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Questions: 1. The reluctancy to accept the idea that Indian culture and spirituality may be important to the prevention and treatment of alcohol problems can be explained by what two reasons? 2. What are four key protective factors that contribute to resiliency in the face of historical trauma and other socio-ecological risk for alcohol abuse and suicide? 3. What is an important element of the White Mountain Apache Tribe (WMAT) suicide prevention program? 4. What are four recommendations to improve current treatment programs? 5. What four aspects of the whole person does the Medicine Wheel focus on? 6. What is a major factor that needs to be considered when evaluating culturally competent substance abuse prevention programs in rural Indian communities?

Answers: A. Every suicidal youth reported to the system receives rapid follow up by the Apache community workers, typically in their homes. B. Full continuum of care that is culture-based as well as age and gender focused, more treatment slots available throughout the statem culturally-competent staff, and Institutions for Mental Diseases (IMD) waiver that allows the utilization of tribal Chemical Dependency (CD) facilities. C. Non-Indian views of the psychology of behavior are primarily secular and, for the most part, relegate culture to a peripheral role and methods to measure spirituality, cultural beliefs, and values have not been well developed, hindering scientific study in those areas. D. Spirituality, physical, mental/emotional, and social/cultural. E. Evaluations must be conducted by culturally competent researchers. F. Attachment, mastery and self-control, sense of belonging (i.e., social connectedness), and spirituality.

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