As a psychologist and researcher working across Indian country for the past 15 years, notwithstanding significant historical trauma and ongoing systemic challenges,  Indigenous people in the so-called “United States” demonstrate remarkable resilience, often drawing strength from their deep connection to land, culture, community, and spiritual practices, even while reporting high rates of psychological distress due to the impacts of colonization and dispossession. This resilience is evident in their ability to maintain cultural identity, adapt to changing environments, and advocate for their communities despite adversity.  

Decolonizing mental health requires being open to understanding that spiritual forces require constant and careful attention. “Decolonizing mental health” means approaching therapy by acknowledging and addressing the historical impacts of colonialism on individuals and communities, often incorporating spiritual practices from Indigenous cultures to promote holistic healing rather than depending solely on Western psychological models. This encompasses actively integrating a person’s spirituality into their treatment plan when appropriate, recognizing that spirituality can be a vital source of strength and resilience for many people. 

Indigenous mental health providers and healers have diverse healing traditions that have endured despite the oppression of colonization. Indigenous spiritual resilience in the treatment of  Indigenous people actively incorporating traditional spiritual beliefs and practices into the  Indigenous healing process, often as a form of resistance against the assimilationist tendencies of  Western healthcare systems that may disregard or devalue Indigenous cultural identity and spirituality, thereby reclaiming agency and power over their wellbeing. 

To incorporate spirituality into treatment for Indigenous clients, practitioners can actively learn about the client’s specific tribal traditions, consider incorporating elements like prayer, ceremonies, connection to nature, storytelling, and community support into the therapeutic process, always ensuring respect for the client’s individual beliefs and practices while acknowledging the central role spirituality plays in their healing journey. 

In my language (Skẻn: nen), peace is not a concept but a way of life, a state of harmony with oneself and others. This happens when everyone works together to benefit everyone, including those yet to come.  

Decolonizing mental health and therapy is a process that challenges the legacy of colonialism,  imperialism, and systemic oppression in mental health and healing. Recognizing the impact of colonization and decolonizing mental health involves acknowledging the ways that Western psychiatric knowledge has marginalized non-Western models of healing. Thus, decolonizing mental health is critical because it seeks to address the legacy of colonialism and imperialism in psychology and mental health. Decolonization seeks to reverse colonization’s impact on minoritized groups. Decolonization reaches beyond increasing inclusivity and aims to re-establish history through the experiences and perspectives of those most affected. However, few alterations have happened in mental health and psychology. Still, approaches fail to target the root of the problem (i.e., the need for authors to use more culturally sensitive language assessments and culturally sensitive wording).

To reverse the effects of colonization within theoretical applications, it would be necessary to re-evaluate Westernized history and teach past events through the experiences of those who suffered. Comprehensive research into decolonization is essential to effectively eliminate colonial practices globally. This is particularly important for Indigenous populations as the incorporation of Indigenous methodologies into mental health care can play a significant role in addressing mental health issues in these communities. Indigenous knowledge can create culturally centered health promotion initiatives by drawing on their cultural identity, community renewal, and self-determination. Indigenous methodologies can help address social and psychological factors that impact a community, limit Western concepts’ influence, and develop socially appropriate methods. Actively dismantling coloniality within the mental health and psychology field necessitates recognizing how it forms the profession’s bedrock. 

Historically, the field of mental health and psychology has been used to justify and provide “‘scientific’ rationalization” for white supremacy (American Psychological Association [APA], 2023b, p. 12). Psychologists were the “leading eugenicists” post-World War II, with intelligence cited as the primary construct supporting white supremacy (Zuberi, 2001, p. 56). The widely used Stanford-Binet Intelligence Scales were revised and published by past APA  president and eugenicist Lewis Terman, essentially to create test results that gave credibility to white supremacy, an act of scientific racism (Winston, 2020). 

Of Indigenous peoples, Terman wrote, “their dullness seems to be racial, or at least inherent in the family stocks from which they come.” He goes on to state that Indigenous children are ineducable and “constitute a grave problem” (Terman, 1916, pp. 91-92). APA PsycNet, APA’s online search platform, still describes Terman’s publication as a helpful text (APA, 2022) with no mention of what Terman himself writes is a  “eugenic point of view” (Terman, 1916, p. 92). 

Similarly, relationality and Indigenous ways of knowing are notably absent from psychology’s major schools of thought. Traditional theoretical orientations to psychological practice typically include psychodynamic, humanistic, cognitive behavioral, biological, and ecological systems perspectives. Indigenous methodologies and frameworks, such as visiting (Gaudet, 2019; Tuck et al., 2023), are not often acknowledged or respected in the field (APA, 2023b; Grayshield et al., 2010). The Visiting Way is an Indigenous research method emphasizing reciprocal relationships and authentic dialogue. It’s different from traditional interviews and focus groups because it allows conversations to flow naturally. Rather than acknowledging  Indigenous ways of knowing as valid and worthy, psychology assumes that Western interventions need to be adapted to suit Indigenous clients, failing to recognize that Indigenous communities have healing practices that have been serving them well since time immemorial (King, 2022; Somerville et al., 2016). 

Indigenous people embrace the whole person, which means honoring all of the person, their gifts, strengths, and areas of being different. The relationship between non-Native practitioners and Indigenous clients will continue to struggle if practitioners only address the negative valence of their mental health and wellness. Working with Indigenous clients, the practitioner must incorporate spiritual/cultural intelligence into the initial dialogue and service plan. For example, sharing about what tribe the client is from and what traditional ways the client participates in uses culturally relevant and appropriate assessments that incorporate and honor culture. 

In that case, the struggle for a successful outcome will continue (Baez & Baez, 2023). Western models have interfered with Indigenous survival methods and the sharing of knowledge, in addition to the responsibilities to one another (Baez & Dirth, 2024). The Indigenous ways of learning and knowing, together with each other, continue to nourish and sustain. Indigenous societies have long practiced Indigenous ways of knowing, incorporating cultural-based and applied learning approaches that have helped the next generation comprehend the meaning of living with all living beings (Baez & Dirth, 2024). 

While some Western interventions may demonstrate success with Indigenous clients after being culturally adapted, it remains that these interventions were adapted. Hence, they rest on the notion that the Western way is the norm and the Indigenous way is the alternative. Indigenized mental health frameworks will provide healthy relational steps that are culturally relevant, sensitive, and appropriate for professionals providing services. 

In addition, broadening awareness and appreciation of Indigenous models is essential in moving forward with culturally responsive approaches (Baez & Dirth, 2024). For Indigenous people, spirituality is considered a crucial aspect of healing, which, when integrated into therapy through traditional ceremonies, rituals, and practices that aim to restore the balance between the physical, mental, emotional, and spiritual aspects of a person (i.e., talking feather, pipe ceremony, naming ceremony, blessing-way ceremony, smoke ceremony, Native American Church ceremony, etc.), will connect them to their community and the natural world. Appreciating that mental health is an experience that must be understood in context, so too is the meaningfulness of mental health models largely dictated within cultural context. 

Towards setting a solid foundation for a method that incorporates Western approaches and Indigenous methodologies (i.e., Sweetgrass Method), to working with AI/AN people and their families in the context of a cultural approach to healing, the breadth of mental health models can allow for more attentiveness to the unique cultural context of clients and their families rather than forcing them into a limited Western paradigm. The Sweetgrass Method (SGM) framework examines Indigenous methodologies and Western approaches to client/student services. It provides a Culturally Responsive framework for addressing mental and behavioral health concerns for Indigenous people.