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Traditional approach to healing encouraged

WINDOW ROCK, Ariz. - There is no denying the powers of Western medicine, not when tribe after tribe negotiated health care provisions in their treaties with the federal government.

But traditional healing practices have never been forgotten among tribes. And after years of frowning upon them or forbidding them outright, the federal government, through the IHS, has begun to encourage a traditional approach to healing, said Herman Largo, director of behavioral health for the Navajo. IHS clinics nationwide are incorporating traditional healing practices, added Carolyn Morris, a licensed clinical psychologist with Navajo health services.

The Navajo traditional healing program got started in 1996 with Substance Abuse and Mental Health Services Administration funds from the Department of Health and Human Services, and became ongoing in 2000 with federal funds, Largo said.

''It's a part of the sustainable program that SAMHSA allows you to develop,'' Morris explained.

''This is a kind of validation [of traditional healing],'' added Madan Poudel, Navajo health services administrator. ''It's complementary.''

Western medical treatment is always available, he said. ''We're very careful about imposing Navajo practices on anyone. We have to respect a family's wishes.''

But on the Navajo lands, where Largo said 50 percent of the people still speak Navajo, ''Sixty percent of the clients come in requesting traditional practices or services,'' Morris noted. Many of them resort to traditional practices as a way to revive their lives after a period of substance abuse, Largo said. The families of substance abusers may also receive treatment, reviving them, too, after the difficult experience of living with substance abuse.

A typical traditional course of treatment begins with a Sweatlodge cleansing or purification ritual, Largo said. Anslem Roanhorse, executive director of the Navajo Division of Health, provided some detail: upon entering, the patient hears two Navajo songs that emphasize ''coming out of something, transcending into something new.''

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Largo compared the Sweatlodge session to residential treatment in Western medicine.

The next step is diagnosis by one of 13 salaried traditional practitioners, which Largo compared to intensive day treatment. Based on the diagnosis, he said, ''We recommend a specialized intervention that might be useful.'' Patients have a choice of interventions, Roanhorse said, the point being to expand and extend the healing process.

The third phase of the treatment, comparable to outpatient treatment in Western medicine, incorporates the results of diagnosis and recommendations in a Beauty Way ceremony, and the final or ''after care'' phase is a Blessing ceremony, always with lots of support from family and extended family.

Although the four-phase model is typical, it is not exclusive. Traditional healing also incorporates prayers, including Native language prayers, and faith-based services, including Navajo faith services. ''It's a variety of interventions,'' Morris said, emphasizing holistic, community-wide treatment over Western individual treatment.

Now that Western medicine has begun to recognize a Native tool in the modern medical kit, however, centralizing Western bureaucracy has become a stumbling block. ''The only problem we have now ... in the traditional Western bureaucratic system, they want a certification'' for traditional healing practitioners, Poudel said.

In Washington, Roanhorse said, ''They always talk about liability, and do you have tort coverage.'' But in Navajo communities, ''It takes many years of apprenticeship before you can become a practitioner.''

Morris said the government should become more respectful of ''cultural competency'' in traditional healing practice because the practices have been effective ''years and years in the community.''

Otherwise, Poudel added, the system has come to ''honor the sensitivities'' around traditional healing practices. ''It's in the process of educating them. ... It's getting better for the past few years.''