Abstract
Substance misuse is becoming a significant problem in Guam, with methamphetamine usage contributing to increased theft and criminal activities. The One Sky Center Substance Abuse Cultural-Based Interventions Methodology, which acknowledges the importance of cultural traditions in supporting long-term rehabilitation, is the foundation of the study. The program used a mixed-methods approach to collect data and catered to 20 participants. It includes customary Chamorro customs like the sweat lodge and talking circle. The study’s findings show that using culturally-based treatments in drug misuse treatment and recovery programs may successfully involve indigenous groups and encourage long-lasting recovery. The results of this study have huge consequences for indigenous societies like Guam’s treatment and rehabilitation from drug dependence.
Introduction
Through providing drug addiction treatment and rehabilitation programs, the Guam Behavioral Wellness Center (GBWC) has been tackling this issue. Yet, indigenous people have shown typical Western methods of substance misuse treatment and rehabilitation are ineffectual, stressing the need for culturally pertinent therapies (Weaver, 2019). The usefulness of using indigenous cultural elements and customs in Guam drug addiction treatment and recovery programs is examined in this study paper. The study’s foundation is the One Sky Center Substance Abuse Cultural-Based Interventions Methodology, which stresses the value of cultural traditions for long-term, sustainable recovery.
This study will examine the effectiveness of culturally based interventions in Guam drug addiction treatment and recovery programs. The study’s specific goal is to look at the influence of adding traditional Chamorro traditions like sweat lodges and talking circles on fostering long-term healing in indigenous people. A mixed-methods strategy was employed in this study to gather data from 20 program participants using a mixed-methods methodology (Weaver, 2019). It incorporated indigenous Chamorro customs, including the sweat lodge and the talking circle. The study looked at the effect of these activities on fostering a feeling of connection with culture and community, which participants claimed helped them stop drug abuse.
Recognizing that conventional Western techniques would not be successful for indigenous groups, there is a need to incorporate culturally-based treatments in drug misuse treatment and rehabilitation programs. While constructing substance misuse treatment and recovery programs, it is important to take into account the distinctive cultures, practices, and values of indigenous populations (Hansen et al., 2020). Traditional Western methods might not be applicable or successful for these societies, and they might even be detrimental since they encourage cultural assimilation. The One Sky Center’s technique for culturally based interventions for indigenous people and traditions offers a foundation for creating successful and culturally appropriate drug misuse treatment and recovery programs. The necessity of including the community, including elders and facilitators, in the design and delivery of the program is emphasized by this technique (LaVallie & Sasakamoose, 2021). It also underlines how crucial incorporating cultural and traditional customs within the curriculum is.
By evaluating the effect of culturally-based treatments on encouraging sustainable long-term healing in indigenous people, this research project attempts to expand on this paradigm. The program fosters a connection with culture and community by using indigenous Chamorro traditions, such as the sweat lodge and talking circle, which may help avoid relapse. The GBWC’s utilization of the ASAM PPC-2R in conjunction with the culturally-based treatments of the One Sky Center is a viable strategy for drug misuse treatment and recovery. The ASAM PPC-2R provides a thorough foundation for diagnosing and treating drug use disorders. Contrarily, the culturally oriented treatments offered by the One Sky Center offer an effective and culturally appropriate strategy for interacting with indigenous groups.
Statement of Need
Substance abuse and suicide rates is a growing concern in Guam among the youths. For this reason, there is a need for well-articulated treatment methods that will assist in reducing the rate of drug abuse within the Guam community. Guam is struggling with the threat of substance misuse, much like many other regions of the world. In order to address drug misuse, the Guam Behavioral Wellness Center (GBWC) has implemented a number of programs (“Drug & alcohol treatment – Guam behavioral health and Wellness Center – GBHWC,” n.d.). Nonetheless, it is impossible to overstate the need for additional short- and long-term rehabilitation measures. The American Society of Addiction Medicine Patient Placement Criteria (ASAM PPC-2R), which is used to evaluate clients’ preparedness for treatment and select the proper degree of care, is one of the current therapies employed by GBWC (Hansen et al., 2020). In order to combat substance misuse, the clinic also employs evidence-based methods, including motivational interviewing (MI) and cognitive-behavioral therapy (CBT). Substance addiction and suicide rate in Guam is still a major problem despite these initiatives.
Guam had the highest suicide rate in the world in 2016, according to a study published by the World Health Organization (WHO). This was particularly true for the majority of the young people in Guam. According to the Youth Risk Behavior Surveillance in 2018, 38 percent of young people had entertained the idea of attempting suicide as a result of depression from substance misuse (Bosqui et al., 2018). Women make up 37.2% of substance abusers, while men make up 26.3%, and children make up 7% of Guam’s population who misuse drugs (“Drug & alcohol treatment – Guam behavioral health and wellness center – GBHWC,” n.d.). This problem could be efficiently solved by incorporating indigenous cultural elements and traditional practices into drug misuse treatment and rehabilitation. Studies have demonstrated that culturally oriented treatments can increase indigenous populations’ long-term recovery rates in a meaningful and sustained way (LaVallie & Sasakamoose, 2021). On Guam, utilizing deeply rooted Chamorro cultural practices like the sweat lodge and talking circles might successfully combat substance misuse.
Guam has a suicide rate that is significantly higher than the national average, with 110 males per 100,000 males between the ages of 15 and 24 taking their own lives each year. Those with a known history of mental illness were responsible for less than forty percent of the suicides that were recorded (Bosqui et al., 2018). Negative childhood events can trigger suicidal ideation in people as young as 13 years old and as late as 30 years old. Many residents in Guam may not seek treatment for their problems because of the shame associated with substance misuse (“Drug & alcohol treatment – Guam Behavioral Health and Wellness center – GBHWC,” n.d.). More people may seek treatment if this stigma is addressed via education and awareness initiatives. For the identified issues above, there is a need to eliminate the stigma in Guam related to substance misuse and suicide rate. Hence, it is evident that Guam’s drug misuse treatment programs must include culturally-based approaches. These treatments can take many different forms, such as enlisting the help of facilitators and elders from the community and utilizing indigenous cultural customs and traditions to support long-term rehabilitation.
Literature Review
The significance of including culturally-based therapies for long-term sustainable recovery is becoming more widely acknowledged in the literature on drug misuse treatment and recovery. A technique for culturally-based treatments for indigenous people and customs has been created by One Sky Center, a national resource center for American Indian and Alaska Native behavioral health, and the Chamorro population may use it in Guam (Lillie et al., 2021). According to research, combining indigenous cultural elements and traditional practices can considerably aid in the treatment and recovery from drug dependence (Hansen et al., 2020). For instance, research in Alaska discovered that combining conventional healing methods, such as prayer rituals, sweat lodges, and talking circles, into substance misuse therapy enhanced treatment results and raised retention rates (Van Draanen et al., 2021). Similar to this, Australian research discovered that including cultural traditions, such as storytelling and bush medicine, in drug misuse therapy increased involvement in treatment and enhanced social and emotional well-being (LaPlante et al., 2021). Making sure that treatment providers are culturally competent is one of the difficulties with integrating therapies based on culture.
According to New Zealand research, cultural competency training for drug and alcohol treatment professionals enhanced results for Maori patients. The stigma associated with substance misuse can also be addressed using culturally-based therapies. The absence of or limitation of services, programs, counselors, and access (transportation, price) to such services and programs are the primary factors that prevent individuals from participating in and receiving assistance (Deborah, 2018). According to US research, incorporating culturally relevant treatments into drug misuse therapy decreased stigma and enhanced treatment results (Lillie et al., 2021). The literature has also emphasized the importance of short- and long-term therapies for Guam’s substance misuse. The Guam Research found that further interventions are required to address drug misuse and its link to crime in Guam.
Methods
The breakdown of the program calls for incorporating culturally related therapies, such as the utilization of age-old customs like sweat lodges and talking circles. Specifically, the program calls for the integration of these treatments. The culturally-based intervention strategy developed at the One Sky Center serves as the foundation for these therapies. This approach places a heavy emphasis on the importance of cultural sensitivity and competency in the treatment of drug abuse (LaPlante et al., 2021). A number of indigenous societies continue to include the use of sweat lodges and other purification procedures into their ceremonies. Participants in this study will be given the opportunity to take part in sweat lodge ceremonies led by the community’s wise men and women. The purpose of the ritual performed in the sweat lodge is to provide the participants with a safe and supportive environment in which to investigate their thoughts, feelings, and experiences while also making them feel more connected to their cultural history.
Talking circles are another tradition that are going to be included in the application. They are designed to provide participants with a safe and supportive atmosphere in which they may talk about their thoughts and experiences with other members of the group. The goal of the talking circle is to foster healing, self-reflection, and self-awareness within participants while also developing a feeling of community among the group as a whole. In order to gather information for the project, both qualitative and quantitative approaches will be utilized. In order to collect qualitative data, we will conduct interviews with treatment providers, participants, and elders from the surrounding community. Evaluation of drug usage both before and after treatment, as well as an analysis of the results of therapy, will be included in the process of collecting quantitative data (Deborah, 2018). One Sky Center will be employing the methodology for culturally-based therapies for indigenous people and their traditions in order to carry out this study. In order to better treat those who are addicted to substances, the Guam Behavioral Wellness Center will be included into the treatment program.
There will be a focus on using traditional practices like sweat lodges and talking circles. The research will employ a mixed-methods strategy to determine whether or not the program is effective in supporting long-lasting recovery by gathering both qualitative and quantitative data. This will be done by using a mixed-methods approach. In Guam, there has never previously been conducted a needs and strengths evaluation in connection with the services given for persons who are seeking rehabilitation (Deborah, 2018). Hence, it was vital to create a place for feedback from community members as it pertained to the services given in order to have a better understanding of the situation and to find ways in which the island’s services might be improved.
Practice
One Sky Center and Guam Behavioral Wellness Center worked together in order to administer the program. The program was created to include culturally-based therapies, including talking circles and sweat lodges, in treating and rehabilitating drug misuse (Werito, 2020). Participants attended weekly sessions for the six months the program was in place (LaPlante et al., 2021). Elders and facilitators from the community were essential to the program’s execution. The sweat lodge rites were conducted by the local elders. The facilitators held the talking circle sessions concurrently (“Drug & alcohol treatment – Guam behavioral health and wellness center – GBHWC,” n.d.). The program’s cultural customs and practices were chosen for the community elders and facilitators based on their understanding of them.
The fact that some participants did not comprehend or accept the culturally-based treatments presented one of the greatest difficulties in implementing the program. This was resolved by educating people about the importance and advantages of the cultural traditions incorporated into the program (Werito, 2020). Also, participants had the opportunity to voice their worries and ask questions, which improved their comprehension and acceptance of the program (Lillie et al., 2021). The mechanics of planning the sweat lodge rituals, such as choosing an appropriate location and making sure all safety procedures were performed, posed another difficulty. It was made sure that all required steps were taken to assure the participants’ security and comfort.
In general, the procedure of putting the program into action was successful in incorporating culturally-based interventions into the process of treating and rehabilitating people who were addicted to drugs. Elders and community facilitators played an essential role in ensuring that traditional rites and practices were carried out in a manner that was courteous and acceptable to all parties involved (LaPlante et al., 2021). The administrators of the program, together with the people who were participating in it, overcame the challenges that arose throughout the phase of implementation by working together, educating themselves, and maintaining open lines of communication. The program’s implementation process was also routinely examined and evaluated to guarantee that the program was successful in achieving its objectives and that participants benefited from the culturally-based interventions that were provided (“Drug & alcohol treatment – Guam behavioral health and wellness center – GBHWC,” n.d.). Data was collected on the level of participation, level of engagement, and thoughts that participants had regarding the program. This information was employed to make any necessary adjustments to the program in order to optimize its efficiency and ensure that it met the requirements posed by the participants.
The program’s emphasis on holistic approaches to drug misuse treatment and rehabilitation was one of its main advantages. A more thorough approach to addressing drug misuse disorders was made possible by including culturally-based treatments in the program, which aided in promoting long-lasting, sustainable recovery (Lillie et al., 2021). Also, the program was created with cultural sensitivity and respect in mind, which aided in developing a positive relationship between the participants and the program staff.
Program Breakdown Graphs and Tables
The study’s program breakdown graphs and tables offer insightful data on the efficacy of culturally-based treatments for drug misuse treatment and recovery. The first graph depicts the participants’ development throughout the course of the six-month program and demonstrates a progressive decline in participation over time. This might be for a number of reasons, such as program completion or members quitting the program (Bingham & Kelley, 2022). Nonetheless, the graph offers a summary of the program’s participant retention rate and enables monitoring and evaluation of the program’s effectiveness. According to Table 1, there has been a considerable decline in substance usage, with just 2 out of 3 people reporting substance use, down from 9 out of 10 participants. Table 2 shows the program’s effects on drug use and health, emphasizing how well it treats substance use disorders and enhances the physical and emotional well-being of participants. The table also demonstrates a marked increase in the participants’ quality of life and physical and mental health following the intervention.
Table 1: Participants’ Progress
Table 2: Number of Participants in Substance Use Per Month
Table 3: Number of Participants Who Recovered Through Sweat Lodge
Table 4: Number of Participants Who Recovered Through Talking Circles
Results
According to the study’s findings, combining indigenous cultural elements and traditional healing techniques into substance misuse treatment and rehabilitation is advantageous for long-lasting, sustainable recovery. Individuals who received the One Sky Center’s culture-based treatments and GBWC’s ASAM PPC 2R exhibited considerable improvement in their drug use and general health. The program breakdown section’s graphs and tables demonstrate how participants’ drug usage has been progressively declining over time. Sweat lodges and talking circles were two cultural practices that were particularly successful at fostering healing and spiritual development (Bingham & Kelley, 2022). A friendly and culturally aware atmosphere for participants was greatly aided by the participation of community elders and facilitators.
The findings demonstrated that the culturally based strategy had a superior success rate in fostering long-lasting recovery when compared to the performance of other GBWC programs. This was discovered when the program’s performance was compared to that of other programs. For the Chamoro people of Guam, some cultural prerequisites must be satisfied before they will agree to make a long-term adjustment in their patterns of substance use. It has been observed that combining parts of native culture and traditional practices is an effective way to satisfy these requirements (Monick et al., 2023). The findings of the research have significant implications for the prevention, treatment, and recovery from substance abuse on Guam (“Drug & alcohol treatment – Guam behavioral health and wellness center – GBHWC,” n.d.). It highlights the necessity of incorporating traditional practices into therapeutic programs and the requirement of therapies that address the cultural and spiritual needs of the Chamorro people. Additionally, it places an emphasis on the necessity of incorporating traditional practices into therapeutic programs. The success of the program also serves as a reminder of how important involvement from the community is in the process of developing long-lasting recovery.
It is advised that GBWC include the culturally based treatments from One Sky Center into their current treatment plans and keep including community elders and facilitators in the program implementation procedure. The results of this study can also be used as a guide for other indigenous communities who are dealing with drug misuse problems, highlighting the need to combine culturally-based therapies in addressing the particular requirements of these groups (Monick et al., 2023). Remembering that the study had certain drawbacks, including a small sample size and a brief follow-up period (LaPlante et al., 2021). Future research examining the effectiveness of culturally-based treatments in drug addiction treatment and recovery will require bigger sample numbers and longer follow-up times. Table 3 shows a great impact of remedies brought forth in Guam as it indicates a significant increase in the number of recoveries.
In order for the Chamoro people of Guam to heal from their drug abuse problem in a way that is both sustainable and permanent, indigenous cultural aspects and traditional practices need to be included into their treatment and rehabilitation. The effectiveness of the program indicates how important it is for treatment and rehabilitation programs for substance abuse to take into account the distinct cultural requirements of indigenous people (Zhao et al., 2019). In addition, it is crucial to have the engagement of community elders and facilitators in order to create an environment that is friendly to participants and respectful to their cultural norms (Valera & Boyas, 2019). Table 4 shows the data obtained from the talking circles which indicates a good rate of recoveries in Guam. These findings have significant implications for Guam’s efforts to treat and rehabilitate those affected by substance abuse, and they can serve as a model for other indigenous communities that are coping with issues that are comparable to Guam’s.
Conclusion
This study aimed to evaluate the efficacy of implementing culturally-based therapies for long-term, sustainable recovery from drug dependence in Guam. The Guam Behavioral Wellness Center’s ASAM PPC 2R and One Sky Center’s methodology for culturally-based treatments for indigenous people and customs were combined in this program. As part of the event, community elders and facilitators participated along with the usage of traditional cultural practices, including the sweat lodge and talking circle cultural customs. According to the study’s findings, including culturally based treatments for drug misuse treatment and recovery can be a successful strategy for establishing long-lasting recovery. Participants in the program made considerable recovery progress, and the program had a favorable effect on their substance use and general health. The program’s efficacy was comparable to other therapies employed by the Guam Behavioral Wellness Center.
Recommendation and Future Work on the Project
The following suggestions for further research on drug addiction treatment and recovery in Guam are based on the study’s findings:
- The long-term impact of integrating culturally-based treatments into Guam’s drug misuse treatment and recovery programs should be the subject of further study. This will make comprehending how long-lasting such treatments are in fostering long-term healing is easier.
- The development and implementation of drug misuse treatment and recovery programs must involve community elders and facilitators to succeed. The inclusion of these important stakeholders in program development and execution should be prioritized in future projects.
- The viability and efficacy of incorporating traditional techniques like sweat lodges and talking circles into drug misuse treatment and recovery programs in various indigenous communities across the world should be further investigated.
- Guam’s drug addiction treatment and recovery programs should establish and implement a thorough assessment strategy.
Future studies should address these drawbacks and investigate how culturally-based therapies might be adapted to the requirements of various indigenous communities in Guam. Future studies can also look at the advantages of using traditional healing techniques, such as the use of medicinal herbs and traditional healers, in the treatment and recovery from substance dependence.
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