Year

2013

Degree Name

Doctor of Psychology (Clinical)

Department

School of Psychology

Abstract

Aboriginal people are one of the populations most in need of mental health and drug and alcohol services within Australia, although it has been questioned whether treatment programs are adequately sensitive to and inclusive of relevant aspects of Aboriginal culture. The primary objectives of the research were to investigate 1) which cultural activities were offered in residential drug and alcohol rehabilitation programs for Aboriginal Australian men, 2) the benefits associated with these cultural activities from the perspectives of service providers and service users, and 3) whether cultural engagement predicted outcomes.

Study 1 assessed the feasibility of collecting outcome data from a residential drug and alcohol rehabilitation program, and the usability of a recently developed Aboriginal-specific measure of empowerment, the Growth and Empowerment Measure (GEM: Haswell et al., 2010). Study 1 also explored consumer perceptions of the helpfulness of cultural activities within the treatment program. Participants were 57 Aboriginal and 46 non-Aboriginal males attending one residential drug and alcohol rehabilitation service in New South Wales (NSW), Australia. Results from Study 1 identified the need for more specific measures of cultural engagement (Study 2) and informed the design of Study 3.

Study 2 examined the views of service providers regarding the cultural activities offered within treatment programs for Aboriginal Australians. Participants were the managers of five residential drug and alcohol rehabilitation services in NSW. Study 2 also describes the development and content validation of a measure of cultural engagement for use with Aboriginal Australians, the Aboriginal Cultural Engagement Survey (ACES: Berry, Crowe, & Deane, 2012). Development involved the participation of the Aboriginal community in four phases, and results demonstrate excellent content validity both at the item level (all items above .80) and full scale level (.98).

Study 3 assessed the outcomes of empowerment and mental health for Aboriginal males attending residential drug and alcohol rehabilitation services. The association between outcomes and cultural engagement, both in everyday life and while in drug and alcohol treatment, were also investigated. Study 3 examined the preferences of service users regarding the cultural activities offered in treatment programs, including their perceived relevance and helpfulness. Participants were 101 Australian Aboriginal male clients attending five residential drug and alcohol rehabilitation services in NSW. Results of hierarchical multiple regression analysis indicate that cultural engagement in everyday life significantly predicted empowerment but not other measures of mental health. Cultural engagement undertaken within treatment programs was not associated with empowerment or mental health. Potential explanations for the differential effects of cultural engagement are considered. The opinions of service users are presented, including the desire for treatment programs to provide more education regarding history/heritage and more time on Country. Recommendations are made regarding ways to enhance the effectiveness of cultural activities within drug and alcohol rehabilitation programs.

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.