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Beliefs about Health and Mental Health Traditional Native American Perspective . University of Oklahoma School of Social Work Master’s Advanced Curriculum Project Dr. Lisa Byers (Cherokee) Supported by:. Social Work Relevance.

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Beliefs about Health and Mental Health

Traditional Native American Perspective

University of Oklahoma

School of Social Work

Master’s Advanced Curriculum Project

Dr. Lisa Byers (Cherokee)

Supported by:

social work relevance

Social Work Relevance

Health beliefs determine the meaning of illness and service preference

Knowledge of Native American traditional concepts of wellness and illness

Compare to Western conceptualizations of illness

Provide knowledge of traditional healing

Impart elements of respect for traditional healing

Assessment of health through explanatory models

origin of illness across cultures

Origin of Illness Across Cultures

Prior to beginning PowerPoint have students engage in the ‘Origins of Illness’ In Class Activity

traditional concept of wellness 1


Medicine Wheel

Traditional Concept of Wellness1


Encompasses Emotional, Mental, Physical, and Spiritual Realms of Self, Others, and the Environment

All must be in balance to have health or wellness




medicine wheel concept of health remains significant 2

Medicine Wheel: Concept of Health Remains Significant2

Big Horn Medicine Wheel


The Medicine Wheel concept from Native American culture provides a model for whom we are as individuals: We have an intellectual self, a spiritual self, an emotional self, and a physical self. Strength and balance in all quadrants of the Medicine Wheel can produce a strong, positive sense of well-being, whereas imbalance in one or more quadrants can cause symptoms of illness. Addressing issues of imbalance can potentially diminish your patient’s symptoms and enrich their quality of life.

- Louis T. Montour, MD, CM; CCFP; ABFPPresented at the Fifth Annual Meeting of the Native Physician Association in Canada, Ottawa, Ontario, August 23-25, 1996.

traditional concept of illness 1

Traditional Concept of Illness1

Illness is the result of imbalance

Within the self systems, the family, tribe, or the world

An individual may not be living up to their roles or obligations to their self or to the group

Bad medicine


A symptom can occur in any of the realms (emotional, mental, physical, spiritual)

traditional healing 1

Traditional Healing1

Goal-Holistic Treatment

Restore balance across all realms within the individual and within relationships

Potential Participants

Individual, her/his family, and/or clan

Individuals that are deemed important to healing process by the person or healer

traditional stories of illness

Origins of Disease and Medicine A Cherokee example:

Traditional Stories of Illness

Story tells of how birds, fish, insects, animals, and humans lived in harmony until the humans overcrowded the animals and created weapons to kill them. The was retaliation from the birds, fish, insects, and animals in the form of disease. The plant world responded by offering their leaves, roots, bark to make medicine to save the Cherokees.

traditional healing

Traditional Healing

Discussion with Client

American Indian and Alaska Natives may be reluctant to discuss traditional medicine

Protective in past traditional spirituality and healing was considered illegal

Current era of exploitation of Native American spirituality and healing

traditional healing10

Traditional Healing


Medicine people are known within the tribe or area

Medicine people do not advertise in a commercial manner

A client may ask for funds to travel back to see their traditional healer-your agency will need to determine if such travel is fundable

If an individual is new to the area and cannot utilize the healer that they have used in the past, here are some options:

Contact local Native American social workers or Native American based social service agencies

Access individuals who will know the way to access a healer and the protocol

sometimes a broken bone is just a broken bone

“Sometimes a Broken Bone is Just a Broken Bone”

Native Americans will not attach every injury with spiritual significance

They know that if they break a bone they need to go to the emergency room or a physician

Later they may reflect on whether there was a meaning behind the event, if they were distracted by a worry that may have lead to carelessness or not.

social work implications

Social Work Implications

Listen to person’s story about their symptoms & illness.

Follow Up Questions:

What do you believe caused this illness?

Who have you seen in the past to help with this kind of illness?

Was it whom you preferred to see?

Was it helpful? What made it helpful or not helpful?

Who would you like to see now?

assessment questions from kleinman 4


How would you adapt the Explanatory Model questions for a Native American elder?

Assessment Questions from Kleinman4

Explanatory Model

What do you think caused this?

Why do you think it started when it did?

What do you think your illness does to you?

How does it work?

How severe is your illness?

Will it have a short or long course?

What kind of treatment do you think you should receive? What are the most important results you hope to receive from this treatment?

What are the main problems your illness has caused for you?

What do you fear most about your illness?



Barlow, A., & Walkup, J.T. (1998). Developing mental health services for Native American children. Child and Adolescent Psychiatric Clinics of North America: The Child Psychiatrist in the Community, 7(3), 555-577.

Montour, L.T. (2000, Winter) The medicine wheel: Understanding “problem” patients in primary care. The Permanente Journal , 4(1), 34-39.

Cherokee Nation (no date). The origins of disease and medicine. Retrieved August 10, 2008 from

Kleinman, A., Eisenberg, L., & Good, B. (1978). Culture, illness, and care: Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 88, 251-58