Experiences of a non-Mãori therapist

working with Mãori clients

Presenter: Marianne Lammers PhD (Psych)Presenter: Marianne Lammers PhD (Psych)Karaka Special Treatment UnitKaraka Special Treatment Unit

Dept. of CorrectionsDept. of Corrections

He moana pukepuke, e ekengia e te He moana pukepuke, e ekengia e te wakawaka

(A choppy sea can be navigated)(A choppy sea can be navigated)A. H. MacfarlaneA. H. Macfarlane

Why work in a culturally safe way?Why work in a culturally safe way?

• To honour the Treaty of Waitangi To honour the Treaty of Waitangi that sets out a basis of respect that sets out a basis of respect between Maori and non-Maori.between Maori and non-Maori.

• To increase client satisfaction and To increase client satisfaction and better therapeutic outcomes for better therapeutic outcomes for clientsclients

How does one do that?How does one do that?

• By accepting that NZ political acts in the By accepting that NZ political acts in the past have diminished and disempowered past have diminished and disempowered the cultural identity of the Maori populationthe cultural identity of the Maori population

• By being aware of how one’s background By being aware of how one’s background has shaped personal values, assumptions has shaped personal values, assumptions and biases related to Maori peopleand biases related to Maori people

• By familiarising ourselves with the values By familiarising ourselves with the values and practices of Maori culture.and practices of Maori culture.

• By supporting the Bicultural Therapy Model By supporting the Bicultural Therapy Model (BTM)(BTM)

Maori Values – based on relationships, Maori Values – based on relationships, a sense of community, on a sense of community, on encouragement, love, care, and encouragement, love, care, and compassion.compassion.

• Mihi – structured greetingMihi – structured greeting• Whanaungatanga – building relationshipsWhanaungatanga – building relationships• Whakamanawa – encouragement and careWhakamanawa – encouragement and care• Manaakitanga – caring based on respect and Manaakitanga – caring based on respect and

kindnesskindness• Aroha – compassion, empathy, Aroha – compassion, empathy,

responsiveness, and concernresponsiveness, and concern• Awhi – to touch, or embrace, to cherish, Awhi – to touch, or embrace, to cherish,

nurture nurture

Awhi – and the Code of PracticeAwhi – and the Code of Practice

• Basic to therapy from Maori perspectiveBasic to therapy from Maori perspective

• Seen at times by non-Maori professionals as Seen at times by non-Maori professionals as violating the Codeviolating the Code

• Psychologists Code of Practice ( 2002) does Psychologists Code of Practice ( 2002) does not explicitly prohibit touchnot explicitly prohibit touch

• Principle 3.3.2. around maintaining Principle 3.3.2. around maintaining boundaries boundaries

• The Code as an aid to ethical decision The Code as an aid to ethical decision makingmaking

Practice implications of using ‘awhi’ in Practice implications of using ‘awhi’ in a Corrections setting - a Corrections setting - an ethical an ethical

challengechallenge • Clinical practice must take account of Clinical practice must take account of

dynamics of offending behaviourdynamics of offending behaviour – Sexual devianceSexual deviance– Antisocial attitudesAntisocial attitudes

• Walking a fine line between Maori clients’ Walking a fine line between Maori clients’ needs and ethical boundariesneeds and ethical boundaries

• Identify and consider higher order Identify and consider higher order principles and values relevant to the principles and values relevant to the situation and then weigh the associated situation and then weigh the associated practice implications. practice implications.

Turning Maori concepts into Turning Maori concepts into practice.practice.

• Whanau, hapu, iwi - genealogyWhanau, hapu, iwi - genealogy

• Tikanga – protocolsTikanga – protocols

• Tika – behave authenticallyTika – behave authentically

• Pono - integrityPono - integrity

• Wairua - spiritualityWairua - spirituality

Te Whare Tapa WhaTe Whare Tapa Wha(Durie, 1994)(Durie, 1994)

• A holistic view of well being, that A holistic view of well being, that states in order to be at one’s optimal states in order to be at one’s optimal health, all areas (hinengaro, tinana, health, all areas (hinengaro, tinana, whanau and wairua) need to be in whanau and wairua) need to be in balance and working orderbalance and working order

• Dept. of Corrections incorporates this Dept. of Corrections incorporates this model of health in their treatment model of health in their treatment programmesprogrammes

Things one can do to respond to Things one can do to respond to the needs of Mãori clientsthe needs of Mãori clients

• Consulting Mãori colleagues in one’s work with Mãori Consulting Mãori colleagues in one’s work with Mãori clients.clients.

• Including Maori social values into group therapy work.Including Maori social values into group therapy work.• Using cultural processes and protocolsUsing cultural processes and protocols• Linking key Mãori concepts, with key behavioural Linking key Mãori concepts, with key behavioural

concepts.concepts.• Using Mãori words where one can.Using Mãori words where one can.• Looking behind behaviours that are seen as ‘deficient’ Looking behind behaviours that are seen as ‘deficient’

from a Western perspective and reading them rather from a Western perspective and reading them rather as behaviours reflective of difference.as behaviours reflective of difference.

• Promoting the Bicultural Therapy Model (BTM) and Promoting the Bicultural Therapy Model (BTM) and encouraging Mãori clients to enrol in it. encouraging Mãori clients to enrol in it.

• Using cultural supervision to guide one’s work Using cultural supervision to guide one’s work

One last offeringOne last offeringKia kite, kia matau, I Te Ao Mãori, ma te reoKia kite, kia matau, I Te Ao Mãori, ma te reo

((A. H. Macfarlane)A. H. Macfarlane)It is only through exposure to and awareness of Mãori culture It is only through exposure to and awareness of Mãori culture and language that an understanding of a Mãori world view will and language that an understanding of a Mãori world view will

developdevelop

• There is emerging evidence in New Zealand, as There is emerging evidence in New Zealand, as well as overseas, that attention to cultural issues well as overseas, that attention to cultural issues not only increases client satisfaction, but also not only increases client satisfaction, but also retention in treatment. It thereby shows that retention in treatment. It thereby shows that attending to cultural issues is not only honouring attending to cultural issues is not only honouring our obligation under the Treaty of Waitangi, it is our obligation under the Treaty of Waitangi, it is also critical to the responsivity aspect of Andrews also critical to the responsivity aspect of Andrews and Bonta’s (2006) Risks/Needs/Responsivity and Bonta’s (2006) Risks/Needs/Responsivity model of treatment upon which the Department model of treatment upon which the Department of Corrections bases their recidivism reduction of Corrections bases their recidivism reduction programmes for offenders.programmes for offenders.

ReferencesReferences• Durie, M. (1994). Durie, M. (1994). Whaiora: Whaiora: MãoriMãori Health Development Health Development. Auckland: Oxford . Auckland: Oxford

University Press.University Press.• Durie, M. & Hermansson, G. (1990). Counselling Durie, M. & Hermansson, G. (1990). Counselling MãoriMãori people in New people in New

Zealand (Aotearoa). Zealand (Aotearoa). International Journal for the Advancement of International Journal for the Advancement of Counselling 13Counselling 13, 107-118., 107-118.

• Evans, I. M., Rucklidge, J. J. & O’Driscoll, M. (2007). Professional practice of Evans, I. M., Rucklidge, J. J. & O’Driscoll, M. (2007). Professional practice of psychology in Aotearoa New Zealand. Wellington New Zealand: New Zealand psychology in Aotearoa New Zealand. Wellington New Zealand: New Zealand Psychological Society.Psychological Society.

• Lammers, M. (2011).Towards cultural safety: Lammers, M. (2011).Towards cultural safety: Experiences of a non-Maori Experiences of a non-Maori therapist working with Maori clients.therapist working with Maori clients. Psychology Aotearoa (in press). Psychology Aotearoa (in press).

• Macfarlane, A. H.; Glynn, T.; Cavanagh, T.; & Bateman, S. (2007). Creating Macfarlane, A. H.; Glynn, T.; Cavanagh, T.; & Bateman, S. (2007). Creating culturally-safe schools for culturally-safe schools for MãoriMãori students. students. Australian Journal of Indigenous Australian Journal of Indigenous Education, 36,Education, 36, 65-76. 65-76.

• Macfarlane, A. H. (1998). Macfarlane, A. H. (1998). Piki ake te tikanga: Culture counts in special Piki ake te tikanga: Culture counts in special education. education. Paper presented at the 28th Annual Conference, Australian Paper presented at the 28th Annual Conference, Australian Teacher Education Associations: Hilton on the Park, Melbourne, 4-7 July, Teacher Education Associations: Hilton on the Park, Melbourne, 4-7 July, 1998.1998.

• McFarlane-Nathan, G. H. (1994). McFarlane-Nathan, G. H. (1994). Cognitive behaviour therapy and the Cognitive behaviour therapy and the MãoriMãori clientclient. Proceedings of Dept of Justice, Psychological Services Conference, . Proceedings of Dept of Justice, Psychological Services Conference, held in March 1994.held in March 1994.

• McFarlane-Nathan, G. H. (1997). McFarlane-Nathan, G. H. (1997). The bicultural therapy project: The bicultural therapy project: Psychological service, Department of Corrections, August 1996Psychological service, Department of Corrections, August 1996. . Te Komako-Te Komako-Social work review viii(1) Jan 1997.Social work review viii(1) Jan 1997.

• Robertson, P. J. (Kai Tahu), Futterman-Collier, A., Sellman, J. D., Adamson, S. Robertson, P. J. (Kai Tahu), Futterman-Collier, A., Sellman, J. D., Adamson, S. J., Todd, F. C., Deering, D. E., Huriwai, T. (2001). Culturally responsive J., Todd, F. C., Deering, D. E., Huriwai, T. (2001). Culturally responsive treatment: Clinician beliefs and practices related to increasing responsivity treatment: Clinician beliefs and practices related to increasing responsivity to the needs of Mãori with alcohol and drug problems. to the needs of Mãori with alcohol and drug problems. Substance Use & Substance Use & Misuse, 36Misuse, 36(8), 1015-1032.(8), 1015-1032.