnicity and race
Colonisation - 1788–1880
Appropriation of Aboriginal homelands and a process of extermination or domestication, sickness and a loss of Aboriginal law, leadership, traditions and language
‘Protection’ through segregation: 1890s –1950s
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).
Assimilation: 1950s–1960s
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).
Integration: 1967–1972
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)
Self-determination: 1972–1975
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).
Self-management 1: 1975–1988
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
Shared Responsibility: 2004–2014
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)
What is Inter-generational Trauma
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
Why does inter-generational trauma exist in Aboriginals?
- 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)
Definition health for Aboriginals
“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
Who is Aboriginal
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
What does culture provide for Aboriginals?
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
Traditional Aboriginal Cultural Practices
Rituals & Ceremonies Traditional Lore Bush Medicine Food Sacred Sites Environment Spiritual Sorry Business Traditional Healers
Why is it important to study Aboriginals?
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.
What are the social determinants of health?
- 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
Social determinants of concern for aboriginals?
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
Culture as A determinant of Health for Aboriginals
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
Clinical considerations for aboriginals social and emotional well-being
• 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
Promoting Healing in Aboriginals
‘Culturally safe’ health care Respect difference Holistic practices Incorporation of concept of SEWB and collectivist worldview Flexible Working in partnership
Strengths Based Approaches
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
Strength based communication does not try to
avoiding the truth, focusing only on the “problems”, focusing only on positive things, accommodating poor health choices, one sided
Low Cultural Context (Non indigenous)
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.
High cultural Context (Aboriginals)
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.
Things to consider for indigenous communication
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
Therapeutic relationships with aboriginals
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
Biomedical Model
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
Biopsychosocial Model
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).
