Creating culturally authentic services for Aboriginal and Torres Strait Islander families
Narrator [00:00:02] Welcome to the Emerging Minds podcast.
Sophie Guy [00:00:08] You’re with Sophie Guy, and today, I’m speaking with Ruth Tulloch about creating culturally authentic services for Aboriginal families and children. Ruth Tulloch has twenty years of experience working in the community services and teaching sectors. For the past five years, she has been involved in developing and implementing the Aboriginal Community Connect program at Uniting Communities. Working alongside Elders and community members to co-design services with a holistic focus on social and emotional wellbeing for Aboriginal families and communities.
Sophie Guy [00:00:39] Thank you very much, Ruth, for coming in to talk to me today. I appreciate that. I guess the first question to ask is, please, could you tell us a bit about your background and your current role?
Ruth Tulloch [00:00:50] Yeah, I’ve had about twenty years experience in community services from a range of different roles to community development specialising in drug and alcohol treatment services, lecturing roles, also training roles.
[00:01:05] And yes, I’ve always been passionate about working with people from culturally diverse backgrounds. For the last five years I’ve worked with Aboriginal Community Connect, so I was the very first manager with this service and was tasked to develop the service alongside the Aboriginal workforce and also Aboriginal communities, regional and metropolitan.
Sophie Guy [00:01:28] Okay.
Ruth Tulloch [00:01:29] Yeah.
Sophie Guy [00:01:30] And what does that mean working, developing it alongside Aboriginal communities?
Ruth Tulloch [00:01:34] So, our model is, is that community actually owns the service, so we very much co-design all our activities.
[00:01:44] We co-designed our model with elders and community and because Aboriginal Community Connect is across three regional areas. So the Limestone Coast, Murraylands, also the Riverland and Adelaide. We have to take into consideration cultural protocols with Boandik people, Ngarrindjeri, First River People and Kaurna people. So it’s been a real journey, even from using the most appropriate marketing materials for each different land, as well as connecting to the diverse range of Elders. And twelve months into setting up Aboriginal Community Connect we were asked to review another Aboriginal service in United Communities, which was our homelessness service which is now branded as Kurlana Tampawardli. And that’s a homelessness service for APY Land families and rural families that are experiencing rough sleeping and overcrowding when they’re staying in Adelaide.
Sophie Guy [00:02:37] Can you tell us a little bit about what is the Aboriginal Community Connect (ACC) program?
Ruth Tulloch [00:02:41] So, we have a drug and alcohol social emotional wellbeing service. Whilst primarily clients may come to see us about drug and alcohol misuse. We also work with clients around a range of factors that could be contributing to their AOD misuse like trauma or inter-generational conflict or family relationships. Or it could be the AOD issues that’s causing them to social problems like legal issues and mental health issues. So, we provide a case management model as well as a counselling model, but we also do refer to specialist service as well. So we do have three psychologists onsite at Prospect Hub Centre. So it’s really a combination of what we’ve really tried to do in ACC is have that combination of cultural healing, community ownership along with cultural connection activities.
[00:03:36] So that is run through everything we do and all our considerations. But we also have the clinical practice as well. So and trying to find the balance in Aboriginal Community Connect, we don’t weight clinical above cultural and we don’t weight culture above clinical. It’s really about treating each component with respect and making sure our workforce has the ability to do each one. So, you know, we’ve had practitioners that have more of the cultural knowledge and the cultural expertise, and then we’ve had practitioners that have had more of the clinical expertise. So its really about us in the leadership team, to be able to coach and mentor. It’s very rare to find someone that has both, to be honest. Well, we haven’t found that yet. So the leadership team in ACC has really spent a lot of time either coaching practitioners on the cultural aspect or coaching practitioners on the clinical aspect. And you know, we’ve have a really good retention rate in Aboriginal Community Connect. And I put that down to the time that is spent coaching and mentoring and the professional development thats offered.
Sophie Guy [00:04:40] And what is your framework or approach for working with Aboriginal people?
Ruth Tulloch [00:04:45] The key to the success of our framework is very much, I mean, we work from reputable counselling approaches, interventions like motivational interviewing, narrative. We do smart recovery, which is around CBT. But I think what this program does is we don’t use mainstream tools. So we were given mainstream tools to use, but we adjusted them and adapted them. So we call them Nunga care plans and assessments. So we’ve developed a social emotional wellbeing profile. And that’s a really comprehensive assessment tool that not only looks at the clinical side of things like medical, physical, mental health, AOD misuse, but we also have a cultural connection assessment in there as well. And so what we’re saying is, is we don’t want to use a Band-Aid approach in Aboriginal Community Connect and just look at the AOD or the mental health, we actually will look at what’s underlying the causing issues. And what we find with Indigenous clients is quite often it might be the loss of cultural identity, disconnection to land, traumas so we work with stolen generation members. So it is really important that we ask the cultural connection questions to identify, particularly with Aboriginal clients, you know, what trauma, what issues exist that have been caused by the loss of land and colonisation and the loss of cultural identity.
[00:06:08] Because if we don’t really ask these questions and we have to do it in a way that’s client focussed because, you know, that can bring out the trauma even more.
Sophie Guy [00:06:17] Can you tell me but what does that mean to do it in a client-focussed way?
Ruth Tulloch [00:06:20] I’ll give you an example for a client who feels that they’ve been displaced, disconnected from family or disconnected from the land. It might be something, as you know, people might think this is small, but it might be something as like coming to a group work program and learning about bush tucker gardening. It might be we have an Elder that comes and actually runs cultural heritage tours to our clients. Who may not know about the significance of the land that they’re on. So it’s really helping clients to reconnect to community, to elders and to whatever cultural healing that they need. Cultural healing could be coming and talking to a counsellor, that has experience and knowledge around culture. And just talking through some of the things they’re experiencing around the loss of cultural identity. And that’s specialist skill, counselling around racial trauma and cultural healing is a specialist skill and it’s so needed. I just don’t think is recognised.
Sophie Guy [00:07:15] Okay. Is that the kind of thing that an Aboriginal practitioner will bring in as part of their skill set? Do they sometimes need training around that, too?
Ruth Tulloch [00:07:25] And that’s a thing, I think, to not make the assumption that every Aboriginal worker will have that skill sets either. So we have we have a workforce, about twenty-four staff. Eighteen that are Aboriginal and one that is Torres Strait Islander. And we’ve got Aboriginal workforce that have different variations of their connection to community and their own cultural knowledge. We have some Aboriginal staff that are adopted, stolen generation members, and some Aboriginal staff that are really well connected to their culture and community. I think a lot of agencies will go well, we just need to recruit an Aboriginal staff member, but in the recruitment process, it’s really depending on what position you’re looking for. If it’s something like a senior Aboriginal practitioner, you really need someone that that has experience and is connected to community and has the cultural knowledge.
[00:08:16] So we do have a Senior Aboriginal practitioner role. It didn’t exist there in the beginning, but it’s something that we had to advocate for, that this is a role thats really needed. And we’ve developed a cultural supervision model. What we say in Aboriginal community connect is you’ve got clinical supervision. But what we say is cultural supervision is just as important for us practitioners to have. And that cultural accountability is just as important as well. And the two really go hand in hand.
[00:08:43] Now, we’d like to think that all clinical supervisors will have the cultural supervision knowledge, but they don’t. So we didn’t want to just send our staff to two days cultural awareness training because we feel like there’s so much of that out there. And people, they go to it and then they think about it for a couple of days. But what we wanted to develop for our practitioners is, is a model that they can continually use throughout their practice. So there’s a whole process that we went through. So the team got together and we had a cultural supervision kind of preparation workshop. Then we spoke to a few elders about it. We had clients sit in on focus groups.
[00:09:23] So there’s a whole process to develop this cultural supervision model. And we developed a series of tools that practitioners can use to self evaluate where they’re at and then they can look at our model and go, oh, well, I’m here or I’m here or I need to work on this. And but it’s very much around their own self-reflection or self-evaluation. And our Senior Aboriginal Practitioner will work through the different set of tools with the worker during a cultural supervision. And then have those reflective discussions and look at, its a triangle model. And then guide, you know, where do you think you are on this and what do we need to do to get you through to the next stage? And yeah.
[00:10:05] So what we believe is that we needed to go beyond the two day cultural awareness training and really because what our model model talks about is not just cultural awareness, but also the need to have the right values as a foundation. And then the cultural awareness, cultural knowledge. But if you don’t have the ability to take all of those things and adapt your behaviours and your skillsets and weave the cultural lens through your practice, then you’ll you’ll never get to the culturally authentic in the way that you practice. And I think I said that, you know, our Aboriginal staff do the cultural supervision, too. And what we emphasise to them is, is it’s not about testing your own cultural identity. So it’s more about looking at your authenticity in the way you practice with Aboriginal clients.
Sophie Guy [00:10:55] And I’m curious to know, you know, as a practitioner or service manager, what’s been your journey like to start working with Aboriginal people and in Aboriginal social and emotional wellbeing space and how you’ve had to go through that process of becoming culturally authentic? Could you talk a little bit about that?
Ruth Tulloch [00:11:13] Yes. I mean, I did the tools myself. And my reflection has been that, you know, if I had done the tools five years ago when I actually started setting up the service, you know, it would have been a different outcome. So my journey, it was a 12 month, just relationship building, really. So our organisation wasn’t known like the broader Uniting Communities, wasn’t no one in the regions and in the Aboriginal space. And there wasn’t a lot of consultation done with elders before getting the service. So, I really had to back pedal a little bit and say, we want this to be a community owned service. So, you know, I need to build those relationships with Aboriginal controlled organisations and Aboriginal elders.
[00:11:59] So the first twelve months I was practically living in the country regions that we were setting up the service and just spending time with the elders there. And, you know, there was lots of questions about why didn’t you speak to us before? We would have liked to have helped develop the model. And, you know, at one point, particularly in the Murraylands, where I met with the elderly women’s group, I actually had to I’m sorry. Because, you know, I knew that we should have had those conversations before putting in for the tender. So, yeah, it is really working on those relationships and gaining the trust from the community and realising as a manager that I didn’t know everything. And that being open to learn from, particularly the Indigenous workforce that I had. So, moving away from this kind of individualised therapeutic approach where you’re in a room and you’re counselling to, you know, how can the community actually have input into somewhat an individual’s wellbeing or family’s wellbeing? How can community support rather than, for some of our clients, rather than coming and seeing a counsellor its about coming and seeing older and just having that cultural support, and increase of knowledge around the cultural protocols and community support that is actually out there.
[00:13:13] And that’s where we’ve seen a real difference, is that we provide both. So if you want to come and see a therapeutic counselling can. However, if this is going to be, we define coming to see, getting community support and elder support, just as therapeutic for some of our clients, but that’s their choice. And what we do is we provide a range of options. We don’t just provide the clinical option. And so, yeah, even for me as a manager, learning that and redefining what therapy means to Aboriginal people, to my own organisation as well, it’s been a real journey. I’ve had to do a lot of advocacy within my organisation, too.
Sophie Guy [00:13:52] What you’re describing about the way it kind of works and building and community health, I always, often think when I hear about the Aboriginal perspective on how we might do things, I feel like these models have so much potential to be healing or beneficial for us more broadly. I always think that
Ruth Tulloch [00:14:10] And what we’ve tried to educate other services in our organisation about, is it’s important to offer that range of treatment options. I’ll give you an example, for our APY Land clients. You know, they might have a medical issue and we do refer them to a GP, but we also ask whether they would like to see a Ngangkari, which is a traditional Aboriginal healer. So, you know, it’s about looking at offering all that. But for that you need the knowledge, you need the willingness to kind of broaden your horizons beyond your mainstream case management model and counselling therapies. And I think for practitioners it’s important. Remember, it’s not so much what you believe, it’s what’s in the best interests of the client and what’s going to be healing for the client.
Sophie Guy [00:14:53] What does that look like if you were sitting down right now with an Aboriginal client, say a mother, what would that look like, starting to engage in a respectful way?
Ruth Tulloch [00:15:05] I think the first thing is to realise you might book an appointment with an individual client but it may be that the individual client turns up with an aunty or an uncle or significant others in their family.
Ruth Tulloch [00:15:17] So for us, we don’t work from an individualised perspective because quite often, you know, our clients refer to their mob. And they might bring their mob with them. And the client may not be a decision maker in that mob. So mob is like family and family can be extended family, could be someone in their kinship group, it could be a significant community member. So I think that’s that’s one of the first things I would say is for a practitioner that, you know. Don’t be surprised if you’re expecting to work from an individualised perspective and then you get to work from the mob perspective or the family perspective.
[00:15:56] Yeah. The other thing I would say is counselling takes more time. So, quite often our clients are storytellers and they don’t like the direct questioning. And you know, for us, that was something we had to learn, is particularly in the drug and alcohol and mental health space, where you have assessment tools like drug and alcohol assessment tools that are very direct, specific questioning like, you know, how many drinks are you having a day? And when did you start drinking? That kind of questioning can be very confrontational to our clients. So, it’s really about pulling the narrative with our clients. So it’s really about listening to the stories.
Sophie Guy [00:16:34] Can you give an example of rather than that direct question of how many drinks do you have a day? How would you introduce that question? How would you…
Ruth Tulloch [00:16:42] So how’s, how’s your wellbeing in your family? Or, tell me more about your story today? Or tell me more about what your story has been this week? What’s what’s been your story today or can you tell me more about what’s been happening for you this week? So it’s yeah, it’s a lot more kind of generalised open questions. Particularly if they’ve got family members there as well. That direct line of questioning can be sometimes seen as offensive or you just get silence or you won’t get accurate information. So I it’s really about pulling the narrative. So our Nunga tools really, like, things like, you know, can you describe the land that you’re from? And just from that one question we can get a story about, you know, how they grew up on their land, which land was, what Aboriginal nation they’re from. Their connection to community. Or we might also find out that the client isn’t connected and feels disconnection. So that one question can tell a whole story that can go on for a very long time. So what I would say to practitioners is, is when you have Aboriginal clients just make more time, because quite often what we’re finding is our clients are storytellers.
[00:17:54] The other way to gather information is through artwork. With children, our Nunga child care plan, we’ve got a blank picture of the Aboriginal flag. And so we’ll ask a child to, to colour in the colours on the Aboriginal flag and to tell us their story about the Aboriginal flag. And you know, from that comes out a story about how they learnt about their culture, what it means to them, what they know about their culture, who taught them. So it’s really, you know, really using different tools to gather the story.
Narrator [00:18:27] You’re listening to an Emerging Mind’s podcast.
Sophie Guy [00:18:35] You’ve talked a little bit about, broadly about engaging Aboriginal people, what about when it comes to children? How does that work?
Ruth Tulloch [00:18:43] Yes, so it’s such a diverse range of diversity within Aboriginal communities. So when we’re working with APY Land children, it’s you know, your approach may be totally different from when you’re working with children that have grown up more in urbanised lifestyle. So for the children, with the APY Lands, so like language can sometimes be a barrier. So quite often interaction with them is visual. So the example I just gave about about the flag works really well with APY Lands children. Sometimes children may be experiencing culture shock, particularly if they’re from APY lands. The remote communities, you know, are a very different world from living in Adelaide. So people don’t realise that, you know, remote families can experience culture shock when they come to Adelaide.
Sophie Guy [00:19:28] And it’s so interesting you don’t think about it happening in our, in your own country, do you?
Ruth Tulloch [00:19:33] So, one of the things we’ve picked up from talking to our APY Lands families is they want to know when they come onto Kaurna land, which is Adelaide, they, you know, they’re very mindful that it’s a different cultural protocol to the APY Lands.
[00:19:46] And they’re very mindful that there’s elders here, there’s Kaurna elders here, and there’s cultural protocols here. So, you know that cultural education goes that way, too. And also dealing with a culture shock. So the model we have in our homelessness service is, for us it’s a housing first model. So we work with families to get a house in three months. But the other thing we do is we address the cultural shock.
[00:20:06] So how we work with children is really dependent on what mob they’re from, what land they’re from and what community group they are from.
Sophie Guy [00:20:15] How do you start a conversation with Aboriginal parents about child social and emotional wellbeing if you’ve got concerns there?
Ruth Tulloch [00:20:21] The conversation we have is, you know, we let clients know that we are mandatory reporters. So that’s that’s something that we would do in a first interview. Sometimes there’s some explanation around that, what that actually means. Given the rate of Aboriginal children in child protection services, quite often parents are quite fearful around that. We asked the children too. So we have a particular child Nunga care plan, where we have a safety hand and, you know, who’s in your your safe connection and contact? We have a healthy wheel that the children actually draw. What does healthy mean to them? Now, from body, to spiritually, to family environment? On the first page of the care plan is an Aboriginal kangaroo cartoon where they draw it. But next to that will have the parent help line number and emergency number. And we say to the children once you’ve done the colouring in, then you can put that on your bedroom door. And see these numbers, and if you’re not feeling safe, then that’s what you can ring. And we do that in front of the parents. So the parents know we’re letting children know these are the emergency numbers, if you’re feeling unsafe. We’re letting the parents know that we’re doing the safety hand with the children around who they can contact if they’re not feeling safe.
Sophie Guy [00:21:33] And going through that process with children and parents does that bring up sometimes some of the issues that you might then work out?
Ruth Tulloch [00:21:40] Yeah. Then we then have to put in either a child specialist supports, or at times we do have to make mandatory reports, or parenting skill workshops. Because we specifically do a child Nunga care plan. It gives us a real picture of what’s happening in in the child’s life as well. But in our AOD, drug and alcohol treatment service, we have community residential rehab houses. So I whilst the parents or parent, maybe the principal drug user, we’re also aware that there may be children living in that house. And so we work with the whole family around the impact of the drug and alcohol misuse, its happening on the whole family, not just the user, because, you know, obviously children living in a house and seeing what their parents are going through.
[00:22:22] That’s what we’ve really had to reflect on is, you know, because in the houses we did drug testing, we have outreach workers that go to the houses every day. And when you think about that through the eyes of a child and how daunting and how intimidating that could be. The good thing is we’ve just employed a child and youth worker to have a real specialist role to actually complete those children Nunga and care plan with the children. And I think that’s something really unique to our model, is a lot of drug and alcohol treatment centres they don’t have spaces for families. It’s very individualised and quite often, particularly with our Aboriginal group cohort families, so important to them that they won’t go into a therapeutic community because they can’t leave their kids or can’t find someone to look after children for three months. I think the other thing about our model, it’s not the short term intervention so families can stay in our rehab houses up to twelve months.
Sophie Guy [00:23:15] Any other message? Final message you’d like to say, or point you’d like to make before we finish?
Ruth Tulloch [00:23:21] Yeah, I think I mean, the main key points for practitioners is, you don’t know when you’re going to get an Aboriginal family walk in. And so it’s really important that you equip yourselves to have the knowledge and skill sets to be able to provide the best possible service you can to that individual or that family. Because what we found is, is you get it wrong and the disengagement happens really, really quickly. So if you’re feeling like you don’t have the knowledge or you don’t have the skill sets, then don’t be afraid to admit that. Certainly, I’ve had to admit that as a manager, and I think a lot of our practitioners have had to go, you know, we need to work on this. We were given a very mainstream clinical model at the beginning and we had to pretty much throw that out the door and redevelop it alongside community and say to community, look, you know, you don’t think this model’s working? We don’t. How do we actually put something in place for you that’s actually going to work? And if you’re working in Aboriginal worlds space, it’s really important not to be afraid to start your model from scratch. Really.
Sophie Guy [00:24:21] I feel as though sometimes I reflect on myself. I’m not a practitioner. But if I, you know, imagine how I go in this space and I feel that I’m so I’m so worried about coming across well and being empathetic and being respectful. And and I feel like sometimes that can that almost does create a bit of fear, like am I going to do it right?
Ruth Tulloch [00:24:41] And we hear that all the time. We’ve had a number of non-Indigenous practitioners, and certainly I went through that myself as a as non in non-Indigenous manager. But, you know, what I’ve learnt is and what I say to practitioners is, elders and community, they can see through what is genuine and what is not. They can see someone who is willing to try and has the right values and is willing to listen. And that’s the key qualities that you need to work in this space. If you have that and also the ability to go, you know what, I need to really reflect on whether my, everything that I’ve learned in the past is actually going to work with this particular client group. And if community and elders see that, they will invest the time to coaching you and mentor you.
[00:25:32] So, you know, I totally understand that sense of anxiety and fear around being non-indigenous in this and working in, with Aboriginal clients. But as long as you have the ability that if you make a mistake, that you’re willing to recognise that and willing to reach out to the community and to elders to be coached on how to do or the right way. Then anyone can work in this space. But being able to monitor everybody, you know, people have unconscious bias as well. And in this role, I’ve had to really think about my unconscious biases and be honest about that.
Sophie Guy [00:26:05] It sounds as though maybe another, perhaps, initially unexpected outcome is that within the service you guys have to get a lot more honest with each other.
Ruth Tulloch [00:26:13] Yes.
Sophie Guy [00:26:14] And because, look at your own authenticity, which is actually probably something very powerful and useful.
Ruth Tulloch [00:26:20] So even our psychologists, we had to provide education to their funding body about the standard procedure is you go get a mental health care plan from the GP and then you get referred to a psychologist. So what we had to advocate for is that doesn’t work with our client group. You know, our clients can actually now see a psychologist for up to five sessions and the psychologist can work with them to connect them to a GP and get a mental health care plan done.
Ruth Tulloch [00:26:47] So the mental health care plan has to be done within the five counselling sessions. And that’s actually increased our client’s accessibility to mental health services.
Sophie Guy [00:26:56] Right. Wow.
Ruth Tulloch [00:26:57] Yeah. Because some of our clients, a barrier just in getting to a GP. The fear and anxiety into walking into a medical clinic. So we’ve reversed it and said, you know what? We’ll get you the mental health counselling first and they can talk you through the anxiety and connect you to a GP. And the psychologist and the GP will do mental health care plan for you together within the five counselling sessions. So it’s really being able to recognise the need to sometimes change the way that you practice because you know, what’s the point of having a service if clients aren’t going to access it?
Sophie Guy [00:27:28] Very true.
Ruth Tulloch [00:27:29] Yes.
Sophie Guy [00:27:31] Alright. Well, I think we might leave it there. Thank you so much, its been a really fascinating and great conversation. Thank you.
Ruth Tulloch [00:27:38] Thank you.
Narrator [00:27:40] Visit our website at www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.