First, regarding psycho-educational assessments and Indigenous clients, I acknowledge my bias. I am a citizen of the Métis Nation, one of three Aboriginal groups recognized in the constitution of Canada, and have worked for many years with Aboriginal/Indigenous populations in social work and mental health settings. Many families that I have worked with have utilized psycho-educational assessments for the purpose of obtaining a diagnosis for their loved one. In turn, it was hoped that the diagnosis would create access to resources, for example, funding for autism therapies, or educational supports for special needs, such as fetal alcohol spectrum disorder (FASD). Alongside the positive outcomes that a diagnosis might trigger, the detrimental impacts of "labels" must also be acknowledged. This includes the tendency to focus on the deficits associated with the "label", rather than the individual's strengths. As well, the individual may internalize and identify with the "label" and, consequently, believe in the psycho-social limitations associated with the diagnosis.
Second, regarding Western psychological assessment tools, cautionary arguments have emerged from Indigenous experts across Canada. For example, according to Stewart (2019), standardized testing and assessment are not appropriate for Indigenous clients as these tests may in fact be damaging as they are generally based on Western concepts of mental health. Stewart is not alone in her conclusions; rather, this is a common position among Indigenous scholars. This has been confirmed through Çerkez, Manyeruke, Oduwaye and Shimave (2018), who completed a review of articles on ethics published by the American Psychological Association (APA) and concluded that over half of the studies from 1986 to 2017 were produced in America, and that counselling psychology was the subject of nearly 37% of the articles. Additionally, although developing countries are working to indigenize psychology and, globally, indigenization has increasingly appeared in research on ethics, to date, no ethical research exists to support using Western approaches with Indigenous clients (Çerkez et al., 2018). Therefore, overall, more ethically-informed research is needed to determine the specific impacts of Western psychological approaches and assessments on Indigenous populations.
A third strand of thought on this issue follows Erford (2013) (e.g., testing has historically marginalized some groups), and acknowledges that non-Indigenous approaches are a continued form of colonization and oppression when used in Indigenous communities (Duran, 2006). Furthermore, McCabe (2007), a Métis psychologist, concluded that home-grown approaches rooted in the worldview and cosmology of the Native community to mental health and wellness are essential to Indigenous communities. Importing mainstream approaches into Native communities, then, creates problematic responses because psycho-social problems experienced by Aboriginal peoples cannot be resolved with mainstream assessments and approaches. Similarly, McCormick (2009) is unwavering in his belief that conventional Western mental health approaches are fundamentally incompatible with Aboriginal peoples. Even despite the diversity of Indigenous peoples and individual Nation members, each shares a common experience: The detrimental and multi-generational impacts of colonization. After scanning the literature, Holmes and Hunt (2017) concluded that colonial policies, values, and patriarchal models of family interrupted Indigenous family structures, practices, and traditions. Collectively, these contexts must be considered by counsellors working with Indigenous clients, even if these clients are not presently connected with their culture. This is because all Indigenous people have, in some way, been impacted by colonial policies and practices. Western concepts of psychological concerns (e.g., depression and anxiety) may be difficult to assess given the compounding effects of colonization and inter-generational trauma. Western mental health practices and assessments, then, might also perpetuate negative colonial experiences.
In closing, for Indigenous clients weighing the pros and cons of psycho-educational assessments, it is important to consider the aforementioned points, as well as to take the time to ask questions and seek information from multiple sources in order to make the best decision for yourself or for other family members.
References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Çerkez, Y., Manyeruke, G., Oduwaye, O., and Shimave, S. (2018). Ethical issues in counseling:
A trend analysis. International Journal of Methodology, 52(Suppl 1), S223-S233.
Duran, E. (2006). Healing the soul wound: Counseling with American Indians and other Native peoples. New York City, NY: Teachers College Press.
Erford, B. T. (2013). Assessment for counselors (2nd ed.). Boston, MA: Cengage.
Holmes, C., & Hunt, S. (2017). Indigenous communities and family violence: Changing the
conversation. Retrieved from https://www.ccnsa-nccah.ca/docs/emerging/RPT
FamilyViolence-Holmes-Hunt-EN.pdf
McCabe, G. (2007). The healing path: A culture and community-derived Indigenous therapy
model. Psychotherapy: Theory, Research, Practice, Training, 44(2), 148-160.
McCormick, R. (2009). Aboriginal approaches to counselling. In L. Kirmayer & G. Valaskakis
(Eds.), Healing traditions: The mental health of Aboriginal peoples in Canada (pp. 337–
354). Vancouver, BC: UBC Press.
Stewart, S. (2019). Family counselling as decolonization: Exploring an Indigenous social
constructivist approach in clinical practice. First Peoples Child and Family Review, 14(1),
43-56.
Image: K. Bayer; photo from a sidewalk on New Garden Street, Vancouver.
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