Characteristics of Indigenous healing strategies in Canada: a scoping review.

OBJECTIVE The objective of this review was to identify the characteristics of Indigenous healing strategies in Canada and culturally relevant approaches within Indigenous contexts. INTRODUCTION In responding to Canadian Truth and Reconciliation Calls to Action, there is increasing interest in Indigenous healing strategies across clinical, policy, and community sectors. The high relevance of Indigenous healing has also encouraged exploration of new approaches to research that are responsive to, and inclusive of, Indigenous contexts. To date, there is no clear understanding of what characterizes Indigenous healing strategies in Canada. INCLUSION CRITERIA This review considered healing strategies for First Nations, Inuit, and Metis in Canada. Strategies examined included those related to health services and programs, policies and guidelines, models and frameworks, and Indigenous narratives and expert opinion in any service setting. METHODS This review employed the JBI approach to scoping reviews. Searches were performed in CINAHL Full Text, Sociological Abstracts, PsycINFO, MEDLINE, and Academic Search Premier in December 2018. Searches for gray literature were conducted in iPortal, Canadian Electronic Library, and a list of Canadian government and Indigenous organization websites in February 2019. This review was limited to publications from 2008. Non-English articles and theses and dissertations were excluded. RESULTS Among the 59 articles included in this review, 41 were journal articles and 28 were published within the last five years (i.e., 2014 and onward). The healing strategies were most frequently implemented in Ontario (n = 13), British Columbia (n = 8) and Manitoba (n = 5). The majority of strategies were utilized in the health setting (n = 37), which included mainstream treatment modalities as well as community-based healing initiatives. Services and programs (n = 24) were the predominant type of healing strategies, followed by models and frameworks (n = 9); policies and guidelines (n = 8); Indigenous narratives and expert opinion (n = 7); and others (n = 11). The most frequent guiding principles were identified as Honoring Cultures and Traditions (n = 14), Medicine Wheel (n = 12), and Strength-Based/Empowerment (n = 12). The most widely used main components were Artistic Expression (n = 16), Ceremonies (n = 15), and Games and Exercises (n = 12). As for human resources, Community Members (n = 19) were most frequently engaged, followed by Local Agencies (n = 12), and Knowledge Keepers (n = 12). Eight culturally relevant approaches were identified from 29 primary research studies, with the most popular being Consultation/Participatory Research (n = 20) and Indigenous Protocols (n = 5). CONCLUSIONS The findings of this review collectively support a decolonizing approach that upholds Indigenous knowledge, respects Indigenous rights to self-determination, and recognizes Indigenous resilience and agency. More research is needed with a focus on Inuit or Metis healing, and innovative knowledge synthesis methods inclusive of diverse Indigenous ways of knowing.