Exploring the Integration of Indigenous Healing and Western Psychotherapy for Sexual Trauma Survivors Who Use Mental Health Services at Anishnawbe Health Toronto Exploration de la guérison autochtone intégrée à la psychothérapie occidentale dans les cas de survivants de traumatisme sexuel qui ont recours aux services de soins de santé mentale d'Anishnawbe Health Toronto

Sexuality and sexual health represent contemporary areas of significant concern for Indigenous1 peoples in Canada, especially around the rates of sexual abuse and trauma, which remain significantly higher than in the non-Indigenous population (Native Womens Association of Canada [NWAC], 2007; Pearce et al., 2008; Statistics Canada, 2006). Negative health outcomes among Indigenous peoples relate to colonial policies that have both historically marginalized, and continue to marginalize, Indigenous peoples within Canada, including the Indian Act (relegating Native peoples to reserve lands, denying cultural rights and language), Bill C-31 (affecting Native womens Indian Status), the residential schooling system, and forced adoption through the Sixties Scoop (i.e., the shift in welfare policy from residential schools to foster care and adoption into non-Indigenous families) (Royal Commission on Aboriginal Peoples [RCAP], 1996). Historical traumas related to colonization have been referred to as a soul wound (Duran, 2006, p. 15) to Indigenous peoples, reflecting social issues related to economic insecurity, family violence, and mental health issues in many Indigenous communities (NWAC, 2007; Reading & Wein, 2009; Stewart, 2008, 2009).One of the more notorious colonial attempts at assimilation was the introduction of the residential school system, which sought to break down family structures, disrupt cultural teachings between generations (Hunter, Logan, Goulet, & Barton, 2006), and essentially kill the Indian in the child (Aboriginal Healing Foundation, 2006, p. 11). The residential schooling system removed well over 100,000 Indigenous children from their families between the years 1831 and 1996. Survivors of residential schools later came forward to reveal various traumas they endured while in these schools, including sexual abuse, beatings, punishments for speaking traditional languages, forced labour, and many others. Due to federal policies such as residential schooling, trauma is conceptualized as a collective experience within many Indigenous families and communities. As such, some authors have called for a broader understanding of trauma that moves beyond the individualistic focus that has been typical for psychological approaches in addressing trauma, in order to account for social contexts in the lived experiences of these individuals (Haskell & Randall, 2009).Mental health outcomes for survivors of sexual health traumas, including intimate partner violence, have been well outlined in the psychological literature. For instance, survivors of sexual trauma often face challenges in forming and maintaining intimate relationships and have relational difficulties generally (Baima & Feldhousen, 2007). Survivors also often experience fear, anger, shame, and guilt in the aftermath of their traumatic experiences, and they are more likely to engage in self-destructive and suicidal behaviours. Other common mental health outcomes for survivors of sexual trauma include posttraumatic stress disorder (PTSD), mood disorders (including depression and a range of anxiety disorders), and somatization disorders (Edwards, Freyd, Dube, Anda, & Felitti, 2012). In the available literature on mental health outcomes among abuse survivors and directions for mental health treatment, studies typically assume homogeneity in the abuse experience and do not differentiate experiences by ethnicity, class, and personal context (Phiri-Alleman & Alleman, 2008). Due to the collective experience of colonial and intergenerational traumas that have led to higher rates of sexual trauma among Indigenous peoples in Canada, authors have called for culturally appropriate methods of addressing the negative mental health outcomes of trauma survivors (Devries, Free, Morrison, & Saewyc, 2009; Farley, Lynne, & Cotton, 2005; Pearce et al., 2008).CONTEXT OF HISTORICAL TRAUMA FOR INDIGENOUS PEOPLESIndigenous scholarship emphasizes the need to situate sexual health issues for Indigenous peoples in Canada within the context of historical and collective trauma (Mehrabadi et al. …

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