Counseling the Counselors:
Alumni Shares Expertise in Native American Culture
Most of us have experienced that helpless feeling of despair when life gets so difficult, you don’t know how you’re going to survive. When your closest friends and family members don’t understand what you’re going through – or when you’re not even able to share your troubles with them – the challenges are even greater.
According to the United Nations Department of Economic and Social Affairs, millions of people worldwide have mental health conditions, and an estimated one in four people globally will experience a mental health condition in their lifetime. Unfortunately, these problems are compounded when the individuals who need help the most are skeptical of the therapists who are there to treat them.
Dr. Kelly Bushéy, who earned her PhD in Psychology with a specialization in multicultural counseling in 2018 from NCU’s School of Social and Behavioral Sciences, knows the struggles all too well. An associate professor of applied psychology at Hodges University, Bushéy also consults counselors on how to effectively interact with Native American clients, a group that has disproportionately higher rates of mental health problems than the rest of the U.S. population.
Bushéy, who is part Mohawk Indian herself, says that understanding unique cultural aspects is critical from the very first meeting. “Unfortunately, there is already a huge stigma in their communities about seeking help,” she says. “Native Americans are also more likely than any other group not to continue treatment after the initial visit.”
Throughout her life, Bushéy has studied, supported and lived among Native American communities. For the past 25 years, she has served as the senior counselor at the Warrior Leadership Summit, an annual youth conference for Native Americans that last year alone served over 750 kids from more than 80 tribes. While obtaining her master’s degree in counseling at Clarks Summit University, Bushéy spent a month with the Oglala Lakota Sioux on the Pine Ridge Indian Reservation in South Dakota writing her thesis on how historical pain and trauma are still impacting the tribe today.
“The loss of land for the Native Americans was tied to who they are. They had everything taken from them – their dignity, their culture, their spirituality.”
—Dr. Kelly Bushéy
Research shows that intergenerational trauma due to forced removal off their land and general loss of culture are directly linked to high rates of substance abuse, post-traumatic stress disorder, suicide and attachment disorders in many Native Americans.
“The loss of land for the Native Americans was tied to who they are,” explains Bushéy. “They had everything taken from them – their dignity, their culture, their spirituality.”
At NCU, Bushéy wanted to dive deeper into what happens during the mental health intake with a Native American and a non-Native counselor, using the lens of historical trauma. “My research suggests that basically everything I learned about mainstream counseling approaches had to be thrown out the window when working with Native Americans,” she says. “From an ethical standpoint, I had to relearn almost everything.”
Some of the insights Bushéy provides to non-Native counselors who work with Native American clients include:
- Accept gifts – While it’s generally unethical to take gifts during a counseling session, not doing so offends most Native American patients.
- Avoid eye contact – Looking someone directly in the eye normally indicates you’re paying attention and are interested in what they are saying. But eye contact often feels invasive and offensive to Native Americans. As always, it’s important to take cues from the patient to see what makes them comfortable.
- Slow down – Native Americans have a cultural sensitivity to feeling rushed or interrogated. Bushéy advises not asking too many questions, too soon, in the relationship. It’s also important to lay out exactly what’s going to happen in the first and future sessions.
- Build a rapport – Trust takes time, and establishing a bond may not happen overnight. “Be considerate if you have consent forms, release of information documents or other papers requiring signatures,” says Bushéy. “Remember the history of broken treaties and promises, and be empathetic in your approach and timing.”
Bushéy points out that the most important thing is to treat every patient as an individual. Despite the cultural characteristics, she says, everyone has his or her own identity, and it’s essential to get to know patients and understand their unique situations.
“NCU has helped me transform what we are doing for this underserved population. It's about making a difference so that we can help transform the way that we think and approach other people to make our society better.”
—Dr. Kelly Bushéy
Interestingly, Bushéy’s research shows a preference among Native Americans for a non-Native counselor. “There’s more comfort opening up to someone who doesn’t have a history with them or their family,” she says. “Their communities are also often very small, so having that extra layer of confidentiality with their deepest thoughts and feelings is helpful.”
Bushéy is on a mission to ensure that non-Native counselors have all of the tools and information they need to improve the quality of care for Native communities and peoples. Through public speaking engagements, consulting and her membership in the Society of Indian Psychologists, she continues to be a strong advocate for the mental well-being of this population.
“From my first class at NCU through my dissertation defense, and even through today, NCU has helped me transform what we are doing for this underserved population,” Bushéy says. “It's about making a difference so that we can help transform the way that we think and approach other people to make our society better.”