David Vicary

Western psychotherapeutic practice: Engaging Aboriginal people in culturally appropriate and respectful ways

Until recently the majority of psychologists in Australia have been confronted by the lack of information relating to culturally appropriate methods of engagement and therapy with Aboriginal clients. Findings from a qualitative study undertaken in Western Australia indicated that Aboriginal conceptualisations of mental health appear more holistic and contain elements that are both cultural and spiritual. The extent of these differences in conceptualisations from Western psychiatry and psychology are so vast that the mental health interventions need to be reconsidered. Extending from an Aboriginal mental health model are traditional treatments that endeavour to address the cultural and spiritual components of the mental illness. Findings from the study indicated that these treatments appeared to be hierarchically organised, depending on cause, severity, type of practitioner required and treatment. The findings also indicated that Aboriginal people generally seek traditional interpretations and treatment of...

That’s just the way he is’: Some implications of Aboriginal mental health beliefs

Abstract Recent qualitative research conducted in metropolitan Perth and the Kimberley region of Western Australia has highlighted major gaps in service delivery to Aboriginal clientele suffering depression and suicidal ideation (Vicary, 2002). Seventy Aboriginal people were interviewed about their beliefs and attitudes towards mental health, western psychology and western practitioners, and strategies for improving mental health care delivery. The study highlights that participants consistently perceived the course and treatment of depression as following a different aetiology to that of mainstream Australia. The authors’ references to depression do not conform with Eurocentric perceptions, but rather to the Aboriginal Australians’ conceptualisation, as explained within the paper. Almost three in four respondents indicated that they believed that Aboriginal people did not perceive depression as a state that could be addressed via treatment. Instead they perceived it as a characteristic of the individual concerned stating ‘that’s just the way he is’. Subsequently they reported that individuals might not get the assistance they require in overcoming their illness.

Children as decision makers

Involving children and young people in planning, decision making and the evaluation of services and programs inevitably raises the eyebrows of adults working in the areas of service delivery, program development and policy formulation. Some adults may question young people’s ability to see the ‘big picture’ and to make decisions, and even their right to be engaged in the first place. In challenging these ideas, the Western Australian Office for Children and Youth established a Children’s Advisory Group (CAG) in 2004 – the first of its kind to be created within the Western Australia Government, and one of the first such groups to be set up in Australia. The current Children’s Advisory Group (CAG) is a diverse group often primary school children aged 9-12 years from the Perth metropolitan area. They are actively involved in all aspects of the Office’s operation. The CAG has been evaluated throughout its inaugural year of operation, both in terms of process and impact, and has been found to have a significant impact upon government policy and practice. This paper will outline the process for the establishment and implementation of a CAG and the evaluation of a CAG on government policy. It will highlight evaluation findings and discuss future directions.

Developing a Culturally Appropriate Psychotherapeutic Approach with Indigenous Australians

Abstract Many Australian psychologists have little information about how to perform culturally appropriate assessment and therapy with Aboriginal clients. This article explores relevant history that affects the psychological health of Aboriginals, and contrasts the western perspective on mental health with Aboriginal beliefs. A case study is used to illustrate a process that might be used by non-Aboriginal therapists when working with Aboriginal clientele. The case study contrasts a culturally sensitive approach with common western psychotherapeutic processes. Recommendations for the enhancement of culturally appropriate therapeutic interventions are discussed.

Public Policy, Participation and the Third Position: The Implication of Engaging Communities on their Own Terms

Policy development and implementation should be fundamental for community psychologists in their endeavors to create social change. Policy necessarily is engaged at broad social and political levels, but it is mediated through communities and individuals, and thus appealing for our discipline. We argue that there are increasing opportunities for social input in liberal democracies with the growing awareness of the need to consider social factors in policy. Public participation is one aspect of policy development, but it can be problematic and can disempowered communities, especially disadvantaged communities. Using the framework of the ‘third position’, a case study of attempts to ameliorate institutional oppression of Australian Aboriginal people through policy change is described. Structural reform to community engagement is described in terms of empowerment and capacity building. Power relationships are deconstructed to allow understandings of the dynamics of policy change, and the broader implications for community psychological praxis are discussed.

Can you hear me?: The active engagement of Aboriginal children in the development of social policy by non-Aboriginals

In recent years significant focus has been placed on the first few years of a child’s life and how their experiences during this time can shape their future development (McCain & Mustard, 1999). Social policy and programs that enhance the capacity of children and their families so that positive outcomes for children are ensured are being developed and implemented throughout Australia. This paper takes up the topic, initially introduced in Children Australia (Vicary et al. 2005), but turns the focus to Aboriginal children. Despite the advances in early years policy and programs development, marginalised children, particularly those from Aboriginal backgrounds, continue to be overlooked in terms of consultation (Vicary 2002). The ramifications of this lack of consultation are profound in terms of cultural appropriateness and sensitivity. The Western Australian Office for Children and Youth has refined a model for the engagement of Aboriginal children in social policy consultation. The model is inclusive of diversity and targets the children who normally would not have their voices heard in the development of social policy. The following paper will describe the Aboriginal Child Engagement Model developed by the Office for Children and Youth in consultation with children, young people and adults from Aboriginal backgrounds. The model consists of six steps, and takes the non-Aboriginal worker from the initial engagement phase through to evaluation and relationship consolidation. The proposed model is further delineated by a case study.

Australian Aboriginal perspectives of attention deficit hyperactivity disorder

[Extract] The diagnosis of attention deficit hyperactivity disorder (ADHD) has been based on a western concept of health, a concern when considering a non-western culture such as Australian Aboriginal and Torres Strait Islander peoples. The lack of statistical data on the extent of ADHD in the Aboriginal community is another concern, a situation similar to many other mental health problems in the Indigenous population. Furthermore, no Australian studies have mentioned specific information on the prevalence of ADHD in Aboriginal communities. The WA Aboriginal Child Health Survey, however, reported that Aboriginal children had a higher risk of hyperactivity problems (15.8%) when compared to 9.7% for non-Aboriginal children (Zubrick et al., 2005).

Sibling relationships in the care system: Attachment, separation and contact issues

A number of key authors maintain sibling relationships are absolutely crucial when considering out-of-home care options, while policy derived from theory and practice must guarantee that the best interests of the child(ren) are taken into account. Furthermore, placing siblings together is most likely to be a protective factor against placement breakdown. This being the case, care plans should focus on ensuring sibling connectedness and the maintenance of emotional bonds into adulthood. This paper discusses current out-of-home care policy and practice in Western Australia which incorporates research from (1) attachment theory, (2) family structure, (3) cultural diversity, (4) development, (5) contact, (6) care planning, and (7) long-term care to provide guidance when considering siblings entering the out-of-home care system. The authors contend that this approach improves decision making practice and is consistent with new legislation — the Children and Community Services Act 2004, which is expected to be introduced in Western Australia on 1 March 2006, and which has as its underlying principle the best interests of the child.