Issue 8 | October 2021
Collaborating to Improve Culturally Appropriate Services for American Indian and Alaskan Native Children
The Western Regional Children’s Advocacy Center (WRCAC) provides training and technical assistance (TTA) to increase access to children’s advocacy center (CAC) services for children and families, with special attention paid to tribal communities and those serving American Indian and Alaska Native (AI/AN) youth in rural, urban, and tribal jurisdictions. This focus on Native families is particularly relevant in the western region, where approximately 80 percent of federally recognized tribes are located and over 1 million individuals who identify as AI/AN reside. According to Child Maltreatment 2019, AI/AN children have the highest rate of victimization at 14.8 per 1,000 children, indicating a need for a thoughtful and culturally appropriate response[1].

WRCAC has utilized a variety of strategies to increase access to a multidisciplinary team response and the services of a CAC for AI/AN children and youth, including focused technical support to individual tribes, and Listen and Learn events that strengthen relationships between tribes and nearby children’s advocacy centers (CACs). We have been fortunate to partner in our efforts with two national, leading organizations that specialize in working with AI/AN communities and service providers: the National Native Children’s Trauma Center (NNCTC), and Native American Children’s Alliance (NACA). Our collaboration results in stronger outcomes for AI/AN families by leveraging our own experience working with teams and CACs with the experience, skills and knowledge of experts working with Native children, families, and tribal communities.

In 2021, NNCTC launched the Training and Technical Assistance Project to Expand Children’s Advocacy Centers Serving American Indian/Alaska Native Communities, funded through the Department of Justice, Office of Juvenile Justice and Delinquency Prevention. The goal of the project is to increase the capacity of tribal CACs and non-tribal CACs serving AI/AN youth. As part of this project, NNCTC provides TTA to CACs that serve tribal communities who have received grants through OJJDP’s “Expansion Initiative of Children’s Advocacy Centers.” NNCTC hosts quarterly online learning events, fosters a community of learning for grantees, and provides customized TTA developed around shared objectives among the grantees. In recent months, NNCTC has launched a web-based Native Child Advocacy Resource Center where tribal communities and CACs serving native children and families can request technical assistance and access resources. NNCTC also provides limited support to applicants who were not selected for funding and CACs who were not ready to apply at this time. Finally, NNCTC continues to work in partnership with WRCAC and others funded through the Victims of Child Abuse Act (VOCAA), including the Midwest, Northeast and Southern Regional CACs, National Children’s Alliance, National Children’s Advocacy Center, and Zero Abuse Project, to respond to TTA needs of CACs and AI/AN communities. I recently met with NNCTC’s Executive Director, Dr. Maegan Rides at the Door, to learn more about their project and the trends they are seeing in the CAC field impacting access to, and services for, AI/AN youth and their families.


Challenges Impacting Tribal Communities’ Access to CAC Services

There are many challenges that tribal communities and CACs face in providing services to AI/AN youth, especially in rural communities, such as high victimization rates, lack of adequate resources and workforce shortages. As Dr. Rides at the Door explains, “it's a dynamic, changing community. A lot of tribal communities depend upon grant support for services and the landscape is always changing.” This changing environment, as well as historical experiences, can make building relationships difficult as well.

For non-tribal CACs serving Native families, Dr. Rides at the Door stated that assistance offered through this project provides “an opportunity to build, or rebuild in some cases, the relationships that they may have with the community.” There is also an opportunity for AI/AN communities to learn and explore the CAC model and how it may be a resource to their youth and families. Through this new project, NNCTC provides CACs with an opportunity to assess who they are serving and who they could be serving. Dr. Rides at the Door noted that some providers may already be serving more AI/AN youth than they realize, while others want to serve more but haven’t had the opportunity to focus on that need. 


Opportunities to Improve Multidisciplinary Collaboration

Despite existing challenges, Dr. Rides at the Door believes there is significant opportunity to improve multidisciplinary collaboration between tribal and non-tribal professionals. She explained, “it's a common perspective from outside entities to treat AI/AN children as other minority groups and forget that tribes are sovereign nations with a government-to-government relationship. And that respecting tribal sovereignty is a core value.” Lack of communication is often a barrier for both tribal professionals and non-tribal professionals to respond effectively to child abuse. One strategy that Dr. Rides at the Door suggests is for CACs to consider sharing more information with tribal council, including how the CAC works, the services available, and how many children were served from that community. This allows tribal leaders to better understand the needs of their community members so they can make more informed decisions about what resources to make available or what changes to make.

Creating strong multidisciplinary teams (MDTs) to improve the collaborative response between tribes and non-tribal CACs is challenging in part because many teams don’t have sufficient time to devote to improving the functioning of their team; instead, they are pulled toward providing more direct service to families in crisis. “We don’t spend a lot of time on aligning values, clarifying roles, and validating people’s input and work, and being prepared for and having a plan for conflict resolution,” Dr. Rides at the Door notes. She suggests that CACs “pull in tribal values to the work that MDTs are doing or look to elders in the community for that guidance in how we resolve difficulties (making sure to first provide them with context on the MDT and their purpose) …MDT members could have a deeper connection for their work in ways that could facilitate stronger MDTs.” 
 
Another challenge Dr. Rides at the Door has observed is that “people will [participate in] teams but really still have a lot of allegiance to their agency. Attending an MDT [meeting] can be a really new experience or a different experience from where they've been before, and people may not have the specific knowledge that they need to respond to child abuse.” To address this, she emphasizes not only a need for training, but also trust-building; she would like to see MDTs in a position to trust those who can provide assistance and be able to ask for that help when needed, without feeling shamed or scrutinized. Building trust among team members can help empower members to be open to looking at how the team improves services together.
 
According to Dr. Rides at the Door, “right now, tribes are in an era of self-determination and that means that when they have a capacity, where they have a capacity, to take on something like developing their own CAC, they will. I think non-tribal CACs have to be in a position to support the community, to help the tribe have their own [response] and be able to have their own services, where they could still work in collaboration and still support and teach them what they’ve been doing, you know, learn from each other.” Dr. Rides at the Door suggests that understanding the CAC’s role at any given time is one way for CACs to support their tribal communities. Sometimes being a consistent presence is what’s important. She suggests “showing up and being consistent about that. A lot of people come into tribal communities, wanting to help. And you know who's going to stay and who really means it. There’s a whole history, a bad history…so CACs really have to work to build up that trust in various ways.”

NNCTC is encouraged by the many examples of CACs who are implementing strategies that are working well. Dr. Rides at the Door sees an opportunity to bring people together to share what’s working and learn from one another and suggests approaching it as a “co-learning process… because it's going to take the community and the CAC to figure out what's going to work out best. It's sort of creating that from the ground up, rather than ‘what we're doing here is what you all need to do’. And I think that positioning really creates an opportunity for decision-making to happen, for the community to own what's happening and what's being provided; really taking ownership.”


Expanding TTA for CACs and MDTs Serving Tribal Communities

Since joining the network of TTA providers for CAC professionals (funded through VOCAA), NNCTC has had the opportunity to participate in the development of a national strategic plan, review guides prepared by other national TA providers, and are now in the process of creating products to support building and establishing relationships between non-tribal CACs and tribal communities. NNCTC hopes to give its constituents information on how to get started in this work and share opportunities to strengthen what they're doing, improve and sustain outcomes and set them on a path for further expansion. “This work has to continue without just one TTA center focused on Native/Tribal children and families, and there does exist other TTA centers and others who are able to help...having the Regional [Children’s Advocacy] Centers continue to carry out this work is such an important part. This is where the collaboration efforts happen because there's still quite a bit of CACs who aren't funded [as part of this project] but are still working on this.”
 
WRCAC looks forward to a continued partnership with NNCTC and NACA to develop resources, support training focused on AI/AN communities and provide TA to MDTs/CACs serving AI/AN youth and families. WRCAC recognizes that tribal MDTs and CACs may be in varying stages of development and implementation regarding the CAC model and that each is unique in terms of its needs, local resources, existing relationships, and ongoing challenges. We will continue to support existing tribal CACs and MDTs through TTA aimed at strengthening the team response to child abuse and implementing best practices. In addition, WRCAC continues to look for opportunities to strengthen the services provided to AI/AN children and families by CACs that are not tribal based. Additional strategies to support the field include providing training (in collaboration with our partners) to build the capacity of MDT professionals to provide a culturally appropriate, trauma-informed response to Native children and families, providing individualized TA to CACs, and offering training and peer learning activities and/or support to enhance or expand services for developing CACs. These activities may be offered as single opportunities or as a combination of instruction, peer networking and consultative support depending on the needs.
For more information and resources on the CAC and MDT response to child abuse in tribal communities, we encourage you to visit the following:










  • Recorded Webinar: Cultural Considerations When Working Within Indian Country Part 1 and Part 2



If you have any questions about increasing access to the CAC model for AI/AN children and families in your community, please reach out to me, Patty Terzian, at pterzian@rchsd.org.
[1] U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2010). Child maltreatment 2019. Available from https://www.acf.hhs.gov/cb/report/child-maltreatment-2019 
Patty Terzian
State Chapter Liaison
Western Regional Children's Advocacy Center
Patty Terzian joined the WRCAC team in April of 2018 and provides training and technical assistance to multidisciplinary team professionals throughout the western region. Prior to coming to WRCAC, she served for nine years as the Executive Director/Statewide Coordinator of the Oregon Network of Child Abuse Intervention Centers (now known as Oregon Child Abuse Solutions), the accredited state chapter of children’s advocacy centers in Oregon. She led the chapter through considerable growth and development and collaborated with professionals across the state to improve services for Oregon’s children when there were concerns of abuse. Patty has nearly twenty years of experience in the non-profit sector developing and directing programs, providing outreach and trainings, and managing grants. Patty’s skills in project coordination, communications and training were honed through her early-career work in both the non-profit and corporate sectors.
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WRCAC is funded through the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, Grant #2019-CI-FX-K002

The opinions, findings, and conclusions or recommendations expressed in this product are those of the authors and do not necessarily reflect those of the Department of Justice.