Does Trauma-Informed Approach work for Maori clients?

I am currently using the trauma informed approach especially for my ACC client. Here is a brief case which I had in the past.

Basic information:

Psychological transgender male,17 years old, and New Zealand Maori.

This client, A, was sexually assaulted multiple times from a young age.

He has anger, self-harming, and constant suicidal ideations with possible DID and C-PTSD symptoms. He cannot control his thoughts of killing others.

Hung et al. (2014) insisted, “A trauma-informed approach seeks to resist re-traumatization of clients as well as staff” (p.10). They continued, “Staff who work within a trauma- informed environment are taught to recognize how organizational practices may trigger painful memories and re-traumatize clients with trauma histories”( p.10). It can say this approach is creating safer environments not only the clients but also staff. I worked with other multiple government agencies for A’s case. We must keep our emotional safety but also considering the justice for A’s sibling and community because A got suspicion of sexual assaults to others. That is why the trauma informed care approach helped me to enhance my ability to work.

On the other hand, this model does not cover A’s cultural aspects including his Maori belief, age group and sexual identity. As Bamblett and Lewis (2007) stated, “Culture is central to identity. Culture defines who we are, how we think, how we communicate, what we value and what is important to us” (cited in Pihama et al.,2020, p.32). In fact,Pihama et al. (2020) argue, “Because trauma-informed care is patient-centered care, it is important to understand how trauma occurs within the context of culture, and how culture affects the ways in which meaning is attributed to trauma” (p.26).

What can other models sustain this gap? I choose Te Whare Tapa Wha Kaupapa Maori approach. Pihama et al. (2020) noticed, “The impact that colonisation has had on Maori identity has been highlighted and includes the inability to identify positively as Maori” (p.27). A disclosed me, “I have never had positive impression as Maori because people believe we are poor, stupid and loser after the colonization.”

Pihama et al. (2020) pointed, “What is raised here is the intergenerational impact of the encoding of historical and colonial trauma, which then has the potential to manifest physically, culturally, emotionally, behaviourally, economically and materially for Maori and Indigenous Peoples” (p.30).

However, McNeill (2009) raised, “The problem with the ‘Whare Tapa Wha’ model is that it does not define the uniqueness of Māori as a cultural entity” (p.102).

NcNeill (2009) continued, “The supposition is that the syncretism of ‘traditional’ values and beliefs and Pākehā adaptations has given rise to a uniquely contemporary Māori worldview; Te Ao Hou (the New World) is a syncretism of traditional Māori and European cultural constructs “(p.103). A told me, “I am not sure how I understand Maori culture because I am not 100% pure Maori. Actually, I got Pakeha cultural impact in my life as well.”

I will refer to Indigenist Stress-Coping Model to be able to address the cultural perception. Walters and Simoni (2002) stated, “highlighting the importance of incorporating identity processes and expressions of self as moderators of the discrimination–health outcomes relationship” (p. 521). They continued,“With respect to the ecosocial framework, our model delineates the pathways between social experiences and health outcomes, thus providing a coherent means of integrating social, psychological, and cultural reasoning about discrimination and other forms of trauma as determinants of health” (p.521).

From this essay, I found that I could work better for A if I could research his cultural aspects rather than focus on his PTSD and potential harm to others because he had variety of different cultural factors which may lead A to be a victim of sexual assaults. For instance, he told me, “When I had the first sexual assault at my school, my teachers and mother did not help me. I was wondering because I am Maori, young kid, transgender. I was thinking because no- one loved me.” This reflection helped me to find my next goal to be a better ACC therapist.

Reference

Huang, L. N., Flatow, R., Biggs, T., Afayee, S., Smith, K., Clark, T., & Blake, M. (2014). Substance Abuse and Mental Health Services Administration SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. Substance Abuse and Mental Health Services Administration. Report No. HHS Publication No. (SMA) 14-4884

McNeill, H. N. (2009). Maori models of mental wellness. Te Kaharoa, 2(1),96-115. DOI:https://doi.org/10.24135/tekaharoa.v2i1.127

Pihama, L., Smith, L., Cameron, N., Te Nana, R., Kohu-Morgan, H. S., & Mataki, T. (2020). He oranga ngākau: Māori approaches to trauma informed care. Journal of Indigenous Wellbeing, 2(3), 18–31.

Walters, K. L., & Simoni, J. M. (2002). Reconceptualizing Native women's health: An “indigenist” stress-coping model. American journal of public health, 92(4), 520-524.