When Indigenous communities seek to support and heal their wounded children and families, they often turn to time-tested practices that haven’t been measured by statistical models, causal inferences and confounding factors.
The Suquamish Tribe takes young people harmed by drugs and alcohol on journeys by canoe. In Washington’s Cowlitz Indian Tribe, parents at risk of losing their kids to foster care are being immersed in traditional Indigenous child-rearing practices through storytelling, song and lessons found in nature. The Gathering of Native Americans heals people from substance abuse through its “Indigenous theoretical framework.” That includes acknowledging the impact of historical trauma, honoring cultural values and focusing on “the sacredness of the inner spirit.”
But under a sweeping change to federal funding for the child welfare system, only programs that meet rigorous, Western-defined scientific standards can expect to draw on the potentially unlimited entitlement funds. Proponents say that ensures the programs are grounded in solid evidence, and merit the public spending.
A pillar of the Family First Prevention Services Act, signed into law in 2018 and now fully in effect nationwide, is the federal government’s matching grants for states to pay for foster care prevention. But programs receiving entitlement funds, totaling $88 million thus far, must first be approved by a national research clearinghouse.
The clearinghouse has approved 43 programs thus far. But only one is a model that originated in the Native American community.
Family Spirit is a home-visiting program created in 1995 that targets intergenerational behavioral health problems. The program serves Native American mothers from pregnancy through their children’s third birthdays. Created through a partnership between the Johns Hopkins Center for American Indian Health and the Navajo, White Mountain Apache and San Carlos Apache tribal communities, its first randomized controlled trials began in 2001.
Parent and child participants have shown positive outcomes. Moms experienced lower stress levels, reduced depression and a decline in substance abuse. Children were less likely to be “dysregulated,” and were found to be at lower risk of addiction and behavioral health problems.
In a promotional video, Crystal Kee, a Family Spirit trainer, describes her program’s messaging to new Indigenous mothers: “When your baby is first born and you’re holding them, shake their hands and say to them, ‘Welcome little one. You’re a miracle!’”
States and tribal governments across the country are readying plans this year to meet the new federal standards: There are now financial rewards not for placing children in foster care, but for keeping them out of a system that can cause lasting harm.
Local agencies receive a 50% match from the federal government for up to a year when they pay for in-home parenting support, mental health care and substance abuse treatment, programs that enable families to remain together and avoid children being placed in foster, adoptive or group homes.
Yet for many Native American children — who federal statistics show are three times more likely than white children to be taken from their parents and placed in foster care — the financial benefits of the Family First Prevention Services Act so far remain elusive, experts in child welfare and Indigenous rights told The Imprint. Too often, they say, the foster care prevention programs that best serve Native Americans are not able to meet the time-consuming and costly standards defined by a historically white establishment. That leaves vital programs designed to keep families intact unable to draw down the tens of millions of dollars now available to states and tribes.
“The Family First Prevention Services Act kind of forgot about the tribes,” said Teresa Sanchez, a tribal council member for the Morongo Band of Mission Indians. Too often, she added, tribes are not even alerted to the families in need. “We’re not involved in the decision-making or notification of who should get prevention services. Morongo always wants to be a resource for families,” she added, “but we need to know when a family has been identified in order to serve and be a resource. That’s not happening.”
Meanwhile, the need for prevention services in tribal communities is acute, as Native American children are the most likely of all demographic groups to be separated from their parents and taken into foster care.
“Native communities have been among the hardest hit by the pandemic nationally and are suffering disproportionately with illness, mortality rates and economic distress,” the U.S. Administration for Children and Families stated in a memo last year. “All heighten the need and urgency for prevention services in Indian country.”
The Title IV-E Prevention Services Clearinghouse is housed in the Administration for Children and Families, a division of the U.S. Department of Health and Human Services. Its obligation under the law known as the Family First Act is “to conduct an objective and transparent review of research on programs and services intended to provide enhanced support to children and families and prevent foster care placements.”
Programs analyzed by the clearinghouse receive a rating of “well-supported, supported, promising, or does not currently meet criteria.”
Family Spirit earned a “promising” rating last spring, based on its study history and the fact that it had “demonstrated a favorable effect on a target outcome.” The only evidence-based, home-visiting program for new and expecting mothers designed by and for Native American families, it is now used in more than 130 tribal, rural and urban communities across more than 20 states, and cities including Chicago and St. Louis.
The program provides young mothers age 24 and younger with one-on-one parent training in their own homes, teaching them to provide consistent and responsive care to their small children, avoid drug use and addiction, and learn coping skills to deal with life’s stressors. The program’s curriculum includes 63 lessons, instructing parents how to take care of the child at each developmental stage and prepare them for school.
What makes the program unique is that it leans on trusted community members — “paraprofessional” mothers from tribal communities who have lived through similar circumstances — to deliver the in-home services.
Elsie Charging Crow is a parent educator on the Wind River Indian Reservation in Wyoming. In a videotaped home visit, she shows one young mom how to swaddle and comfort her baby. “After you get him all wrapped up, and he’s still fighting, he’s still fussing,” she says, demonstrating with a baby doll, swaying and cooing a lullaby, “like how our grandmothers did when they rocked us.”
Charging Crow is raising nine of her grandchildren and lives in the community among the mothers she serves. She said she understands what many of them have gone through: “It took a lot of hurt to make me be the person I am.”
The program is explicit about the shared hurt. Built into the curriculum are discussions of intergenerational and historical trauma brought on by forced attendance in Indian boarding schools and adoptions into white homes, as well as the effects of poverty that the U.S. government has left Native communities to battle for centuries.
In 2020, the state of Washington commissioned a report that examined child abuse and foster care prevention programs being used in the state’s 29 federally recognized tribes. Each, to some extent, had been studied and appeared in peer-reviewed literature.
“Western parenting programs often fail to address the unique challenges faced by American Indian and Alaska Native parents, children, and families, and they neglect the rich tribal traditions and knowledge passed down from generation to generation,” wrote authors Angelique Day, a professor at the University of Washington’s School of Social Work, and her colleague Angelina Callis at the Indigenous Wellness Research Institute.
The four programs highlighted in the report included Family Spirit, Healing of the Canoe and Positive Indian Parenting — a program undergoing study in the hopes of achieving clearinghouse approval. The report’s description of Family Circle, also known as Talking Circle or Healing Circle, outlines its reliance on the traditional tribal practice of passing a sacred object — a stick or eagle feather — from one speaker to the next. The circle leader begins by passing around sweet grass, cedar or sage, herbs used to cleanse mind, body and spirit.
As a result of the report and the May 2021 clearinghouse ranking, Washington’s Department of Children, Youth, and Families is able to incorporate Family Spirit in its statewide Family First plan, according to Tleena Ives, director of tribal relations. Ives said Washington has shared information on the program with other states to further expand its reach among tribal communities nationwide.
But with the exception of Family Spirit, the programs studied in Washington are far from receiving clearinghouse approval and federal funding.
Day said in an interview that many other well-regarded, Native-designed programs across the country, such as the Fatherhood is Sacred, Motherhood is Sacred model, have little chance of ever being accepted into the clearinghouse as the standards are now.
Some programs are unknown outside the communities that rely on them, she added. Others are simply too small to collect meaningful data for mainstream evaluation methods, or too low-budget to be able to continue operating and pay for research, which typically requires yearslong investments.
What’s more, Day said, Indigenous people who are the source of the research often don’t trust non-tribal, non-Native researchers, those who have historically wronged their communities. As a result, the providers will miss out on the windfall of federal funding.
“There are many child welfare programs that have been developed by Indigenous communities that don’t even appear in the peer-reviewed literature,” she said. “Those are secret gems that tribal communities hold dear to themselves that haven’t been available for review.”
In response to these challenges, last January the U.S. Children’s Bureau issued new guidance to allow tribes to make cultural adaptations to approved prevention models in the clearinghouse. Eligible adaptations include delivering the intervention in the home instead of an office, providing a service in a different language, and using different kinds of professionals to offer the service, such as using a social worker instead of a counselor.
But those tweaks do little for communities who could be better served by their own locally developed programs. And in some cases, private donors are stepping in with study funds allowing them to seek clearinghouse approval.
Positive Indian Parenting — a program of the National Indian Child Welfare Association that is centered on learning and celebrating cultural traditions — received grant funding in 2020 to create an evidence base for its model. The program is now being evaluated by Indigenous researchers with the Child Trends firm and the National Indian Child Welfare Association, with backing from the Casey Family Foundation and a $700,000 grant from the Doris Duke Charitable Foundation.
But David Simmons, the director of government affairs and advocacy at the National Indian Child Welfare Association, estimates it could take as long as six or seven years to get clearinghouse approval — and it’s expensive. For many smaller programs, even applying is out of reach.
Meanwhile, the debate over what qualifies as “evidence” is raging in some academic circles within the child welfare field.
A recent article was published in the Research on Social Work Practice journal, written by five scholars who identified themselves as Black, Indigenous and people of color, as well as those with lived experience in the child welfare system. In the article, they challenged other academics who characterize “standard Western measures and methods” as producing the only “legitimate ‘evidence.’”
Such a position, they argue, “discounts the wealth of deep and expansive data generated by community studies, collaborative and participatory methods, case studies, field work, storytelling and story collecting, archival and historical sources, and participant-observer/observation in the qualitative tradition.”