Cooperative Research Centre for Aboriginal Health
Alexandra McEwan and Komla Tsey
Mary Whiteside, Janya McCalman, Yvonne Cadet James, Les Baird, Ruth Fagan, Senimelia Kingsburra, David Patterson, Kayleen Jackson, Bradley Baird, Andrew Wilson and Melissa Haswell
- Gurriny Yealamucka Health Service
- James Cook University
- University of Queensland
This Discussion Paper presents the findings of the 2003 and 2005 Family Wellbeing (FWB) empowerment project evaluation in Yarrabah in order to explore the role of spirituality in social and emotional wellbeing from the perspective of an Indigenous community. The findings demonstrate that a range of attitudes, beliefs, values and behaviour associated with a contemporary concept of spirituality are important personal resources that can be drawn upon to facilitate improvements in social and emotional wellbeing. The outcomes reported by FWB participants can also be linked to several protective factors for suicide.
Background and key questions
The connection between Indigenous Australian health and spirituality is recognised in the national Social and Emotional Well Being (SEWB) framework, which was put in place by the Commonwealth in 2004. Since then, there has been little work done which has focused on integrating spirituality into SEWB programs in Indigenous communities. In the mid-1990s Yarrabah experienced a series of suicides. One of the outcomes of this crisis was the establishment, in 2001, of a partnership between the Empowerment Research Program (James Cook University and University of Queensland)) and Yarrabah’s Gurriny Yealamucka Health Service. At that point the objective was to test the appropriateness of the FWB empowerment program as a basis for Gurriny Yealamucka’s newly established social health program. The FWB program was conducted in Yarrabah and as part of the project evaluation, FWB participants were interviewed to find out what they got out of the course. Analysis of the 2003 interviews revealed that spirituality was an important but contested topic.
To explore this aspect of the project further, the researchers focused on analysing the 2005 interviews with two questions in mind:
- What is the most appropriate way to approach spirituality when evaluating SEWB program outcomes?
- How can the results of SEWB programs be made more meaningful within a population health framework?
Summary of project implementation
The data constituted 38 participant interview transcripts and notes taken in focus groups. Analysis of the 2003 evaluation interviews had adopted ‘empowerment’ as a conceptual framework, with one of the emergent themes being spirituality. In light of the 2003 results, the 2005 interviews were interpreted using ‘spirituality’ as the analytical construct. The themes that emerged from analysis of the interviews were then explored to see how the outcomes reported by FWB participants, such as better communication with family members, resonated with the concept of spirituality. So as to capture all of the different ways in which participants expressed their spirituality the researchers searched health literature to find a concept of spirituality that did not emphasise any particular religious tradition and which acknowledged the land as sacred or of great spiritual significance. As a result the findings were discussed as they related to five themes: ‘meaning’, ‘transcendence’, ‘value’, ‘connecting’ and ‘becoming’ (Martsolf & Mickley 1998). The findings were then interpreted and discussed in terms of how they relate to suicide prevention and empowerment programs (such as FWB), which contribute to population health outcomes.
Participant feedback overwhelmingly indicated that positive, though in some cases modest, changes had occurred in the way they viewed and understood themselves, their loved ones and the community. These self-reported changes included:
- Improved communication skills with loved ones, family and particularly with children.
- Empathy, especially thinking about how other members of the family or community might feel.
- Establishing a vision for the future and recognising personal potential, eg formulating career or educational goals.
- Thinking more about fundamental values such as trust, courage, hope and honesty and their influence in our lives.
- Some talked of a renewed sense of calm in their lives and not getting angry as often as they did before completing FWB.
- Seeing ways of connecting with the past and finding new ways of expressing the Indigenous spirit and of healing oneself.
- A better ability to reflect critically on oneself and one’s life journey.
This Discussion Paper indicates that:
- The capacity for hope, empathy, a sense of connectedness and respectful communication with loved ones are essential ingredients in the ‘control factor’, a recognised psychosocial variable in epidemiological patterns of disease. Increased control and mastery means that people have greater capacity to deal with the day-to-day challenges of life without being overwhelmed by them.
- The task for the future is to continue to work in partnership with Indigenous communities to strengthen both the sustainability of empowerment strategies and their evidence base, with a particular focus on the role of spirituality.
The FWB project started in 2001 and is ongoing. This Discussion Paper was published in March 2009.
McEwan, A & Tsey, K. 2009, The Role of Spirituality in Social and Emotional Wellbeing Initiatives: The Family Wellbeing Program at Yarrabah, Discussion Paper No. 7, CRCAH, Darwin.