Can The Complex Care and Intervention (CCI) Program be Culturally Adapted as a Model For Use

126 Pages·2017·0.71 MB·English

Antioch University
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Dissertations & Theses
Dissertations & Theses
2016
Can The Complex Care and Intervention (CCI)
Program be Culturally Adapted as a Model For Use
With Aboriginal Families Affected by Complex
(Intergenerational) Trauma?
Chipo McNichols
Antioch University Seattle
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Recommended Citation
McNichols, Chipo, "Can The Complex Care and Intervention (CCI) Program be Culturally Adapted as a Model For Use With
Aboriginal Families Affected by Complex (Intergenerational) Trauma?" (2016).Dissertations & Theses. 279.
http://aura.antioch.edu/etds/279
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CAN THE COMPLEX CARE AND INTERVENTION (CCI) PROGRAM BE CULTURALLY
ADAPTED AS A MODEL FOR USE WITH ABORIGINAL FAMILIES AFFECTED BY
COMPLEX (INTERGENERATIONAL) TRAUMA?

A Dissertation
Presented to the Faculty of
Antioch University Seattle
Seattle, WA

In Partial Fulfillment
of the Requirements of the Degree
Doctor of Psychology

By
Chipo McNichols
April 2016
CAN THE COMPLEX CARE AND INTERVENTION (CCI) PROGRAM BE CULTURALLY
ADAPTED AS A MODEL FOR USE WITH ABORIGINAL FAMILIES AFFECTED BY
COMPLEX (INTERGENERATIONAL) TRAUMA?

This dissertation, by Chipo McNichols, has been approved by the
Committee Members signed below who recommend that it be accepted
by the faculty of the Antioch University Seattle at Seattle, WA
in partial fulfillment of requirements for the degree of

DOCTOR OF PSYCHOLOGY
Dissertation Committee:
________________________
Jude Bergkamp, Psy.D.
Chairperson

________________________
William Heusler, Psy.D.

________________________
Aruna Gore, Ph.D.

________________________
Chuck Geddes, Ph.D.

________________________
Date

ii
© Copyright by Chipo McNichols, 2016

All Rights Reserved

iii
1

ABSTRACT
CAN THE COMPLEX CARE AND INTERVENTION (CCI) PROGRAM BE CULTURALLY
ADAPTED AS A MODEL FOR USE WITH ABORIGINAL FAMILIES AFFECTED BY
COMPLEX (INTERGENERATIONAL) TRAUMA?

CHIPO MCNICHOLS
Antioch University, Seattle, WA
Seattle, WA
Despite living in a country with a world renowned healthcare system, Canadian Aboriginal
children, youth and their families, consistently have poorer access to healthcare as well as higher
mortality and morbidity rates, in comparison to non-Aboriginal Canadians (Tang & Browne,
2008). Among factors including their history of residential school and intergenerational trauma,
the lack of a culturally specific treatment intervention for complex trauma, is identified as a key
factor in maintaining this health disparity. This study used participatory action research within an
identified Aboriginal community, to develop a culturally adapted complex trauma intervention
model. This was based on an existing model that has been used with primarily non-Aboriginal
children living in the foster care system. The result was an adapted model an intervention model
that kept culture at the core of the treatment program. The model was adapted using both a
Western neurodevelopmental theory and an indigenous framework based on local traditional
knowledge. The adapted model will be applied in the community with the potential for further
adaptations, and may be generalised for use with other Aboriginal communities. The electronic
version of this dissertation is at AURA Antioch University Repository and Archive,
http://aura.antioch.edu/ and OhioLink ETD Center, https://etd.ohiolink.edu/etd
Acknowledgements
I would like to acknowledge Dr. Chuck Geddes, for developing the Complex Care and
Intervention program and allowing me the honor of making cultural adaptations to the model.
Thank you for your guidance and support through this process and beyond. I also wish to
acknowledge Dr. Jude Bergkamp for introducing me to PAR as a qualitative methodology;
your passion for it ignited mine; your support and belief in my ability to succeed despite the
multitude of challenges I faced along the way, inspired me to keep going to the end. My
gratitude to you, and all the faculty who supported me throughout the long Antioch season of
my life! Particular thanks to Dr. Liang Tien for helping me navigate the cross border
complexities! I wish to thank my village of many family and friends who walked alongside
me on this journey. Particular gratitude to my sister Vera, who made my first steps possible,
Aunty Nyirenda and the Ngosi’s; your support carried me through many challenging times.
To my husband Bob, thank you for believing even when I didn’t, and for all the late nights
you stayed up with me while I worked. To you, and my precious children Caroline, Lindiwe,
and Manasseh, your encouragement and the sacrifices you have all made through this long
journey cannot be measured. Your unwavering support and belief in me, makes this
accomplishment ours, not mine.
In memory of my mom Eleanor Hlupekile Nyirenda who always believed in me. Thank
you for teaching me by example that “I can do all things through Christ who strengthens me”
(Phil. 4:13).

IV
Table of Contents Page
Abstract ............................................................................................................................................1
Acknowledgements ........................................................................................................................ iv
List of Tables ............................................................................................................................... viii
List of Figures ................................................................................................................................ ix
I. Introduction ...........................................................................................................................1
Background History .........................................................................................................................1
Culture ..............................................................................................................................................5
Trauma .............................................................................................................................................7
Identifying the Gap/History on the Problem ....................................................................................9
How Will This Research Fill the Gap ............................................................................................12
Overview of the CCI Program .......................................................................................................13
Statement of the Problem ...............................................................................................................15
Research Question .........................................................................................................................16
Specific Area of Research Focus ...................................................................................................16
Goals of Indigenous Healing Process ............................................................................................17
Purpose of the Study ......................................................................................................................18
Theoretical Frameworks ................................................................................................................20
II. Literature Review ...................................................................................................................22
Intergenerational Trauma in Aboriginal Communities ..................................................................22
Incorporating Indigenous Principles of Research ..........................................................................26
Treatment of Complex Trauma ......................................................................................................30
Cultural Trauma Critical Race Theory ..........................................................................................35
V
Trauma Theory ...............................................................................................................................38
III. Method ..................................................................................................................................41
Introduction ....................................................................................................................................41
History of PAR ..............................................................................................................................41
Rationale for Particular Approach Used ........................................................................................47
Research Approach ........................................................................................................................48
Research Method ...........................................................................................................................51
IV. Procedures .............................................................................................................................57
Procedures……………………………………………………………………………….……….58
Participants .....................................................................................................................................59
Exclusion Criteria ..........................................................................................................................60
Data Collection ..............................................................................................................................61
Data Analysis .................................................................................................................................62
Role of the Researcher ...................................................................................................................64
V. Findings and Discussion .........................................................................................................67
Findings .........................................................................................................................................67
Coding for Adaptations ..................................................................................................................69
Cultural Adaptations ......................................................................................................................71
Theoretical Overview of Trauma ...................................................................................................71
Attachment Style and Relationships Domain ................................................................................71
Identity Development Domain .......................................................................................................74
Intervention Planning Stage of the Program ..................................................................................77

VI
Discussion ......................................................................................................................................84
Potential Ethical Issues ..................................................................................................................84
Discussion of Themes ....................................................................................................................85
Intergenerational Trauma and Its Impact on Identity Development ..............................................85
Attachment Style and Relationships ..............................................................................................87
Adaptations to CCI Interventions ..................................................................................................88
Developing Community Capacity ..................................................................................................90
Community Empowerment ............................................................................................................90
Limitations, Implications for Future Research and Conclusion ....................................................91
Limitations ................................................................................................................................….91
Implications for Future Research ...................................................................................................93
Conclusion .....................................................................................................................................93
References ......................................................................................................................................95
Appendix A: IRB Application .....................................................................................................102
Appendix B: Informed Consent Form .........................................................................................110
Appendix C: Informed Consent Letter .......................................................................................113

VII
List of Tables Page

1. Examples of Cultural Interventions Across Domains ................................................................78

VIII