Exploring how indigenous healing practices and a western treatment model “seeking safety” can co-exist in assisting indigenous peoples to heal from trauma and addiction

Abstract

Background: Indigenous communities in Canada face significant challenges with trauma and substance use disorders (SUD). Most Elders, traditional healers and Indigenous scholars agree that connecting to culture, land, community, and spiritual practices is a pathway to healing trauma and SUD in Indigenous peoples. The purpose of this study was to explore whether the blending of Indigenous healing practices (IHP) and a mainstream treatment model, Seeking Safety (SS), resulted in a reduction of intergenerational trauma (IGT) symptoms and SUD. The SS model has been studied in other populations but there was no evidence of its effectiveness with Indigenous peoples. Some studies have shown the positive impact of Indigenous healing practices on SUD. Methods: A mixed-methods design was used to evaluate the impact of a 13-week Indigenous healing practices and Seeking Safety (IHPSS) implementation project. This was a pilot study with one group of 12 Indigenous women and one group of 12 Indigenous men (n = 24) in Northern Ontario. Semi-structured interviews and focus groups were conducted at the end of treatment. The transcripts underwent qualitative thematic analysis to depict themes and understand the ways in which the program promoted healing. Data was collected pre- and post-implementation using the following assessment tools: the Trauma Symptom Checklist-40 (TSC-40), the Addiction Severity Index-Lite (ASI-Lite), the Historical Loss Scale (HLS), and the Historical Loss Associated Symptom Scale (HLASS). The effectiveness of the new program was assessed using paired t-tests, with the TSC-40 as the main outcome. Results: A total of 17 participants completed the study. Four core themes emerged from the qualitative data that showed a positive impact on the symptoms and behaviors related to IGT and addiction in the participants. The benefits from both Indigenous healing practices and SS were clearly depicted through the voices and viewpoints of all 17 participants. Participants demonstrated improvement in the trauma symptoms, as measured by the TSC-40, with a mean decrease of 23.9 (SD=6.4, p=0.001) points, represented a 55% improvement from baseline. Furthermore, all six TSC-40 subscales demonstrated a significant decrease: anxiety (p = 0.001); depression (p=0.000); sexual abuse trauma index (p=0.0011); sleep disturbance (p=0.003); dissociation (p=0.027); and sexual problems (p=0.037). Substance use did not increase as measured by the ASI-Lite alcohol composite score (mean difference = -0.011) and drug composite score (mean difference = 0.032). Conclusion: Evidence from this mixed-methods pilot study indicates that blending IHP with the SS model was beneficial in reducing trauma symptoms. The combination of IHP and mainstream healing methods has the potential to enhance the health and well-being of Indigenous peoples.