Indigenous Model of Mental Health Care: an exploratory study of the therapeutic benefit of Aboriginal tradition healing combined with a trans-diagnostic CBT program for treating depression

The intervention will be delivered by qualified clinical psychologists and Aboriginal Traditional Healers. Treatment will consist of 10 - 12 sessions of transdiagnostic cognitive behavioural therapy (CBT) combined with traditional healing approaches. Trans-diagnostic CBT targets common cognitive, emotional, physiological, or interpersonal processes that underlie and maintain mental disorders, such as poor emotional regulation, behavioural and emotional avoidance and inflexible thinking. It uses a streamlined set of CBT techniques to target multiple problems based on an individual case formulation. For example, the approach can draw on activity scheduling and cognitive restructuring to manage depression, whilst also drawing on exposure to manage anxiety responses associated with trauma reactions. Aboriginal traditional healing aims to support the physical, social and emotional wellbeing of people. The traditional healers approach healing by observing, listening and touching. With massage and rubbing they release “blockages” from the body and apply various herbal tinctures and ointments where required. There is an understanding that the spirit can become dislodged through trauma, causing mental and physical disorders. Traditional Healers bring the spirit back into place. The first one or two sessions will involve the assessment by the psychologist of the cognitive and behavioural factors maintaining the disorder, and assessment by the traditional healer of the spiritual and wellbeing needs of the individual. These treatment sessions could last up to 90-minutes. The psychologist and traditional healer will then develop a tailored treatment plan, in consultation with the participant. Changes in symptomatology may warrant adjustments or changes to the treatment plan. 10 - 12 sessions will be provided. Transdiagnositc CBT Intervention Schedule: Week 1: Overall assessment this includes clinical history and history enough information for a clinical formulation Week 2: Feedback to the client, Psychoeducation about CBT. Commencement of Behavioural Activation and/or Relaxation Strategies. These are incorporated into in-between session practice. Week 3-5: Review of Practice and techniques, commencement of identifying links between thoughts, beliefs, emotions and behaviours. Week 6-8: Challenging thoughts, beliefs and behaviours (‘traps’) that are unhelpful and impact on negative emotions that are linked to depression and anxiety. During this process the client will become increasingly skilled at in identifying these traps and modifying these him or herself. Behavioural activation and relaxation is continues both in session and in between sessions. Week 9-10/12: Consolation of cognitive and behavioural techniques, Relapse management planning. Traditional healing sessions will occur concurrently with the transdiagnostic CBT sessions, and may occur before or after the sessions with the psychologist, depending on each participant's therapeutic treatment plan. The exact details of the traditional healing sessions will depend on the participants' needs, as assessed by the Traditional Healer. As outline above, Traditional healing aims to release blockages through massage and traditional bush medicines, and return the spirit to its rightful place. This traditional approach to healing is immersed in Aboriginal ways of being and cannot easily be explained through the scientific framework Western understanding demands. Nevertheless, increasingly across Australia, Aboriginal Traditional Healers are working alongside western doctors and other health professional to care for Aboriginal and Torres Strait Islander people.