Treatment for American Indians and Alaska Natives: Considering cultural adaptations

American Indians and Alaska Natives (AI/ANs) are citizens of sovereign tribal nations and comprise 1.7% of the U.S. population. They represent a multitude of tribes and traditions and have endured genocide, forced assimilation and relocation by colonizers and the U.S. government. AI/ANs face significant health disparities, including increased rates of diabetes, PTSD, substance use disorders, infant mortality, and suicide. The U.S. has a responsibility to provide health care to AI/ANs based on agreements in which tribes ceded land to the U.S. government in exchange for health care, yet health services for AI/ANs remain chronically underfunded. What can therapists and researchers do to address these injustices? One urgent need is to ensure that available mental health treatment is appropriate for and acceptable to AI/ANs. Cultural adaptations of evidence-based treatments (EBTs) make important advances in this direction.