Hello, everyone. Welcome to the Tribal Opioid Response Webinar. Excited to have you all join us. Thank you for putting your name and your organization into the chat. And I'm going to hand this over to Norman McLeod, who's going to be kicking us off today. Hi, good afternoon, everyone. I'm Norman McLeod. I'm a member of the Turtle Mountain Bandit Chippewa. I work for the Opioid Response Network as a regional outreach and engagement specialist. I am going to be co-facilitating this presentation today along with Ethylene Ironcloud Two Dogs. And I am going to hand it over to Jonna James to do a little bit of a land acknowledgement and also introduce herself. Hello, my name is Jonna. I'm a citizen of the Chickasaw Nation. I want to welcome all of you today. I want to send out a special thanks to our partners from SAMHSA for being on the call. And I would like to recognize the Western Institute Commission for Higher Education, a partner on the Opioid Response Network Tribal Opioid Response Webinar, which is based in Boulder, Colorado, and provides behavioral health system support to western states and indigenous communities in the western region. Today, I'd like to provide to you a land acknowledgement. We acknowledge that the land that now makes up the United States of America was a traditional home, hunting ground, trade exchange point, and migration route of more than 574 American Indian and Alaska Native federally recognized tribes and many more tribal nations that are not federally recognized or no longer exist. We recognize the cruel legacy of slavery and colonialism in our nation and acknowledge the people whose labor was exploited for generations to help establish the economy of the United States. We honor indigenous, enslaved, and immigrant peoples' resilience, labor, and stewardship of the land and commit to creating a future founded on respect, justice, and inclusion for all people as we work to heal the deepest generational wounds. I'm going to turn it back over to Norm. Hey, thank you, Jonna. All right. Just a few acknowledgments before we get started with the presentation. Funding for this initiative was made possible in part by a grant from SAMHSA. The views expressed in written conference materials or publications and by speakers or moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations implied endorsement by the U.S. government. Opioid Response Network, or ORN, assists states, tribes, urban, native organizations, cities, communities, and individuals by providing culturally responsive education and training to address the overdose crisis. It also helps to enhance prevention, treatment, recovery, and harm reduction efforts, and we provide free training and consultation to help fill gaps as defined by the requester. The premises of ORN are to assume native brilliance, assume native community strength and expertise, support sovereignty, follow local and community leads. Opioid Response Network also provides support through the Indigenous Communities Response Team. Each state or territory has a designated team led by a regional technology transfer specialist or TTS who is an expert in implementing evidence-based practices. ORN developed an Indigenous Communities Response Team to support requests from tribal opioid response grantees and other native communities. And this is a map that just shows the Indigenous Communities Response Team regions. There are five regions throughout the U.S. Again, they all will have or do have a tribal opioid response technology transfer specialist to respond to community requests. All right. And at this point, I will hand it over to Athleen to introduce our next speaker. Good afternoon. Miigwetch. All my relatives, thank you for joining us. My name is Sheena Ikiguchi. I am Oglala Lakota and Crow. My census name is Athleen Ironclad Two Dogs. I live in Porcupine, South Dakota. I'm very happy to respectfully welcome Smuiyamani Walks With a Roaring, Mr. Rick Two Dogs, who is also my life partner. And he hails from Porcupine, South Dakota on the Pine Ridge Indian Reservation in South Dakota. He is from the Kiyuksa Band of the Oglala Lakota people. He has been providing spiritual healing guidance and teachings to his people for the past 50 years. Smuiyamani Walks With a Roaring, Mr. Rick Two Dogs. Thank you. Good morning. I was asked to give an opening, so at this time, I'm going to pray in my Lakota language. I'm going to pray in my Lakota language. Thank you very much. Back to Norm to introduce our esteemed presenter. All right. Thank you so much, Athleen and Mr. Two Dogs. We are definitely honored to have our next speaker here with us today to kick off this webinar series for the Opioid Response Network. Our speaker hails from the Little Shell Band of Chippewa Cree of Montana. His name is Mr. Al Falcon, and he is currently the Director of Special Health Projects for Native American Development Corporation, or NADC. He has worked as both a clinical provider and as administrative leadership for both community and mental health centers and a child and adolescent behavioral health center in the state of Montana. He is a licensed clinical professional counselor as well as a licensed addiction counselor for the state of Montana. Mr. Falcon now works on bridging gaps in our communities and healthcare systems for the Department of Holistic Care Practices with Native American populations. Please welcome Mr. Al Falcon. Thank you for that. My name is Al Falcon. I am of the Cree Nation, as I identify primarily. I am an enrolled member with the Chippewa Cree. The language that my grandfather and grandmother spoke was Cree, so therefore I mostly identify as Cree, although I do have Chippewa blood as well. I have Assiniboine blood as well, and also some Nez Perce blood as well. So, when it comes to identifying we as Natives, I think it's where our hearts are and how we're raised. But I do acknowledge all of the different tribal nations that I am a part of and that are a part of me. So, thank you for this opportunity today. I want to talk a little bit here about NADC itself, the organization that I work for. You know, our mission is, as it says here, to serve as a hub for Native American businesses, mostly in our area, meaning Billings, Montana and Yellowstone County, although we have outreach all the way into North Dakota, South Dakota, Wyoming. So, we work a lot with some of the nations here within Montana as well, and also in Wyoming. And our primary mission is to give support to Native American businesses and help them to not just get stood up, but also succeed. So, that's been our primary drive for many, many years. Our vision is to be a high-quality, high-performing, sustainable community economic development corporation so that we can continue to support Native businesses and Native individuals. We have many different programs within our organization that do just that. Everything from things like, currently we have what's called the TRIA program, which actually supports Indigenous artists and help them to get started. So, we have our hands in a little bit of everything that is Indigenous in our community to help our community grow and our community members and Native Americans succeed. Next slide, please. The history of NADC is actually started in 1996 when we were established, but we became a CDFI in 2001. And then in 2009, we actually started the PTAC program, which is Procurement Technical Assistance Center. And then in 2011, we actually put together what we call ACES, the American Indian Consulting Services, which works with federal programs and federal contracts. The presentation that you're going to see today was actually with myself in collaboration with ACES to put together what we call cultural standards of care, and I'll talk about that in just a minute. 2018 is when we actually put together what we call BUIC, Billings Urban Indian Health and Wellness Center. We had lost in the Billings area, maybe two or three years previous to that, we had an Indian health board here, and it had dissolved and gone away. So, we were a couple of years without any services that catered directly to our Native American population. So, Native American Development Corporation was approached by IHS with a contract to actually start a clinic. So, they started a clinic in 2018, and that clinic is thriving and doing very well today, and it is a part of Native American Development Corporation. We are the parent company of all of these different programs that you see here. Next slide, please. So, what we put together in the presentation you're going to see today are actually cultural standards or cultural standards of care. You know, as I think you all may know that within the medical profession, within the medical field in the United States, whether it be a hospital, a small clinic, everyone in the medical profession, they operate under standards of care, medical standards of care. And we wanted to take that same concept because what we were seeing within our community and around our state, and I venture to guess that this is nationwide, is that we don't have any true standards, cultural standards, when it comes to working with Native populations. And we felt we needed this. You know, there are a lot of different trainings out there which offer, you know, cultural sensitivity, you know, and things of that nature. But we wanted to put something together that we felt could be more universal and encompass all of the tribes that are represented, especially in the state of Montana. But when we start looking at this on a brighter scope, a wider scope, excuse me, we started to see the commonalities amongst our Native peoples across this nation, even into Canada. And so we started to put together some standards of care that we feel any provider, Native or non-Native, any entity, institution, facility, working with Native populations, whether it's an individual, a family, or a community, should have basic understandings of us as a people. So this training that we put together, which what you're about to see is just the cultural standards of care. We actually have a training that is much larger than this. It's at least four hours long, which goes into more depth of each one of these standards that I'm going to talk about. And we feel that we needed to take this out there and begin to present it to the different entities, things that work within Native communities, such as here in the Billings area, the recovery courts, the drug courts, the DOC, the justice system itself, CPS, so Child Protective Services, anyone who works with Native American populations in any form of behavioral health or even contracting on reservations and in reservation communities should have some of these basic understandings. So that's where this stuff comes from. So as you can see in this slide here, what I have represented is Maslow's hierarchy of needs. And I do believe that with Maslow's hierarchy of needs is it probably goes without saying exactly what that is. This representation here, the pyramid that we see here on the left, is actually a more detailed model of Maslow's. And I hope that you're all familiar with Maslow's hierarchy of needs when helping individuals. But understand that Maslow, there is documentation to support that he lived with the Blackfoot Nation in Alberta, Canada for well over a year. And there are some writings and some discussion around that may have been the influence around some of his work. Maslow's hierarchy of needs, as we see here in the pyramid, didn't start out necessarily as a pyramid. That was not his model. But what's within the pyramid themselves, the physiological needs, the safety needs, the esteem needs, the aesthetic needs, and the self-actualization were all a part of his model. And it was more of a linear model. But it's been placed over time into this pyramid framework where one of these needs is actually connected to the next need. So it's almost as if self-actualization itself is the end goal of the journey, if you will. So in order to move to the next level of needs, safety needs, a person would need to meet those physiological needs. For instance, physiological needs would be food and shelter, basic needs. Once you have that, then a person can move on to that next set of needs and so forth and so on. So it almost puts self-actualization as the end game to this structure. One thing I will say with that is self-actualization itself, you know, I hope that you all are familiar with what self-actualization actually is and what it means. But in a nutshell, self-actualization is a person's identity and a person's self-awareness of that identity. So really knowing who you are. Maslow's pyramid, once again, puts that as the goal to achieve, if you will. So then we come to this next model, which is just to the right of it, which comes from Blackstock. Blackstock was actually of the Gitxsan Nation out of Canada as well. She is a professor at McGill University there. And her model actually takes Maslow's hierarchy and inverts it in a sense. It actually puts self-actualization at the bottom of the pyramid. One thing to note with this particular model and what I'd like to share with you is that as a practitioner, I'm an LAC, Licensed Addiction Counselor, and I'm also a Licensed Clinical Professional Counselor. That's a fancy term for a therapist as well, so I'm duly licensed. The work that I've done in my career has taken Maslow's hierarchy before I knew that Blackstock's model existed. And I would invert Maslow's hierarchy so that self-actualization was the thing I worked on first with my clients. So when I actually was introduced to Blackstock's model, it made sense to me because this is the way that I work with human beings. And I do want to say that working with human beings from an inverted model or from Blackstock's model, I have had a lot of success with doing so. Reason being is that I work with the individual. I work with the human being first. But the reason that we have this particular model and why we think this way as Indigenous people is that many of our nations, but I was raised with the belief system that I was born into an identity. I was born into who I am as a human being. And who I am as a human being was then nurtured within my community and within my family so that I actually, the identity I was born with, those gifts that I was given by the creator were actually nurtured throughout time until I got to a place where we achieved community actualization. This is where we begin to take our gifts, whatever those may be within us as an individual, and we begin to give back to our communities, back to our people and back to our families. And then the final rung on the top of this particular model is cultural perpetuity, which is where we then begin to take the gifts that we have and the knowledge of our existence as a people, our culture, our spirituality, our practices, and we move those forward to the next generation so that our culture lives on. So this next model here with Blackstock's model is also a very valid model. So I'm not trying to discount Maslow's model by any means. There's always a place and a time for that particular model. When working with individuals, Blackstock's model also is very relevant. So I'm introducing these to you as we go through these standards of care. Keep both of these models in the back of your mind and also keep in the back of your mind one other model as well. Next slide, please. This here is just a generic form of this, but this is the medicine wheel. This is a model that I use quite often when working with individuals based off of Blackstock's model. The little smiley face at the center of this circle would be the individual I'm working with. And the four different directions within the medicine wheel itself would represent all of creation, if you will, the circle itself, if you understand and know the medicine wheel. And the medicine wheel is a little bit different from nation to nation and tribe to tribe. Sometimes the colors and where the colors are represented are different. Sometimes you see the medicine wheel as a plus more than an X, like you see it here, breaking the circle into four different sections. But just know that the wheel itself or the circle itself represents all of creation and the four directions. Each one of those directions has multiple different meanings to each tribe. So I didn't want to represent just the Cree way of looking at this, which is how I was raised, but wanted you to see this model and keep this model in mind. Because when we start talking about people who struggle with mental health issues, struggle with other disparities related to historical, generational, and individual traumas, when we look at substance use issues and things like that, this model itself will become very important because of the person at the center of creation and balance and harmony with all of creation is what we strive for as Native individuals. I've heard this referred to in many different ways. The way that I like to refer to this is, what I think is most common these days is the red road or the path that we walk from birth to death. If we stay on that path at the center of creation, our medicine wheel would look like this. So this is individualized for each person. As we see disparities, as we see different issues and struggles in a person's life, that little person at the center of creation begins to veer off in one direction or the other because they are imbalanced within the circle. So, and that'll, I'll make that more apparent later in a later slide when I talk a little bit more about this, but this is just one more model to keep in mind as I move through the different standards of care. Next slide, please. The cultural standards themselves, the primary goal is to expand the practice of healthcare professionals by providing a better understanding of the cross-cultural and cross-historical context that affect indigenous populations, whether it be the different healthcare outcomes that we have, to improve healthcare among indigenous communities and the relevance of such approaches in application, creating quality healthcare metrics. What we're really referring to there is how do we begin to use the information we're gonna talk about today to have a better and stronger understanding of the individuals we treat or care for as we work within these systems, within these communities or with these individuals. So mostly today I'm talking about behavioral health type things and maybe even medical health type things, but you can take a lot of these cultural standards that I'm gonna refer to and just talk about, I think, what is key to even positive health outcomes in the behavioral and medical health professions, and that's relationships. So if you were to use these standards just to strengthen relationships with Native Americans, whether it's in an urban setting or a reservation setting, understanding these cultural standards that we'll go through will give a person the insights they need to help develop stronger relationships. And then at that point, no matter what your goal is within that community, you have a higher chance of having a positive outcome with your goals and objectives. If you approach your relationship from these cultural standards. Next slide, please. So the objective here today is just to introduce the commonalities and some of the differences as well, because as the map showed earlier in the introduction, you've got the United States, even Canada, but Turtle Island basically broken into these different regions. And each of these regions come with their own beliefs, their own cultural systems. And even within each of those regions, the tribes themselves come with their own ways of doing things and ways of being. So with that said, we're not trying to promote any one way. Some of the information I will share here today as we move through this will be from my own personal perspective as a traditional Cree person, but that doesn't necessarily mean that's the way it should be looked at across the board. What we mostly want to look at are the commonalities and those will make more sense as we move through the standards. But there are commonalities we have as native peoples across this land, the way that we look at the earth itself, the land and honoring of the land and honoring of the land that we stand on and things like that. So as we go through the standards, some of this will make a little bit more sense and won't be so vague. We want to create a pathway to relationships, to healing, to wellness. Another objective is establishing healthcare standards to improve the relational quality and experience, promote ease of access and to establish culturally appropriate and responsive interventions to treatment in healthcare. We want to advance health equity, supporting ongoing consultation for transformative practices. That's something we also try to provide here at Native American Development Corporation is not just kind of a one and done with a training when we deliver the cultural standards training, but really be present for consulting for follow-up questions and things like that. Many questions that may come up for you folks while we go through this presentation, you may not think up here today, but maybe as you reflect on some of the material, you'll have questions. And we try to be here to help support those questions or perhaps you'll try to implement some of the things we talk about today, but you're not really sure exactly what that should look like or how that should be practiced. So our hope is to be able to consult and advise beyond this and eventually create a network of culture keepers and other individuals like here within Montana on the reservations who we can actually, so if you have a specific question about somebody from say the Crow tribe or the Fort Peck tribe, we can connect you with somebody from that actual tribe itself to be more detailed in some of the feedback that you get versus some of the commonalities that we'll talk about today. We want to support ongoing, oh, I just mentioned that one, providing comprehensive technical assistance as well. So that kind of goes hand in hand with that. We are still working on that network. People kind of come and go within that network. We do have some folks we can refer people to when it comes to specific tribes and specific information from a tribe. Next slide, please. So the general application quality measure for all standards, providers will have an increased understanding of native resilience and the act of overcoming disparities. Providers hopefully will recognize the strength-based models for natives and the examples of how to engage with native clients. I would expand that to not just clients, but also families because our family units are so closely knit and also within communities. Providers will have a better understanding of their own privileges, biases, behaviors, and how these can affect engagement with native clients. That's a really important concept there. And we'll talk a little bit about that in one of the standards. Providers will develop a practice of how to be present in the moment to be more effective in their engagement in support of their native clients. So really it comes down to understanding how time itself, the history of this country, the laws and acts that were put into place that have changed us as a people and has actually changed some of our worldview. So we'll talk a little bit about those things as well. Next slide, please. So our first standard is, and I do want to say this. So we originally came up with 11 standards. We were able to take a couple of the standards and put them in others because they were closely related. We have nine standards of care that we had come up with with these cultural standards. And these are being presented to you now in no particular order. There's a little bit of thought behind the order itself, but really any of these standards can be looked at upon themselves in just about any of these standards. So our first standard is understanding indigenous life on and off the reservations. The broad topic on this is understanding life in urban areas and life on reservations, natives, reservations and native, and the impact it has working within health systems. Excuse me, I'm a little congested today. So this particular standard isn't a lot different. And I think in most states, if not all, when you start looking at the difference between rural and urban areas to start with, you know, when you start to get into some of the rural areas of just about any area of our country, you're going to find small communities, native and non-native, that really are more clannish, if you will. By clannish, I mean, these are communities where everybody knows everybody. These are communities where you may move to a small town, but if you weren't born and raised there, you are not from there, you know, and so forth and so on. So those types of things very much stand true in reservation life as well. Some of the other things are just the access to different services. Whether it be health, you know, there may be a local community hospital or even clinic, but actual access to some of the more robust medical or even behavioral health services, you're going to find more of those in the urban areas. So, for instance, we are in Billings here. We're not too far from the Crow and Northern Cheyenne Reservations. They're just not too far down the road, but not too far down the road. I mean, Crow is as close as, you know, 20 miles roughly down the road where it starts, and Northern Cheyenne, you know, less than an hour away. Yet some of these folks have to come all the way to Billings for things like dialysis and things like that. So you can see where in these urban areas, we have more resources here than they do in some of the rural areas. So understanding that, understanding that folks who live on the reservation or raised on the reservation, you know, these folks themselves, they, because of that clan-ish nature of that, and that's lack of a better term, but that clan-ish nature meaning that everybody knows everybody, there's more access to some of the cultural practices for those who are traditional. You know, maybe it's a sun dance. Maybe it's, you know, practicing their religion and their culture because they're surrounded by other natives within their areas. When you live in an urban area, and I myself am a third-generation urban native, you know, having access to culture and traditional upbringing, I have to travel a bit to go back home and be a part of some of these practices. So there's a separation that does happen there over time. So understanding the difference between those types of things, you know, this really does help an individual. And like I said, with the larger training, we go into some of the different ways of thinking that happens for Native Americans who live in urban areas and those who live in and on the reservations, so areas where there are more natives that they can encounter and interact with. One of those things I'll talk about when we get to the historical trauma piece, and I'll elaborate a little bit more on that at that time. Next slide, please. Our second standard is understanding Indigenous communal processes and social values. So what we're talking about here is, you know, that I mentioned, I keep using that term, clannish, but really what we're talking about, you know, we as Native Americans, we have social communities, you know, where prosperity of one means the prosperity of all. And when one person struggles, the entire unit struggles because we share who we are within our communities. So you can see where we have both healthy and unhealthy pockets within the reservations. This actually spills right into urban settings as well. So when somebody within a family unit is prospering, the entire family will prosper in that way. But when somebody is struggling within that family unit, the family struggles itself. So this is part of our value system and a part of who we are as a people is that we, if you think back to Blackstock's model, we give of ourselves and our gifts to our communities. We share that for the betterment of our people. You can look at this in a traditional and historical sense and the way of hunting and even gathering and things like that, the things that were hunted. So like the buffalo, other game, these were shared and distributed amongst the entire community. So if the hunt was good, the entire community would prosper from that. And if the hunt was not good, then the entire community would still share and whatever's there. But there might be more struggling within that in the way of food resources or other resources. So you can see where that social community way of being is still a part of who we are today. We may be more separated in many ways. There are a lot of Western cultural, and when I say that, I mean we're talking about United States culture now, practices that happen as assimilation and acculturation have taken over time. So you may not see as strong a social bond as there once was, but that social bond is still there. And it is definitely there within family units in those types of things as well. The things that get in the way of that now are again, some of the assimilation and acculturation and some of the health disparities that are out there as well, where we have individuals who struggle with substance use, for instance, and they struggle with mental health issues. And all of these, once again, are related to some of the historical stuff that I'll talk about. So understanding how our social values work within our communities, because they are still alive and well today. Next slide, please. So talking about Native culture itself, something that I think I need to just kind of expand on a little bit when I talk about those social values, again, families. Our families are very tight knit. A lot of Native families, my Native family, for instance, I come from a family of 13 aunts and uncles. Well, I should say 12 aunts and uncles. One was my mother. Very large family, lots of cousins. And how this basically breaks down in most Native families, and this is, once again, universal, is that my aunts and uncles were more like surrogate fathers and mothers to me. They took a part in my upbringing, my raising, and my belief system. So that old saying from Africa that it takes a village to raise a child, that stands very true with Native communities as well, and Native families. So our families are very close. My cousins, even those who we would deem as second and even third cousins, are like brothers and sisters to me. We are that close. So even though we use these terms like second cousin, my cousin's son or daughter is my cousin, and they are more like a brother or a sister. So our families can be very tight knit. Now, again, this isn't in the sense that all families you're gonna find today are like this, but historically and traditionally, this is how close our families were, our family units were. So we are very close, and looking, when we lose somebody within our family, it's a loss to the entire community. So you see a lot of this alive and well today in our families, and taking on the responsibility of raising children is a family or even community ordeal. So the way that I was raised, I was raised by my grandfather, I was raised by my grandmother, I was raised by my aunties and uncles, not just my mother and father. And a lot of the things that I've learned throughout my life came from different teachings and different people. I learned to hunt and fish from a couple of my uncles. I learned to be who I am in the spiritual sense and cultural sense through my grandfather. And then some of those teachings came from people like my uncles and my aunties and things like that. So it takes the entire family unit to raise a child or children within that so that we all are raised in the context of what that family is. And it creates very tight social bonds. Another part of our native culture is our ceremonies. We have so many different ceremonies and this is gonna be, in some cases, unique to the tribe in the way that they are performed. But amongst us Plains tribes, many of us have the Sundance. You know, some of us have the Sundance that has come back again. It has a resurgence. And by that, I mean, because of things like the Dawes Act of 1887, where a lot of our cultural practices were actually outlawed and forbidden, some tribes actually lost some of these ceremonial practices, but they've come back again, whether they've come back, just as an example with the Crow tribe, the Sundance has come back to the Crow tribe by way of the Shoshone Sundance because it's very similar. So it's come back into the tribe in that way over time. But our ceremonies are very important to us. And whether a person is actually what we would deem as a traditional Native American, by that, I mean, we practice our traditional cultural spirituality, religion, ceremonies, and those types of things. Or if a person is actually more acculturated and assimilated and actually practices more spirituality in a Christian sense or some other religious denomination and that type of thing. You know, it's kind of a spectrum of where you're gonna find a Native person. You might find some Natives who practice both, maybe it's Christianity and traditional ways of worship and religion. So there's no way to really say, oh, a traditional Native is this and a non-traditional Native is this. It really is a spectrum of where do they sit on that in the way of traditional values and cultural practices and those that are not. You know, all us Natives today, regardless of where we sit on that spectrum, are assimilated and acculturated in some way and fashion. Some of us still adhere very closely to our traditional ways of living and our traditional ways of being. That doesn't mean we don't drive cars or trucks. What that means is that we practice in our own cultural way. So ceremony is very important because even for those who are what might be further on the spectrum of being non-traditional, we'll still come to some of these traditional ceremonies because there's still social gatherings. There's still places where we Native families get together and support one another in these practices and worship and pray and the things that we do, depending on what the ceremony is. So there are multiple, multiple different types of ceremonies and ceremonial practices amongst Native peoples. But understanding how it comes back around to community and those social values is really important. Or social events like powwows. You know, these are social gatherings once again. And within powwows themselves, there are sub gatherings as well. Things like hand game or stick game, if you're familiar with that. You know, there are even non-traditional ways that a lot of Natives will gather. I grew up in Great Falls, Montana. And one of the things we did, because we come from a horse culture, is that my family was always around horse racing and the horse racing track. So I basically grew up at the racetrack, you know, in the spring and the summer. And that was a huge part of my upbringing. And still some of my fondest memories come from being, you know, at the racetrack there and in buildings here as well. Because sometimes we would follow the racing circuits around as well. So there are non-traditional social events as well, where a lot of Natives will gather. The next thing on our cultural piece here is also the foods, you know, and the importance of foods. We, in many ways, oftentimes will feed our guests when they come, we'll have a gathering. Or if we have a social event or even a ceremony, there's usually a feed involved with that. And these feeds are oftentimes associated with prayer, Thanksgiving, and things of that nature. So when we're looking at foods, there are a lot of different culturally traditional foods that we use. You know, we know about the three sisters, you know, the corn, beans, and squash, which I think a lot of people are taught in public schools. But there are so many other foods that are Native to North America, Central America, and even South America that have contributed to the world, you know, tomatoes and potatoes and things of that nature that have come from this continent. So these things are very important within our communities as well. Food is, like with any, I think any culture, food is a great way of folks getting together and sharing of one another amongst a meal. So in many ways we actually take this a step further and in some of our culture and our traditions it's, I wouldn't really like, I don't like the word mandatory, but in the sense it's almost a mandatory thing that we feed our guests, that we have some kind of feed going on. So the way that food can bind us together as a community, socially, is a very important concept as well. A reason that would probably be important to a provider is if you come in as a guest into a community or into a family and you're offered food, it might be seen as disrespectful to refuse that gift, that offering. So it's very important to understand that food is held to very high regard in the way of social, ceremonial, and cultural practices. Next slide please. And our third standard is understanding Indigenous socio-ecological systems, you know, matriarchal, patriarchal, and communal. I hope that many of you know and have heard that Native American cultures are matriarchal. There may be some that are patriarchal, but for the most part you're going to run into matriarchal systems. Matriarchal systems matriarchal systems themselves are systems where there's balance between both the male and the female within the roles within the community. They share power but have their own specific roles within the community. This hasn't been lost to this day. If you're working with a Native American family, you're going to see where there are matriarchs at the center of that family unit. If you work within a Native American community, you're going to see that there are matriarchs within that community. Oftentimes they are elders, and there's significant roles and specific roles, you know, depending on the tribe and where you're at. But understand this, the primary difference between matriarchal and patriarchal that I like to talk about is, let's look at patriarchal societies. Patriarchal societies are those where you oftentimes, more often than not, especially historically, you've seen a man at the top of the mountain, lack of a better analogy. At the top of that mountain sits a king, a president, a czar, an emperor, whatever those things are, and oftentimes this was a male figure. Patriarchal societies have this individual at the top of the mountain, and when you think about somebody, if you've ever played king of the mountain growing up as a kid, the goal is to get to the top of the mountain and throw the person off the top of the mountain down to the bottom so then you can assume that role of leadership and power at the top of the mountain. Patriarchal societies very much practice in this manner. There's always somebody looking to overthrow or assume power at the end of a term, at the end of overthrowing maybe a civil war, whatever it might be. These are societies that live in fear. Fear of somebody coming in and dethroning whoever that is at the top. So a society that lives in fear oftentimes is trying to sustain itself and its power. Matriarchal societies, once again, adhere closer to natural law in that there is balance within nature between male and female. So within these communities, you see the sharing of that power. For example, this is just an example that I use. Say that historically a warring faction or warring tribe or another tribe came in and stole ponies from the tribe. Well, the young men within the tribe would want to go back and get those horses back and maybe a little bit payback as well. We as men are very pragmatic. We're solution seekers, and the solution to our stolen horses is, get them back. We'll go make war if that's what we need to do. Now, that's not necessarily the wrong move, but what will happen is that will be decided upon by our council and our chief would make a decision of, okay, maybe it is time for war. Maybe this is what we do. We go back and get the horses. But that actually wouldn't be enacted until it had the approval of a matriarch or matriarchs within the family unit or within the tribal unit because women have more insight. They aren't as apt to act from that place that we men do. So they might be the voice of reason within this situation. So if a matriarch steps in and says, no, not at this time. It's not time for war yet, for whatever reason or that, that is often honored and that it will be the direction that the tribe will go on that particular day. Or they may actually endorse that and say, yes, it's time for that. We need to make preparations for this. So that sharing of that power is there. The decision might be made to do this by the men, but it has to be endorsed by the matriarch or matriarchs as well. That's not so different than what you see today in family practices, where if you step into a family situation and you're working with a family, oftentimes you're going to be talking to the matriarch or matriarchs within my family. I have a matriarchal relationship with my wife. We have a matriarchal partnership. So when we go to, say, for instance, a school parent teacher conference, the teacher is speaking to us as a family, but if they're speaking to me as head of household, that's not how this works. And I will oftentimes tell them, you need to speak with my wife. We will talk about this afterwards. We may make a decision together as far as what the best decision is if we need interventions for our children, but keep in mind that I'm going to lean more heavily on her insights than my own. So that is how that sharing of power would work within my family unit, and it works that same way within communities and so forth. So understanding that, and the reason that's important to understand is that if you insult somebody within a family unit by assuming that the man is the head of household and there's something said or done there where you insult that family or that matriarch, we as Native people, we talk to one another a lot, especially within our family units. So if you become known as somebody who's disrespectful, that is actually going to have some impact on engagement of individuals within whatever it is you're trying to do, whether it's social services, behavioral health, medical. If you disrespect somebody in a cultural way because you don't understand how matriarchal family units work, then you run the risk of these individuals not using your services, which would then develop negative outcomes, potentially negative outcomes for whatever services that is that you're trying to provide. So having an understanding of how matriarchal societies work and having that within our communities, our families, is very important to engagement with individuals within your practice. Next slide, please. So before we jump into male and female roles, why don't we stop there and see if anyone has any questions? I don't see any questions in the chat yet, but if anybody has questions, then Bobby, do they have the ability to unmute themselves? That is a great question, Jillian. I'm going to defer that question to you. Yes, people are able to unmute themselves. Does anybody have a question? You're able to unmute yourself or you can put it in the chat? I really appreciate your discussion, Al, on the standards so far. And one of the things I would I was thinking about in that standard, too, understanding Indigenous communal processes and social values. I know that, you know, like when appointments are made, for example, in a healthcare setting, behavioral health, you know, sometimes, you know, those appointments get broken because of something that happened to a cousin, you know, like or an aunt or an uncle. And sometimes those systems don't understand that, well, you know, immediate family is important, but in Indigenous society, you know, the extended family is equally as important. So that might, you know, create some misunderstanding between the patient or the client and, you know, provider. The other thing I was thinking about, too, was gift giving, that we have a strong sense of reciprocity. And so if a client or a patient would give, really appreciates the help that was given and will bring a gift, and the response might be, well, we're not allowed to, you know, receive gifts, but how can that be more graciously communicated, you know, as far as so as to not offend the gift giver? I think about those things, too. Absolutely. I think that's a great question. And I've actually experienced that. And it's actually a part of one of my other slides here that you will see. But I'll answer that now in the sense that ethically, as a clinician, I am not to accept gifts from patients and clients. But with my culture, I'm not to refuse gifts from people. So it's a part of our, because it's a sign of disrespect. So how I've overcome that is, well, I will say first and foremost, money should never be a gift. So I would never accept money. And I would make that very clear that I can't accept that. But when it came to gifts, I've had gifts presented to me by clients who have been so appreciative of the work that we've done together. So what I've often done is accepted that gift on behalf of our agency, our group, because a lot of times it's a group setting that they're in with me, especially with substance use. And it stays within my office so that all can share in its beauty, you know, because a lot of times I've been presented with things like regalia, native dancing dolls, and things of that nature, where they can actually adorn my office so that everyone can enjoy them. So that way, it's a gift that I will accept on behalf of the giving, but in a sense, give that to the community, community being all of those that I work with, and whether it's client or colleague. So that's one way that I've found that I can overcome that cross section between offending someone culturally and even breaking my own cultural understandings, yet still being professionally ethical. Thank you for that. There was a question about, are the slides available to print? And the response from Bobby was the recording and PowerPoint will be made available within two weeks, and we'll follow up with attendees on how to access this. Norm, did you have any comments or questions before Al moves on to the next set of standards? No, not personally. I don't have any. I didn't see any other questions either, so. Okay. Okay. Well, we'll move forward then. I do want to say one thing. Yeah, I'm throwing a lot of information out there within these slides, and know that I keep referring to that larger presentation, because that one is over four hours long. It goes over all of these. We go into more depth. So really, you guys are getting the stones skipping across the water with these, with hopefully enough ripple to them that you're getting the concepts of what we're talking about here. So know that, yeah, we do a much deeper training with this, in the sense that for those who want to know more and feel they need to know more. So moving on, let's look at male and female roles, as we start looking at both historically and contemporary roles. We as men, so warrior, we come from warrior societies, and so we as men, we were warriors. We were hunters. We were the providers and protectors of our people, our families, our communities. And because of that, we're often referred to as life takers, because oftentimes in the taking of game to feed our communities, we take life. Sometimes in the protecting of our communities from dangers, you know, whether it's a warring faction, tribes, or U.S. government during the American Indian Wars, you know, the different episodes of American Indian Wars, we were life takers as well. So we are seen as those who are the strength in that way from those warrior societies. Even today, we still fulfill some of these roles. The picture that you see here of the life taker, you know, is a Navajo man who actually joined the military and serves our country to fulfill that warrior mystique. There are many men and women who have joined the armed services throughout time who are Native American. In fact, some data you look at will show that Native Americans are the highest rate of minority joining the military services per capita. So we have a lot of people who have served in our military, you know, following in that that warrior tradition, going just back to World War II. I can't speak to World War I, and I don't have any stories for that, but World War II, two of my grandfathers, one served in the South Pacific, and the other served in the European campaign, actually in Normandy. And then from that, I have a couple of uncles who actually served, three uncles, in fact, that served during the Korean War. And my father himself and one of my uncles served during the Vietnam War. So with that said, I too followed in that same fashion, and I joined the army when I was 19 years old. So went into the service as well, as part of that tradition of being a warrior and a protector, being hunters and gatherers. Well, we don't hunt in the same sense of what we once did, where that's our primary food source, but we still hunt. I hunt, I was taught to hunt. We Cree, of the Cree Nation, have a long history of trapping and hunting, going all the way back to the Hudson Bay Company up in Canada, and being guides and that for fur trappers. So we have a long history of being hunters. That was not lost within our culture. I was taught to hunt by my uncles. I mentioned that earlier. We pride ourselves on being able to go out and get game. And when we get game, we bring that back and we distribute, whether it's deer or elk, and we distribute these, or fishing itself, you know, amongst our families. My two aunties that live here in town get a portion of the food that I harvest every time that I do. So we, in a sense, feed our family still in that traditional way. You know, and also in that traditional way, when I do hunt and I do harvest game, there's an honoring that happens with that as well, the thanking of the spirit of that animal for its life being forfeited so that our family may eat. So we still practice some of these things to this day. They haven't been completely lost. But one thing I want to make note of is that a lot of these ways of being have been lost by many of our men and women when it comes to our traditional ways of life. And I'll talk some more about that when we get to historical trauma. Next slide, please. Our standard four is understanding indigenous relational engagement and value systems. What we're talking about here is, you know, the broad topic, as it says, understanding Native American values and how they they there's something but how respect, discipline, compassion, trust, generosity, honesty. I'm going to add a few to this compassion. Oh, it's on there. Humility. These types of things are instilled in us as as children, as a part of our identity. Now, when I talk about things like respect and discipline and compassion and trust and honesty, you know, I gave this presentation, part of this presentation to a group of commissioners here in the state of Montana earlier this year. And I talked about this particular slide and what I said to them, because this was a commission of senators and other representatives from around the state. And these were mostly, if not all, non-native folks. And I said, when you look at these things like respect and discipline, you know, trust and generosity and honesty, that doesn't sound far-fetched, does it? It sounds very familiar. I think every culture around the world tries to instill these things or at least guide these these things within the principles of their communities. But there's a difference here when it comes to our native upbringing and our understanding. You know, and it kind of goes back to, Athlene, what you were talking about, you know, within the insulting of a cousin or an auntie or something like that. You know, within our communities, let's look at honesty. We are taught to be honest and not just honest in the words that we speak, but in our behaviors, our integrity, being honest in our actions. We are taught this because when you are seen as somebody who is dishonest within our community and within our people, you are always going to be seen as somebody who is dishonest, no matter how much you try to reverse that. So you're going to be known as a dishonest person. That's a very important concept when you are looking at a social and communal people. So you do not want to be somebody who is not trustworthy. So we are known for our generosity and our giving of ourselves, things like compassion, being compassionate. We are taught within the Cree culture. And again, this is universal. And I actually heard, Athlene, in your introduction, when you spoke to, in a sense, all of creation, what we use in the Cree way is wahotowin, which means all of my relations. And when we say all of my relations, we are referring to, you know, the winged and the four-legged and the two-legged and the crawling and all of those things of the world. We're referring to the earth itself. We're referring to the trees and the rock. Everything is related. So we have this understanding that all life is sacred. And from that comes compassion. We have to have compassion for all life. That's where we get the honoring of the animal that we harvest, because we still want to show that compassion, that respect of that animal's life for being a part of giving us life. So there's always that piece of compassion that is there within our belief system. So these are very important concepts within our communities. You know, things like discipline. Discipline itself is something, it comes in a lot of different forms, but one of the forms of discipline I was raised with is my grandfather would take me down to the Missouri River in Great Falls. And he would sit me, I was just a little boy, you know, four or five years old, somewhere in there, maybe six. And we would sit there along the river, the banks of the river, and he would have me just watch the water, watch the river, and listen to all the sounds that were coming, the running of the water, maybe the wind through the trees sometimes, birds. He would do things like take sticks and leaves, and he'd throw them just upstream from me, and he'd have me watch them dance with the water as it moved through the water, because they each have their own dance and their own part to play in that. These are things that he instilled in me young, and I didn't understand it at the time. I felt like I had to sit and do this for hours, and it was probably maybe 10, 15 minutes at a time. But I was a boy, I wanted to go flip over rocks and catch crawdads and go do things that little boys do. But he had me sit quietly and still and do these things and observe. And I didn't learn until much later that he was instilling a discipline of quieting myself and being in the moment within myself as a child, so that everything wasn't the next adventure. Everything had to do with sitting still and listening. So it's a form of discipline that I was given, a gift I was given by my grandfather as a young boy, and I didn't understand it. It's not like he said, I'm going to teach you discipline. What he did is he took me down and he had me practice these things. And through that trust, through that respect, especially for our elders, these types of things that I did as he asked. And it instilled a lot of strengths and a lot of things within me that today in the behavioral health realm we call coping mechanisms. But he instilled these things in me as a young child because it helped me look at the world through that lens of who I was as a human being. So these value systems are very important within our communities. And of course, we know that they're disrupted and they're challenged with some of the dysfunction that happens within our communities, the disparities within our communities. But know that the core of who we are as a people, these values were very sacred to us. Next slide, please. So standard five is understanding indigenous trauma histories. You know, having an understanding of historical trauma, intergenerational trauma, or generational trauma. Those terms are used intermixed. They mean the same thing. And also individual trauma that has come from some of these things and how these traumas have impacted native communities, individuals, and even families when working within mainstream systems of care. This one here we spend a lot of time on within the larger training itself, looking at the historical trauma dating all the way back to, we're going to say 1492, but really taking a solid look at America and American policies, laws, and acts that were put into place to really eradicate us as a people. Whether the eradication was the genocide and killing off of a people, or whether it was the forced acculturation and assimilation of us as a people. But when you start looking at these different eras, these different things that have happened in these different regions across the history of this country, you can see how they've created many of the disparities that we see today. Going back to men's roles as lifetakers, as protectors, as, you know, those who provided for families. When we got to things like the reservation systems and we were placed on reservations with fewer resources for the same, you know, for this group of people, we had, we became more dependent on government rations and things of that nature. But what that actually did is took men out of the roles of being providers for their people, because they can no longer provide in the old way. The buffalo was nearly exterminated. There were fewer resources. Some of the lands we were placed on in the way of reservations were not good producing lands, whether it be game or even cultivating and growing our own foods. The gathering of traditional herbs and berries and other plant life that we used to sustain ourselves throughout the year was less accessible. So we have starvation. We have people who, their identities as hunters were disrupted. Then we get into things like the boarding school era, where these traditional ways of being, and remember again, going back to the models that we were born into an identity. My identity is as a healer and my community and family helps me to develop as a healer, so I can give back to my community that was disrupted within the boarding school era. If my role as a female is as a, not necessarily a matriarch, because that becomes over time, but maybe a healer as well. Somebody who holds to our culture and our cultural practices, because women play such an important role in ceremony and the roles that they play within those. These children were removed from their families, placed in boarding schools, and those teachings, that way of growing within the community was disrupted. So not even to mention some of the historical trauma of the boarding schools themselves, which I think we're all well aware of, you know, the inability to practice culture, the cutting of hair, the removing of anything that would resemble regalia or cultural wear was removed for school uniforms. Languages were forbidden to be spoken. The punishment that happened during the boarding schools, not just the punishment, but the way that, you know, some, the lack of care, not just punishment. Those who were sick did not get the proper care that they needed, and so many children died within the school systems themselves of the boarding schools. So, but you take that aside and you take those who survived, those who maybe escaped, or those who actually aged out and were sent back to their reservations. They went back into their communities not knowing who they were. What we've done here as a nation is disrupted an entire generation or generations of children from really developing those identities that give them purpose within their communities because the Dawes Act of 1887 made it illegal to practice culture and religion, language, and regalia. So, and you know, our religious regalia and things of that nature. So these things couldn't be practiced. These folks come back into these communities and they don't know who they are. They don't know where they fit and how they belong, not to mention that they're being placed back on a reservation where resources to even be who you are, if you knew who that was, is not available. So that major disruption to a way of life is one of the most detrimental pieces of historical trauma. I think that has happened to us as a people. You know, through all of that, there's plenty of resiliency. And of course, we see that resiliency today in the resurgence of culture over the last, oh, say 20 years or so. You know, there's been a real resurgence of culture and language. We have some reservations like Rocky Boy, for instance, actually teaches the Cree language directly within the school systems now, so that they're bringing the language back to the new generations. So there's a lot of resilience, but this historical trauma piece has really impacted our people in our worldview. Remember what I had said about those value systems? You know, we have a government that couldn't be trusted, that was continuously dishonest, that kept moving the goalpost every time that we would have reached that goalpost. You know, when we start talking about the different treaties and rights that were given, you know, through those treaty rights. And because of that, we have a government that continuously moved that goalpost. So how do you trust? You know, and one of the natural byproducts of trauma itself is the breaking of trust. If you work with anybody who has trauma in their history, you know, let's look at neglect, for instance. You know, if they're neglected or they're abused by their own parents or their own guardians, these children learn not to trust. If you can't trust the people who are there to actually guide you, raise you in a good way, who can you trust? Well, it's that same process when it comes to things like trauma, where the trust was not there. It was because it had been broken so many times. How do you now trust anything that comes from this group of people in the way of helping us? So historical traumas had so many different faces to it over time from the eradication and near genocide all the way down to the different policies. You know, perhaps the whole concept of boarding schools, even in the best light, was simply to help educate Native Americans into a society or into a culture of, you know, what the future might bring. But the way that it was done was so wrong. Al, Carrie had her hand raised for a question or a comment. Carrie, would you like to pose your question or comment? Yeah, I have a young woman just yesterday. She's 22 and she's, you know, struggling with her family's, her mother's trauma, her grandmother's trauma. And I tried to explain to her how difficult it is for those generations to talk about the trauma in general because things were handled within the family. You don't talk to someone else. And I, she's really struggling with having a connection with her elders because they don't talk about this trauma. I tried to explain how horrific the schools were and gave her examples of different documentaries she can watch, but I don't know how to help her move forward with that to open that conversation with them since they are less likely to talk about it. Yeah, and that's going to be very difficult. The one thing that I've used in trying to talk, even personally in my own life, trying to talk to some of the elders within my own family, is that rather than talk to them about the traumas that they've witnessed or that they know have been experienced within their lifetime, really try to take a more neutral approach of talking about the traumas that have happened to us as a people. Because somewhere in there, they're going to hit on some of those key points that they're still holding within themselves, but it may open the conversation up to this is the way it was versus this is the way it was for you. Because I've seen where that's helped actually open up some of the dialogue. So then you can begin to relate with that individual and they see that they're not alone in that, that these things have impact beyond just their generation. But it's a very difficult thing to talk about. You know, as a therapist, I work with trauma all the time and, you know, peeling away the scab off of those wounds is very painful. And sometimes when you peel that scab off, you know, that the bleeding starts and you can't get it to stop. So it's a very delicate situation based on that. Yeah. Is it inappropriate to give her documentaries to watch to try to understand that past? I don't think so. Honestly, I don't think so. As long as you're there to process with her beyond that. So she's not watching these things and then she's left there wounded as well because these things are hard to watch. Some of the movies of old, even though they're not very culturally sensitive, you know, we're talking about some of the movies of the 70s. Here's one for you. Little Big Men. I mean, you know, great show. I actually love the show, but not very culturally accurate in a lot of ways. But yet some of the historical trauma in there, I can still watch and I feel such an impact from that to this day to watch that because it weighs heavy on my heart when I see the cavalry come in and wipe out an entire tribe. There's something within me that is stirred that is so emotionally damaging. So I would not recommend that she watches these and then just leave it at that, but really needs to process through, you know, what that looked like and how that impacts her to this day. Okay. Thank you. Thank you for the question. Just a quick time check. We have about 11 minutes left. Yeah, so we're, we are short on, we're going to run out of time, aren't we? So let's go ahead and jump to the next slide. Okay. Historical trauma, once again, I've talked extensively about this, but these are just some examples of that, you know, the starvation, the injustices, the assimilation, acculturation, those types, the boarding schools, the racism. Racism and discrimination, even today, you know, racism itself is what I refer to as a community health crisis because racism creates what we call complex trauma because it's ongoing. And so even some of the racism and discrimination that happens today as a part of a trauma and trauma response from individuals, when you can't trust individuals within the community because of some of these things, you know, you continue to be triggered when you experience something that is perceived as racism. You know, it's one of the reasons you hear a lot of folks and even folks of other minorities say that, well, they must be being racist. Whether they're being racist or not doesn't really come into play when you look at this as a trauma response to that pushback or to that interaction that is negative because it triggers that response. So, you know, we go into more depth with that with a larger training. Next slide, please. Standard six is understanding indigenous perceptions of mental health. We have traditional ways of looking at mental health, you know, as you may or understand, we have a spirit realm, you know, and how spirits interact with us on a daily basis. So sometimes mental health in a traditional sense was seen as interaction with a spirit realm. I've actually experienced this within my career with several different natives who actually felt as though the voices they were hearing were from that spirit realm. So understanding that this belief system within these individuals has to be honored. It has to be looked at from that, you know, there's ways to work with that with an individual so that they understand that even though it is something that's coming from the spirit realm, there are things they can do with that. There are ways that they can work with that and it's no different than any Western approach of working with the mental health to help manage the mental health. Just understanding that from a traditional standpoint. Okay. Some of those ways of looking at that again are also things like we have in any community where mental health is sometimes seen as a form of weakness or something wrong with the individual. So, you know, those things aren't so different in native communities as well. Next slide, please. Standard 7 is understanding the process of addiction and substance use for indigenous peoples, families and communities. I actually have a training that I do on this as well, which is more of a two-hour training, two, two and a half hour training. And this training itself actually goes into that process of addiction, but it doesn't leave it at that. It also goes into the process of recovery as well. But what I use within this is really what we call the four relationships or the four sacred relationships and we use the medicine wheel or I use the medicine wheel to describe this and it's really taken that person if you think back to that medicine wheel picture that we had earlier with the person at the center of the medicine wheel. Addiction takes a person out of that medicine wheel in the four areas of the medicine wheel represent the four relationships in a person's life, relationship with self, relationship with inner circle or friends and family and relationship with community and relationship with creation. Addiction is a process that takes you away from those relationships. This model actually takes the individual back into the center of that circle in the way of recovery and how recovery helps that individual. So there's a visual that I have that goes along with that understanding and understanding the process of addiction. Next slide, please. Oh, there's a there's a visual of it there of what I'm exactly what I'm talking about. Next slide, please. Standard aid is understanding spirituality, holistic healing and role of elders, traditional healers and knowledge keepers. We could spend quite a while on this, but obviously we're running out of time. But just understand that, you know, when we're looking at our spirituality and our way of being spirituality for we as Native people isn't a religion. It isn't something that we practice. It's actually who we are. It's a part of our being, how we interact with the world and how we conduct ourselves as we move through the world or walk that red road, if you will. It's a way of being. So just please understand that when you're working with Native Americans and and we're talking about our spirituality. It's a part of who we are. It's not something we adhere to. Next slide, please. Our spirituality has what we call the four sacred medicines. Okay. There are a lot of different medicines within Native culture, medicines for healing, sickness, illness, those types of things. When we talk about the four sacred medicines, we're talking about sweet grass, tobacco, cedar, sage. Those are the four sacred medicines. And Ethelene, you had mentioned earlier about gifts. A lot of times gifts that can be given within our communities and for presenters and things like that are oftentimes one of these four sacred medicines presented to them in a way of honoring and thanking them for being there. So this is just a picture of those four sacred medicines. Next slide. Standard nine is the role of tribal governments. We won't spend much time with this at all anyways, though we're running out of time. But just understand that, you know, our sacred knowledge, our intellectual property rights, things like that, you know, and the role of our tribal governments since 1975 with the Indian Self-Determination Act, our tribal governments are now able to actually put in laws and practices on the reservations for our people that protect these sacred knowledges. You know, in 1979 with the American Indian Religious Freedom Act, we were given back the right to practice our religions and use the regalia within our religions, things like eagle feathers, which were deemed federally illegal to possess. So since the 70s, we are able to be self-determined as a people to move forward with some of these practices and holding on to our cultural and our ceremonial rights. The government has been given that right to do so. Next slide. These are the tribal nations of Montana. We'll go ahead and just jump past this since we have some folks who aren't in Montana, won't spend any time with this. Next slide. So that kind of brings us to the end of our presentation. Like I said, there's so much more we could go into with each of these slides. I could spend, like I said, hours doing this, but I really wanted to give you guys an overview of those standards of care and how we're trying to put these in place and take this training to especially non-native entities that work with native populations so they have a better understanding of some of the behaviors they may be seeing and how they are culturally relevant. So with the last minute or so, if there are any final thoughts or questions, I would be happy to field those. All right. Thanks, Al, for the great presentation. If anybody has any questions, you know, we certainly still have a little bit of time for those. So if you would, I'll just come off mute and ask any questions if you have them. I was just curious if you could send us information about your longer training so we can get more information about that. I could do that. I could do that maybe through you, Bobbie, and you can get that to the right person. We sure can. You bet, Al. Okay. So we can send out something that just some information around that. Thank you. Thank you. Perfect. And of course, that was a question that just came up at the link also. So thanks, Camille, for your question. Thank you so much, Al. This is really wonderful information. I'm really anxious to hear more, and we will be hearing more from you at our next training session on Wednesday, January 8th at 2 p.m. Eastern Time. So there will be an announcement sent out. So really appreciate your work. Thank you. Yeah. My understanding of the next training is we'll go back not necessarily through this training, but the standards and field deeper questions. So if you guys think of something between now and then, please come back, and hopefully we can delve a little deeper into what you want to know more about. Yeah. Thanks again, Al. Just want to let everybody know you can scan the QR code here, and it'll just bring you to a brief survey link for this presentation that'll come back to us for feedback. You can also, Jillian also put the link right into the chat. So if you just want to click that link, it'll bring you right there to that survey. All right, again, want to thank everybody for joining us today. We will see you all next month for the next presentation. Thank you, everybody.

Tribal Opioid Response

Native communities

cultural standards of care

indigenous histories

SAMHSA

healthcare providers

historical trauma

cultural practices

extended family structures

gift-giving

culturally responsive interactions

Native identity

ongoing training