Friday, April 26, 2013

Last year Hospice of Humboldt began collaborating with two communities in Trinity County to implement grief support services in Willow Creek, and also in Hoopa, a nearby Indigenous Community. These communities are not only rural, but also remote, and deaths in the community, which appear to be frequent, affect the entire community. An agreement, spanning six months, was developed between the community health clinic in Willow Creek, and the Family Resource Center in Hoopa. However at some point in the implementation process, differences in cultural values and structures began to challenge the relationships between the organizations involved. From discussing the idea for the implementation of the Trinity County grief support groups with the Manager of Grief Support Services for Hospice, it sounds as though Hospice staff had several initial expectations or assumptions, which were based on their past lived experiences, and their own cultural backgrounds or professional training. Hospice staff agreed to drive to Trinity County once a month and provide volunteer grief support training. Based on their dominant white cultural values, and past lived experiences, Hospice staff assumed that when they came once a month to teach courses, the same cohort of students would be in attendance. However over the course of the Trinity County Grief Support training program, the Trinity County facilitators did not meet the expectations of the Hospice staff, and this caused frustration. As I come into the Trinity County Grief Support program, I am attempting to understand what cultural values and structures may be leading to a disconnect between the experts (the Hospice staff) and the Trinity County facilitators (which are in certain ways assuming the role of the client). The actual experience for Hospice staff is that it is difficult to coordinate the monthly meetings with the Trinity County facilitators. Each time Hospice staff make the journey to Trinity County, which they feel on some level is a special exception or gift to the Trinity County facilitators, the attendance at the trainings is inconsistent; former attendees are missing, and new attendees are showing up several sessions into the training program, and then they will disappear again. Clearly there is some level of disconnect between what Hospice of Humboldt staff are expecting from the implementation of the Trinity County program, and what the Trinity County facilitators are expecting. As I switch perspectives and try to understand the reality of how the Trinity County facilitators may be experiencing the Hospice trainings, several questions come to mind. I wonder if the Trinity County staff felt that a mutually respectful relationship was sufficiently established prior to engagement in the official training. Did the Trinity County facilitators and Hospice staff both have a clear expectation of what ‘the plan’ was going to be? It may be possible that Trinity County facilitators, particularly Indigenous staff do not do not feel that a sufficient context of familiarity and relationship, and therefore trust, has initially been established between the Hospice staff and themselves prior to beginning to work together, and particularly to discuss private topics such as family, religious ceremonies, and feelings about death. Or maybe it could be that the general Hospice curriculum did not feel culturally relevant for their community, given the additional factors of multiple losses and complicated grief that significantly impact their population. Perhaps the Trinity facilitators decided the dominant culture’s direct approaches to facilitated grief support would not be accepted in their communities; however they did not feel empowered to openly express their views to ‘experts’ i.e. Hospice staff, and therefore they demonstrated avoidance and disengagement. The staff at Hospice are reevaluating their own values and biases and identifying new ways to approach the Trinity County facilitator meetings. The grief support manager brings some training materials to the meetings, however she also is open to following the ‘flow’ of the meetings and responding to the input she can gather from the Trinity County volunteers. This is allowing room for discussions of Indigenous cultural practices, and how some are in conflict with the group facilitation practices Hospice normally utilizes. Facilitators are openly sharing what ways they will be utilizing some aspects of the Hospice training, but also looking for additional models, which may be more culturally appropriate. I feel that progress is being made toward developing mutually respectful relationships involving trust, and feeling that there is an opportunity for both parties to be the provider versus the client, or the teacher versus the student, which assists in equalizing the relationship.  

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