Land-based cultural programmes

1. Introduction

Version followed: Thunderbird Partnership Foundation, Land for Healing: Developing a First Nations Land-based Service Delivery Model (Radu, 2018) and its "Wellness on the Land" summary poster as the main Canadian framework, with the First Nations Health Authority (FNHA, BC) 2023 land-based healing guidance; for Alaska (US), the community-owned Qungasvik toolbox (Alakanuk and Toksook Bay Community Planning Groups, People Awakening Team; UAF print edition dated 2012) as summarised by NIAAA; for Australia, the Yiriman Project (Kimberley) as published by its auspice body and governance profiles, and the Elder-governed cultural therapy reported by Vance et al. (MJA, 2025). Where these differ, the guide says which one it is following.

What it is. Land-based cultural programmes are not one therapy. They are a family of community-owned programmes: culture and language camps, on-the-land treatment and aftercare, youth "back to Country" trips, seasonal harvesting programmes and Elder-governed cultural therapy. Each one belongs to a particular Nation, community or language group, and is led by its Elders, Knowledge Keepers or cultural bosses. Thunderbird describes the land, or Creation, as "a healer and a teacher". Redvers and Tyler (2016) describe land-based healing as culturally defined healing practice in which the land is "a host and partner to the healing process". [source: Thunderbird 2018; Redvers & Tyler 2016]

Who holds cultural authority. In every source, authority rests with the community, not with a clinician or institution:

• Canada: Elders, cultural resources and Knowledge Keepers. Sanction may also come from sacred societies or First Nation governments, and Thunderbird recommends a competency screening process for Knowledge Keepers. FNHA says Elders and Knowledge Keepers must help develop and deliver programmes and should be paid for that role. [source: Thunderbird 2018; FNHA 2023]
• Alaska (Qungasvik): each community's Community Planning Group, guided by Elders, owns and adapts the toolbox. It is "Tribally directed". [source: NIAAA; Qungasvik manual]
• Australia (Yiriman): Elders of the Nyikina, Mangala, Karajarri and Walmajarri language groups conceived and developed the project, and cultural bosses make the decisions. The Kimberley Aboriginal Law and Culture Centre (KALACC) only auspices it. The Vance et al. cultural therapy was governed by a board of Elders and Senior people. [source: KALACC; AIGI; Vance et al. 2025]

A clinician's role. A non-Indigenous clinician supports, refers and partners: assessment, preparation, safety planning, clinical counselling where the programme asks for it, outcome tracking and aftercare. The clinician does not lead ceremony or teach cultural knowledge. This guide does not describe ceremonial content, and readers should take ceremonial details only from the community concerned. [source: consistent with Thunderbird 2018 and the Qungasvik manual]

How change is understood. The sources share one core idea: colonisation broke people's relationship with land, language, kin and culture. Rebuilding that relationship in practice is itself the healing. Through harvesting, travel, stories, language and protocols, often led by Elders, people regain the four outcomes Thunderbird and the First Nations Mental Wellness Continuum name: hope, belonging, meaning and purpose. Qungasvik puts it as "Yup'ik culture is prevention". Redvers puts it as "being on the land itself heals". [source: Thunderbird 2018 and poster; FNHA 2023; NIAAA; Redvers & Tyler 2016]

2. Framework

No source defines universal phases. Each programme sets its own structure, so below are the structures the sources publish, followed by a clinician-facing pathway that is marked as synthesis.

A. Thunderbird land-based service delivery model (Canada). [source: Thunderbird 2018; poster]

• Organising frame: the four Continuum outcomes (hope, belonging, meaning, purpose). The poster maps spiritual wellness to hope, emotional wellness to belonging, mental wellness to meaning and physical wellness to purpose.
• Eight foundational elements that every programme should plan for: principles and cultural protocols; governance; operational structure; capital; referral and assessments; aftercare plans; specific cultural components; and outcome measures.
• Three operational guidelines: Indigenous values and worldview; personal and cultural safety; healers and healing teams.
• Programme types: treatment, either inside a treatment centre or with about half of treatment held on the land (Charles J. Andrew Youth Treatment Centre); prevention and empowerment camps for youth (Makimautiksat, Wikwemikong OLAE); and alternative justice or education (Chisasibi).
• Durations the report names: an 8-week programme, 4–6 weeks per intake, and seasonal summer programmes.
• Formats: group, peer-based or family-centred, with one-to-one counselling, journaling or reflection time for individuals.
• Team: multidisciplinary. It includes Elders, traditional counsellors, clinically trained counsellors and helpers. Clinicians are often not on site and may handle assessment or continuing care instead.

B. FNHA (BC) planning sequence (2023). [source: FNHA 2023]

1. Involve Elders and Knowledge Keepers from the start, and fund their roles.
2. Build partnerships with local organisations.
3. Form an operational group to share lessons learned.
4. Secure operating and capital funds.
5. Plan for year-round access, because each season carries different teachings.
6. Measure outcomes.
7. Develop workforce standards and training.

C. Qungasvik (Yup'ik, Alaska). [source: Qungasvik manual; NIAAA]

• Set-up: hold information meetings, then form the Community Planning Group (tribe, city, school, Elders, church and youth), then the Adaptation Group. The Adaptation Group must include youth and consult Elders.
• Adaptation meetings: each module is "walked through" from start to finish, then a timed agenda is agreed and experts are confirmed.
• Each module has the same shape: a community-designed opening, the activity, an Elder or expert teaching with stories, reinforcement and discussion, and a closing. Each module runs as one or more sessions of 1–3 hours, delivered to individuals, families or the whole community.
• Dose: counted as the number of modules received. Higher doses produced greater growth in the protective factors.
• Movement between modules: the community chooses order and season. A checklist confirms that all protective factors are covered, and a debrief after each module feeds the next revision.

D. Yiriman (Kimberley, Australia). [source: AIGI; KALACC; NIT 2025]

• Governance: cultural governance allocates resources to each language group and sets the annual calendar: which group runs which activity, where and when.
• Format: Elder-led camps on Country. Follow-on activities in 2025–26 included weekly on-Country day trips with local schools for young people who had disengaged from school, and shorter Elder-led engagement camps.
• Not published: trip length, intake and referral rules. [uncertain]

E. Elder-governed cultural therapy as an adjunct to clinical care (Vance et al. 2025, Melbourne). [source: Vance et al. 2025]

• Who and how much: young people aged 7–18 with multiple diagnoses, referred through Aboriginal Health Liaison Officers. About 8 hours of therapy over 6–8 outdoor sessions on Country, with parents, carers and sometimes extended family.
• Who delivered it: two Aboriginal clinicians.
• Ending: a message stick carrying the agreed themes.
• Follow-up: yarning interviews before, at the end and at 3 months.

F. Clinician-facing pathway. [synthesis, built on Thunderbird's referral, assessment and aftercare elements]

1. Identify interest and fit: the client's own wish, cultural identity and connection, medical and withdrawal stability, and safety.
2. Contact the programme: follow its own intake and protocols, and get consent to share information.
3. Prepare the client: practical needs, expectations, and the programme's rules and protocols.
4. Agree roles during the programme: for example, the clinician is available for counselling if the programme asks, and keeps to the clinical lane.
5. Plan aftercare: return home, and links to a local wellness worker or an Elder.
6. Review outcomes: use measures the programme has chosen, such as the Native Wellness Assessment.

Move from one step to the next when the client and the programme both agree. Medical or withdrawal stability comes before remote placement (FNHA's stabilisation guidance).

3. Guiding principles

• Indigenous knowledge and culture lead. Programme content comes from the local Nation's culture, language and priorities. In practice: ask the programme what it does, and never import practices from another Nation. [source: Thunderbird 2018]
• Creation as healer and teacher; Country as co-therapist. The land is an active partner. In practice: let what happens on the land (weather, animals, a task) shape the conversation rather than a fixed agenda. [source: Thunderbird 2018; Vance et al. 2025]
• Experiential learning ("the land is the classroom"). People learn by watching, doing and relating. In practice: expect skills and stories, not didactic sessions. [source: Thunderbird 2018; Redvers & Tyler 2016]
• Community focus and local control. Programmes are community-driven and run under local governance. In practice: the clinician is accountable to the programme's governance (for example a Community Planning Group, cultural bosses or an Elders' board). [source: Thunderbird 2018; FNHA 2023; Qungasvik; AIGI]
• Social inclusion and flexible eligibility. Programmes consider family and children, and may admit non-Indigenous people by agreement. In practice: ask before assuming who is eligible. [source: Thunderbird 2018; FNHA 2023]
• Cultural protocols: respect, relationality, trust, compassion. In practice: learn and follow the programme's protocols for gifting, approaching Elders and confidentiality. [source: Thunderbird 2018]
• Language as foundation. In practice: support time for language, and do not treat it as a side activity. [source: FNHA 2023; Thunderbird poster]
• Seasonality. Elders decide timing, and each season has its own knowledge. In practice: plan referrals around the programme's calendar. [source: FNHA 2023; AIGI]
• Personal and cultural safety, plus land safety. Programmes use clear, public rules and codes of ethics, a non-judgemental atmosphere and survival training. Safety covers the spiritual, mental, physical and emotional. In practice: complete a medical and safety plan before any remote placement. [source: Thunderbird 2018; Redvers & Tyler 2016; FNHA 2023]
• Trauma-informed, with counselling "as people are ready". In practice: offer cultural or clinical counselling and do not require it. [source: FNHA 2023]
• Culture alongside, but separate from, Western care. Vance et al. kept cultural therapy "alongside but separate from Western mental health management". In practice: do not turn cultural activities into clinical homework, and keep the two records separate. [source: Vance et al. 2025]
• Anti-hierarchical, mutual learning. In practice: the clinician learns as well as helps, and reframes traits labelled as pathology where the community's view differs. [source: Vance et al. 2025]
• Community ownership of content ("make this program your own"). In practice: adapt only through the community's own process, never as an outsider. [source: Qungasvik manual]
• Strengths-based outcomes. Measure wellness and protective factors rather than only deficits. Qungasvik's tribal leaders rejected direct alcohol and suicide measures as culturally incongruent and stigmatising. In practice: agree measures with the programme. [source: NIAAA; Thunderbird NWA page]
• Healing is lifelong. In practice: build aftercare and continuing links before the programme ends. [source: Thunderbird 2018]

4. Intervention inventory

The inventory has two parts:

• Part A covers the clinician's own procedures for referring to, preparing for, partnering with and following up land-based programmes.
• Part B describes the programme components as their owners publish them. Elders, Knowledge Keepers, cultural experts or cultural bosses lead these components. The clinician supports and does not run them.

Ceremonies are named only where the sources name them, and their content is deliberately not described. [source: Thunderbird 2018]

Part A: Clinician procedures

A1. Assessing interest and fit for a land-based programme

• Purpose: to match a client to a programme they want, that will accept them, and that they can safely attend. Thunderbird lists "referral and assessments" as a core element but does not set out intake steps. [source: Thunderbird 2018] The steps below are [synthesis].
• Steps:
  1. Ask whether the client wants cultural or land-based support, and what connection they have to a Nation, community or Country. Do not assume either.
  2. Find out which programmes the client's own community or region runs. Programmes are local, and one Nation's practice is not interchangeable with another's.
  3. Check eligibility with the programme, including family members and children, and non-Indigenous participation (FNHA notes this may be arranged).
  4. Screen practical and safety factors:
     • withdrawal risk and the need for stabilisation first (FNHA);
     • medical conditions and medications on a remote site;
     • current suicide risk;
     • mobility;
     • legal conditions, such as justice-linked attendance.
  5. Record the client's goals in their own words, using hope, belonging, meaning and purpose as prompts.
• Example language (illustrative):
  • "Some people find that time on the land with Elders helps in ways our sessions can't. Is that something you'd want to look into?"
  • "Which community or Country do you connect with? I'd like to find what your own people offer."
• Watch for:
  • pressure from family or the courts rather than the client's own choice;
  • shame about cultural disconnection (see section 5);
  • unstable withdrawal or acute risk, which calls for stabilisation first.
  • It is working when the client names a programme and a goal that are theirs.

A2. Referral and liaison with the programme

• Purpose: to make the referral through the programme's own channels and protocols. Examples of those channels: referral through Aboriginal Health Liaison Officers in Vance et al.; Qungasvik's local staff reporting to the Community Planning Group. [source: Vance et al. 2025; Qungasvik manual]
• Steps:
  1. Get written consent covering what you share and with whom.
  2. Contact the programme coordinator or the Indigenous liaison role, not an Elder directly, unless the programme says otherwise.
  3. Ask about:
     • intake;
     • dates and the seasonal calendar;
     • rules and codes of ethics;
     • what the clinical team on site can manage;
     • how the programme wants clinicians to take part;
     • any protocols for approaching Elders. Thunderbird describes gifting, sacred trust and breach-repair protocols at one Ontario clinic. Follow the local protocol only as the programme instructs.
  4. Send only the information needed: risk, medical needs and contact plan.
  5. Agree who to call if problems arise.
• Example language (illustrative): "I'd like to refer someone and support them from the clinical side. What would be helpful from me, and what should I leave to your team?"
• Watch for:
  • sending full clinical files the programme did not ask for. Vance et al.'s therapists deliberately did not read clinical files beforehand.
  • assuming that Elders' time is free. FNHA and Thunderbird both say cultural roles should be funded, so ask how the programme handles this.

A3. Preparing the client

• Purpose: to reduce dropout and distress by making expectations concrete. [synthesis, drawing on Thunderbird's emphasis on clear public rules, and on land safety]
• Steps:
  1. Go through the logistics: dates, transport, gear for the season, food, phone coverage and medication storage.
  2. Explain that the programme sets its own rules, and that activities may include harvesting, travel, stories and language, with ceremony only if the community includes it. Do not describe ceremonies yourself. Say the programme will explain what is appropriate.
  3. Rehearse coping skills that are useful away from services, such as grounding or contacting a support person.
  4. Agree a contact plan with the client and with the programme.
• Example language (illustrative): "The Elders and staff will guide you on what to do and how. If something feels hard, who on the team would you go to?"
• Watch for:
  • anxiety about not knowing culture or language;
  • fear of being judged;
  • worries about the cold, being remote or the bush.
  • It is working when the client can name the rules and their support person.

A4. Safety and medical planning for land-based settings

• Purpose: to meet the programmes' own safety standards. Those standards cover spiritual, mental, physical and emotional safety, along with first aid, a suitable camp, transport and fuel. A lead guide trained in risk management, or an Elder with land experience, leads activities. [source: Redvers & Tyler 2016; FNHA 2023; Thunderbird 2018]
• Steps:
  1. Share the medical and risk information the programme needs, with consent.
  2. Write a personal safety plan with the client covering:
     • warning signs;
     • who on site to tell;
     • crisis contacts that work without phone signal (ask the programme);
     • safe storage of medications, held by staff if the programme requires it.
  3. For suicide risk, follow standard current risk assessment and safety planning. Agree with the programme how acute risk will be escalated from the land. Qungasvik includes a community Crisis Response Team module.
  4. Confirm that land-safety training is part of the programme (Thunderbird lists water, ice, weather, shelter and first aid). [source for the land-safety and Crisis Response Team elements: Thunderbird 2018; Qungasvik manual] Steps 1–3 and the escalation agreement are [synthesis].
• Example language (illustrative): "Out on the land there's no clinic around the corner, so let's plan now for what you'd do on a hard night."
• Watch for: recent self-harm, uncontrolled withdrawal, and seizure or cardiac risk. These may call for a later intake or a day programme rather than a remote camp.

A5. Clinical counselling within or alongside the programme

• Purpose: to offer clinical support, when the programme asks for it, in ways that sit next to cultural work and do not replace it.
  • Thunderbird programmes offer one-to-one counselling, journaling and reflection time, and blend Western methods such as talking circles, visualisation, meditation and yoga.
  • FNHA advises counselling (cultural and/or clinical) "as people are ready".
  • Vance et al.'s therapists drew on supportive psychotherapy and CBT outdoors, in a reflective, narrative and interpersonal style. [source: Thunderbird 2018 and poster; FNHA 2023; Vance et al. 2025]
• Steps:
  1. Agree with the programme when and where counselling happens, for example at reflection time or after the day's activity.
  2. Start from what the client noticed or did that day, such as a task, a story or something seen on the land.
  3. Link it to their goals in their own language.
  4. Keep cultural teachings as the Elder gave them. Do not reinterpret them clinically.
  5. Keep notes minimal, and follow the programme's confidentiality rules.
• Example language (illustrative):
  • "What stayed with you from today?"
  • "You said you felt steady when you were setting the net. What was that like?"
• Watch for:
  • pathologising behaviour the community sees differently (Vance et al. reframed traits labelled as pathology);
  • taking over reflection time the Elders use.
  • It is working when the client brings what happened on the land into talk without being prompted.

A6. Outcome measurement with community-agreed tools

• Purpose: to show change in a way the programme accepts.
  • Thunderbird's Native Wellness Assessment (NWA) is a strengths-based, whole-person measure of how cultural interventions affect wellness. It comes in a self-report form (NWA-S) and an observer form (NWA-O) completed by a service provider. It was developed with Elders, Knowledge Keepers and cultural practitioners.
  • The forms can be downloaded and copied freely if unchanged and credited, and formal permission is available from Thunderbird.
  • Qungasvik tracked protective factors, fidelity ratings and attendance.
  • Vance et al. used yarning before the programme, at the end and at 3 months, rather than scales. [source: Thunderbird NWA page; NIAAA; Qungasvik manual; Vance et al. 2025]
• Steps:
  1. Ask the programme what it measures, and use the same tool.
  2. Give the measure at agreed points. The NWA page does not specify timing, so align with the programme. [uncertain]
  3. Feed the results back to the client and the programme in a strengths frame.
  4. Do not add deficit measures the community has rejected.
• Example language (illustrative): "This form asks about strengths and connection, not only problems. We'll look at it together again after the programme."
• Watch for: measures that feel stigmatising to the community. Qungasvik's tribal leaders rejected direct alcohol and suicide measures for this reason.

A7. Aftercare and return home

• Purpose: to hold gains after the programme. Thunderbird describes two kinds of aftercare: formal plans overseen by a local mental wellness worker, and informal support from a willing Elder. It also stresses transferable skills and transition support. [source: Thunderbird 2018]
• Steps:
  1. Before the programme ends, agree an aftercare plan with the client and programme. Cover who, where and how often.
  2. Link the client to ongoing local land activities where they exist. Yiriman added weekly on-Country day trips with local schools and follow-up camps. [source: NIT 2025]
  3. Schedule clinical follow-up.
  4. Plan for relapse or crisis on return.
  5. Bring a lasting reminder of the work into sessions if the client offers one. Vance et al. gave each young person a message stick carrying their agreed themes. Do not request or interpret it beyond what the client shares. [source: Vance et al. 2025]
• Example language (illustrative): "What from the land do you want to keep going once you're home, and who can help you do that?"
• Watch for: the drop-off after the high of a camp, a return to a home where substances are used, and losing touch with the Elder or worker. It is working when there is continued contact with a cultural support and with land activities.

A8. Supporting a community that wants to start a programme

• Purpose: when a clinician or service is asked to help, the job is to support community-led development. Community-led means Elders and Knowledge Keepers lead it, partnerships are built, an operational group is formed, capital and operating funds are secured, evaluation is built in from the start, and workforce standards are developed. [source: FNHA 2023; Thunderbird 2018] Qungasvik offers a worked governance model (a Community Planning Group plus an Adaptation Group). [source: Qungasvik manual]
• Steps: follow the community's lead.
  1. Help with logistics, funding applications and evaluation design when asked.
  2. Do not draft cultural content. Qungasvik records that outside researchers' first drafts "missed the mark" and were rewritten by community co-researchers.
• Example language (illustrative): "What would be most useful from our service, and who should we be taking direction from?"
• Watch for:
  • the service setting the agenda;
  • Elders being unpaid;
  • staff burnout and turnover. Thunderbird flags overwork, turnover, and pay equity between cultural and clinical staff.

Part B: Programme components (led by Elders, Knowledge Keepers or cultural experts; the clinician supports)

In each component below, the steps describe what the sources say happens and then what the clinician does. Content and sequence belong to the community.

B1. Land skills and seasonal harvesting

• Purpose: to rebuild identity, competence and relationship with the land through doing.
• What the sources publish:
  • Thunderbird: trapping, fishing, hunting, camp maintenance, bush-food preparation, and arts and crafts.
  • FNHA: berry picking, fishing, hunting and trapping, with nutrition and wellness education. Timing follows the seasons as Elders guide.
  • Yiriman: young men learned to hunt turkey, emu and kangaroo, to fish, and to find native foods.
  • Qungasvik: module titles include under-ice fishing, seal hunt, berry picking, akutaq and blackfish trap. Each is linked to protective factors such as self-efficacy and communal mastery. [source: Thunderbird 2018; FNHA 2023; NIT 2025; Qungasvik manual]
• Steps (clinician):
  1. Help the client prepare practically (A3).
  2. Afterwards, invite reflection on mastery, teamwork and belonging if the client wishes (A5).
  3. Do not set harvesting as therapy homework unless the programme suggests it. [synthesis]
• Example language (illustrative): "What did you learn to do this week that you couldn't do before? Who taught you?"
• Watch for: physical limits and injury risk. Signs it is working include a growing sense of competence, and contribution to the group, such as sharing food.

B2. Survival, bush skills and land safety

• Purpose: physical safety, and also confidence and self-efficacy.
• What the sources publish:
  • Thunderbird: axe use, water and ice safety, weather, shelters, canoeing, snowmobiling and first aid, taught by Elders or certified outfitters.
  • Redvers and Tyler: firearm safety certification.
  • Qungasvik: modules include "Watch the Ice" and a survival-skills module (Manartuq) that makes safety "the primary concern" and includes a wilderness-safety expert. [source: Thunderbird 2018; Redvers & Tyler 2016; Qungasvik manual]
• Steps (clinician):
  1. Confirm with the programme that the client has the medical clearance and gear needed.
  2. Treat what the client learns here as evidence of capability in later work.
• Example language (illustrative): "You kept yourself and others safe out there. Where else could that steadiness help you?"
• Watch for: avoidance driven by fear of the land or water. Discuss it with the programme rather than pushing exposure. [synthesis]

B3. Storytelling, teachings and language

• Purpose: to carry values, identity and ways of being in relationship. Storytelling, teachings and local language are core components in Thunderbird's model. FNHA calls language foundational. In Yiriman, young men heard stories of Law from Elders. Qungasvik has a Storytelling module and Elder teaching in most modules. [source: Thunderbird 2018; FNHA 2023; NIT 2025; Qungasvik manual]
• Steps (clinician):
  1. Do not record, write up or retell teachings without permission. Some knowledge is restricted, for example Law stories in Kimberley contexts.
  2. If the client brings a teaching into session, ask what it means to them and how they might use it.
  3. Do not interpret it yourself. [synthesis]
• Example language (illustrative): "You mentioned a story the Elder told. Is it something you're okay talking about here? What does it say to you?"
• Watch for: the client feeling they must share restricted knowledge. Remind them they need not.

B4. Medicine walks and harvesting protocols

• Purpose: to restore knowledge of plants, medicines and right relationship.
• What the sources publish: medicine walks are listed by Thunderbird. FNHA says Knowledge Keepers should be funded to identify medicines and guide harvesting protocols, and that programmes should cover medicine knowledge, preparation and use. Yiriman mentors taught protocols for approaching, using and caring for freshwater springs. [source: Thunderbird 2018; FNHA 2023; NIT 2025]
• Steps (clinician):
  1. Support participation.
  2. Ask the client about any traditional medicines they are taking or using, without judgement, and coordinate with the prescriber if relevant.
  3. Defer all content to the Knowledge Keeper. [synthesis]
• Example language (illustrative): "Are you using any traditional medicines alongside your other ones? I ask only so the team can keep everything working together safely."
• Watch for: the clinician giving opinions on traditional medicines. Refer content questions to the Knowledge Keeper.

B5. Ceremony (only where the community includes it)

• Purpose: spiritual healing as the community understands it. Thunderbird notes that some programmes include sweats, smudging, and pipe or blanket ceremonies, but that this is "not always the case". FNHA mentions ceremony and rites of passage in Elder-youth knowledge transfer. Qungasvik modules open and close with community-designed rituals. [source: Thunderbird 2018 and poster; FNHA 2023; Qungasvik manual]
• Steps (clinician):
  1. Respect the client's choice to take part or not, including Christian or other faith positions. Many communities blend these; Qungasvik meetings may open with prayer.
  2. Never lead, simulate or describe ceremony.
  3. Attend only if invited by those with authority, and follow their instructions.
  4. Ceremonial content is not described in this guide. [synthesis]
• Example language (illustrative): "That's for the Elders to guide. Whether you join in is your choice, and either way I'm here."
• Watch for:
  • conflicts between faith positions, which should be held without taking sides;
  • clients feeling pressured;
  • the clinician over-identifying with or appropriating ceremony.

B6. Reflective practice on the land

• Purpose: to build inner awareness through direct contact with the land. Shibogama's family healing programme invites participants to develop "inner-knowing" by reflecting on their five senses while physically connected to the land. Yiriman camps included quiet reflection. Thunderbird programmes set aside journaling and reflection time. [source: Thunderbird poster; NIT 2025; Thunderbird 2018]
• Steps (clinician, when the programme asks for this kind of support):
  1. Offer a short, unscripted prompt to notice what the senses report.
  2. Allow silence.
  3. Invite, but do not require, sharing or journaling. The prompting style is [synthesis]. The five-senses focus is Shibogama's.
• Example language (illustrative): "Take a few minutes just to notice what you hear, smell and feel here. Nothing to do with it."
• Watch for: dissociation or intrusive memories. Use a grounding plan (A4). It is working when the client can describe calm or connection in sensory terms.

B7. Talking circles and blended methods

• Purpose: shared voice and mutual support. Thunderbird lists blended Indigenous and Western methods: visualisation, yoga, meditation, talking circles, rites of passage and singing. Qungasvik activities often take place in a qasgiq-style circle, and some modules give Elders a set place in the circle. [source: Thunderbird poster; Qungasvik manual]
• Steps (clinician, if co-facilitating a non-ceremonial circle at the programme's request):
  1. Follow the programme's circle protocol.
  2. Speak in turn, and briefly.
  3. Model listening.
  4. Hold confidentiality according to the group's rules. [synthesis]
• Example language (illustrative): "I'll follow how this circle is run here. When it's my turn, I'll keep it short."
• Watch for: the clinician dominating or interpreting. Disclosures of risk need follow-up afterwards, in private.

B8. Caring for Country and environmental stewardship

• Purpose: to give responsibility and reciprocity with the land.
• What the sources publish: Thunderbird uses the Selkirk First Nation salmon project as an example of stewardship. Yiriman participants took responsibility for caring for Country. Redvers and Tyler recommend programmes with joint health, education and environmental outcomes. [source: Thunderbird 2018; NIT 2025; Redvers & Tyler 2016]
• Steps (clinician): link the client's stewardship role to purpose and contribution in sessions, if the client wishes. [synthesis]
• Example language (illustrative): "Looking after that place: what does that responsibility mean to you?"
• Watch for: signs it is working include the client taking on roles in the community or with rangers.

B9. Elder–youth knowledge transfer and mentoring; peer roles

• Purpose: to pass knowledge between generations and build role models.
• What the sources publish:
  • FNHA lists Elder–youth knowledge transfer, including rites of passage and gathering traditional medicines, and training youth to build community capacity.
  • Makimautiksat trains peer facilitators and youth role models.
  • Some staff are former participants or survivors.
  • Qungasvik's protective factors include role models. [source: FNHA 2023; Thunderbird 2018; Qungasvik manual]
• Steps (clinician):
  1. Support young people stepping into peer roles, and watch their own wellbeing.
  2. Help with supervision and respite for peer staff if asked (Thunderbird flags burnout). [synthesis]
• Example language (illustrative): "You're now someone younger ones look up to. How are you looking after yourself in that role?"
• Watch for: overload on peer staff who are themselves in recovery.

B10. Qungasvik module cycle (Yup'ik communities, Alaska)

• Purpose: to build protective factors through community-chosen cultural activities. Examples of those factors: safe places, clear limits and limits on alcohol, role models, communal mastery, self-efficacy, ellangneq (awareness), giving and meaning. The toolbox is community-owned and "Tribally directed".
• What the sources publish:
  • The manual groups modules into three kinds:
    • Community modules, for example Coming Together, Qasgiq, Storytelling, Crisis Response Team and Prayer Walk.
    • Individual modules, for example Watch the Ice, Under Ice Fishing, Seal Hunt, Berry Picking and Surviving Your Feelings.
    • Family modules, for example Traditional Parenting in the 21st Century and Yup'ik Kinship Terms.
  • Each module follows the cycle in section 2C, is planned through adaptation meetings, and is debriefed afterwards.
  • Cultural experts are nominated from within the community to deliver modules.
  • The NIAAA summary counts 18 module outlines. The print manual lists more than 30, so the numbering varies by edition. [uncertain] [source: Qungasvik manual; NIAAA]
• Steps (clinician):
  1. Only where a Yup'ik community invites you, support evaluation, the crisis response team or youth follow-up.
  2. Do not deliver modules yourself.
  3. NIAAA notes that transfer to non-Yup'ik communities needs significant modification, so any adaptation must come from that community's own process.
• Example language (illustrative): "How does the planning group want us involved, if at all?"
• Watch for: outsiders writing content, which the manual says "missed the mark".

B11. Family-centred land-based healing

• Purpose: to heal family relationships on the land.
• What the sources publish: the Shibogama Traditional Land-Based Family Healing Program is listed by Thunderbird. Qungasvik has family modules, and FNHA lists traditional birthing and parenting programmes. Thunderbird and FNHA both ask programmes to consider families and children. Vance et al. included parents, carers and extended family in sessions. [source: Thunderbird poster; Qungasvik manual; FNHA 2023; Vance et al. 2025]
• Steps (clinician):
  1. Coordinate any family therapy, child protection or parenting work with the programme.
  2. Agree who shares what with whom. [synthesis]
• Example language (illustrative): "What would you like your family to take from this time together?"
• Watch for: child-protection concerns, which must be reported as usual and handled with the programme, and family conflict surfacing on camp.

B12. Elder-governed cultural therapy on Country (Vance et al., Melbourne)

• Purpose: a time-limited cultural therapy for Aboriginal and Torres Strait Islander young people with multiple diagnoses. It runs as an adjunct to their usual care.
• What the source publishes:
  • Format: 6–8 outdoor sessions, about 8 hours in total, on Country. In the study these were held at Royal Park, a Kulin Nation camping area, and at a rural property with animals.
  • Who attended: parents, carers and sometimes extended family.
  • Who delivered it: two Aboriginal clinicians, governed by an Elders' board, with an Aboriginal research assistant supporting families.
  • Content: walking on Country, art, music, dance and animal-assisted therapy. Young people tended animals, collected stones and leaves, and followed what caught their attention, such as insects and birds. Therapists did not read clinical files first, and the work was reflective, narrative and mutual.
  • Ending: agreed themes were burned into a message stick given to the young person.
  • Safety: a psychiatrist or senior psychologist monitored safety. [source: Vance et al. 2025]
• Steps for a clinician: this model was delivered by Aboriginal clinicians under Elder governance. A non-Indigenous clinician's role is to refer through the Aboriginal liaison pathway and to keep clinical care running "alongside but separate". Replicating it requires local Elder governance and Aboriginal clinicians. [synthesis]
• Example language (illustrative): "There's a programme where Aboriginal clinicians take young people and families out on Country. I keep doing our usual work alongside it."
• Watch for: engagement, which the study judged by willing participation, changes in social and emotional wellbeing, and whether gains lasted at 3 months. It is a single uncontrolled study. [uncertain]

B13. Back-to-Country camps and follow-on day trips (Yiriman, Kimberley)

• Purpose: to give young people a remote, culturally significant place where they can "separate themselves from negative influences" and reconnect with culture. The project was set up in response to self-harm and substance misuse.
• What the sources publish:
  • Elder-led camps on the Country of the four founding language groups.
  • Activities: hunting, fishing, finding native foods, Law stories, protocols for springs, caring for Country and quiet reflection.
  • Partners included Walalakoo Aboriginal Corporation and the Nyikina Mangala Rangers.
  • Follow-on: weekly on-Country school day trips for disengaged students, and shorter engagement camps.
  • Cultural bosses set the calendar. [source: KALACC; AIGI; NIT 2025]
• Steps (clinician):
  1. Refer only through the project's own channels, which are not published. [uncertain]
  2. Keep in touch with the young person's school and family supports.
  3. Plan follow-up for after the camp. [synthesis]
• Example language (illustrative): "The Elders run trips out on Country for young people. Would you want me to ask how to get involved?"
• Watch for: the clinician confusing cultural governance with a service referral system. Ask, and wait for the cultural bosses' decisions.

B14. Arts, crafts and making

• Purpose: skill, identity and calm focus.
• What the sources publish: arts and crafts appear among Thunderbird's activities. Qungasvik's modules include beading and story-knife, men's-knife and women's-knife modules. Vance et al. used art, music and dance. [source: Thunderbird 2018; Qungasvik manual; Vance et al. 2025]
• Steps (clinician): invite the client to show or describe what they made, if they wish. [synthesis]
• Example language (illustrative): "Would you like to tell me about what you made?"
• Watch for: objects with cultural significance, which should not be interpreted clinically.

5. Handling problems

The sources say little about individual clinical problems. They mainly address programme-level issues: funding, staffing, safety, and evaluation that does not fit the culture. Unless a source is tagged, the guidance below is [synthesis].

• The client feels "not Indigenous enough" or ashamed of losing language and culture.
  • Name disconnection as a result of colonisation, not a personal failing. Redvers and Tyler cite relocation, residential schools and the school calendar as having disrupted how knowledge was passed on, and say programmes especially help people without family access to the land. [source: Redvers & Tyler 2016]
  • Ask the programme how it welcomes newcomers.
  • Example (illustrative): "Lots of people come to this wanting to learn what was taken. You don't need to know it already."
• Stuck or flat after the programme (post-camp drop).
  • Review the aftercare plan.
  • Reconnect the client with the Elder or wellness worker and with ongoing land activities. Thunderbird describes both formal and informal aftercare. [source: Thunderbird 2018]
  • Use the client's own memories and objects from the programme as anchors, without interpreting them.
• Withdrawal, intoxication or relapse risk.
  • FNHA calls for stabilisation services and links to addiction medicine (RAAM clinics, mobile teams, virtual support) to complement land programmes. [source: FNHA 2023]
  • Arrange stabilisation before a remote intake, and agree with the programme what happens if the client uses substances on site. Follow the programme's rules, which are "clear, public". [source: Thunderbird 2018]
• Suicide or self-harm risk before or during the programme.
  • Do a standard risk assessment and safety plan before placement (A4).
  • Agree an escalation route from the land: who is on call, transport, and communications.
  • Qungasvik's community Crisis Response Team module shows the community-side equivalent. [source: Qungasvik manual]
  • Defer placement if acute risk can't be managed on site.
• Overwhelm, trauma triggers or dissociation on the land. The land, a ceremony or a story may bring up trauma, including grief or residential school or removal histories.
  • Prepare a grounding plan.
  • Agree with the client which staff member they will go to.
  • Make sure the client knows they can step back from any activity.
  • FNHA asks programmes to be trauma-informed and to offer counselling "as people are ready". [source: FNHA 2023]
• Non-attendance or dropping out.
  • Look at the practical barriers (transport, work, childcare). Redvers and Tyler recommend more flexibility for employees and students to access the land. [source: Redvers & Tyler 2016]
  • Check fear or shame, and whether the programme was the client's own choice.
  • Offer a lower-intensity entry point, such as a day programme or school day trips like Yiriman's. [source: NIT 2025]
• Rupture with the clinician over cultural matters (for example, the clinician says something dismissive or pathologising).
  • Acknowledge it directly, apologise, and ask how to repair.
  • Where the programme has its own breach-and-repair process, follow it. Thunderbird describes one at an Ontario clinic. [source: Thunderbird 2018]
• Conflict between clinical and cultural views (diagnosis, medication, risk).
  • Keep them "alongside but separate": continue clinical care, and do not override or judge cultural guidance. [source: Vance et al. 2025]
  • Where safety is at stake, discuss it openly with the programme lead and the client.
• Faith conflicts (for example, a Christian client unsure about ceremony).
  • Take part is the client's choice. Many programmes include both. Qungasvik meetings open with prayer and use community-designed rituals. [source: Qungasvik manual]
  • Help the client ask the programme what is expected.
• The clinician is pulled into cultural roles (asked to smudge, lead a circle or explain a teaching).
  • Decline kindly and refer to the Elder or Knowledge Keeper.
  • Join a ceremony only at the invitation of those with authority, and follow their direction.
• Confidentiality in small communities.
  • Agree up front what you share with the programme and in what form.
  • Remember that Elders, staff and the client may be related.
  • Keep cultural information out of clinical records unless the client wants it there.
• Non-Indigenous clients asking for referral.
  • FNHA notes that non-Indigenous participation can be arranged with local health units. [source: FNHA 2023]
  • Ask the programme first, and do not assume access.
• Evaluation pressure from funders.
  • Use measures the community accepts, such as the NWA, protective factors or yarning. [source: Thunderbird NWA page; NIAAA; Vance et al. 2025]
  • Thunderbird recommends evaluation built in from the start, with funding attached. [source: Thunderbird 2018]
• Programme instability (funding "always at risk", staff turnover, weather or season cancellations). [source: Thunderbird 2018; Redvers & Tyler 2016]
  • Have a back-up plan for clinical support and keep in touch with the programme.
  • Avoid promising a client a place before it is confirmed.
• Inappropriate borrowing of practices (a service wants to "add land-based healing" without community governance).
  • Push back. Every source places authority with the local Nation, Elders and Knowledge Keepers. Qungasvik warns that outsiders' drafts "missed the mark". [source: Thunderbird 2018; FNHA 2023; Qungasvik manual]
  • Redirect the service to partnering with and funding the community's own programme.

Sources

Sources:

• Land for Healing: Developing a First Nations Land-based Service Delivery Model (Radu, Thunderbird Partnership Foundation, 2018)
• Wellness on the Land: Land-Based Service Delivery Models (Thunderbird poster)
• Native Wellness Assessment (NWA), Thunderbird Partnership Foundation
• FNHA Wellness Summit 2023: Land-based Healing
• Land-based Practice for Indigenous Health and Wellness: Plain Language Research Summary (Redvers & Tyler, 2016)
• Redvers, J. (2016) Land-based Practice for Indigenous Health and Wellness in Yukon, Nunavut, and the Northwest Territories (thesis record)
• Qungasvik toolbox (UAF Center for Alaska Native Health Research print edition)
• Qungasvik, NIAAA Native-AIR
• Yiriman Project, KALACC
• The Yiriman Project, AIGI governance stories
• Elders lead young men back to Country through Yiriman Project, National Indigenous Times (Dec 2025)
• Vance A, McGaw J, Winther J, Tootell N, Patten H, Eades S (2025). Country revealing the way: evaluating Elder-governed cultural therapy, Med J Aust 223(6):304–311

Books and reports cited:

• Alakanuk and Toksook Bay Community Planning Groups, Yup'ik Regional Coordinating Council and People Awakening Team (2009/2012). Qungasvik: A Toolbox for Promoting Youth Sobriety and Reasons for Living in Yup'ik/Cup'ik Communities. University of Alaska Fairbanks.
• Radu, I. (2018). Land for Healing: Developing a First Nations Land-based Service Delivery Model. Thunderbird Partnership Foundation.

Further reading (not drawn on) [uncertain]: Yiriman intake and trip-length documentation; the full Redvers thesis PDF; individual programme manuals for Makimautiksat, Shibogama, Chisasibi and the other Canadian programmes named by Thunderbird.