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The Medicine Wheel as a Holistic Model for Social Work Practice

Values and norms transmitted through this symbol system

The Medicine Wheel as a Holistic Model for Social Work Practice

The Medicine Wheel has been described as a circular template that can provide both understanding and direction for those seeking to restore balance and harmony in their lives (Nabigon, Wenger-Nabigon, 2012, p. 48). "It is a rich resource that can bridge differences in worldviews and act as a spiritual map to heal people …" (Mawhiney, Nabigon as cited in Turner, 2011, p. 15).

Every culture uses symbols to represent ideas which are common throughout the culture. For example, the dove is a symbol of peace in many cultures. In some Indigenous cultures the Raven is revered while in others, it is the Eagle. Indigenous cultures are characterized by highly structured symbol systems that mark an individual's journey through the life cycle. Important events such as birth and death, grieving and healing are also intertwined with environmental forces acknowledging that the relationship between human and environment is considered symbiotic. The elements of an Indigenous symbol system usually appears in fours. There are the four colours of the Medicine Wheel, the Four Directions, the Four Aspects of Balance (physical, mental, emotional and spiritual) and the Four Races of Mankind which are represented in the colours of the Medicine Wheel. For the purposes of this course, the Medicine Wheel becomes a guide for the Four Doorways of your educational journey.

Activities for healing within the Medicine Wheel Model include: the use of Indigenous language, membership in a Healing Lodge, Healing Circles, participation in Sweat Lodge ceremonies, Pipe ceremonies, use of the Four Sacred Medicines (Keezhik (cedar), Shkodawabuk (sage), Semaa (tobacco), Weengush (sweetgrass)), smudging, Sunrise ceremonies, Naming ceremonies, Powwows, fasting, feasts, giveaways, visioning through dreams, mourning rituals/ceremonies and other traditions that may be specific to different belief systems.
Values and norms transmitted through this symbol system and these activities include but are not limited to:

Reinforcement of communal cohesion
The environment as a living system with sacred meaning
The value of Elders as resources of traditional knowledge
The belief in a higher being
The perception of children as gifts
The importance of the family/kinship system
The reinforcement of cultural identity
The expression of feelings of belonging
The Medicine Wheel as a model for holistic social work practice is inclusive of these elements and activities. 

Take the time now to read the following:
Nabigon, H.C. & Wenger-Nabigon, A. (2012). 'Wise Practices': Integrating Traditional Teachings with Mainstream Treatment Approaches. Native Social Work Journal, 8, 43-55.
Holism in the Indigenous Symbol System: The Healing Circle
The symbol system and activities which exist within holistic Indigenous traditions act as guides for healing goals, confidentiality, protocols, group processes and relationship building. In this way a holistic framework can be operationalized within the context of a Healing Circle.
The Healing Circle is an example of the holistic Indigenous worldview in practice. Its Four Directions encompass the Four Elements of wellbeing which all must be in harmony for a person to be considered healthy: physical, mental, emotional and spiritual health.

Activities for healing within the Medicine Wheel Model


When the Healing Circle is used as a healing tool, all Four Elements must always be addressed. It is impossible to consider one element in isolation from the rest, unlike many mainstream therapies, in which mental health is often considered separately from physical health and in which the spiritual is rarely taken into consideration; the only way to apply the Healing Circle as a healing method is through a holistic approach.


We will now consider the article, The Circle of Healing by J. Stevenson. As you soon progress through the reading, you should attempt to identify elements of the symbol system, healing activities and values evident in, the Circle of Healing.


This article is a good example of how Indigenous social work practitioners are using traditional practices in order to reconnect Indigenous peoples and connect non-Indigenous peoples to a symbol system which promotes learning, growth, nurturance, positive cultural identity and balance.


Stevenson indicates that there is another reality of the helping relationship contained in the values of the Circle. The social worker who is considering joining a Circle in which their clients may also be participants must realize that the Circle process redefines the helping relationship in cultural and spiritual terms. One might say that within the Circle a cultural ecology exists which redefines the role of helper from a spiritual dimension.


The presence in the Circle of the Grandfathers and Grandmothers and other 'spirit helpers' is an important part of the healing environment. All participants, including the worker are considered equal in the Circle.


Stevenson indicates that worker and client boundaries undergo some fundamental changes within the Healing Circle. In the holistic framework of helping, the distinctions between client and worker are eliminated as both are expected to participate as members of the Circle. For social workers who may want to utilize or refer clients to Healing Circles, this is an important issue in accepting that traditional Indigenous forms of group processes do not fit the person-in-environment view but more accurately, reflects a concept of healing-in-environment.


The Healing Circle is an open system in which the participant process is not directed or dominated by a group facilitator, people are not required to share their feelings if they choose not to, and members are still considered to be participating by sitting quietly in the Circle. When Stevenson describes the Circle as being closed it means that all sharing is bound by strict confidentiality. All statements are to remain within the process of the Circle and are closed to outside discussions.

Holism in the Indigenous Symbol System: The Healing Circle


Another cultural difference which redefines the helping relationship is the group process within the Circle. Most mainstream literature that describes group process focuses on fostering an interactive atmosphere between group members. Within the Circle the principle of non-interference is valued through non-coercive and indirect helping which respects the participant's autonomy. Active listening, reflection and body language are aspects of interactive support which are often evident. Group facilitator skills such as encouraging, sharing, directing, validating, positive feedback, clarifying and summarizing feelings are not overly present in the Circle process. The context of healing is one where the helper and the person receiving the support are involved in a shared experience of learning and growth.


As you read this article, carefully consider and identify the goals and protocols of Healing Circles. In addition, familiarize yourself with the process Stevenson describes for Healing Circles as well as the aspects of the healing process she describes. You are encouraged to make notes on the above information as it will facilitate your understanding of Healing Circles within a holistic framework of social work practice. 


Take time now to read the following article:


Stevenson, J. (1999). The Circle of Healing. Native Social Work Journal, 2(1), pp. 8-21. 
The following reading focuses on individual social intervention through the development of a person's self-care plan called, My Wellness Wheel. It identifies that the concept of the Medicine Wheel as an approach to helping has significant relevance in today's society (2006).  The Stevenson article and the Loiselle & McKenzie articles provide a specific insight into social work practice that is guided by the Medicine Wheel.

Take time now to read the following article:
Loiselle, M. & McKenzie, L. (2006, May 27). The Wellness Wheel: An Aboriginal Approach to Social Work. Retrieved from


Aspects of the Healing Process

Indigenous healing processes stress that it is important to move forward with one's life. Letting go of the past and strengthening a person's coping capacities is emphasized through personal connection to others, decreasing isolation, practicing healthy lifestyles, and spiritual growth. Indigenous healing methods possess curative possibilities for a variety of problems affecting the physical, mental, emotional and spiritual aspects of a person's life.
"It is hoped that the participant can make the changes necessary through group support for recovery from personal problems and maintenance of healthy lifestyles" (Regnier, 1994, p. 131).


Holism as Pedagogy: The Teachings as Learning Theory

The Circle of Healing


Indigenous knowledge is increasingly being used as a foundation for restoring balance and a renewed commitment to Indigenous communities. The cultural ecology of many Indigenous communities remains strongly attached to a distinct Indigenous worldview. Governmental attempts at assimilation which sought to eradicate the very foundations of Indigenous identity have for the most part failed. However, the legacy of colonization, oppression and isolation, have created social problems which continue to plague Indigenous communities. Today, a resurgence of interest in traditional healing practices is occurring in Indigenous communities across Canada.
In many ways the revitalization of traditional knowledge reflects what Regnier (1994) described as a "… process pedagogy of healing." "Within this framework issues associated with physical, emotional, spiritual and mental difficulties are viewed holistically" (p. 132). The holistic symbol system encompasses the relationship and interdependency between the micro, meso and macro systems which affect the lives of Indigenous peoples.
The ecological model or person-in-environment worldview can be used to account for cultural variations and environmental influences (Compton & Galaway, 1995; Devore & Schlesinger, 1996).
The relationship between western theories of helping and the Indigenous theory of healing is often described as a wide gulf in terms of acceptance and understanding. In addition, paradigms within social work education often reflect a secular perspective, while Indigenous curriculum content does not constitute a distinct sub-discipline in most undergraduate or graduate schools of social work.


There is increased interest within Canadian schools of social work to devote more attention to the integration of Indigenous content into educational curricula.


Innovative and creative approaches to helping must move beyond the generalist model of education and explore more substantially the role that culturally distinct helping practices play in assisting Indigenous communities. New collaborative partnerships and training opportunities for Indigenous and non-Indigenous social work practitioners are required in order to meet the challenging demands on the profession. In many ways, the vision for helping and self-determination are not exclusive to the Indigenous social worker.


It is an important principle that Indigenous knowledge be respected not only as a healing science, but that its role and purpose in strengthening communities be viewed from the perspective of Indigenous rights. Self-determination and cultural preservation are often used as interdependent concepts when describing community healing efforts being undertaken by many Indigenous populations across Canada.
The analogy of the Two Row Wampum acknowledges the reality of respectful partnerships.


Considerations for Cross-cultural Communication


The goals and protocols of Healing Circles

As social workers seeking to improve cross-cultural communication, there are steps that offer guidance. It is important to note that the social work profession is not alone in its desire to improve cross-cultural communication. Many business and educational institutions have developed strategies to build cross-cultural communication through the provision of education designed to enhance cultural sensitivity and communication skills. There is a growing realization that communication behaviours are in response to the identity and the culture people have grown up in (State of Massachusetts, n.d.). 

Take the time now to read the following:
AuCoin Lee, S. (1997) Communication styles of Wind River Native American clients and the therapeutic approaches of their clinicians.In Smith College Studies in Social Work, 68 (1), 57-81.
Available through the JND Library.
If you are trying to access this resource from off-campus, you may be required to follow these steps:
1.Visit the Laurentian University Library website.
2.Search the Catalogue for the name of the journal; in this case, Smith College Studies in Social Work.
3.Select “Scholars Portal.”
4.Use your Laurentian University login information to sign in to the database.
5.Using the additional information provided about the article (year, volume number, issue number, etc.), search for the desired article. In this case, the article was published in 1997 and the volume and issue numbers are 68(1).   
This article will provide insight into a therapeutic model that AuCoin Lee's study identifies as conducive to practice with Native clients.
Steps towards Effective Cross-Cultural Communication
AuCoin Lee's study highlights a number of differences between the communication styles of Native and non-Native peoples. They include:
Degree of eye contact
Expression of emotion
Spirituality and communication
Self in relationship to others
Communication about family
How problems are described
AuCoin Lee makes connections between her Halcyon Model and an eclectic mix of several mainstream helping theories. These connections will facilitate increased understanding of how theories can be integrated into practice

Verbal and Non-verbal Communication
Communication, both verbal and non-verbal, can provide valuable clues to furthering effective communication approaches. Workers must be highly observant as well as knowledgeable of intrinsic cultural aspects. For example, in some tribal groups asking direct questions is considered rude. As well, there may be no rule which obliges a person to answer a question when asked. For social workers who have been trained to ask questions and complete copious forms requesting information based on the responses to questions, this can be frustrating.
Listening is a powerful form of communication. Active listening is a holistic approach to communication that occurs spiritually, emotionally, mentally and physically. When social workers are engaged in active listening, they are fully present and able to hear people's stories and thus gain valuable insight into the identity of those they are working with. For example, through active listening, workers may receive firsthand knowledge of trauma and loss experienced by someone who attended residential school. In addition, the impact of colonization may become very real when heard through the stories of those who continue to deal with such realities as the Indian Act, high poverty rates and economic intrusion pertaining to resources. Such information generates awareness, ensuring that social work practices are respectful of the shared stories. As a worker who is listening to individuals, it is important to recognize that shared stories are a 'gift.' They are foundational pieces of effective cross-cultural communication.
Cultural Diversity
The diversity within various Indigenous cultures provides valuable direction as each one has a distinct way of interpreting their world according to their traditions and beliefs (Rice, 2005, p. 16). Therefore, there is recognition that cultural mores within different Indigenous peoples will reflect their individual ways. This requires communication that is mindful of those cultural nuances, such as respectful ways to make introductions and ask questions (Nash, Munford, O'Donoghue, 2005, p. 148). Taking the time to become culturally aware and knowledgeable provides an opportunity for relationship building that is reflective of those engaged in the helping process. I have witnessed this in other interactions where cross-cultural communication also recognizes the communication process between different Indigenous groups such as Oji-Cree in northwestern Ontario and Ojibway on the Bruce peninsula. For example, at a meeting of Elders from different geographic locations and different cultural practices, initial interaction was both respectful and unhurried. Communication was not a power struggle but one that was based on equality (Morrisseau, 2010, p. 103). It was a poignant reminder of the details within communication that are indicative of identity within all peoples. The Elders in this example established an atmosphere of trust that was sensitive to their cultural norms (AuCoin Lee, 1997, p. 22).
Cross-Cultural Communication in Relation to the Therapeutic Relationship
In the Southern Doorway the relationships of all beings are acknowledged. There is a recognition that relationships are reciprocal and are necessary to maintaining harmony and balance (Rice, 2005, p. 25). Balance and harmony can be threatened in many ways such as the use of language.
Rupert Ross, in his book, Returning to the Teachings, describes the English language as largely judgemental and argumentative. This is due, in large part for example, to adjectives that are not so much descriptive of things as much as they are conclusive about things; as an example, an adjective such as 'horrible' (1996, p. 102).  This is a concern when taking in to account the impact of such words on those who come from another culture. Non-Indigenous workers must strive to find ways of exchanging information that honours different communication responses (p. 103).

A Social Worker's Responsibility for Self-Reflection through the Seven Grandfathers Teachings
Module 3 of the Southern Doorway introduced the ITP Loop – the integration of theory and practice. With the loop, reflection is identified as an important component within this model of practice. As a social worker, reflection is in keeping with the Seven Grandfathers Teaching of Respect, Mnaadendiwin. This teaching asks us to look at things twice and, as a social worker, it serves as a reminder that careful consideration of the many aspects of practice requires a reflective continuum. For example, workers must reflect on their own cultural context and ask themselves if they are making assumptions within their practice based on their own cultural assumptions. Such assumptions could be damaging without self-checking. Therefore, workers must be guided by the Seven Grandfathers Teaching of Honesty, Gwekwaadziwin. By doing so, they take an inward journey as they gain Wisdom, Nbwaakaawin, about their own strengths and weaknesses (Rice, 2005). This requires Bravery, Aakde'win, in order to do so with Truth, Debwewin.
As social workers reflect on their practice, there is a need to do so with an awareness that the historical involvement of their profession in areas such as child welfare is firmly rooted in colonialism. Many of the people they work with will have either direct or intergenerational experiences pertaining to social work practices that have been negative in nature (Sinclair, 2004). Historically, social work practice has been Eurocentric in design and social workers have applied theoretical approaches that have been reflective of those values and mores. The vast array of social work knowledge that has its roots in Eurocentric approaches gives further cause for social workers to reflect on how they can organize such information in a meaningful way (Mullaly, 2007, p. 226). Theoretical frameworks or paradigms (see Module 1) can facilitate this sorting of information. Responsibility for self-reflection then occurs, with a knowledge that there are differing theoretical explanations with unique perspectives of the social world (p. 277). Therefore, reflection becomes an integral step as workers consider how to reflect on cross-cultural approaches in their practice when Eurocentric approaches are so dominant.
Social work has tended to assume that the helper, not the client, has the right to define the problem and decide on the solution, regardless of the client's culture or class. The emphasis on a social issue as a problem deviates from the Indigenous perspective of a social issue as a need for healing. As a social worker, there is a need to find balance between two ways of knowing.
In 1984, Jurgen Habermas described these different attitudes as 'incompetent communication' between the partners in the therapeutic relationship. According to Habermas, communication between people becomes distorted and therefore, ineffective, in two ways: first, when power relations between the two are unequal so that the opinions and ideas of one carry more weight than those of the other; and second, when the speakers are communicating from two different perspectives or worldviews (Habermas, 1984).
Workers must focus on the Seven Grandfathers Teaching of Humility, Dbaadendiziwin, to ensure that their relationship with a client comes from an equal place. This also emphasizes the Seven Grandfathers Teaching of Respect, Mnaadendiwin, recognizing that the helper and client must be able to discuss where each of them is coming from.
Responsible reflection is motivated by the Seven Grandfathers Teaching of Love, Zaagidwin, honouring the relationships within the Southern Doorway.

Assignment question 
In Module 4, the Nabigon and Wenger article, Wise practices: Integrating traditional teachings with mainstream approaches, provides approaches to healing in First Nations communities as well as off-reserve settings.
Write an essay discussing how mainstream social work theory and practice must be adapted in order to truly reflect "Wise Practices" from an Indigenous perspective.
In writing this essay, include references to the readings included in Module 4 and Module 5.
This essay should be 6  typed, double spaced pages in length. Use APA referencing. Reference and content pages are not included in the 6 page typed. 

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