Indigenous-informed counselling

1. Introduction

Version followed: Eduardo Duran's soul-wound / liberation-psychology approach, as he describes it himself in his Indian Health Service lecture transcript and his psychotherapy.net interview. Healing the Soul Wound (2006; 2nd ed. 2019, Teachers College Press) and Native American Postcolonial Psychology (Duran & Duran, 1995) are known here only from publisher and catalogue descriptions and abstracts; their full text is not drawn on here [uncertain].

What it is. This is not a manualised therapy. It is a clinical approach and worldview developed by Eduardo Duran, a clinical psychologist (Apache/Tewa heritage per one event biography, which also mentions Lakota; sources differ [uncertain]) who has worked mostly in Native communities. He calls his model a hybrid one, built on teachings from Native elders and traditional healers [source: Zen Mountain Monastery biography; IHS transcript]. The publisher describes the core model as one in which "patients have a relationship with their problems", whether physical, mental or spiritual. It also describes a method of translating Western clinical metaphors into Indigenous ones [source: GoodMinds/TCP description of 2nd ed.].

How change happens. Duran sees much present suffering (substance misuse, violence, suicidality, depression) as a soul wound: trauma from colonisation and genocide that has been passed down through generations without healing. He describes it as a wound to the soul rather than a set of symptoms [source: IHS transcript; Counseling Today; Duran et al. 2008 abstract]. Change comes from:

having the client's experience validated rather than pathologised;
forming a respectful relationship with the illness or substance, rather than "waging war" on it;
restoring cultural identity and connection to community, land and the client's own traditions;
liberating client, community and the counselling profession from internalised oppression.

The aim is healing, which Duran separates from curing [source: IHS transcript; psychotherapy.net interview; Duran, Firehammer & Gonzalez 2008 abstract].

Scope note. This guide describes only what Duran and other Indigenous authors and organisations publish. Ceremonies belong to communities and their healers. They are not described here, and a counsellor should not run them [synthesis].

2. Framework

No published phase protocol was found. Duran's sources give no fixed stages, session counts or criteria for moving between phases. He explicitly rejects checklists of culture-specific techniques [source: psychotherapy.net interview]. The sequence below is a working order put together from what he describes. Treat it as [synthesis], not a Duran protocol.

Levels of intervention (Duran). He describes three levels: individual work restoring harmony of mind, body and spirit; community work (outreach, advocacy, healing services); and "healing the land", meaning attention to the bonds between people, all beings and the Earth, since harm to the environment is itself a source of trauma [source: Counseling Today].

Working sequence [synthesis, assembled from Duran's described practice]:

Entry and trust. Goal: safety and alliance before any interpretation. Duran says he builds trust first and works with the client's own dreams and process after that [source: psychotherapy.net]. In community work, he gets guidance from elders and local helpers before trying any assessment [source: psychotherapy.net]. Move on when the client discloses what they had hidden, such as dreams, visions or beliefs about being "witched" [inferred].
Listening to the lifeworld and validating. Goal: hear how the client understands the problem in their own terms, without pathologising. Duran calls validation the biggest part of the work [source: IHS transcript].
Historical framing (soul wound). Goal: link present suffering to intergenerational history, including events before the client was born, and to future generations [source: IHS transcript].
Relationship with the problem. Goal: treat the illness, substance or emotion as an entity with its own lineage. Learn from it, make amends with it, or end the relationship respectfully. Dreams are a main route in [source: IHS transcript; psychotherapy.net].
Identity restoration and liberation. Goal: sort what colonisation and alcohol distorted from the essence of tradition, and reconnect the client with identity, community and their own healers [source: psychotherapy.net; Duran et al. 2008 abstract].
Community and land. Goal: extend healing beyond the individual [source: Counseling Today].

Format. Individual counselling, family work (the multigenerational genogram), dream groups in substance-misuse programmes, and integrated primary care/diabetes settings. Duran speaks of integrating body, mind and soul rather than splitting them across providers [source: IHS transcript; psychotherapy.net]. Session counts: none published [uncertain]. The 2nd edition adds a chapter on veterans that is not drawn on here [uncertain].

3. Guiding principles

The soul wound is real and historical [source: IHS; Counseling Today]. Ask about history before the client's birth, and treat it as clinically relevant rather than as background.
Seven generations, backwards and forwards [source: psychotherapy.net; IHS]. Include ancestors and unborn descendants in your formulation and interventions.
Relationship, not war [source: psychotherapy.net; GoodMinds description]. Avoid "fighting" or "eliminating" the problem. Ask what the client's relationship with it is and how it could become respectful, or end.
Healing is not curing [source: IHS, "They can die healed, maybe not cured."]. Hold meaning, reconciliation and dignity as goals even where symptoms or illness persist.
Validation first; the client has usually already been pathologised [source: IHS]. Receive reports of presences, dreams or witching without immediate diagnostic labelling.
Language of movement, not nouns [source: psychotherapy.net]. Avoid sentences that fix a person in a diagnosis, and describe states as visiting or passing.
Indigenous knowledge is legitimate knowledge [source: Duran & Duran 1995 abstract; psychotherapy.net]. Treat oral tradition, dreams and the community's own explanations as data of equal standing, not as "beliefs" to be tolerated.
Epistemological hybridity [source: IHS]. Move between Western and Indigenous frameworks as the client needs. Neither one cancels the other.
Humility, not expertise [source: psychotherapy.net; IHS]. Expect to be taught by clients, elders and healers, and say what you do not know.
Authenticity [source: IHS; "if it's fake... it ain't going to work" paraphrased]. Do not borrow rituals or stories. Engage another worldview genuinely, or do not claim to.
Know your own story [source: IHS]. Learn your own people's creation story and ancestral homeland. Do not use another people's.
Identity restoration protects [source: psychotherapy.net]. Reconnection with cultural identity is treated as protective, including against suicide. It does not replace risk assessment [synthesis].
Liberation from internalised oppression, including the profession's [source: Duran et al. 2008 abstract; psychotherapy.net]. Check whether your own methods, language ("Westernese") and institution repeat colonial patterns.
Community and elders lead [source: psychotherapy.net]. Ask permission and guidance before assessing or intervening in a community.
Integrate body, mind and spirit [source: IHS; Counseling Today]. Coordinate with medical and traditional providers rather than splitting the person up.
Don't carry it home [source: IHS]. Have a practice for setting down what clients bring, because absorbed burdens lead to clinician burnout, substance use and suicidality.
Productive disorientation, with containment [source: psychotherapy.net]. Some unsettling of ego certainty helps growth, but watch for fragmentation and contain it.
No checklists of cultural techniques [source: psychotherapy.net]. Use the inventory below as a set of options shaped by the specific client and nation, not as a protocol.
Ethical research [source: psychotherapy.net; 2nd ed. description]. Evaluate in ways the community considers respectful. Duran proposes "applied story science" (details [uncertain]).

4. Intervention inventory

Duran does not number or name a fixed technique set. Each item below is a practice he describes in the sources. Step sequences are my operationalisation of those descriptions, marked [synthesis] where I add structure. Example language is illustrative unless quoted.

4.1 Trust first: entering the client's world

Purpose / when: At the start, and whenever the alliance is thin. Duran builds trust and alliance before he works with dreams or interpretation [source: psychotherapy.net]. He also proposes a "therapist-centred" stance in place of client-centred: the therapist has to be grounded enough to hold the work [source: IHS transcript].
Steps:
1. Spend early sessions listening, without using standard technique to redirect. Duran reports that his early CBT techniques missed what clients brought, and that listening helped [source: IHS].
2. Ask about family, community and place before symptoms [synthesis].
3. Avoid clinical jargon ("Westernese"), which he says shuts people down [source: psychotherapy.net].
4. Where appropriate and invited, take part in community life. Duran describes trainees going to ceremonies with clients' families when invited, which deepened trust. Attend only on invitation, and follow the hosts [source: psychotherapy.net; synthesis].
Example language (illustrative): "Before we get to what brought you in, tell me about your people and where you're from."
Watch for: The client starts disclosing material they had hidden, such as dreams, visions or spiritual explanations. Guardedness can be appropriate given the history of institutions in the community. Don't push [synthesis].

4.2 Opening inquiry, disclosure check and validation

Purpose / when: At intake and early on. It surfaces the client's own explanation, which is often spiritual (for example, being "witched"), and counters earlier pathologising [source: IHS].
Steps:
1. Ask an open question about what is happening. Duran's own wording is "what's going on?" [source: IHS].
2. Ask whether they have told anyone else. Usually they have not, because they fear being seen as crazy [source: IHS].
3. Validate the experience as meaningful within their frame. Duran calls validation the biggest part of the work [source: IHS].
4. You do not have to declare your own beliefs. Duran says he doesn't tell patients what he believes, but that patients sense safety when the provider has genuinely engaged another worldview [source: IHS].
5. Do a separate clinical check of mental state and risk, quietly and without contradicting the frame (see §5) [synthesis].
Example language (illustrative): "Have you been able to tell anyone about this? ... It makes sense that you kept it to yourself. Many people do, because they're afraid of being called crazy. I'm not going to do that."
Watch for: Relief and further disclosure show it is working. In clients who described seeing deceased relatives or presences, naming these within a historical frame helped them come forward [source: psychotherapy.net].

4.3 Soul-wound / historical-trauma framing

Purpose / when: Once trust exists and the client is struggling to make sense of violence, alcohol, suicidality, depression or chronic illness. It moves the problem from personal defect to unhealed collective history [source: IHS; Counseling Today; psychotherapy.net].
Steps:
1. Ask about family and community history, including events before the client was born (removals, boarding schools, losses) [source: IHS; boardingschoolhealing.org on the term].
2. Offer the frame that what happened to earlier generations can show up in the present. Duran draws on the "seven generations" teaching, which he applies both backward and forward [source: psychotherapy.net]. He also cites findings on children of Holocaust survivors who had PTSD without trauma of their own [source: IHS].
3. Name the experience as suffering of the soul and the work as healing, not only cure [source: IHS].
4. Link the frame to responsibility and agency in the present: what the client can heal now for those who come later [synthesis].
Example language (illustrative): "Some of what you're carrying may not have started with you. Your grandparents lived through things nobody helped them heal. That doesn't make it your fault, and it doesn't mean it has to keep going."
Watch for: Shame softening into grief or anger is a sign of movement. The frame can also be heard as fatalism ("it's in my blood"). If so, stress what the client can heal and choose [synthesis].

4.4 Genogram including unborn generations

Purpose / when: Family or individual work where motivation for change is low, including medication adherence and health behaviour. Duran reports that it creates urgency and willingness to change [source: IHS transcript].
Steps (as Duran describes them):
1. The family draws a genogram going up as many generations as they can and down as far as they know.
2. They add imagined future generations below.
3. Ask which unborn child is likely to inherit the sickness if nothing changes.
4. Process the response and link it to concrete changes now [synthesis on step 4].
Example language (illustrative): "Let's draw your great-grandchildren down here. If nothing changes, which of them do you think this sickness would go to?"
Watch for: Strong emotion, sometimes guilt. Frame it as power to change rather than blame [synthesis]. Increased willingness to take medication or make changes is the reported marker [source: IHS].

4.5 Relating to the problem as a relative or spirit

Purpose / when: This is the central technique. It works for substance misuse, depression and chronic illness. The problem is approached as an entity or energy the client has a relationship with, so they can learn from it rather than make war on it [source: psychotherapy.net; IHS; GoodMinds description].
Steps:
1. Offer, but don't impose, the idea that the depression or alcohol is an energy or spirit the client is in relationship with [source: psychotherapy.net].
2. Explore its lineage. Duran asks where the sickness comes from, and who its "father", "mother" and "grandpa" are [source: IHS]. In practice: when it entered the family, who else it visited, and what history it came with [synthesis].
3. Explore the relationship: what it gives, what it takes, what it may be trying to say. Duran frames illness as often being the Creator trying to get attention [source: IHS].
4. Decide on the direction. For depression this may be "making a relative out of it" and learning from it [source: psychotherapy.net]. For alcohol, it may be ending the relationship respectfully (see 4.8).
5. Keep using the frame in follow-up sessions, tracking how the relationship changes [synthesis].
Example language (illustrative): "If this sadness were a visitor, when did it first come to your family? What do you think it wants you to notice?"
Watch for: The client may reject the frame. One young client told Duran he sounded just like his grandmother, but later engaged after a frightening night-time experience [source: psychotherapy.net]. Follow the client's lead. The frame works for some clients and not others [synthesis].

4.6 Non-crystallising diagnostic language

Purpose / when: Whenever you communicate a diagnosis or formulation to the client. Labels such as "major depressive disorder" fix a person in sickness. Duran contrasts this with "You are being visited by the spirit of sadness," which he finds more empowering [source: psychotherapy.net].
Steps:
1. Keep the formal diagnosis for records and billing as required [synthesis].
2. With the client, use language of process and movement (visiting, passing, carrying) instead of identity nouns [source: psychotherapy.net].
3. Check that the client finds the language respectful. Some prefer clinical terms [synthesis].
Example language (illustrative): "Right now, sadness is staying with you. It hasn't always been here, and it doesn't have to stay."
Watch for: Hope and agency rising. Make sure the client still understands any medical information they need [synthesis].

4.7 Dream work

Purpose / when: Whenever clients bring dreams, which Duran found they often did. Dreams were the main way into the work [source: psychotherapy.net; IHS].
Steps:
1. Invite and welcome dreams. Don't redirect them [source: IHS].
2. Ask the client first what they think a dream means. Duran describes clients replying that if they knew, they wouldn't need him. Stay with the shared exploration [source: psychotherapy.net].
3. Explore dream figures, including ancestors or the "spirit of alcohol", as communications in the client's framework [source: psychotherapy.net].
4. Expect dreams to intensify as the real issue comes forward. This can be frightening, so prepare and contain [source: psychotherapy.net].
5. In substance-misuse programmes, Duran runs dream groups [source: psychotherapy.net]. No group procedure was found [uncertain].
Example language (illustrative): "What do you make of it? ... What did the figure in the dream seem to want from you?"
Watch for: Frightening dreams or sleep paralysis. Duran reports a client paralysed in sleep after the alcohol frame was raised [source: psychotherapy.net]. Make sure the client has support, check sleep and safety, and refer to the client's own healers if they wish [synthesis].

4.8 Amends to the substance and ending the relationship respectfully

Purpose / when: Substance misuse, especially alcohol, including within 12-step work. Duran adds amends to the medicine or substance itself to the usual amends steps [source: IHS]. He compares the process to ending a marriage respectfully [source: psychotherapy.net].
Steps:
1. Build on 4.5: describe the history of the relationship with alcohol as a relationship.
2. Explore what was disrespectful in the relationship. Duran tells some inpatients they were "witching" themselves by disrespecting the medicine [source: IHS].
3. Invite the client to make amends and to end the relationship deliberately, without hatred [source: psychotherapy.net; IHS].
4. If the client's tradition includes making an offering, they may do this in their own way or with their own healer. Duran suggested a tobacco offering to one client [source: psychotherapy.net]. The counsellor does not prescribe or conduct it [synthesis].
5. Integrate with relapse-prevention planning and medical care as usual [synthesis].
Example language (illustrative): "If this was a marriage, how would you end it with respect, so it doesn't keep coming after you?"
Watch for: A shift from shame and fighting to respect and a clear decision. Watch for withdrawal risks and the need for medical detox; the frame doesn't replace them [synthesis].

4.9 Traditional illness categories as an assessment map

Purpose / when: To hear how the client explains their illness in spiritual terms. Duran uses anthropologist Forrest Clements' five categories as a map, each with its typical traditional remedy: object intrusion, loss of soul, spirit intrusion, breach of taboo, and sorcery [source: IHS transcript].
Steps:
1. Listen for which explanation the client holds. Don't suggest one [synthesis].
2. Respond within the counsellor's scope. Breach-of-taboo explanations fit counselling work on confession, forgiveness and amends, which Duran links to that category [source: IHS]. Soul loss, intrusion and sorcery are matters for the client's own healers, so offer a referral if the client wants one [synthesis].
3. Record the explanation as part of the cultural formulation [synthesis].
Example language (illustrative): "In your family's way of understanding, where does a sickness like this come from? Who would usually help with it?"
Watch for: Don't play healer. Separately, screen for psychosis or severe depression without discounting the cultural explanation (see §5) [synthesis].

4.10 Direction-of-energy assessment (inward vs outward violence)

Purpose / when: Assessing trauma-related violence. Duran describes violence turning inward (self-hatred, addiction, chronic illness) or outward (domestic violence, often against Native women), and suggests asking which way the energy is moving [source: IHS].
Steps:
1. Map the self-directed harms and the other-directed harms [synthesis].
2. Ask which way the energy is moving now [source: IHS].
3. Prioritise safety: suicide risk assessment if it is moving inward, and safety planning and protection duties if it is moving outward [synthesis].
Example language (illustrative): "When this anger and hurt build up, where does it go: at yourself, or at the people around you?"
Watch for: Disclosures of domestic violence or child risk that trigger reporting duties [synthesis].

4.11 Identity restoration and liberation work

Purpose / when: Clients who feel cut off from their roots (Duran's word is "flailing"), and clients carrying internalised oppression [source: psychotherapy.net; Duran et al. 2008 abstract].
Steps:
1. Explore what the client knows of their nation, language, land and teachings, and what they have lost [synthesis].
2. Help the client separate what colonisation and alcohol distorted from the essence of their traditions [source: psychotherapy.net].
3. Name internalised oppression where it shows up: self-contempt, contempt for one's own people, or adopting the coloniser's view [source: Duran et al. 2008 abstract].
4. Support reconnection through the client's own community, elders and cultural programmes. The counsellor connects; the community teaches [synthesis].
5. Duran sometimes teases a client about identity ("What kind of Indian are you, anyway?") to unsettle a stuck stance [source: psychotherapy.net]. Use this only with strong trust, and only if you share the culture or have earned that licence [synthesis].
Example language (illustrative): "Which parts of how you were raised feel like your people's way, and which feel like what was done to your people?"
Watch for: Grief and anger at losses. Pressure to be "traditional enough" can be a new burden, so respect mixed, Christian, urban and adopted identities [synthesis].

4.12 Collaboration with traditional healers, elders and community helpers

Purpose / when: Throughout. Duran learned to understand clients through traditional healers, used their guidance in therapy, and relied on elders and local helpers after a failed community survey [source: psychotherapy.net; IHS].
Steps:
1. Before community-level work, ask elders and local helpers how to proceed [source: psychotherapy.net].
2. Build referral relationships with traditional healers recognised by the client's community, through the tribal health programme where one exists [synthesis].
3. Coordinate with consent, and respect what healers choose not to share [synthesis].
4. Attend ceremonies only on invitation. Do not record or describe them, and do not take on roles [synthesis; Duran describes trainees attending when invited, source: psychotherapy.net].
Example language (illustrative): "Is there someone in your community you'd want to be part of your healing? I'm glad to work alongside them, if you'd like."
Watch for: Communities differ widely. Some clients may want no traditional involvement, and that is their choice [synthesis].

4.13 Respecting medicine (medication and treatment)

Purpose / when: Treatment ambivalence or non-adherence, especially in integrated care. Duran suggests treating medication as having a spirit, and explaining its origins in plain English. He describes how a patient began taking her medicine after a physician prayed over it with her [source: IHS].
Steps:
1. Explore the client's relationship with the medicine, including fears and its meaning [synthesis].
2. Ask the prescriber to explain plainly what it is and where it comes from [source: IHS].
3. If the client wishes, they may bless or pray over it in their own tradition. The counsellor facilitates; the client or their healer leads [source: IHS; synthesis].
Example language (illustrative): "How do you feel about this medicine? Would it help to know more about where it comes from, or to treat it in your own way before you take it?"
Watch for: Adherence rising. This never replaces medical advice [synthesis].

4.14 Meaning-making for loss: healing without cure

Purpose / when: Chronic or terminal illness, disability, amputation and irreversible losses [source: IHS].
Steps:
1. Separate healing from curing [source: IHS].
2. Explore loss as something that can be given meaning for relatives and descendants. Duran suggests framing a lost body part as an offering for relatives' healing, and urges "don't waste it" [source: IHS].
3. Help the client set down the illness rather than carrying it home. Duran describes patients doing this through their own spiritual practice [source: IHS; detail omitted].
Example language (illustrative): "This loss is real. Is there a way it could mean something for the people who come after you?"
Watch for: Premature meaning-making can bypass grief. Let the grief come first [synthesis].

4.15 Community and land-level work

Purpose / when: When suffering is collective or environmental [source: Counseling Today].
Steps: Take on outreach, advocacy and community healing services. Act as consultant and agent of social change. Treat environmental harm (for example, pollution) as a trauma source, and consider supporting the community's efforts to protect land [source: Counseling Today]. Work under the community's direction [synthesis].
Example language (illustrative): "What would healing look like for the whole community, not just for you?"
Watch for: Overstepping into leadership roles that belong to the community [synthesis].

4.16 Clinician self-work and supervision

Purpose / when: Before and throughout practice. Duran treats the healer's own healing and authenticity as a precondition [source: IHS; psychotherapy.net].
Steps:
1. Learn your own creation story and ancestral homeland, and visit ancestral sites if you can. Do not use another people's story [source: IHS].
2. Have a practice for setting down what clients bring. Duran warns of clinicians who absorb these burdens and then drink, use drugs or become suicidal [source: IHS].
3. Supervision: move trainees from note-taking and thinking towards heart-based, embodied awareness. Ask whether they and their clients are dreaming [source: psychotherapy.net].
4. Contain trainees who begin to have unusual perceptual experiences, because the ego can fragment without support [source: psychotherapy.net].
5. Examine your own internalised oppression, which Duran says practitioners of colour can also carry [source: psychotherapy.net].
Example language (supervision, illustrative): "Put the notes down for a minute. What did you feel in the room?"
Watch for: Signs of vicarious trauma or spiritual overwhelm in yourself or your trainees [synthesis].

Not covered

The veterans chapter (2nd ed.), the full case materials, the content of chapter-by-chapter interventions in Healing the Soul Wound, and the dream-group procedure are not covered [uncertain]. They may contain further techniques not listed here.

5. Handling problems

Duran's sources address only a few of these problems directly; they are tagged [source]. Everything else is my own synthesis, consistent with his principles [synthesis].

Client rejects the spirit frame. Duran's young client said he sounded just like his grandmother. Duran didn't argue, and the client later came back to the frame on his own [source: psychotherapy.net]. Offer the frame lightly, drop it if it doesn't fit, and work in the client's own language, which may be Christian, secular or clinical [synthesis]. Never make cultural framing a test of authenticity [synthesis].
Client hides experiences for fear of being called crazy. Ask directly whether they have told anyone, and validate the experience [source: IHS]. State that you won't pathologise what is meaningful in their culture [synthesis].
Distinguishing culturally normative experiences from psychosis or severe depression. No guidance is given [uncertain]. Assess function, distress, how the client's own community sees the experience, and the presence of other psychotic features. Consult a cultural consultant or the client's healer with consent. Use standard cultural formulation tools (e.g. the DSM-5 Cultural Formulation Interview) [synthesis].
Suicide and self-harm risk. Duran sees identity restoration as protective [source: psychotherapy.net]. Still carry out standard suicide risk assessment and safety planning, including lethal-means counselling (safe storage and removal). Involve family and community supports the client chooses. Use the direction-of-energy question (4.10) to open the conversation [synthesis].
Overwhelm from historical material or intensifying dreams. Duran warns that dreams intensify and can frighten, and that ego fragmentation needs containment [source: psychotherapy.net]. Slow the pace and return to grounding and present-day supports. Check sleep and safety. Offer referral to the client's own healers if wanted, and increase session frequency or coordinate psychiatric care if needed [synthesis].
Fatalism ("it's in my blood"). Reframe historical trauma as something that can be healed rather than destiny. Use the unborn-generations genogram to point towards agency [source: IHS for the genogram; synthesis for the reframe].
Non-adherence to medication or treatment. Use 4.13 and 4.4: respect for the medicine, plain explanation of where it comes from, and the urgency created by the unborn-generations genogram [source: IHS].
Continued drinking, relapse. Revisit the relationship with alcohol (4.5, 4.8): what has not been made right, and what the dreams are saying. Combine this with standard relapse prevention, medical care and mutual-help groups as the client prefers. Duran works within 12-step contexts [source: IHS; synthesis].
Rupture through clinical language or institutional distrust. Duran says Western jargon shuts people down, and that his intrusive community survey failed until he deferred to elders [source: psychotherapy.net]. Name the rupture, acknowledge the institution's history, drop the jargon and ask how the client would like to proceed [synthesis].
Rupture from teasing or provocative "disruption". Duran uses these deliberately [source: psychotherapy.net]. If one lands badly, repair it at once and own it. Non-Native clinicians should generally avoid identity teasing [synthesis].
Non-Native clinician authenticity. Duran says that if it's fake it won't work, and that clinicians must not use another people's story [source: IHS]. Do your own ancestral work (4.16). Don't perform rituals or use teachings from other nations. Be open about the limits of your knowledge, and seek Indigenous supervision or consultation [source: IHS; synthesis]. The book includes sections on this for non-Native counsellors, but they are not drawn on here [uncertain].
Pan-Indian generalisation. Ask about the client's specific nation, place and practices rather than assuming. Some clients are urban, adopted, mixed or Christian [synthesis].
Confidentiality in small communities and with healers. Get explicit consent before involving elders or healers, agree what is shared, and plan for meeting clients in community settings, including ceremonies [synthesis; Duran's trainee met a client's family at a ceremony, source: psychotherapy.net].
Conflict between cultural practice and medical advice. Support the client's practices alongside, not instead of, needed medical care. Coordinate with prescribers and healers [synthesis].
Clinician burnout or spiritual overwhelm. Use Duran's "don't carry it home" practice, together with your own grounding in your tradition, supervision and limits on caseload [source: IHS; synthesis].
Client is not Indigenous. The publisher presents the relationship-with-the-problem model as usable with any population affected by trauma [source: GoodMinds description]. Adapt the frame to the client's own heritage and history, and do not import Native teachings [synthesis].

Sources

Sources:

Further reading (full text not drawn on): books and papers cited:

Duran, E. (2006). Healing the Soul Wound: Counseling with American Indians and Other Native Peoples. Teachers College Press.
Duran, E. (2019). Healing the Soul Wound: Trauma-Informed Counseling for Indigenous Communities (2nd ed.). Teachers College Press.
Duran, E., & Duran, B. (1995). Native American Postcolonial Psychology. SUNY Press.
Duran, E., Firehammer, J., & Gonzalez, J. (2008). Liberation psychology as the path toward healing cultural soul wounds. Journal of Counseling & Development, 86(3), 288–295.
Duran, E., Duran, B., Brave Heart, M. Y. H., & Yellow Horse-Davis, S. (1998). Healing the American Indian soul wound. In Y. Danieli (Ed.), International Handbook of Multigenerational Legacies of Trauma. Plenum.
Clements, F. E. (1932). Primitive Concepts of Disease (as cited by Duran; not drawn on).

← Previous · III-118Black psychology approaches Next · III-120 →Ubuntu-informed counselling