In the Conduct Problems: Effective Programmes for 3-7 Year Olds (AGCP, 2009b) report strategies when working with hard-to-engage clients were identified, and included ensuring generic programmes were delivered in culturally appropriate ways by culturally competent practitioners (AGCP, 2009b). To ensure a programme was culturally appropriate, there needed to be:
consultation with key cultural groups
inspection of programme context to determine cultural appropriateness
statistical comparison of rates of participation, drop out, programme completeness and programme outcomes for different cultural groups (AGCP, 2009b).
In discussing strategies to reach hard-to-engage clients (not only for Māori whānau) it was highlighted that timing of programmes was important, as was providing financial support, ensuring that clients (the family) had other supports and providing families with incentives for completing the programmes (AGCP, 2009b).
Māori children and adolescents experiencing conduct problems can also be seen by local child and adolescent mental health services. The Child and Adolescent Mental Health Services (CAMHS) contract specifications exclude those with conduct disorder alone. In practice this poses a number of problems; a reluctance to assess young people who have a referral suggestive of conduct disorder and to make the diagnosis of conduct disorder as this may compromise service provision (H. Elder, personal communication 2009). In 2005, Ramage et al (TRK, cited in AGCP, 2009a) conducted research into identifying the barriers for Māori to mental health services. TRK were of the opinion that these barriers generalised to Māori with conduct problems. These barriers centred on:
In essence, service delivery issues such as the referral process leading up to being seen, and communication issues once involved, were barriers for Māori being seen by generic child and adolescent mental health services.
TRK (cited in AGCP, 2009b) identified principles of best practice as a way of ensuring service providers promote identity and enhance connections when working with Māori tamariki, taiohi and whānau experiencing conduct problems. The holistic approach required of programmes and a focus on whānau ora were essential requirements of both generic and Kaupapa Māori programmes. In order to achieve this, TRK recommended there be an increase in Māori participation in the planning and delivery of conduct problem programmes as well as promoting workforce development issues for Māori practitioners and providers.
Providing ongoing support to Māori whānau attending programmes reflects the concepts of manaaki, aroha and ohaoha. Cargo (2008) identified actions that could enhance the support provided to Māori whānau attending parenting programmes: This included:
The issue of a buddy or teina/ tuakana (younger/ older) system was identified by Māori facilitators (Cargo, 2008) as being another factor that would assist with retention of whānau and providing ongoing support. In particular they advocated that participants from previous courses come and talk with the new group.
The teina/ tuakana system dates back to pūrākau and utilises a whānau concept where one who is older, or more knowledgeable or more experienced supports the younger, less knowledgeable or less experienced person. This system of responsibilities again highlights the values of manaaki and aroha. From a whānau ora approach, attendance at parenting programmes may not be just for the matua (parents) of a tamaiti or taiohi, but also for the rest of the whānau who have contact or care for the child. It could be of benefit to have an older brother or sister attend with parents as support, and who have accountability to each other during and after programme attendance.
Support and connection to a turangawaewae, hapū and iwi
Lyrics from ‘Stronger’ by Scribe
And I made it through the rain and cold, through the dark all alone. My life hit rock bottom, I had no where to go and if I could change back time and change the road that I chose, all the mistakes I made that burnt a hole in my soul, and it took all that I had to get out of the hole…
It took the love of my family and friends to show me the truth
I’ve lived a life time of pain and I am only a youth…
And even the strongest trees must grow from the roots
See a house without love aint a home, it’s a roof, a shelter without warmth, man you know its true. This song highlights the importance of connections, whānau and the depth and meaning of relationships. Knowledge alone of one’s turangawaewae requires the establishment of a connection and relationship, a sense of whanaungatanga. The concept of turangawaewae, knowing and connecting with the place you are from is a vital component of Māori identity. However, having knowledge is one component; having a connection and ongoing relationship is also of vital importance. Many Māori whānau are unaware of their connections to hapū and iwi. Programmes that want to enhance identity and connections need to make sure the beginning steps are in place for a relationship to exist with the whānau and their turangawaewae, hapū and iwi.
The reality of urban Māori raises challenges in terms of turangawaewae, but this does not mean that connections with people from their own hapū and iwi cannot occur. Connecting whānau with taura here roopu (iwi groups that are not local) and kaumatua living in the locality has the potential for positive outcomes in terms of identity and a sense of belonging and connection. Additionally, connection with hapū and iwi is forever and does not end on completion of a programme. This reality can have a significant impact on whānau ora if initiated in a meaningful way.