Date of Conferral







Nina Nabors


The need for mental health service is increasing in American Indian/Alaska Native (AI/AN) communities. While research has examined the availability, access, and effectiveness of provided services to the AI/AN, very little is known about the influence of the attitude and perceptions of both clinicians and clients in their therapeutic relationship in the treatment process. Using the frameworks of liberation, oppression, and trauma theory, this qualitative phenomenological study explored mental health service delivery and utilization issues within an AI/AN community. Data were collected through semistructured interviews with 14 clinician and client participants. The data were sorted into themes and subthemes and analyzed using the NVivo 11 computer software. Intergenerational struggle represented the primary theme and other subthemes such as assimilation, acculturation, and communication were among some of the secondary themes gathered from the data. Analysis of the themes provided greater insights into the dynamics of the participant's lived experience in various organizational structures within the larger community as well as a better understanding of mental health service delivery and utilization in maintaining sobriety in their daily struggles. The results indicated that intergenerational struggle along with other environmental factors were the chief causes of their cyclical journey through the penal and other systems; thus reducing their ability in maintaining longer sobriety and in improving their mental health. The implications for positive social change in this study include the reduction of stigma associated with these health issues through the education of the community and in training clinicians in factor-specific issues impacting life altering critical events in AI/AN struggles.