1. According to the authors, American Indians and Alaska Natives have consistently experienced serious health disparities, which include each of the following EXCEPT:
A. They face disparities in access to services, funding, and resources as well as quality and quantity of services, treatment outcomes, and health education and prevention services B. They face a higher burden of illness, injury, disability, and mortality compared to other underrepresented groups C. Acceptability of behavioral health services is a major barrier to recovery for American Indians and Alaska Natives, and this may be impacted by cultural responsiveness of services, treatment settings, geographic locations, and tribal affiliations D. Common factors that influence engagement and participation in services for this population include availability of transportation and childcare, treatment infrastructure, level of social support, perceived and provider effectiveness2. Which of the following is a correct statement about behavioral health issues facing American Indians and Alaska Natives?
A. Genetic factors unique to Native Americans are associated with high rates of substance use B. Suicide and suicide attempts are a significant problem in many American Indian and Alaska Native communities, and young women ages 25–32 are the most impacted by this C. American Indians and Alaska Natives are less likely to drink than White Americans, however, those who do drink are more likely to binge drink and to have a higher rate of past-year alcohol use disorder than other racial and ethnic groups D. These populations tend to experience depression at a higher rate than other Americans, but are less likely to experience anxiety disorders3. Most American Indians and Alaska Natives believe that at the heart of substance use and mental disorders within their communities lies which of the following factors?
A. Historical trauma B. Genetic causes C. Environmental stressors D. Lack of social support4. Among many Native Americans, substance abuse is seen as a symptom that reflects an imbalance in the individual’s relationship with:
A. His/her spirituality B. The culture C. The world D. Him/herself5. Treatment providers in native and non-native programs need to understand the role of the governance system in treatment referrals as well as tribal:
A. Dominance B. Jurisdiction C. Ascendancy D. Sovereignty6. Culturally responsive services offer clients a chance to explore the impact of various experiences and how these experiences relate to their behavioral health, including the impact of culture, history, discrimination, bias, and:
A. Self-esteem B. Acculturation C. Perceptions D. Connections7. To American Indians and Alaska Natives, healing is intuitive, it is interconnected with others, it comes from within, from ancestry, from the environment, and from:
A. Stories B. Visions C. Dreams D. Ceremonies8. Which of the following is NOT an accurate statement about how the circle is symbolized in American Indian and Native American Culture?
A. Among native cultures, all of life, seen and unseen, moves in circles and cycles B. The circle symbolizes a key philosophy for understanding the relationship of people to everything in their environment and represents many things to American Indians and Alaska Natives C. It represents the circle of life, the seasons, and unity and harmony among all creation D. The importance of striving for energy and fruitfulness is incorporated into the circle9. Cultural knowledge, including awakening, newness, and understanding occurs in the southern experiences of the circle.
A. True B. False10. In 1830, the Indian Removal Act was passed to force American Indians to relocate west of the Mississippi River so that they could be more readily assimilated into mainstream culture and become more:
A. Homogenized B. Civilized C. Accepted D. Natural11. In the late 1800s through the mid-1900s, American Indian and Alaska Native children were removed from their families and forced to attend boarding schools, which prevented the transmission of tribal culture, language, traditional parenting skills, and:
A. Stability and bonding in a safe environment B. An alliance where parents and children could reinforce their importance to each other C. Naturally occurring patterns of family socialization D. Continuity between parent-child interactions, values, and beliefs12. In the late 1960s and 1970s, the new watchword of policy toward American Indians and Alaska Natives became:
A. Self-efficacy B. Autonomy C. Persistence D. Self-determination13. In 2013, The Violence Against Women Reauthorization Act was passed to grant federally recognized tribes jurisdiction over protective order violations, domestic violence, and dating violence that occur on tribal lands.
A. True B. False14. The cumulative emotional and psychological wounding across generations, including the lifespan, which is known as historical trauma, emanates from:
A. Foundational Crises B. Massive group trauma C. Institutional repression D. Societal distress15. Historical trauma may involve events that happened hundreds of years ago or more recent traumatic events and it may impact the way that American Indians and Native Americans experience:
A. Grief B. Relationships C. Safety D. Identity16. In addition to historical trauma, factors that may affect the psychological development of children and increase their risk for problems such as PTSD and substance abuse include parental illness and:
A. Lack of proper emotional support B. The breakdown of the family C. Multiple family transitions D. Inadequate family resources17. Each of the following is an accurate statement about the economic and social conditions of American Indians and Alaska Natives EXCEPT:
A. According to the 2018 Census Bureau, 25.4 percent of American Indians and Alaska Natives were living in poverty, compared with 13.4 percent of the total population B. Unemployment is high among American Indians and Alaska Natives, although the rate is lower for Native Americans living on reservations and other tribal lands, than for those living away from the reservation C. American Indians and Alaska Natives have a high rate of homelessness D. Compared with the general population, American Indians and Alaska Natives are less likely to graduate from high school or to have an equivalency, bachelor’s, or advanced degree18. Compared with every other major racial or ethnic group, Native Americans are more likely to experience violence from members of other racial or ethnic groups and are more likely to experience violence from:
A. Members of the same sex B. Members of the opposite sex C. Strangers D. Acquaintances19. American Indian and Alaska Native men and women are more likely to report having experienced domestic violence than are men and women from other racial/ethnic groups, and unlike other types of violent crime, domestic violence toward Native Americans is generally committed by other Native Americans.
A. True B. False20. Researchers have found that a stronger connection to one’s traditional native culture or to certain parts of it can be a protective factor against some mental and substance use disorders, and this may be affected by place of residence and:
A. Gender B. Age C. Genetics D. Level of support21. In the cycle of assimilation and reconnection, individuals who may live in or near native community or migrate back and forth between native community and urban areas and who participate in both traditional and non-native activities are said to be at which phase of the cycle?
A. Bicultural B. Collective C. Interconnected D. Enculturation22. Native traditions teach that all things have life and deserve respect, and they traditionally believe in the importance of balance and harmony at all levels of life, including:
A. Cognitively, spiritually, and subjectively B. Emotionally, physically, and worldly C. Internally, socially, and naturally D. Personally, jointly, and environmentally23. Which of the following are NOT primary values shared among the five major Alaska Native cultures?
A. Show respect to others, share what you have, and know who you are B. Accept what life brings, have patience, and live carefully C. Take care of others, honor your elders, pray for guidance, and see connections D. Practice honesty and integrity, appreciate and honor women, and value the sacredness of life and intention24. Although American Indians and Alaska Natives today are more likely than members of other groups to face a host of problems, they continue to be a resilient people who can draw on the strength of their cultures, communities, and families to help face these problems.
A. True B. False25. Those who are culturally aware examine how their own definitions of normal and abnormal behavior, behavioral health, and recovery from behavioral health problems are impacted by their:
A. Beliefs, experiences, and biases B. Values, knowledge, and environment C. Histories, encounters, and lifestyle D. Perceptions, practices, and principles26. Within a treatment setting, the third step for cultural awareness is evaluating how inadequate treatment of American Indian and Alaska Natives clients can be impacted by:
A. Lack of awareness of individual distinctions B. Misconceptions related to values, beliefs, and norms C. Misunderstandings created by cultural differences D. Misjudgments about behavioral cues and practices27. The term used to describe brief, everyday slights, insults, snubs, derogatory statements, or indignities that communicate hostility or negative, judgmental messages to a person in a marginalized group based on his or her race, ethnicity, religion, nationality, sexual orientation, gender expression, gender identity, disability, age, socioeconomic status, or other identity characteristics is:
A. Fractal harassment B. Subtle hostility C. Understated persecution D. Microaggression28. In the context of developing culturally responsive attitudes and behavior, an explanatory model calls for:
A. Devoting time to understanding how clients perceive their presenting problems, how these problems are understood in American Indian and Alaska Native cultures, and how healing takes place B. Appreciating that clients may have different expectations about treatment C. Eliciting clients’ concerns and apprehensions about entering a treatment setting and about the behavioral health system D. Committing to behaviors that enhance the therapeutic relationship29. Research and clinical experience suggest that American Indians and Alaska Natives respond poorly to providers who try to instruct them on how to behave, but tend to respond well to providers who share their own experiences, use stories, and give examples of how behavioral change:
A. Can be made in small increments B. Has helped in their own lives C. Can lead to positive outcomes D. Has helped others in similar situations30. Concepts of health and illness for these populations include that health is viewed holistically, illness effects the community as well as the individual, being healthy means living in harmony and balance, and illness may be:
A. Unnecessary and avoidable B. Inevitable and justified C. Shameful and immoral D. Purposeful or personified31. Behaviors that mainstream providers might label as symptoms of mental illness, such as hallucinations or manic symptoms may be seen among American Indians and Alaska Natives as:
A. The manifestation of spirituality B. The expression of special gifts C. A necessary part of the healing process D. Mystical encounters32. Traditional healers may look at someone who would be diagnosed with depression and view the same symptoms as problems stemming from unbalanced relations with family or community or from:
A. The intervention of a dead ancestor B. Imbalance in the body C. Breaking a taboo D. Bad luck due to external factors33. Binge drinking among American Indians and Alaska Natives largely reflects the drinking patterns to which they were first exposed when alcohol was introduced to their cultures through the drinking patterns of White American frontiersmen, fur traders, and others.
A. True B. False34. Although it may be easy to mislabel clients’ reluctance to use mental health services as treatment resistance or the result of prejudice against people with mental illness, reluctance may actually result from:
A. Well-grounded, historically based mistrust in outside institutions B. The desire to avoid culturally homogenous mental health care C. Previous negative experiences, including misdiagnosis D. The lack of accurate information about the assessment and treatment process35. In order to support healthy communication with American Indian and Alaska Native clients, the authors recommend each of the following EXCEPT:
A. Listening, respecting silence, and adjusting eye contact B. Observing nonverbal communication and valuing linguistic preferences C. Using hopeful language and avoiding labeling D. Being and active speaker and listener and being open36. Providers need to understand that native communities believe that the pathway to prevention and healing is:
A. Cultural history and traditions B. Cultural knowledge and practice C. Cultural significance and understanding D. Cultural principles and ideals37. Key considerations when planning services with American Indian and Alaska Native clients include obtaining their perceptions first, assessing critical identity, exploring their treatment goals, and:
A. Being open to discussing ethnicity and cultural differences B. Paying particular attention to the role of the family C. Engaging traditional healers in treatment D. Maintaining a supportive and non-judgmental atmosphere38. When adapting motivational interviewing for Native American cultures, specific strategies include:
A. Having clients create personal stories for each stage of change and presenting stages of change model as a circle B. Recognizing cultural differences in hierarchy, dynamics, and history C. Designing reinforcements specific to community needs and with governance input D. Avoiding overuse of a very directive approach, and instead, assuming the honored role of consultant and provider of resources for the client39. During the treatment process, it is important not just to ensure support, but also to explore potential conflicts and minimize exposure, particularly in the early stages of recovery from substance abuse or mental distress.
A. True B. False40. One way to build relationships in Native American and Alaska Native communities is to learn from elders and to listen without:
A. Questioning or leading B. Interruption or imposing timelines C. Judgment or predetermined expectations D. Providing feedback or sharing41. While many native people are seeking emotional, mental, and spiritual healing for past abuses and traumas or for the pain that they are carrying as a result of what generations of their families went through, according to the authors, others are hoping to heal from the separation from family and culture that has resulted in:
A. Difficulty recognizing and expressing emotions B. Unresolved grief C. Loss of identity D. Hopelessness and helplessness42. Which of the following is NOT a correct statement about the Smudging Ceremony in the native tradition?
A. An abalone shell, sage, and matches are materials used for smudging, which involves prayer, burning a small amount of an offering, and using the smoke to purify the people and space B. The smoke serves as a symbol of advice or protection from a guardian spirit C. The holder of the shell or bowl approaches each person present, who may choose to draw the smoke toward his or her body, his or her heart, and over his or her head D. The purpose is to clear away bad spirits and energies and dedicate what happens in the space to the Creator43. Reflective listening is a skill that requires active silence, attending to the story of the person sitting with you, listening for what is not being said but implied, checking out your reflection to make sure it matches what your client is trying to say, and:
A. Approaching every client with empathy B. Demonstrating authentic connection C. Listening without reacting or judging D. Putting what is being said by the client in context of the client’s situation44. A key strategy in CBT is helping people explore the meaning of their experiences, difficulties, or verbal expressions, which is referred to as “distinctive” or “respective” meaning.
A. True B. False45. Wellness courts are a component of the tribal justice system that incorporate and adapt the wellness concept to meet the specific substance abuse needs of each tribal community, as they provide an opportunity to address the devastation of alcohol or other drug abuse by establishing:
A. Community safety and a greater quality of life B. Effective interaction and the use of resources C. Structure and a higher level of accountability D. A holistic and inclusive approach to well-being46. In Native American and Alaska Native cultures, emphasizing and safeguarding the clients’ strengths is essential in healing and recovery, and focusing on strengths-based practice requires changing the script, internal dialog, or focus to:
A. Match the client’s vision of recovery B. Allow for change and growth C. Remember something positive from the past that had provided comfort or healing D. Attach meaning to circumstances and experiences47. The Stages of Change model incorporates four stages from precontemplation to action, where decisions and change behavior are:
A. Static B. Linear C. Predetermined D. Able to move back and forth among stages48. When working with these populations, it is critical to take cultural cues from clients, to be welcoming toward them, and to conduct sessions and assessments in an open-ended, relational style to encourage an engaging connection.
A. True B. False49. Simply looking at a problem is not enough for clients to make a difficult change, but rather it is essential to acknowledge how the issue interferes with well-being and stops clients from:
A. Re-establishing their true identities B. Living their values C. Fully connecting with their families, communities, and traditions D. Developing and maintaining resilience50. In American Indian and Alaska Native communities, even in urban areas, it is common that a provider will have multiple connections or relationships with a client besides the professional relationship, and when this happens, it is important that the provider makes use of clinical supervision to discuss and clarify boundaries and to assure the client of confidentiality.
A. True B. False51. Each of the following is an accurate statement about the how the “circle of gifts” can be used in healing EXCEPT:
A. It can be easily incorporated into family programming to help parents share stories with children about traditional ways and values B. It can be used to discuss how traditional ways provide lessons on how to cope with life circumstances C. This exercise can easily be adapted as a group activity in treatment, whereby clients complete, share, and process their circle within the group or community D. It provides an opportunity to gain wisdom that can be shared with others outside of the community52. Honoring Children, Making Relatives is a cultural adaptation of Parent-Child Interaction Therapy that supports traditional native parenting practices and values, focuses on parents who have difficulty with parenting skills or with addressing their children’s problematic behavior, and incorporates an essential native belief that:
A. Children are the responsibility of the entire community B. Children must be given security and a sense of belonging C. Children are the center of the circle D. Children are perceived as how they function in social context rather than as individuals53. The native belief that helps maintain peace or decreases conflict within the family and community, reinforces the importance of interdependence and autonomy, and allows people to learn from their own actions is known as:
A. Noninterference B. Individual responsibility C. Self-determination D. Natural choice54. As a provider, it is important to match the language and the words used by the client, as beliefs and the expression of those beliefs are often different from one individual to another because they are influenced by life experiences, family upbringing, elders, and:
A. Piety B. Outsiders C. Spirits D. Nature55. Role reversal can be a powerful counseling tool in a group setting, as it can help manage the intensity of the experience by removing the group’s focus from the client, and it allows the client to see a different perspective while leading to:
A. A reduction in conflict B. The practicing of new behaviors C. More compassion and awareness D. The strengthening of relationshipsCopyright © 2024 Mindful Continuing Education
Visit us at https://www.mindfulceus.com