It’s Not Our Way: Navigating the Principle of Dual Relationships as a First Nation Practitioner

Abstract

First Nations and Eurocentric approaches in the field of psychology and mental health are rooted in different worldviews which creates incongruencies as to what may be deemed as effective standards of practice. This autoethnography describes the experience of a school psychology intern navigating through practice particularly as it pertains to the principle of dual relationships. With a first-person perspective the journey of exploration into this matter brings together the research found in academia and the guidelines formally set as well as the beliefs and values of local community members which were brought forth through a series of interviews and conversations. There are three main themes which arose that are highlighted and they are the embodiment of a spiritual orientation, substantiation of trust and integrity, and obligation to community. These themes explicate the differences in and implications for practice when working with First Nations people, particularly in remote spiritually connected communities. The practice of psychology in and with First Nation people needs to be rooted in their beliefs, values, and customs to be effective, to reflect the experience of Indigenous ways of helping, and to decolonize approaches in the field of psychology.

On June 1st, 2021, the remains of 215 children were found in a mass grave on the grounds of Kamloops Residential School. This event tore open painful wounds. I attended a ceremony where I danced for healing and listened to survivors. Emotions were overwhelming and the pain of our collective past was revisited. After listening to a story that my kindergarten teacher shared, I was in awe at her strength to stand there with us. What struck a deep chord with me were the words she yelled: “When are we going to realize that their way is NOT our way and IT DOESN’T WORK FOR US!” (Monias, personal communication, June 2, 2010). Her words sent chills through my body. I was absorbing this message at the end of my internship year in becoming a school psychologist. Her words matched the exact sentiment of what I had been discovering over the past year. This autoethnography highlights one of the most important teachings that I have had on this journey as it relates to service provision in my home community of St. Theresa Point First Nation, the western principle of restricting dual relationships is inappropriate for our community, and the root of this learning experience began with a very special child.

I often think about the time when I taught him how to swim, holding him gently but firmly at water’s surface so he knew I was there. I had helped him gain confidence in the water by allowing him to take his time becoming familiar with it. My nephew JC is 9 months younger than my son and they are close . He always struggles with some things that come easy for my son, particularly with “school stuff.” At his young age I could already see him growing into a respectful man. As my mother’s companion, he follows directions very well and is responsive to her needs. He pursues his interests with vigor, and it is a blessing to know that he literally trusts me with his life. I am both humbled and grateful for that trust.

At the beginning of my internship year, I was looking forward to working with clients. During my practicum at the university clinic, having clients was a different experience for me because we were unknown to each other. This experience taught me a lot about my natural way of connecting with people. I was instructed not to build too close of a relationship with my clients and this was enormously difficult for me because it went against my way of relating. I saw this from my very first client when I wanted to gift her with a notebook to honor her being my first client. It became a process whereby I had to request formal permission. Although this did not make sense to me, I complied and was able to gift her on our very last meeting. In another instance, a client and I were sharing stories about our mothers. When I spoke about my mother, I showed her a picture and was promptly instructed to stop. These strict guidelines were in place for a reason, and while I did not truly understand the reasoning, I respected and did follow.

I was looking forward to my final internship, which was to be in Alberta. When the pandemic brought the world to a halt and fear into our hearts, I was unable to leave my community. A wave of casualties was anticipated due to our majority being identified as “vulnerable to complications.” This motivated implementation of strict prevention and containment measures in our community and I was informed that if I relocated for the term, I would not be allowed back. Thoughts of potential situations were too much to bear and I made the tough decision to let go of that wonderful opportunity. I could not sacrifice being apart from my family for that length of time, especially during this life-threatening pandemic. Fortunately, I was granted permission to complete my internship in my home community.

When reflecting on who could be a potential client, JC was one of the children that first came to mind. He struggled with academics having grown up with our home language of Ansinineemowin (Oji-cree) as his first language and having low attendance up until grade two . He did not speak English until he was seven, and in grade six, he demonstrated that he could not name all the letters of the alphabet. There are children in my community who are in similar situations, but with the pandemic restrictions, I knew I would have limited access to them. As my mother resides with me, JC would be available for assessment sessions and any respective interventions because he was and still is her main companion. The pairing seemed obvious, and I requested permission to take him as my first client.

My request was met with expected hesitancy. Although I went into this request thinking I would accept if it wasn’t allowed, when it was denied I found that another response from deep inside me would not let me put it down. He was a child who needed support and I wanted to provide it to him. Although the logistics of the situation and accessibility for assessments and interventions were initial reasons to pursue approval, this was no longer my main point. When I asked for the reasoning behind my denied permission to assess JC, I was reminded, like with the notebook and sharing of my mother’s photo, of the principle of dual relationships. Dual relationship means having another type of a relationship with a service recipient outside of the professional relationship.

I thought about all the children in my community. For decades, I worked hard as a teacher and administrator to develop relationships with each of them. I paid particular attention to those with extenuating needs. If they needed an auntie, I was her. A sister’s advice, they found it here. A grandmotherly hug or cuddle, I would gladly. If they needed a parent to discipline then I, with their parent’s blessings, was that as well. I was not just the community’s school principal for the past 5 years, I was Tanya. I worked tirelessly to construct strong relationships. It would be a tough pursuit to find any child I didn’t have an additional relationship with, when I based my entire professional practice on building them. To limit my services to children I had no additional relationship with seemed absurd, if not impossible. The dual relationship principle did not align with the values instilled in me. I could not articulate it, but inside myself I felt it was not right. I was feeling marginalized. I felt that I had to explore this further because the whole reason I applied for this program in the first place was so that I could ensure that our children receive proper supports. I owed it to my community, to my family, and to myself.

I was helpless against the wall before me; this wall built on the foundation of Eurocentric values. I did not understand why it had to be there. Coming to understand this has been part of my journey. I had been raised and supported by my community, yet could not serve to my fullest. It was frustrating and hurtful. My integrity was questioned. This principle seemed based on a belief that I would treat one child differently than I would another simply because I knew them in a different way. The other justification I heard was that dual relationship rules would protect me. It would protect me from being in a position of personal attack should a family member not accept a diagnosis. I saw this as questioning the trust I had built. I could not envision a scenario that would degrade to a point of my needing protection. For my entire life, I had been working to build relationships and they were based on trust. I have always put the needs of the child first and foremost, and decades of service had proved this fact. I was feeling like all of my time and relationships were suddenly invalidated. My arriving to this point of contention was no accident. Before I expand on the teachings that this experience of working with JC has brought forth for me, I would like to share a bit of myself in order to allow the reader to explore the issues highlighted in this autoethnography with consideration of my vantage point. So please, I am offering you my moccasins to wear as I invite you to understand where I am coming from.

I am Kathleen Mason’s granddaughter. Community servant leadership is in my blood. Seeing her and my mother work as community leaders, I had the values of service and self-sacrifice instilled in me. The dynamics of obligation to the community do not seem to be fully understood by western societal values, which focus on more of an individualistic perspective. This contrast has been observed and mentioned several times in research, but living and seeing the line between the two systems is something quite different. I do not resent or feel “held back” by this obligation, but rather understand it as an honor and consider it to be a grave act of disrespect if I were to shun that responsibility. My grandmother groomed me from a young age to value community service. She spoke of the honor it is to be a leader for our people. She also spoke of how intimidating it could be, but that those intimidations needed to be challenged if it meant gathering resources that families needed. I have kept her wisdoms close as I ventured outside of our community to study.

I am of the Fish Clan, responsible for helping children and families develop healthy spirits. It requires interacting with community members in a way that addresses their holistic needs. Elder Roy Mason (personal communication, October 7, 2010) had listened to my grandfather speak of the loss of the clan system and the desperate need for it to be held onto as he looked at the situation of the community and reflected on its future. He spoke specifically about the Fish Clan responsibilities. I was not cognizant of my belonging to this clan until recently, but the fact that this was my spiritually intended role made so much sense and aligned with my life decisions. I always knew, on a spiritual level, I was meant to serve my community and had naturally pursued occupations putting me in the best positions to exercise this responsibility.

I am a leader in education. My mother was a teacher and growing up, I always admired the position she held in the peoples’ lives. I aspired to do the same. I cherish the experiences from this field, and one of the most important skills I developed is collaboration. I work well with others, and firmly believe that everyone has a valuable contribution to make with their own unique perspective. This belief positioned me to be a part of the process of leading. It strengthened my abilities as a teacher, and, eventually, as an administrator. All throughout, I fought to remain competent, resourceful and responsive to the needs of the people with whom I work.

I dance for healing. I am a jingle dancer and a sundancer. I sacrifice myself for other’s healing and I embrace this sacrifice because I carry hope that it helps. Due to the spiritual nature of this role, I am required to maintain healthy balance in my life. My journey to being a sundancer was intertwined with my journey to becoming a school psychologist. I consider this a blessing because it enabled me to remain rooted in my traditional knowledge systems while I traversed through the Eurocentric system. It is a gift that grounded me and kept my values resilient through a time when I was navigating a foreign world.

I am Tanya. I have no desire to be anyone other than myself. My traditional name is translated as “the day straight up in the heavens.” I continue to learn and grow with my name. As I understand it now in this moment, my name tells me that I am at a vantage point that supports having a broad perspective. I hope that I have shared enough about myself to bring you to a sense of understanding this challenge of working in the field of psychology.

Returning to JC, the main reason I was discouraged from working with him involved the principle of dual relationship, which, as mentioned, means having another type of a relationship with a service recipient that is outside of the professional relationship. The Canadian Psychological Association (CPA, 2017) encourages professionals to avoid dual or multiple relationships in order to avoid conflict of interest in the Canadian Code of Ethics for Psychologists Fourth Edition. The ethics of practice have legal foundations based on client rights that “arise out of the need for protection resulting from the inherently unequal relationship between mental health professional and client and from the vulnerability of the client receiving services” (Sawyer & Prescott, 2011). The unequal relationship referred to the resulting power imbalance when practitioners have power over the client. According to Sawyer and Prescott (2011) “dual relationships (or multiple relationships) in therapy practice are identified as an ethical issue and a boundary violation” (p. 373). In the literature, this principle is offered as a protective measure to both the client and the practitioner. For clients, the existence of dual relationships could possibly “impair professional judgment or increase the risk of client exploitation” (Gonyeah et al., 2012). For practitioners, according to Pugh (2007), being engaged in a dual relationship with clients could leave the practitioner “vulnerable to social isolation, social pressure, or even personal threats and violence” (p. 1409). These operative reasons behind encouraging avoidance of dual relationships only make sense when rooted in Eurocentric individualistic beliefs about effective practice of psychology. From my perspective, and my role in our clan, it represents a violation of the community’s trust.

While it is true that CPA’s (2017) Code of Ethics Fourth Edition acknowledges that “dual or multiple relationship might be inevitable or culturally expected (e.g., in rural, indigenous, or immigrant communities), or could enhance the benefit of an activity” (p. 26), the framing and interpretation of relationships continue to be steeped in the language of risk and Eurocentric perspectives: “It also requires that psychologists, in as much as they present themselves as members and representatives of a specific discipline, have a responsibility to actively rely on and be guided by that discipline and its guidelines and requirements” (p.26). As this quote suggests, guidelines and requirements of the discipline are to be favored. Perhaps not surprisingly, school psychologists continue to interpret dual or multiple relationships as a source of difficulty. Difficulty coupled with the threat of litigation, likely pushes those working with Indigenous communities to conform to Eurocentric views. Another (mis)interpretation is that dual relationships are specific to small groups (e.g., remote fly-in communities), thus not requiring wide acknowledgement or change of current ethical guidelines.

A tension exists between the ethical standard of the field of psychology and the implementation of Indigenous practices and values when it comes to the matter of dual relationships. Some professionals hold such strong views of dual relationships as unethical, that they say that any professional engaging in such should not be working in the field at all. Also, some professionals assert that it is impossible, no matter how well intentioned, to not have clouded judgment in their practice if there is a dual relationship. As a community service provider, I have not found this to be my experience; I have always been expected to manage my roles and relationships within those roles in a professionally and personally responsible way.

I am heartened that scholarship is beginning to challenge the negative assumptions of dual relationships. Brownlee et al., (2016) explain that the seriousness of dual relationships being regarded as a violation of standards of professional practice by regulatory bodies. They pay particular attention to the profound implications for social workers and their clients in remote First Nations communities but the same can be extrapolated to non-remote communities. It is important to understand that avoidance is not always possible, nor is it necessarily believed to be in the best interests of the client. In reference to challenges of mental healthcare services for Indigenous individuals and communities, Stewart et al. (2016) make three points:

First, Western and Indigenous notions of mental health are different; second, counsellors trained in Western notions of mental health do not effectively service Indigenous mental health populations; and third, using a Western paradigm of mental health in an Indigenous context is a form of continued oppression of Indigenous peoples. (p. 80)

Despite these openings, research on the tension between Eurocentrically rooted standards and Indigenous values in the practice of psychology is sparse, virtually absent in school psychology, and non-existent from the perspectives of my home community and others like it. Finding myself on this learning journey faced with challenging the principle of dual relationships I purposefully, with the blessing and encouragement of my supervisor, embarked on a knowledge seeking mission and engaged in discussions with community knowledge keepers about their thoughts regarding the principle.

In my knowledge seeking quest, I closely held my grandmother’s teaching that I am not the one who determines my own readiness to learn. She simply stated that even if I think I know what to do, I might not always know, and I should take my time when I am learning. The word she used was beh-yeh-tuk, meaning “carefully” or “unrushed.” This starkly contrasted with the western school system where I was encouraged to learn as much as I could, as quickly as I could. I am appreciative of her teachings. I have been applying this teaching in my growth and learnings, particularly over these past few years with the many new experiences I have had in becoming both a sundancer and a psychologist.

This brings me to the junction I was at when faced with the dilemma of dual relationships. I did not understand the foreign reasoning behind this principle. Thus, with humility, respect, and courage I trekked on my mission to learn. I had no idea what teachings lay ahead of me; however, I was certain they would be teachings based on the beliefs and values of my own community. I was fortunate to be given the time to conduct this inquiry and the timing at that point in my life’s journey was perfect.

With the advice of my supervisor, I began with the seed of the question “What do you think and feel about service provision being done by community members?” I was purposely clear and open about the dilemma of dual relationships because I was needing an open discussion. I kept my prayers close to heart to keep it open, mindful, and grounded. I met with school leaders and local traditional leaders. I share some of these teachings that I gathered with a tobacco offering in the hopes that they are protected from exploitation and facilitate understanding.

Several powerful and authentic themes arose from my discussions with community members and three are discussed here: embodied spiritual orientation, substantiating the gifts of trust and integrity, and obligation to community.

The drive to sundance was not physical nor mental, but it did exist. I felt it in my being that this was something I needed to do. The experience and life of a sundancer exposed the power of the spiritual realm. It was not until I interacted with this realm in the sundance that I understood why I needed to be there. Words cannot gauge the authority in that part of life. I believe there was a reason for the congruent timing of my sundance journey and my journey into becoming a school psychologist. There was a spiritual life force at work that brought these together and it was my responsibility to listen, acknowledge, and walk through them. One Elder speaking in ceremony said, “you will never feel complete in your life if you don’t take the time to take care of the spiritual part of you” (H. Harper, personal communication, November 8, 2020). Another Elder disclosed when talking about the Eurocentric practices that “in everything these people [colonizers] brought, there was an absence of spirituality” (R. Mason, personal communication, October 7, 2010). Reflecting on these teachings brought me to the realization that I needed to have a dual way of thinking in order to remain grounded. The spirit was not just something that existed up in the sky, but rather within everything around us. In his book, Tewa scholar, Cajete (2000) states, “Native science incorporates spiritual process: no division exists between science and spirituality. Every act, element, plant, animal, and natural process is considered to have a moving spirit with which humans continually communicate” (p. 69). This perspective is beyond objectivity because it acknowledges an interconnectedness that is beyond conscious awareness. Considering that the people we work with all have spiritual needs, it is not effective practice to ignore them. A holistic approach would more likely ensure a meaningful contribution. Most knowledge keepers discussed a need to be aligned and balanced in all aspects of ourselves: physical, mental, emotional, and spiritual. Growing into who I am today and working in this field, I had to acquire the knowledge and develop my mental awareness of psychological concepts, but I also had to establish a strong relationship with and respect for spirit. Relationships cannot be linear if they are to be healthy, but rather be multifaceted.

When I approached the Elders and leaders for a series of conversations about my service provision in the community, they were aware of the challenges, dilemmas, and risks of having multiple relationships with the service recipients. In these discussions, which have happened over a long period of time, they discussed possibilities of clients not being open with information, awkwardness, and the sense of personal safety in anonymity. However, they more heavily weighed the benefits of knowing the people you work with in different contexts. As discussed by Brownlee et al. (2016), avoidance of dual relationships is not always in the client’s best interests, particularly in remote First Nation communities. This phenomenon was no different in the hearts and minds of my people. In fact, when I explained the concept of dual relationships and how it could be an infringement, their response was similar to mine in that the idea made no sense. “The values we are taught as professionals and the values we are taught as human beings are sometimes different things. We have to decide a lot of times to take over and apply the human value to help people” (Taylor, personal communication, October 6, 2010). This matter is echoed by Pugh (2007) in his article regarding rural workers “cannot easily maintain social distance from service users by relying upon a neutral or detached professional persona, for this is likely to obstruct the building of trust” (p. 1412). It is worth noting that while I am emphasizing rural and remote First Nations communities, much of the same is held consistent for urban, and even other Indigenous communities in Canada and elsewhere.

Therefore, I argue that avoiding dual relationships can at times hinder services being provided and that the matter must be addressed within local contexts. For myself, I came into this profession after working within the field of education for decades. It was through the roles of teacher and administrator that I established a certain identity within my community as someone who works for the benefit of our children and who the majority have grown to trust.

When talking about my personally delivering psychological services to the community’s families and students, one of the school administrators made three points in support: first, parents may be more cooperative with their children being assessed when they know who I am; second, I speak both English and our local language, which enables people to better express themselves to me and for me to convey the results, interventions, and potential implications; and, third, I “know the community well and are better able to see what resources are available realistically” (P. Harper, personal communication, October 7, 2020). These three points align with Pugh (2007) who found that “workers in small communities are likely to have developed ways of working which enable them to operate effectively in their communities and which help them maintain the co-operation and consent of service users and other agencies” (p. 1411). Trust is key to a healthy relationship and questioning my ability to provide quality and fair services to children in my community felt like my integrity, built over decades, was being questioned.

Traditional Elder Roy Mason (personal communication, October 7, 2010) shared that the responsibilities of Fish Clan members are to support community well-being. The clan system is one that we as a community are revisiting in this age of reclamation. It is beyond my scope of knowledge to comment specifically, but the fact that this clan exists and is within my bloodlines tells me that I have an obligation to fulfill. When my mother spoke, she told me that “a community raises a child from birth to have special skills to be a productive member of the community” (Cromarty, personal communication, October 6, 2020). I recall my late uncle Joe Guy Wood being direct with the point that leaving the community was necessary at times in order to gather what was required, but to come back home, service the community, and fulfill a need of our people. This is not unlike medicine picking. I had been taught whenever I journeyed out to pick medicine, I always had to gather as much as I could, so that I could share with those who had none. Today, there are models being discussed after revisiting famed Maslow’s Hierarchy of Needs, which has been evidenced to have been formed after Maslow spent time with the Blackfoot (Siksika) Nation in 1938 (Bray, 2019). This model depicts First Nations’ perspective and posits self-actualization as a base upon which community actualization and cultural perpetuity can be founded upon. With this model, collective well-being of the nation is of greater value than the individual, further exemplifying the difference between Eurocentric and Indigenous perspectives. My services to the community are not only an expectation, but they are also an obligation that I take on with great honor and humility. The expectation that I heard consistently echoed in the conversations along my knowledge seeking mission, was that whatever I bring back, in terms of my service and expertise, they must reflect the values and beliefs of our people.

I see the response of mainstream society to the needs of First Nation people slowly coming like a drumbeat in the distance. In the report put forth by the Canadian Psychological Association & the Psychology Foundation of Canada (2018) entitled Psychology’s Response to the Truth and Reconciliation Report, they presented a path toward accountable practices that involved

recogniz(ing) the value and importance of Indigenous epistemologies, and the roles of culture and tradition in the conceptualization of problems and healing. This includes respect for the wisdom and knowledge already held by Indigenous Peoples, including the contribution of Elders and knowledge keepers, as well as the cultural knowledge and experience held by all Indigenous Peoples (p. 10).

Further to

develop a broader vision of psychology to include a responsibility to respond to the calls to action of the Truth and Reconciliation Commission of Canada’s report (2015) in an ongoing and evolving capacity and recognize the importance and urgency of stepping outside of existing protocols of assessment, treatment, and program evaluation, so alternative approaches may be explored, developed, and implemented. (p. 11)

Also, to “recognize and acknowledge that appropriate assessment and treatment of Indigenous Peoples includes understanding people in the context of their family, community, and their history of colonization and resurgence” (p. 11). These are strong recommendations requiring deliberate, collaborative action, and I look forward to taking future steps in the field of psychology in a decolonizing and respectful way.

This journey of examining dual relationships in psychological practice was one of the most valuable learning experiences of my life. It not only familiarized me with how our beliefs and values are articulated by community knowledge keepers, but also reaffirmed my own identity and place amongst my people. I have come to deeply understand “their way is not our way and it doesn’t work for us” (Monias, personal communication, June 3, 2010). For myself, dual relationships cannot be entirely avoided, and I would rather focus my energies in taking a more pragmatic approach in navigating these complex relationships. Communication is key in having open discussions about any dilemmas that might arise. It will be important to negotiate a social contract between myself and the family that contains mutually accepted alternatives if the professional relationship does not seem to be working for either party in a healthy way. It is also important that we communicate our wants, needs, and outcomes clearly, as Brownlee et al. (2019) found it was “not that rural and remote social workers lack good decision-making skills with regard to dual relationships, it is that they may not be making the process as explicit as they could, both to themselves and to others.” (p. 638). Furthermore, it is imperative that we are utilizing a community or team approaches to providing diagnoses or treatments. McIntosh et al. (2014) promoted an Indigenous approach for Indigenous students that “involves connecting with Elders, engaging with the community, inclusion of students’ culture and experiences, and actively teaching social responsibility” (p. 240). I am aware that a community member providing psychological and mental health services in their own community is not a unique situation to me and my community. Having faced this situation myself and journeying on a knowledge seeking mission, I encourage anyone else in this situation to reach out to their community knowledge keepers to gather their perspectives.