CultureCard

A Guide to Build Cultural Awareness

American Indian and Alaska Native About Tribal Regional and Cultural Communication this Guide Myths and Facts Sovereignty Cultural Differences Customs Spirituality Styles

The purpose of this guide is to provide Myth: AI/AN people are spiritual and live Presently, there are more than 560 Prior to European contact, AI/AN Cultural customs can be viewed as a A strong respect for spirituality, whether Nonverbal Messages basic information for Federal disaster in harmony with nature. Federally recognized AI/AN tribes in communities existed throughout various particular group or individual’s preferred traditional (prior to European contact), • AI/AN people communicate a great responders and other service providers Fact: The idea of all AI/ANs having the United States. Over half of these are areas of North America. Federal policies way of meeting their basic human needs Christian (resulting from European deal through non-verbal who may be deployed or otherwise a mystical spirituality is a broad Alaska Native villages. Additionally, there led to voluntary and forced relocation and conducting daily activities as passed contact), or a combination of both, gestures. Careful assigned to provide or coordinate services generalization. This romantic stereotype are almost 245 non-Federally recognized from familiar territory to the current day on through generations. is common among all AI/AN observation is in American Indian/Alaska Native (AI/AN) can be just as damaging as other more tribes. Many of those are recognized by reservation system. communities and necessary to avoid communities. negative stereotypes and impairs one’s their States and are seeking Federal Specifi c cultural customs among AI/ often forms a sense misinterpretation ability to provide services to AI/ANs as recognition. When the reservation system was formed AN groups may vary signifi cantly, even of group unity. of non-verbal This guide is intended to serve as a real people. in the late 1800s, some bands and tribes within a single community. behavior. general briefi ng to enhance cultural There is a unique legal were forced by the U.S. government to live Many AI/AN competence while providing services to Myth: AI/AN people have and political relationship together. In some instances, these groups Customs are influenced by: ethnicity, communities • AI/AN AI/AN communities. (Cultural competence distinguishing physical between the Federal were related linguistically and culturally; in origin, language, religious/spiritual beliefs, have a strong people may is defined as the ability to function characteristics, and you government and Indian others, they were not closely related and socioeconomic status, gender, sexual church community and look down to effectively in the context of cultural can identify them by how tribes and a special legal may even have been historic enemies. orientation, age, marital status, ancestry, organized religion that show respect differences.) A more specifi c orientation or they look. relationship with Alaska Native history, gender identity, geography, and is integrated within or deference to training should be provided by a member Fact: Due to Tribal diversity, Corporations. On reservations where different AI/ so on. their culture. elders, or ignoring of the particular AI/AN community. as well as hundreds of years AN groups were forced to co-exist, an individual to show of inter-Tribal and inter- The U.S. Constitution (Article repercussions occurred that still can be Cultural customs are often seen explicitly Traditional spirituality and practices disagreement or displeasure. Service providers should use this guide racial marriages, there is no 1 Section 8, and Article 6), experienced today in those communities. through material culture such as food, are integrated into AI/AN cultures and to ensure the following Five Elements single distinguishing “look” treaties, Supreme Court Historic rivalries, family or clan dress, dance, ceremony, drumming, day-to-day living. • A gentle handshake is often seen as of Cultural Competence* are being for AI/ANs. decisions, Federal laws, and conflicts, and “Tribal politics” may song, stories, symbols, and other visible a sign of respect, not weakness. addressed: Executive Orders provide present challenges for an outsider manifestations. Traditional spirituality and/or organized 1. Awareness, acceptance and Myth: Casinos have made authority to the Federal unaware of local dynamics who is religions are usually community-oriented, Humor valuing of cultural differences AI/ANs rich. government for Indian affairs trying to interact with different groups Such outward cultural customs are a rather than individual-oriented. • AI/AN people may convey truths 2. Awareness of one’s own culture Fact: Out of more than 560 with Federally recognized in the community. refl ection of a much more ingrained and or diffi cult messages through humor, and values Federally recognized tribes, tribes. implicit culture that is not easily seen or Spirituality, world view, and the meaning and might cover great pain with smiles 3. Understanding the range of dynamics only 224 operate gaming facilities. About While there is great diversity across and verbalized. Deeply held values, general of life are very diverse concepts among or jokes. It is important to listen closely that result from the interaction three-fourths of those tribes reinvest As sovereign nations, Tribal governments within tribes, there are within-region world view, patterns of commun- regions, tribes, and/or individuals. to humor, as it may be seen as invasive between people of different cultures revenue in the community. In 2006, only have the right to hold elections, determine similarities based on adaptation to ication, and interaction are often to ask for too much direct clarifi cation 4. Developing cultural knowledge of 73 tribes distributed direct payments to their own citizenship (enrollment), and to ecology, climate, and geography the differences that affect the Specifi c practices such as ceremonies, about sensitive topics. the particular community served or individual Tribal members. consult directly with the U.S. government (including traditional foods); helping relationship. prayers, and religious protocols will This guide was developed by an to access cultural brokers who may on policy, regulations, legislation, and linguistic and cultural vary among AI/AN communities. • It is a common conception that “laughter ad hoc group of U.S. Public Health have that knowledge Myth: The Bureau of Indian Affairs (BIA) funding. affi liations; and sharing A common practice of a is good medicine” and is a way to cope. Service Commissioned Officers, 5. Ability to adapt individual interventions, and the Indian Health Service (IHS) are of information for long group or individual that A blend of traditions, traditional spiritual The use of humor and teasing to show American Indian/Alaska Native programs, and policies to fit the the only agencies responsible for working Tribal governments can create and enforce periods of time. represents thoughts, practices, and/or mainstream faiths affection or offer corrective advice is cultural context of the individual, with tribes. laws that are stricter or more lenient than core values, and may coexist. It is best to inquire about also common. (AI/AN) professionals, and family family, or community Fact: The U.S. Constitution, Executive State laws, but they are not subservient Differences beliefs may be an individual’s faith or beliefs instead of advocates working together from Orders, and Presidential memos outline to State law. State laws cannot be applied in cultural described by making assumptions, but be aware that Indirect Communication 2006-2007. The abbreviation AI/AN policy requiring that ALL executive where they interfere with the right of a tribe groups are community many AI/AN spiritual beliefs and practices • It is often considered unacceptable is used for American Indian/Alaska *Adapted from Cross, T., Bazron, B., departments have the to make its own laws protecting the health closely related members as are considered sacred and are not to be Dennis, K., and Isaacs, M. (1989). for an AI/AN person to criticize Native in the interest of space and Towards A Culturally Competent responsibility to consult and welfare of its citizens, or where it to regional “the way we do shared publicly or with outsiders. another directly. This is important consistency. System of Care Volume I. with and respect Tribal would interfere with any Federal interest. differences and things” in a particular to understand, especially when Washington, D.C.: Georgetown sovereignty. may be distinguished tribe, community, Until passage of the Indian Religious children and youth are asked The authors of this guide wish to thank the University Child Development Criminal legal jurisdiction issues are very by their language or clan, or family. This Freedom Act in 1978, many traditional to speak out against or testify Center, CASSP Technical many AI/AN professionals and community Assistance Center. Myth: AI/ANs have complex, depend on a variety of factors, spiritual belief systems. includes decision-making AI/AN practices were illegal and kept against another person. It the highest rate of and must be assessed based on the They are also a result of the processes. secret. may be considered disloyal or members across the country who alcoholism. specifi c law as applied to a specifi c tribe. diversity of historic homelands disrespectful to speak negatively contributed their thoughts and comments Fact: While many tribes In general, the Federal law applies. across the Nation and migration Respectful questions about Social/health problems and their solutions about the other person. to this guide. The challenge in developing and AI/AN villages do patterns of Tribal groups. cultural customs are generally are often seen as spiritually based and a basic guide for an incredibly diverse experience the negative The Indian Self-Determination Act (Public welcomed, yet not always answered as part of a holistic world view of balance • There is a common belief that group of people such as AI/ANs cannot be effects of alcohol abuse, Law 93-638) gives the authority to Tribal Cultures developed in adaptation to their directly. between mind, body, spirit, and the people who have acted wrongly what is less known is governments to contract programs and natural environment and the infl uence of environment. will pay for their acts in one way or understated. The authors hope the result that AI/ANs also have services that are carried out by the Federal trade and interaction with non-Indians and Any questions about culture should be another, although the method may is accurate, respectful to the communities, the highest rate of complete government, such as services provided by other AI/AN groups. for the purpose of improving the service It is a common practice to open and not be through the legal system. and helpful for the users. abstinence. When socioeconomic the BIA or IHS. provider’s understanding related to the close meetings with a prayer or short level is accounted for in a comparison Urban Indian communities can be found services being provided. ceremony. Elders are often asked to offer Storytelling group, alcoholism rates are no different The Alaska Native Claims Settlement Act in most major metropolitan areas. These such opening and closing words and given • Getting messages across through for AI/ANs than for other ethnic or was signed into law on December 18, populations are represented by members Many AI/AN people have learned to a small gift as a sign of respect for sharing telling a story (traditional teachings racial groups. Most AI/AN-sponsored 1971. Settlement benefi ts would accrue of a large number of different tribes and “walk in two worlds” and will observe the this offering. and personal stories) is very events ban the use of alcohol and to those with at least one-fourth Native cultures that have different degrees cultural practices of their AI/AN traditions common and sometimes in contrast even “social” drinking is often frowned ancestry, and would be administered by of traditional culture and adaptation when in those settings, and will observe with the “get to the point” frame of mind upon. the 12 regional corporations within the to Western culture norms. They form other cultural practices when in dominant in non-AI/AN society. State. a sense of community through social culture settings. Myth: AI/AN people all get “Indian interaction and activities, but are often money” and don’t pay taxes. “invisible,” geographically disbursed, and Sharing food is a way of Fact: Few Tribal members receive multi-racial. welcoming visitors, similar payments from the BIA for land held to offering a handshake. in trust and most do not get signifi cant Food is usually offered “Indian money.” AI/ANs pay income at community meetings tax and sales tax like any other citizen and other gatherings of their State while the U.S. Alaska as a way to build Natives may get dividend payments relationships. from their Native Corporation or the State of Alaska as State citizens. JJanuaryanuary 2009 Role of Strengths in Health and Historic Distrust Cultural Identity Veterans and Elders AI/AN Communities Wellness Challenges Self-Awareness and Etiquette

Establishing trust with members of an When interacting with individuals who Elders play a signifi cant role in Tribal It is easy to be challenged by the conditions Concepts of health and wellness are Prior to making contact with a community, AI/AN community may be diffi cult. Many identify themselves as AI/AN, it is important communities. The experience and wisdom in AI/AN communities and to not see broad. The foundations of these concepts examine your own belief system about Etiquette – Do’s Tribal communities were destroyed due to understand that each person has they have gained throughout their lifetime, beyond the impact of the problems or are living in a harmonious balance with AI/AN people related to social issues, to the introduction of European infectious experienced their cultural connection along with their historical knowledge of crisis. all elements, as well as balance and such as mental health stigma, poverty, Learn how the community refers to If you are visiting the home of an AI/AN illnesses. Similarly, many treaties made by in a unique way. the community, are considered valuable harmony of spirit, mind, body, and the teen suicide, and drug or alcohol use. itself as a group of people (e.g., Tribal family, you may be offered a beverage the U.S. government with Tribal nations in decision-making processes. Recognizing and identifying strengths environment. Health and wellness may name). and/or food, and it is important to were broken. An individual’s own personal and family in the community can provide insight be all encompassing, not just one’s You are being observed at all times, so accept it as a sign of respect. history will determine their cultural It is customary in many Tribal for possible interventions. Since own physical body; it is holistic avoid making assumptions and be Be honest and clear about your role and From the 1800s through identity and practices, which communities to show respect by each community is unique, look to the in nature. AI/ANs define what conscious that you are laying the expectations and be willing to adapt Explain what you are writing when the 1960s, government may change throughout their allowing elders to speak first, not community itself for its own identified health and wellness is to them, groundwork for others to follow. to meet the needs of the community. making clinical documentation military-style boarding lifespan as they are exposed interrupting, and allowing time for opinions strengths, such as: which may be very different from Show respect by being open to other or charting in the presence of the schools and church- to different experiences. and thoughts to be expressed. how Western medicine defi nes Adapt your tone of voice, volume, and ways of thinking and behaving. individual and family. run boarding • extended family and kinship ties; health and wellness. speed of speech patterns to that of local schools were used The variation of cultural In group settings, people will often community members to fi t their manner of Listen and observe more than you During formal interviews, it may be best to assimilate AI/AN identity in AI/AN people can ask the elder’s permission to speak • long-term Many health and wellness communication style. speak. Learn to be comfortable with to offer general invitations to speak, people. Children be viewed as a continuum publicly, or will fi rst defer to an elder natural issues are not unique to AI/AN silence or long pauses in conversation then remain quiet, sit back, and listen. were forcibly that ranges between one to offer an answer. support communities, but are statistically Prefered body language, posture, and by observing community members’ Allow the person to tell their story removed from their who views himself or herself systems; higher than in the general population. concept of personal space depend on typical length of time between turns before engaging in a specifi c line of families to attend as “traditional” and lives their Elders often offer their teaching or advice It is important to learn about the key community norms and the nature of the at talking. questioning. schools far from traditional culture daily, to one in ways that are indirect, such as through • shared sense health issues in a particular community. personal relationship. Observe others and home where they were who views himself or herself as storytelling. of collective allow them to create the space and initiate Casual conversation is important Be open to allow things to proceed punished for speaking their “Indian” or “Native”, but has little community Among most AI/AN communities, 50 or ask for any physical contact. to establish rapport, so be genuine according to the idea that “things language and practicing spiritual knowledge or interest in their traditional When in a social setting where food is responsibility; percent or more of the population is and use self-disclosure (e.g., where happen when they are supposed to ways in a stated effort to “kill the Indian, cultural practices. served, elders are generally served fi rst, under 21 years of age. You may experience people expressing you are from, general information happen.” save the child.” Many children died from and in some traditional Alaska Native • physical resources their mistrust, frustration, or disappointment about children or spouse, personal infectious diseases, and in many schools Many AI/AN families are multicultural villages, it is the men who are served fi rst (e.g., food, plants, Health disparities exist with limited from other situations that are outside interests). Respect confi dentiality and the right of physical and sexual abuse by the staff was and adapt to their surrounding culture. by the women. It is disrespectful to openly animals, water, land); access to culturally appropriate health of your control. Learn not to take it the tribe to control information, data, rampant. Boarding school survivors were argue or disagree with an elder. care in most AI/AN communities. personally. Avoid jargon. An AI/AN community and public information about services taught that their traditional cultures were From the 1950s to the 1970s, the Federal • indigenous generational member may nod their head politely, provided to the tribe. inferior or shameful, which still affects government, adoption agencies, state AI/AN communities historically have high knowledge/wisdom; Only 55 percent of AI/AN people If community members tease you, but not understand what you are many AI/AN communities today. child welfare programs, and churches rates of enlistment in the military service. rely on the Federally funded understand that this can indicate rapport- saying. adopted out thousands of AI/AN children Often, both the community and the veteran • historical perspective and IHS or Tribally operated clinics/ building and may be a form of guidance or The Federal “Termination Policy” in the to non-AI/AN families. The Indian Child display pride for military service. strong connection to the past; hospitals for care. an indirect way of correcting inappropriate It is acceptable to admit limited 1950s and 1960s ended the government- Welfare Act was passed in 1978 to behavior. You will be more easily knowledge of AI/AN cultures, and invite to-government relationship with more end this practice. There are many AI/ Veterans are also given special • survival skills and resiliency in the Suicide is the second leading cause accepted and forgiven for mistakes if people to educate you about specifi c than 100 Federally recognized tribes. The AN children, as well as adults, who were respect similar to that of elders face of multiple challenges; of death among AI/AN people age 10- you can learn to laugh at yourself and cultural protocols in their community. result was disastrous for those tribes due raised with little awareness or knowledge for having accepted the role 34. The highest rates are among males listen to lessons being brought to you to discontinued Federal support, loss of of their traditional culture; they may now be of protector and experienced • retention and reclamation of between the ages of 24 and 34 and 15 through humor. land held in trust, and loss of Tribal identity. seeking a connection with their homelands, personal sacrifice. AI/AN traditional language and cultural and 24, respectively. Most of the tribes terminated during this traditional culture, and unknown community members practices; Living accommodations and local resources time were able to re-establish Federal relatives. recognize publicly the Following a death by suicide in the will vary in each community. Remember recognition through the Congressional service of the • ability to “walk in two worlds” community, concern about suicide clusters, that you are a guest. Observe and ask process in the 1980s and 1990s. When asked “Where are you veteran in formal and (mainstream culture and the AI/AN suicide contagion, and the possibility questions humbly when necessary. from?” most AI/AN people will informal settings. cultures); and of suicide pacts may be heightened. A Etiquette – Don’ts The Federal “Relocation Policy” in the identify the name of their tribe/village response to a suicide or other traumatic Rapport and trust do not come easily 1950s and 1960s sought to move AI/AN and/or the location of their traditional AI/AN community • community pride. occurrence requires a community-based in a limited amount of time; however, Avoid stereotyping based on looks, Avoid frequently looking at your watch families to urban areas, promising jobs, or family homeland. This is often a members who are veterans and culturally competent strategy. don’t be surprised if community language, dress, and other outward and do not rush things. housing, and a “new life.” Those that key to self-identity. are honored at ceremonies members speak to you about highly appearances. struggled and stayed formed the core of and pow wows, and by Prevention and intervention efforts charged issues (e.g., sexual abuse, Avoid pressing all family members to the growing Urban Indian populations. It is important to remember that special songs and dances. must include supporting/enhancing suicide) as you may be perceived as Avoid intrusive questions early in participate in a formal interview. Ultimately, many families returned home most Alaska Natives do not refer to They have a special role in the strengths of the community an objective expert. conversation. to their reservation or home community. themselves as “Indians.” community, so veterans and their resources as well as During a formal interview, if the person Today, many families and individuals travel families are shown individual and family clinical Issues around gender roles can vary Do not interrupt others during you are working with begins to cry, between their home community and urban Age is another cultural identity respect by public interventions. signifi cantly in various AI/AN communities. conversation or interject during pauses support the crying without asking communities for periods of time to pursue consideration. Elders can be acknowledgment Males and females typically have very or long silences. further questions until they compose education and job opportunities. very traditional while younger and inclusion in public Service providers distinct social rules for behavior in every themselves and are ready to speak. people can either be multicultural or events. must take great care day interactions and in ceremonies. Do not stand too close to others and/or Churches and missionaries have a long non-traditional. In many communities, in the assessment Common behaviors for service talk too loud or fast. Do not touch sacred items, such as history of converting AI/AN people to leaders and elders are worried about The AI/AN community’s process to consider providers to be aware of as they relate to medicine bags, other ceremonial items, their religions, and in the process often the loss of the use of the traditional view of Uniformed Service cultural differences gender issues are eye contact, style of Be careful not to impose your personal hair, jewelry, and other personal or labeled traditional cultural practices such language among children and young members being deployed to in symptoms and dress, physical touch, personal space, values, morals, or beliefs. cultural things. as songs, dances, dress, and artwork adults. Still, in other communities, young an AI/AN community in times of crisis health concepts when decision making, and the infl uence of as “evil.” Today there is a diverse people are eagerly practicing the language or disaster (such as the U.S. Public making a specific male and/or female elders. Be careful about telling stories of distant Do not take pictures without mix of Christian beliefs and traditional and other cultural traditions and inspiring Health Service Commissioned diagnosis or drawing AI/AN relatives in your genealogy as an permission. spirituality within each AI/ older generations who may have felt shame Corps or National Guard) will vary conclusions about the Careful observation and seeking guidance attempt to establish rapport unless you AN community. in their identity growing up as AI/AN. greatly. There may be respect for presenting problem from a community member on appropriate have maintained a connection with that NEVER use any information gained the uniform similar to that shown or bio-psychological gender-specifi c behavior can help service AI/AN community. by working in the community for Historical trauma and grief events, such to a veteran, but there may also be history. providers to follow local customs and personal presentations, case studies, as boarding schools or adoption outside feelings of distrust related to the demonstrate cultural respect. Be careful about pointing with your research, and so on, without the of the tribe, may play a dramatic role in U.S. government’s and the military’s Every effort should be fi nger, which may be interpreted as rude expressed written consent of the shaping attitudes, sense of identity, and historical role and presence in AI/AN made to consult with behavior in many tribes. Tribal government or Alaska Native levels of trust. communities. local cultural advisors for Corporation. questions about symptomology and treatment options. This publication may be downloaded or ordered at www.SAMHSA.gov/shin. Or, call SAMHSA’s Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español). DHHS Publication No. (SMA) 08-4354

January 2009