Discussion Paper No. 7
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Published by:
Cooperative Research Centre for Aboriginal Health (CRCAH)
Authors: Alexandra
McEwan
Komla Tsey
Team Members:
Mary Whiteside, Janya McCalman, Yvonne Cadet James, Les Baird, Ruth
Fagan, Senimelia Kingsburra, David Patterson, Kayleen Jackson,
Bradley Baird, Andrew Wilson & Melissa Haswell
Program Manager:
Vanessa Harris,
Social and
Emotional Wellbeing Program
Partners Involved:
Gurriny Yealamucka Health Service
James Cook University
University of Queensland
CRCAH
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Summary:
This Discussion Paper presents the findings of the 2003 and 2005
Family Wellbeing (FWB) empowerment project evaluation in Yarrabah
in order to explore the role of spirituality in social and
emotional wellbeing from the perspective of an Indigenous
community. The findings demonstrate that a range of attitudes,
beliefs, values and behaviour associated with a contemporary
concept of spirituality are important personal resources that can
be drawn upon to facilitate improvements in social and emotional
wellbeing. The outcomes reported by FWB participants can also
be linked to several protective factors for suicide.
Background and Key Questions:
The connection between Indigenous Australian health and
spirituality is recognised in the national Social and Emotional
Well Being (SEWB) framework, which was put in place by the
Commonwealth in 2004. Since then, there has been little work done
which has focused on integrating spirituality into SEWB programs in
Indigenous communities. In the mid-1990s Yarrabah experienced a
series of suicides. One of the outcomes of this crisis was the
establishment, in 2001, of a partnership between the Empowerment
Research Program (James Cook University and University of
Queensland)) and Yarrabah’s Gurriny Yealamucka Health
Service. At that point the objective was to test the
appropriateness of the FWB empowerment program as a basis for
Gurriny Yealamucka’s newly established social health program.
The FWB program was conducted in Yarrabah and as part of the
project evaluation, FWB participants were interviewed to find out
what they got out of the course. Analysis of the 2003 interviews
revealed that spirituality was an important but contested
topic.
To explore this aspect of the project further, the researchers
focused on analysing the 2005 interviews with two questions in
mind:
- What is the most appropriate way to approach spirituality when
evaluating SEWB program outcomes?
- How can the results of SEWB programs be made more meaningful
within a population health framework?
Summary of Project
Implementation:
The data constituted 38 participant interview transcripts and
notes taken in focus groups. Analysis of the 2003 evaluation
interviews had adopted ‘empowerment’ as a conceptual
framework, with one of the emergent themes being spirituality. In
light of the 2003 results, the 2005 interviews were interpreted
using ‘spirituality’ as the analytical construct. The
themes that emerged from analysis of the interviews were then
explored to see how the outcomes reported by FWB participants, such
as better communication with family members, resonated with the
concept of spirituality. So as to capture all of the different ways
in which participants expressed their spirituality the researchers
searched health literature to find a concept of spirituality that
did not emphasise any particular religious tradition and which
acknowledged the land as sacred or of great spiritual significance.
As a result the findings were discussed as they related to five
themes: ‘meaning’, ‘transcendence’,
‘value’, ‘connecting’ and
‘becoming’ (Martsolf & Mickley 1998). The findings
were then interpreted and discussed in terms of how they relate to
suicide prevention and empowerment programs (such as FWB), which
contribute to population health outcomes.
Key Findings:
Participant feedback overwhelmingly indicated that positive,
though in some cases modest, changes had occurred in the way they
viewed and understood themselves, their loved ones and the
community. These self-reported changes included:
- Improved communication skills with loved ones, family and
particularly with children.
- Empathy, especially thinking about how other members of the
family or community might feel.
- Establishing a vision for the future and recognising personal
potential, eg formulating career or educational goals.
- Thinking more about fundamental values such as trust, courage,
hope and honesty and their influence in our lives.
- Some talked of a renewed sense of calm in their lives and not
getting angry as often as they did before completing FWB.
- Seeing ways of connecting with the past and finding new ways of
expressing the Indigenous spirit and of healing oneself.
- A better ability to reflect critically on oneself and
one’s life journey.
This Discussion Paper indicates that:
- The capacity for hope, empathy, a sense of connectedness and
respectful communication with loved ones are essential ingredients
in the ‘control factor’, a recognised psychosocial
variable in epidemiological patterns of disease. Increased control
and mastery means that people have greater capacity to deal with
the day-to-day challenges of life without being overwhelmed by
them.
- The task for the future is to continue to work in partnership
with Indigenous communities to strengthen both the sustainability
of empowerment strategies and their evidence base, with a
particular focus on the role of spirituality.
Timeline:
The FWB project started in 2001
and is ongoing. This Discussion Paper was published in March
2009.
Related Links:
McEwan, A & Tsey, K.
2009. The Role of Spirituality in Social and Emotional
Wellbeing Initiatives: The Family Wellbeing Program at Yarrabah -
Discussion Paper No. 7. CRCAH, Darwin.
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[Last updated 2.3.09]