Honoring children, making relatives: Indigenous traditional parenting practices compatible with evidence-based treatment

Describes how the Indian Child Trauma Center transformed evidenced-based Parent-Child Interaction Therapy (PCIT) protocols to be responsive and honor American Indian/Alaska Native traditional beliefs of both well-being and appropriate parenting practices.

By Dolores Subia BigFoot, PhD, and Beverly W. Funderburk, PhD

Cultural/historical background

The Indian Country Child Trauma Center designed a series of American Indian and Alaska Native (AI/AN)1 transformations of evidence-based treatments. Parent-Child Interaction Therapy (PCIT), an effective treatment model for parents who have either difficulty with appropriate parenting skills or children with behavior problems, was examined within the cultural framework of AI/AN parenting teachings. Honoring Children - Making Relatives, embeds the empirically based, assessment driven PCIT model within a framework that honors AI/AN traditional beliefs of wellbeing and parenting practices.

Present day disparities within AI/AN populations can be traced to changes in the political, economic, social, cultural, and spiritual pathways that previously served to hold tribal or village groups together and provided the structure for family relations and social order. Boarding schools, missions, military conflict, broken treaties, oppression, exploitation, and removal undermined the structure of that order. Major concerns remain about the ability of vulnerable AI/AN parents to parent their children in a stable, healthy, non-violent environment.2 Honoring Children - Making Relatives recognizes the old wisdom that was applied to parenting and family relationships for many generations, the teachings and practices that were interrupted when the structure of the Indigenous social composition was almost destroyed.

Examination of components of traditional parenting practices reveals that PCIT, an evidence-based treatment which combines elements of social learning, family systems, and play therapy techniques, actually reflects some traditional practices. PCIT uses live coaching of the parent during a play/discipline situation to attain specific skills in nurturing parent/child play interactions, effective instructions and consistent consequences. AI/AN cultural consultants assisted with the adaptation process to assure that the beliefs, practices, and understandings incorporated were consistent with AI/AN cultures. Developers or leading trainers of the treatment models were included to maintain fidelity to the model and clarify their perspectives.

PCIT reflects indigenous traditional ways

The nurturance practices in PCIT target goals compatible with traditional AI/AN beliefs about the "planting of good seeds," i.e., directing a child's thoughts and actions. Indigenous beliefs assumed that each child possessed qualities to develop into a worthwhile individual with caregivers encouraging correct behavior by acknowledging traits that would be helpful as the child grew older. For example: "My son brings me pride because he helps keeps the shelter warm through his willingness to help with the fire," or "My daughter is considerate of my old bones because when I move about, she watches and helps me as I rise." Even small efforts by children were honored by family members who "tended that good seed." The use of praise to encourage positive actions is an old AI/AN method of rearing children (BigFoot, 1989).

In the typical PCIT protocol, there is little or no discussion of family traditions and family values, particularly regarding discipline. The Honoring Families - Making Relatives approach allows for discussion of traditions and beliefs about discipline. Children were not granted unlimited freedom in traditional AI/AN practices (BigFoot, 1989). A concept that has been widely described in AI/AN cultures is that of non-interference - let things happen the way they are meant to be. While the concept of non-interference is important in the traditional context of living in close quarters, maintaining peaceful relations with extended family, or allowing natural consequences to happen, non-interference was never intended to result in inaction in the face of grave potential harm. Presenting an alternative to an unsuccessful condition is not interfering but allowing a person to have choices. Historic skills in negotiations, treaty making, and especially tribal protocol, demonstrate that there is a place for active resolution of problems in AI/AN traditions. It is helpful to view discipline as the teaching of self control as opposed to only punishment. For many Tribes, self discipline is highly prized, as demonstrated by traditions of fasting, vision quests, endurance during ceremonies, or self denial in ceremonies.

Adaptions for engagement of AI/AN families

There is great beauty in American Indian Plains dancers in full regalia with twin bustles made of Eagle feathers and coordinated beadwork on leggings, armbands, and moccasins. There is not only form but there is function to their movements. There is great sophistication in tribal protocol depending on status (chief, headman, elder, visitor), activity (ceremony, meals, blessing), or purpose (recognition, sacrifice). Following protocol to accomplish a positive outcome is not new for Indigenous people. Thus, it is helpful for many families to describe PCIT, or indeed any evidence-based treatment, as a structured protocol that provides boundaries and encourages respectful behaviors in much the same way a traditional dancer complies with dance protocol. Once AN/AI parents understand the structure and sequence of the protocol (e.g., behavioral coding, learning specific words, and meeting criteria) that serves to accomplish the broad outcome of improved warmth, cooperation, and mutual respect, they tend to not be distracted by it.

With the mindset of following a proven protocol to achieve a desirable goal, the individual components of the EBT can be discussed using words that avoid jargon and incorporate familiar terms. For example, the PCIT clinical term, Behavioral Description (an important skill acquired in PCIT) was reframed as telling the story of the child's play.

Another difficult requirement of PCIT is that of giving very specific praise to the child. Culturally, recognition of accomplishments often is given indirectly in AI/AN families. For example, a parent might say "Your Uncle will be proud when I tell him how well you listened today." Using culturally appropriate praise words like "honor" or "respect" or calling a child after a namesake, i.e., "little grandma" or "little grandpa" might be comfortable labeled praises for the Indigenous adult to use. This is another method in which a transformation of the wording was used while the basic intent and outcome remain unchanged.

Cultural accommodation process

The cultural transformation of PCIT, Honoring Children-Making Relatives, did not change the basic PCIT tenets; rather the foundation is observed from a world view that can honor the teachings and the practices that have been part of AI/AN understandings for generations. Old wisdom does not lose meaning; its deeper truths only become more relevant with time.


BigFoot, D.S. (1989) Parent Training for American Indian Families. Unpublished manuscript.

Dolores Subia BigFoot, PhDDolores Subia BigFoot, PhD is an enrolled member of the Caddo Nation of Oklahoma and is an Assistant Professor in the Department of Pediatrics, University of Oklahoma Health Sciences Center. Dr. BigFoot is recognized for her efforts to bring traditional and spiritual practices and beliefs into the formal teaching and instruction of American Indian and Alaskan Native people and to the professionals who work with American Indian and Alaskan Native populations.


Beverly W. Funderburk, PhDBeverly W Funderburk, PhD is an Associate Professor of Research at the Center on Child Abuse and Neglect in the University of the Oklahoma Health Sciences Center's Department of Pediatrics. She conducts treatment and training in Parent-Child Interaction Therapy. Research interests include issues of training and dissemination in PCIT.



1American Indian and Alaska Native terminology is used to describe the Indigenous people of the continental UnitedStates; other terms use in the literature include Indians, Treaty Indians, Tribal, Native Villages, Alaskan NativeVillages, Native Corporations, Native American, Native, First Americans, Tribal Nations, First Nations, IndigenousNations, American Indian Tribes, plus other terms; more information can be found at the websites listed in footnote 2.

2American Indian and Alaska Native people's service needs are well documented in Profiles of American Indian andAlaskan Native Populations in Various Settings, (U.S. Census Bureau, 2000). This publication presents the widevariation in demographic characteristics for all tribes, villages, and rancherias, and includes descriptors of housing,population, sources of income, employability, education level, household members, and primary providers.Additional information on the mental health needs of American Indian and Alaska Native population can be foundat www.ihs.gov; www.icctc.org; www.nihb.org; Additionally, proceedings on these same are available by the U.S.Senate Committee on Indian Affairs at http://indian.senate.gov/. For specific information on individual tribes orNative corporations, please visit their respective websites.