Mo#va#ons for sobriety among Alaska Na#ve Elders - A$aining Eldership through recovery

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1 Mo#va#ons for sobriety among Alaska Na#ve Elders - A$aining Eldership through recovery Jordan Lewis, Ph.D., MSW (Aleut) 41 st Annual School on Addictions & Behavioral Health Elizabeth Fleagle, Inupiat Elder May 5, 2015 IWRI

, MSW (Aleut) 41 st Annual School on Addictions &

2 Introduc#on Little research has focused on factors contributing to AI/AN sobriety and abstinence (Mohatt et al., 2004; Moos et al., 1985, Moos, 2007). The current study is a shift in the focus of alcohol studies to the motivating factors for sobriety and to what has helped maintain sobriety among Alaska Native (AN) Elders.

The current study is a shift in the focus of alcohol studies to the motivating

3 AUD and successful aging Alcohol use disorders (AUD) are a major barrier to successful aging Negative impacts on family and community Prevents older adults from becoming respected Elders or achieving Eldership. Prevents them from enjoying their later years, and engaging in cultural generative acts i.e., teaching sewing, beading, hunting skills, skinning, carving, language, etc.

4 People Awakening (PA) Project (Mohatt et al., 2004; Mohatt et al., 2007) An exploration and elaboration of an AN understanding of sobriety to generate a exploratory model suggesting testable hypotheses for later population-based studies. Reshaped how researchers understood and approached alcohol research with AN communities.

generate a exploratory model suggesting testable hypotheses for later

5 Current study The major purpose Understand motivating factors beneficial to the Elders achievement of sobriety (Moos et al., 1985) and successful aging, or Eldership This study was approved by University of Alaska Fairbanks Institutional Review Board University of Washington Institutional Review Board Alaska Native Tribal Health Consortium Health Research Review Committee.

, 1985) and successful aging, or Eldership This study was approved by University of Alaska

6 Study sample 10 interviews with PA participants aged 50 and older who made data publicly available 8 men, 2 women Age range: Tlingit, 3 Yup ik/cup ik, 2 Athabascans, 1 Alutiiq

7 Research methods Secondary data analysis of interview data (n=10) Transcripts read to become familiar with content using content analysis (Green & Thorogood, 2009). Identified themes in transcripts Themes were placed into major categories Exploratory in nature as it sought to describe influence and maintenance factors for sobriety among Alaska Native Elders.

Identified themes in transcripts Themes were placed into major categories Exploratory in

8 Research ques#ons 1. What influenced participants decision to quit drinking? 2. What assisted them [Elders] to stay sober, or prevented relapse?

9 Findings The four reasons Alaska Native Elders abstain from drinking alcohol or quit drinking alcohol: Family members influence and their desire to care for their family members; Role models for others; Pass on their wisdom to the younger generations (i.e., engage in cultural generative acts).

desire to care for their family members; Role models for others; Pass on

10 Findings: Family (n=5) Family members who drank in the past were willing to share their experiences with problem drinking, including: Binge drinking, What their lives were like since they quit drinking. There were also family members who never drank in their lives and shared their reasons.

drinking, What their lives were like since they quit drinking.

11 Words of the Elders And I credit my parents and grandparents for the wisdom of telling the entire family, drinking is not the right thing to do. My parents were non-drinkers. My grandparents were non-drinkers.

12 Findings: Role Models More than half of participants (n=6) discussed role models in their lives (outside family) and wanting to serve as a role model for others. Sharing their own experiences with alcohol was important to their own recovery.

wanting to serve as a role model for others.

13 Words of the Elders Because I really believe I m over that point not to drink again, because the longer I m staying away from it, the stupid everything starts to look stupid to me, how I used to be. So I thought I d share, not only with the people out there, but with my children, how it was with me as I was going through this alcohol thing.

14 Findings: Community & Cultural engagement Staying sober and being healthy is required in most communities to participate in cultural events, such as potlatches and dances. Participating in cultural activities with family and community was an important part of their identity, gave them a sense of purpose, and strengthened the sense of community (i.e., unity).

Participating in cultural activities with family and community was an important part of

15 Findings: Community & Cultural engagement Quitting drinking also enabled Elders to engage in cultural, generative acts, with younger people. Indigenous cultural generative acts included: sewing, beading, cutting and hauling wood, traditional dancing, teaching and speaking their Native language, other activities throughout the community, and so on.

Indigenous cultural generative acts included: sewing, beading, cutting and hauling

16 Words of the Elders Just like our Tlingit songs. It s important to us. Oh, that s something that our people need to hear. That there was so much unity in this village in the past. No one went to the river alone. You had to have someone There was unity in their way of getting their food. Life was good.

That there was so much unity in this village in the past.

17 Findings: Spirituality 8 out of 10 participants made direct references to spirituality, religion, God, or a higher power, Elders attributed this relationship as a recovery factor central to their ability to become and stay sober. These events were turning points in their lives, when they realized they could not stop on their own and turned their drinking and desires to quit over to a higher power.

18 Words of the Elders I accepted the Lord as my personal savior. I don t know how far you guys go on believing in the Lord or those kind of things but I m a great believer of it now. If it wasn t for that I d probably be six feet under by now. I quit drinking, I quit boozing, cigarettes and everything; any bad habit, it was all behind me.

19 Discussion A shift from negative to positive outlooks on sobriety and quitting drinking highlights the strengths and resiliency factors that exists within our tribal communities. This heightened consciousness and spirit of self-determination and improving one s health and well-being is a positive force for our sobriety movements and rebuilding healthy families and communities.

This heightened consciousness and spirit of self-determination and improving one s health and

20 Summary As the oldest old Alaska Native Elders pass on and the upcoming cohort of Elders age, it will be important to develop elder-centric programs and services If we can develop supportive intervention based on the experiences, lessons, and motivations of those who have overcome AUD, we can work collaboratively to ensure more AN Elders age successfully Fill the roles of family and community leader, teacher, and role model for our youth, families, and Elders in training.

lessons, and motivations of those who have overcome AUD, we can work collaboratively to ensure more AN Elders age

21 Summary This project: Highlights strengths and positive characteristics of our tribal communities and Elders, Teaches us how to highlight these successes and Teaches us to remember the value and importance of our Elders for their families, communities, and all Native People.

22 Elder Reflec#ons and Story Learn from an Elder s story and experiences, reflec>ons on recovery among older adults, and what has worked well with Na>ve Elders.

23 Thank you! Any questions?

24 References Green, J., & Thorogood, N. (2009). Qualitative methods for health research. Los Angeles, CA: Sage Publications. Lewis, J. (2014). What successful aging means to Alaska Natives: Exploring the reciprocal relationship between the health and well-being of Alaska Native Elders. International Journal of Ageing and Society, 3(1). ISSN: Lewis, J.P. (2011). Successful aging through the eyes of Alaska Native Elders. What it means to be an Elder in Bristol Bay, AK. The Gerontologist, 51(4), Miller, W.R. (1983). Motivational interviewing with problem drinkers. Behavioral Psychotherapy, 11, Miller & Rollnick, (2002). Miller, W., & Rose, G. (2009). Toward a theory of motivational interviewing. American Psychologist, 64(6), Mohatt, G.V., Rasmus, S.M., Thomas, L., Allen, J., Hazel, & Marlatt, G.A. (2007). Risk, resilience, and natural recovery: A model of recovery from alcohol abuse for Alaska Natives. Addiction, 103, Mohatt, G.V., Rasmus, S.M., Thomas, L., Allen, J., Hazel, K., & Hensel, C. (2004). Tied together like a woven hat: Protective pathways to Alaska native sobriety. Harm Reduction Journal, 1(10), Moos, R.H. (2007). Theory-based processes that promote the remission of substance use disorders. Clinical Psychology Review, 27, Moos, F., Edwards, E.D., Edwards, M.E., Janzen, F.V., & Howell, G. (1985). Sobriety and American Indian Problem Drinkers. Alcoholism Treatment Quarterly, 2(2),

Lisa Rey Thomas, Ph.D.

CURRICULUM VITAE Lisa Rey Thomas, Ph.D. PERSONAL Tribal Affiliation: Address: Tlingit Phone: (206) 897-1413 Fax: (206) 543-5473 Email: Alcohol and Drug Abuse Institute University of Washington Campus Box