Iwankapiya – Healing: Historical Trauma and Unresolved Grief Intervention (HTUG) and Group Interpersonal Psychotherapy (IPT) with American Indians

American Indians (AI) are disproportionately burdened by mental health disparities and severely underrepresented in mental health services research. In addition to inadequate funding, low rates of treatment engagement and retention contribute to disparities in mental health disorder prevalence. Engagement and retention of AIs in therapy has been difficult due to mistrust of government sponsored treatment, lack of cultural sensitivity of providers, challenges in establishing a therapeutic alliance, and lack of empirically supported treatments (EST) with AIs. In this roundtable session, AI researchers leading funded research, and non-Native allies, will discuss their unique collaborative process for engaging urban and rural AI communities in the development, adaptation and implementation of an existing EST to address depression, PTSD and suicide. Presenters will focus particular attention on the use of HTUG, a Tribal Best Practice, as an engagement strategy to facilitate engagement and retention in therapy.  HTUG frames depression, grief, loss, and trauma within a collective historical context and emphasizes cultural responsiveness as well as the unique status and generational traumatic experiences of AIs.  Presenters will begin with a discussion of relevant literature on community-engaged approaches for participatory research as well as the cultural, historical, economic and psychosocial issues that intersect with trauma in AI communities.  This roundtable session will also highlight the benefits and challenges associated with intervention research in AI communities. Specifically, presenters will address the impact associated with: (1) lack of resources and infrastructure; (2) differences among tribes, degree of acculturation and assimilation; (3) navigating institutional demands with traditional relationships, communication styles and multiple identities; and (4) recognizing traditional tribal culture as protective factors. Recommended strategies for successful engagement with AI communities by “outside researchers” will also be discussed. This includes: (1) facilitating healing from within the community by engaging local AI partners and experts; (2) practicing cultural humility and taking a “not-knowing” stance; (3) developing trust by doing homework, listening and being consistent, humble and sincere; (4) recognizing and respecting tribal wisdom, knowledge and intelligence.  The goal of this roundtable is to begin a dialogue about how these efforts could be applied to support and enhance resilience in AI communities as well as with other populations experiencing intergenerational trauma, genocide and massive group trauma.