American Indian Development Associates

Promising Practices

Section I. Program Information

1.  Issues of program. NCI is the country’s largest residential center for Native American Detox and Substance Abuse treatment. Because NCI is the only crises center for the large Gallup-area trading center, we deal with a wide range of problems including, but not limited to, substance abuse. Each year we detox 17,500 people for an average five-day stay, 450 people graduate from our residential 23.5 day Native American Traditional therapy program, and 150 people graduate from our residential DWI academy. We also act as a shelter, a crises center, as well as adopting the role as community prevention and strategy leader. 

With 150 beds we commonly overload to 180 residential “client-relatives”. NCI is a minimum secured facility where 80% of the “relatives” are either court-ordered or brought in “against their will” by law enforcement. A New Mexico State statute allows any authority of family member to place any intoxicated person on a five-day “protective custody” hold if they present  “a danger to themselves or others”. It is not uncommon that clients stay at NCI for several months (or more) of assorted shelter and substance abuse treatment.

Of NCI’s 27 counselor’s 17 of them are Traditional medicine practitioners of various kinds.

2. Target population: Because the 95% of our clients are from rural reservations, even though NCI is located within the Gallup city limits, NCI is classified as a reservation based service provider. Clients largely come from the Navajo Nation, the Pueblo of Zuni, and the Laguna Pueblo. Many other tribal members participate.

3. Program Philosophy:  HBS provides an intense environment of therapeutic, spiritual, and life-skill practices from both Dine’(Navajo) and inter-tribal traditions. Although Native American in origin, the majority of these practices also conform to the essential components of UNM-CASAA’s well-acclaimed Community Reinforcement Approach (CRA); social involvement, spiritual platforms, job support, marriage skills, sober social events, sobriety reinforcement, sobriety sampling and drink refusal training, medical treatment, family counseling, coping and resiliency skills, motivational counseling, and relaxation training.

Therapeutically, HBS provides a training ground for “Positive Warrior Tough-mindedness”. This positive, yet tough, frame of mind emphasizes self-sufficiency, self-esteem, coping skills, spiritual and psychological inner-power, family values, cultural identity, and personal pride (values already present in the Dine’ Beauty-way philosophy). HBS protocols emphasizes intense emotional change and deep cognitive reframing within a cultural context rather than the more common educational or medical model of treatment.

It is important to realize that select Native American therapeutic practices are as therapeutically complex, as insightful, as intellectual, and as effective (when properly applied) as the best western approaches (scientific literature on this point is available from NCI). Protocols currently involved in HBS are the Dine’ Beauty-Way philosophies, talking medicine circles, NAC drumming and song sessions, affirmation and prayer instruction, Peace Making-family intervention, clanship instruction, storytelling and traditional subjects, pow wow and gourd dancing, Native American guided meditation, sweatlodge, various medicine-way diagnosis and healings, sacred crafts, tobacco and cedar ceremonies, herbal medicine, GED training, vocational counseling, and individual counseling. Occasionally outside community/ therapeutic events such as ceremonial activities and the Native American Church are also utilized. Western intervention techniques such as sobriety prevention, low-level ropes courses, exercise, and hygiene improvement are also utilized.

4. Existing Model:  Although NCI has borrowed ideas from many places, there are no know existing models done at this level of intensity.

5. Program approach: Our approach philosophy has been mentioned above. Our approach is a direct response to the therapeutic needs of our Native American client-relatives who are chronically abusing alcohol and who are not responding to western-oriented treatment.

6. Program Goals: The first goal is to reduce the harm caused by substance abuse (costs, injury, death, lack of production, tribal and social health). The second goal is to assist our client-relatives towards wellness, self-sufficiency, and empowerment.

7. Program objectives: NCI’s immediate objectives constantly evolve as our programs improve over time.  These are too numerous and fluctuating to list.

8. Methods of achieving objectives?  The follow key strategies have been essential in our progress:

1. NCI is an independent non-profit corporation, which can largely operate independent from Federal, State, or Tribal micromanagement. Our very supportive and hard working Board of Directors consists of appointed Navajo Nation, Zuni Pueblo, City, County, and Law enforcement members. This gives us both support yet maintains our operational independence. We can innovate and take risks rapidly with little political constraint.
2. Our evaluation data base over seven years has been useful in establishing both funding and creditability.
3. Positioned next to the county’s largest reservation, we have immediate access to a huge pool of traditional Native American. They have offered us their full support. The majority of our client-relatives are Dine’ speaking and very traditional.
4. We attempt to remain science-based in our approach. We have dropped ideas that haven’t show scientific efficacy this population (eg. Forced AA attendance, scolding clients, lecturing all day about drinking, exclusive adoption of the disease theory of alcoholism, etc).

  Section II: Program Components.

1.      Program Components: 1. 23.5 day residential Eagle Plume Society - Hinn’ah Bits’os Society (HBS); 28 day residential DWI Academy; 5 day social detox; 5 day medical hold; crises shelter.

2. Identify Clients; Clients are brought in by law enforcement, self-referred, agency-referred, or court-ordered.

3.      Client selection process; As above, if clients are in need we accept them.

4. Intake and assessment: Our intake procedure is very simple. Assessment ranges from simple to complex depending upon the client and program need.

5.  Approaches: HBS provides an intense environment of therapeutic, spiritual, and life-skill practices from both Dine’ (Navajo) and inter-tribal traditions. As already mentioned above, although Native American in both origin and delivery, the majority of these practices also conform to the essential components of UNM-CASAA’s Community Reinforcement Approach; social involvement, spiritual platforms, job support, marriage skills, sober social events, sobriety reinforcement, sobriety sampling and drink refusal training, medical treatment, family counseling, coping and resiliency skills, motivational counseling, and relaxation training. HBS is also a training ground for “Positive Warrior Tough-mindedness”. This positive, yet tough, frame of mind emphasizes self-sufficiency, self-esteem, coping skills, spiritual and psychological inner-power, family values, cultural identity, and personal pride (values already present in the Dine’ Beauty-way philosophy). HBS protocols emphasize intense emotional change and deep cognitive reframing within a cultural context rather than the more common educational or medical model of treatment.

Protocols include Dine’ Beauty-Way philosophies, Pueblo philosophies, talking medicine circles, NAC drumming and song sessions, affirmation and prayer instruction, Peace Making- family intervention, clanship instruction, storytelling and traditional subjects, pow wow and gourd dancing, Native American guided meditation, sweatlodge, various medicine-way diagnosis and healings, sacred crafts, tobacco and cedar ceremonies, GED training, vocational counseling, and individual counseling. Occasionally outside community/therapeutic events such as ceremonial activities and the Native American Church are also utilized. Western intervention techniques such as sobriety prevention, low-level ropes courses, exercise, and hygiene improvement will also utilized.

6. Cultural Elements: 80% of all activities are culturally oriented. 100% of our counselors speak Dine’ or a Pueblo language. 95% of all support and security staff is Native American (see above).

7. Referral System?  We primarily accept referrals form our immediate area only. Special cases, however, come in from outside areas.

8. Exit procedures? Our vans transport all protective custody clients into their home area. All extended treatment program clients are responsible for their own transportation. Discharge is a simple procedure. 

9. Aftercare: NCI had developed a crises oriented aftercare team for graduates in distress. Other significant aftercare services are very marginal. Effective aftercare systems are the more neglected and needed aspect of our services.

  Section III. Program Evaluation

1. What is working?: Our intense cultural residential program (HBS) has been achieving significant success. Our evaluation department will release data within a few months.

In addition, our Protective Custody program has been extremely effective in reducing the public costs and harm of intoxication.  

2. Why?  We are attempting to develop a new paradigm very different from the poorly disease and education model. Problem drinking is a complex psycho/social/economic problem. We are attempting to provide problem drinkers with a culturally empowered and dignified alternative to drinking. We are also very firm about public intoxication. If you drink irresponsibly in Gallup you will be picked up and brought to NCI. 

SECTION V. Client Demographics:

18,000 residential clients per year, all over 19 years. 

80% 14,400 male;  20% 3,600 female.

80% are court ordered or brought in by law enforcement.

10% are referred by agencies

10% are self-referrals.

Section V. Program Administration:

1. Formal relationships: We have formal relationships with more than 10 local agencies. MOA’s are not as effective and productive as informal, working relationships.

2. Informal Relationships. Few agencies help us on a practical level with the exception of law enforcement, VA, PHS-GIMC hospital, and Western New Mexico Counseling Services. 

  3. Program Description? All of our information is available.

Personnel and Staffing

1. Training: Relatively few dollars are available for training.

2. Training Curriculum: We try to participate in what we can when it happens.

Budget

1. Annual: $1.2 million

2. Non-recurring money: An additional $1. Million is available this year as short-term grants.

  3. Sources:  Our current funding sources are CSAT, Navajo Nation –IHS, the State of New Mexico BHS, and McKinley County. No fees are charged to clients.

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Copyright © 2005 Na' Nizhoozhi Center Inc.
Last modified: May 24, 2005