Cultural Identification of American Indians and It's Impact on Rehabilitation Services.

The socioeconomic and cultural characteristics of the American Indian people distinguish them from other cultural and ethnic groups within the United States. The mores and cultural patterns of the dominant society are quite different from the culture and worldviews traditionally held by American Indian people. If American Indians with disabilities are to be served effectively, rehabilitation professionals must understand American Indian culture. To this end, this paper will explore American Indian cultural worldview, the Orthogonal Cultural Identification Model, and the implications of American Indian cultural identification for rehabilitation services.

Keesing (1974) offers four traditional theories of culture. First, structural functionalism conceptualizes culture as a system that humans utilize to adapt to their environment. A central tenet of the adaptive function of structural functionalism is the role of culture as an organizing regulatory system. Second, ethnoscience offers a view of culture as a cognitive system of shared beliefs and knowledge of shared rules that govern an individual's behavior. Third, classic structuralism views culture as the manifestation of a universal unconsciousness, suggesting that individuals project their own psychological structure onto the world. According to the theory, culture thus becomes a representation of the individual's own super-ego. Fourth, symbolic structuralism views culture as being composed of symbols and the shared meanings that are attached to those symbols. In general, Keesing conceptualizes culture as an ideational system:

   ... of competence shared in its broad design and deeper principles, and
   varying between individuals in its specificities, is then not all of what
   an individual knows and thinks and feels about the world. It is his theory
   of what their fellows know, believe, and mean, his theory of the code being
   followed, the game being played, in the society into which he was born (p.
   89).

Triandis, Kashima, Hui, Lisansky, and Matin (1982) defined culture as a human-made part of the environment, with two levels. The first level is the objective culture, including cultural artifacts such as food, tools, and the media. The second level is the subjective level, consisting of norms for behavioral values within given social contexts. Similarly, Smircich (1983) conceptualized culture as a social instrument, organized to achieve biological and social functions within the social environment.

Finally, culture can be conceptualized from a behavioral perspective. Levine (1982) viewed human behavior as a product of the interactions among cultural structure, individual cognitive and affective processing, and the biological and social environment. Levine's view is consistent with Bandura's (1978, 1986) notion of reciprocal determinism, suggesting that behavior is influenced by and influences an individual's social context. This behavioral model of culture holds that cultural competence is based on abilities to (a) perform socially sanctioned behavior in a situationally appropriate manner, (b) communicate clearly in the language of the given cultural group, (c) negotiate the institutional structures of that culture, (d) maintain active social relations within the group, (e) understand and use the beliefs and values of the culture, and (f) display sensitivity to the affective processes of the culture (LaFromboise, 1991).

American Indian Culture

American Indian culture is vastly different from the dominant culture in American society, particularly in terms of concepts regarding health and unwellness. According to Locust (1985), beliefs, philosophies, and religions are extremely personal, and American Indian people are reluctant to discuss personal matters, particularly with non-Indians. Talking about such things may violate tribal customs. Also, many American Indian tribes believe that speaking about a deformity or disability may give it power to manifest itself or express itself in human form.

Religious beliefs and beliefs about health and rehabilitation are highly integrated for most American Indian cultures. Healing or rehabilitation cannot be separated from culture, sacred narratives or practices, or religion; further, the social behavior of American Indians cannot be separated from these beliefs (Locust, 1985). Accordingly, in the American Indian belief system, health is not only a physical state but also a spiritual state as well.

Locust (1985) suggested ten general commonalties among American Indian spiritual beliefs:

1. American Indians have a belief in a supreme creator. In this belief system there are lesser beings as well. Many American Indian tribes identify a supreme creator, and this supreme creator is generally perceived as omnipotent. The name of the supreme creator is very seldom spoken because it is sacred.

2. Humans are threefold beings made up of body, mind, and spirit. Of the three elements, body, mind, and spirit, the spirit is the most important because in the American Indian world, spirit is the essence of being. The instrument by which the spirit expresses itself is the body. The mind is the link between spirit and body and is viewed as being the interpreter between the two.

3. American Indian tribes believe that all creation has a spiritual component. In the native world, the earth is the mother, the sky is the father, and animals are the brothers and sisters.

4. The spirit world existed before it came into a physical body and will exist after the body dies. American Indian people conceive of immortality as circular in nature. In the American Indian belief system, once the physical body dies the spirit is free to inhabit another body. This cycle is repeated until the spirit reaches perfection and returns to the supreme creator.

5. Illness affects the mind and spirit, as well as the body. The interaction between body, mind, and spirit is common to American Indian people. In attempting to heal one or the other, all three of these entities must be dealt with simultaneously.

6. Wellness is harmony in body, mind, and spirit. Harmony, in the American Indian world, understands that all is well with one's body, mind, and spirit. This harmony is not found within the environment, nor does it come from others. Harmony is not an event that occurs to an individual; rather it is the individual's response to those events that create harmony. Each individual chooses his or her responses and will then create harmony or disharmony.

7. Unwellness is disharmony in body, mind, or spirit Many American Indian people experience unwellness. Unwellness in one of the three areas will affect the other areas.

8. Natural unwellness is caused by the violation of a sacred or tribal taboo. Many American Indian tribal belief systems include a distinction between illnesses that are a result of natural causes and those that are a result of unnatural causes. Natural unwellness may be a consequence of violating a taboo. Each native tribe has its own set of taboos that may be moral, religious, or cultural in nature.

9. Unnatural unwellness is caused by witchcraft. In most American Indian tribes, an evil power is perceived to exist, and individuals must be aware of that power.

10. Each individual is viewed as responsible for his or her own well being. Many American Indians believe that they are responsible for their own wellness. Individuals can make themselves well, and they can make themselves unwell. When individuals allow themselves to be upset, they allow themselves to experience disharmony in their lives.

Although more American Indian people, through acculturation, have been removed from traditional belief systems, these beliefs remain a part of the American Indian's cultural heritage. Many American Indians with disabilities hold on to these traditional beliefs, which must be taken into account by rehabilitation professionals (Locust, 1985).

Cultural Identification

Fields (1990) has established a general cultural continuum to conceptualize cultural identification of American Indian people. He proposes that generalizations and ethnocultural judgments need to be replaced by an appreciation of the diversity of tribal groups. When working with American Indians with disabilities, it is important to understand their cultural identification.

Fields offered this cultural continuum model:

1. Traditional. Maintains language, culture, and traditions, such as dances; likely to be influenced by non-American Indian forces; usually marries within tribe and/or follows clan/tribal guidelines.

2. Traditional Adaptive. Strong affiliation with tribe; maintains American Indian lifestyles; speaks or understands tribal language; participates in tribal customs and traditions; may practice nontribal religious beliefs; more likely to accept inter-racial marriages; has developed "coping skills" in dealing with non-American Indian standards.

3. Contemporary. No firm identity with either American Indian or non-American Indian worlds; may exhibit "generic" American Indian attributes; probably associates with contemporaries or "traditional adaptive" Indians; more likely to have been educated by non-American Indian standards.

4. Adaptive. Does not usually carry "American Indian" identity, but may be recognizable as American Indian by non-American Indian society; usually multicultural mixed-blood; may practice Christianity or other religions; social contacts with non-American Indian community; may claim to be American Indian when social (or other) benefits may be derived.

5. Assimilated. May be found throughout mainstream non-American Indian society; not usually recognized as American Indian; a "lost American Indian" or a "successful American Indian," depending on who is speaking.

Cultural Differences

A culture will influence and reflect the worldviews of those who live by its rules. These worldviews consist of shared perceptions and values. However, the relationship of any worldview to experience is complex, subtle, and multifaceted. Many differences exist between American Indian and non-Indian cultures, and disability can be viewed differently depending upon culture or worldview. Table 1 represents some of the major cultural differences between American Indians and non-Indians (Joe & Miller, 1987).

Table 1

American Indian and Anglo Worldviews Contrasted

              American Indian

Group-life is primary.
Respects elders, experts, and those with spiritual powers.
Time and place viewed as being permanent, settled.
Introverted; avoids ridicule or criticism of others if possible.
Pragmatic; accepts "what is."
Emphasizes responsibility for family and personal sphere.
Observes how others behave; emphasis on how others
  "behave," not on what they say.
Incorporates supportive non-family, or other helpers, into
  the family network.
Seeks harmony.

Anglo

The individual is primary.
Respect youth, success, and social status.
Time and place always negotiable; plans for change.
Extroverted; seeks analysis and criticisms of situation.
Reformist: changes or "fixes" problems.
Emphasizes authority and responsibility over a wide area
  of social life.
Eager to relate to others, emphasize how
  others "feel" or "think."
Keep the networks of family, friends, and acquaintances
  separate.
Seeks progress.

In the Anglo worldview, should something go awry or be damaged, attempts are typically made to have it repaired or replaced. However, in the American Indian worldview, the same situation may not be seen as being awry, and even if it is, individuals may still believe that there is nothing to "fix" (Joe & Miller, 1987). Rather, the American Indian worldview allows acceptance of whatever has gone awry as simply a part of nature and as a part of the world as it is. Such a view often will lead to a radically different approach to problems or challenges. According to Joe and Miller (1987), many Anglo people may seek to define a "problem" or challenge in such a way as to suggest a "solution" so that something can be done to resolve the problem or consequences that have occurred. On the other hand, when faced with a consensually determined "problem," American Indians may seek solace, acceptance, or explanations in the familiar social, cultural framework rather than attempt to change the "nature of life" (Joe & Miller).

Thomas (1981) suggests that the cultural conflict or differences between American Indian people and non-Indian people occur because some traditional American Indian cultural views do not accept secular causes but only sacred foundations as explanations for all experiences. Also, according to Thomas, "an Indian family is not a structure in a system of roles," but rather "a system of relationships from which activities emerge" (p. 97).

For some American Indian tribes, the cultural definition of the term "disability" emerges out of relationships, not out of a rigid medical model or environmental consequences. The overriding American Indian cultural value, respect for life, often determines the perspective of the relationship between persons of unequal abilities or skills. All relationships involve giving and sharing personal interactions with one another. Within the American Indian culture, relationships tie one individual to another with an aura of respect, of dignity, and of reciprocity (Joe & Miller, 1987). A concept of relationship provides a way of understanding how many American Indians define the concept of "disability." More specifically, a "true" disability in an American Indian may occur when a person has few or weak relationships with others within the tribal community. This definition may explain the reluctance of many American Indian families to label a family member as being disabled. This definition also may explain the reluctance of an American Indian family to seek additional or outside care for someone who has a severe disability. This reluctance may derive from the American Indian worldview in which the relationship or the network of relationships within the tribe is the most important factor for the person with the disability.

Many American Indians have combined their traditional cultural views or worldviews of disability with those of non-Indians. Therefore, it may not be uncommon to find an American Indian with a disability being treated by an American Indian healer as well as a physician or a rehabilitation counselor. According to Joe and Miller (1987), most American Indian people view disability as the result of multiple causations. Because of this view, multiple treatments are often used, and traditional and modern approaches are not always viewed as being in conflict. Some disabilities, however, may be viewed more negatively by one culture than by another culture. For example, Erickson (1964) states that social and cultural beliefs are, in most situations at least, as important as psychological and biological reasons for disability and, in some situations, much more important. Erickson has defined disability in social terms as the importance of undesirable differences.

Within the American Indian worldview, an undesirable difference may not be defined in the same manner as it would be by non-American Indians. However, in a culture which is continually being altered and changed by the dominant culture, much of the traditional cultural support may have been seriously eroded, leaving American Indians without proper assistance, support, and treatment from either the American Indian culture or the dominant culture. As Myers (1965) writes, "One consequence arising from such a cultural-failure would be an increased likelihood of chronicity of a drift into neglect, abandonment, and chronic disability." (p. 17). This concept of social marginality allows little hope for rehabilitation, full inclusion, and/or recovery. Given the many social, political, economic, and environmental challenges of American Indian people on reservations, the problem of availability, as well as appropriate use of resources, becomes crucial for the rehabilitation of American Indian people.

Cultural worldviews offer many opportunities for understanding the context or the social situation in which a person with a disability lives. The American Indian cultural worldview includes the following assumptions: respect for life; spirituality in nature; the privacy of the group and the individual; and the need to tolerate, accept, and support one another. These cultural worldviews have been under pressure since contact with Europeans. Nonetheless, many of these concepts and assumptions still remain in the American Indian worldview.

Cultural Identification

Traditional values, beliefs, and customs have been largely maintained by American Indian people throughout the United States. This cultural identification has provided a source of strength to cope with the many diverse challenges faced by American Indians. The continued influence of the dominant society on the American Indian people results in cultural change and disruption within the American Indian culture. Traditional beliefs and culturally specific family patterns may affect the ability of American Indians to withstand social, economic, and psychological challenges. American Indians with disabilities often reside in a rural area, often on reservations, with limited resources, and significant distance to travel to reach those resources available. In addition, American Indians are affected by both American Indian culture and the dominant white or Anglo American culture.

Alternation Model of Culture Identification

Several different models have been used to describe the psychological processes, social experiences, and individual challenges and obstacles resulting from bicultural influences. One such model is the Alternation Model. This model suggests that an individual can alter his or her behavior to fit a particular social context. Ramirez (1984) alluded to the use of different problem-solving, coping, human relations, communication, and incentive motivational styles, depending on the demands of a social context. This model assumes that it is possible for an individual to have a sense of belonging in two cultures without compromising the sense of cultural identity. Ogbu and Matute-Bianchi (1986) further elaborate this concept: " ... it is possible and acceptable to participate in two different cultures or to use two different languages, perhaps for different purposes, by alternating one's behavior according to the situation" (p. 89). More specifically, LaFromboise and Rowe (1983) have referred to this concept of biculturalism of American Indians as involving dual modes of social behavior that are employed appropriately in different settings.

Several authors have stressed that those individuals who are able to alternate their behavior to the demands of two cultures will likely be less anxious than individuals who are assimilating or undergoing the process of acculturation. Additionally, literature has revealed that those persons who possess the skills to alternate their use of culturally appropriate behavior may demonstrate higher cognitive abilities and mental health statuses than those who are acculturated, assimilated, or monocultural (Garcia, 1983; Rashid, 1984; Rogler, Cortes, & Malgady, 1991).

The alternation model suggests the possibility of maintaining a positive relationship with two different cultures without choosing between the cultures. More specifically, it is seen as possible for individuals to assign equal status to two cultures, even though they may not value or prefer them equally. Further, individuals may identify the manner and degree to which they will affiliate with each of the cultures.

This model is significant for the purposes of the present investigation because it has been used to describe American Indian biculturalism. In an early investigation of gang behavior of Mesquakie boys in Iowa, Polgar (1960) found that they alternated modes of expression according to the different cultural demands of specific situations. Of particular interest was the adaptation of the gang members to Anglo American norms when in town and to the tribal culture when in the Mesquakie community with the traditional, spiritual, and political leaders.

Supporting Polgar's work, McFee (1968) investigated two prototypes of bicultural individuals from the Black Feet Indian Nation. The first group of Black Feet was full-blooded members who had a strong understanding of their culture and heritage. Educated in the dominant culture, this group experienced a variety of the activities and ways of the dominant culture. A strong desire to remain Indian was evident, with the expectation of combining the best of the American Indian culture with the Anglo American culture. The second group was knowledgeable of the Black Feet culture, but was reared with Anglo-Americans. Referred to by the author as "situationally Indian," the members of this group learned to speak their own native language and to understand and maintain tribal rituals that were used in special Black Feet ceremonial events. Involvement was maintained with the Anglo-American and Indian cultures; however, the Black Feet community welcomed them with respect and acceptance.

Orthogonal Cultural Identification Model

Oetting and Beauvais (1990-91) described an Orthogonal Model of Cultural Identification that can include any combination of high, medium, and low identification with two or more cultures. These authors advocate independent assessment of identification with cultures (e.g., culture of origin and/or American Indian, Mexican American, Asian American, African American, or Anglo-American). This model, in part, has grown out of the work of the alternation model.

The Orthogonal Cultural Identification Model supports the contention that identification with any culture may serve as an individual source of personal and social strength, and that such an identification would relate to one's general well being and positive personal adjustment. Oetting and Beauvais (1990-91) suggest that it is not mixed identification with multiple cultures, but rather weak cultural identification with any culture, that may create problems for ethnic minority people.

The Orthogonal Cultural Identification Model suggests that identification with one culture can be independent of identification with any other culture. With many other models, two or more cultures are often placed in opposition to each other, with individuals required to indicate preference for one culture rather than another. In this particular theory, cultural identification dimensions are orthogonal to one another; in principle, then, they are uncorrelated. Other models limit the possibility of identifying some patterns of cultural identification that may exist, such as high identification with two or more cultures simultaneously. The orthogonal model suggests that any combination or pattern of cultural identification is possible. Specifically, a person may have a single cultural identity, may be bicultural, may have a high identification with one culture and a modest one with another, or may have a weak identification with any culture (Oetting & Beauvais, 1990-91).

Within the orthogonal model, competence in or preference for any one culture is independent of competence in or preference for any other culture. Further, as identification with one culture increases, identification with another can decrease or it can also remain the same. The model also has a "zero point." Unlike other models, it shows that it is possible to have a low level of identification with all cultures.

The model presented by Oetting and Beauvais (1990-91) takes a very different approach to culture and an individual's identification with a culture or many cultures. Instead of two cultures being placed at opposite ends of a single dimension, cultural identification dimensions are at right angles to each other. At the origin of the angles is a lack of identification with any culture, cultural anomie, or cultural alienation. The Orthogonal Cultural Identification Model indicates that any pattern-any combination of cultural identification-can exist and that movement or change throughout and within cultural identification is very possible. Accordingly, within this model, there can be high bicultural identification, unicultural identification, high identification with one culture and medium identification with another, or even low identification with both cultures.

Cultural identification is a personality trait that is viewed as a persistent, long-term underlying characteristic that organizes cognitions, emotions, and behaviors (Oetting, 1993). Individuals with high identification with a culture will perceive themselves as adapted or adjusted to that culture. They will see themselves as involved in the culture and as capable and competent within the culture. Generally an individual with high cultural identification will see events from the perspective of that culture, will make evaluative judgments that are based on cultural beliefs and values, will choose behaviors that are culturally congruent, and will succeed in cultural activities (Oetting, 1993).

Success within a culture brings many benefits; advantages are defined in terms of cultural values. These benefits may include status, monetary rewards, property, control, or admiration. More basic to the culture would be the opportunity to raise a family within a healthy environment. Consequences of cultural failure may be devastating. Culturally marginal individuals may lack influence and interpersonal regard within their cultural context. Their social environments may offer few rewards. Further, culturally marginal people will turn elsewhere to find involvement in life and, subsequently, may turn to less than healthy, often even destructive, behaviors.

Development and maintenance of cultural identification. Cultural identification develops and is maintained through interaction with the environment-in this particular case, the cultural environment. The Orthogonal Cultural Identification Model suggests that both the individual and the culture have needs or demands that must be met by the other (Oetting, 1993).

Cultural identification is viewed as a product of an ongoing interaction between the culture and the person. It is a very basic characteristic, usually grounded in early family experiences, but changes throughout life with an individual's experiences (Oetting, 1993). These experiences are defined as cultural activities, and nearly all activities involve other people. People act individually and collectively. They provide the opportunity for cultural interchange and activities, assess the person's behavior, make judgments about that behavior based on cultural criteria, and respond accordingly. Thus, the culture serves as the equivalent of a functional organism (Oetting, 1993).

Cultural activities are viewed as having two components. First, certain actions or behaviors are required by the culture on the part of participants. Second, the culture responds when people participate in cultural activities (Oetting, 1993). A person must interact with the culture to meet the cultural demands. Cultural identification then has two components involving interaction with the culture: (a) culture-related actions, or the behaviors that occur in cultural context; and (b) culture-related needs, or personal requirements that are met through cultural involvement (Oetting, 1993).

Benefits of cultural identification. According to the Orthogonal Cultural Identification Model, a high level of cultural identification results in individuals remaining within the culture and maintaining the activities of that culture (Oetting, 1993). An immediate benefit of continuing cultural interaction is that the needs of individuals are met. The cultural response serves as a reinforcer, shaping and maintaining behavior. The overall effect is a sense of competence and an increase in life satisfaction.

Cultural demands also allow the culture to survive (Oetting, 1993). When needs of individuals are met, the culture is likely to increase in value to those individuals. Positive feelings encourage involvement in cultural activities, which allows the culture to meet the needs of other members. The rewarded person is also likely to recruit others into cultural activities. Through increased participation, the culture gains in its ability to provide reinforcement and reward for all of its members.

Adjustments between the culture and the person occur constantly. Minor problems in the adjustment are considered a normal part of the adaptation of both the culture and the person (Oetting, 1993). Continual shifts occur: people test limits, people may construct inaccurate cognitions, and people may deviate from the acceptable norms, all creating a continual state of flux. The environment changes as well: resources are lost, gained, or both; ecologies shift; and norms and values are altered. However, feedback provides the mechanism that can successfully carry the individual and the culture through such changes.

Oetting and Beauvais (1990-91) posit that behaviors, responses, needs, and cognitions will change through feedback in order to modify the system and keep it in balance. Accordingly, when a strong culture and high levels of cultural identification exist, there is likely to be considerable congruence in perception and cognition. Subsequently, necessary adjustments are smooth and occur quickly. Nonetheless, problems occur within a culture and its people. When such a problem leads to a serious mismatch, either between the cultural demands and actions of individuals or between the needs of individuals and cultural responses, cultural identification will suffer. Should enough people lose cultural identification, the culture will be damaged as well.

Oetting (1993) assumes that people shape a culture so that it will meet their needs, and the culture tends to shape needs that it can meet. When the culture and the person remain reasonably healthy, the interactions between the culture and the individual are mutually supportive. When a culture fails to reinforce, or does not meet, the cultural needs of the people, the result will be unpleasant for the people involved in the culture. Negative consequences result, stress and anger increase, and a general state of unhappiness occurs. The person comes into conflict with the culture, reducing cultural identification, and possibly leading to culturally destructive or unhealthy behavior (Oetting, 1993).

As long as the culture and the person maintain a reasonably healthy interaction, increased probability of engaging in behaviors specific to the culture would be viewed as positive (Oetting, 1993). However, a serious breakdown within the interchange of culture and the person will lead to problems and may eventually lead to a chronically damaged interaction. This breakdown then results in failure to meet the personal needs of the individual, a breakdown of the culture, or both.

A strong and culturally successful family would be able to provide an individual with access to reinforcements and rewards. Therefore, this family would be better able to develop the skills of the child in meeting the demands of the culture. According to the Orthogonal Cultural Identification Model, an individual within the family would have certain advantages and would be able to develop a high level of cultural identification. That cultural identification would involve the formation of accurate cultural perceptions and cognitions. In turn, these perceptions and cognitions would help the individual develop the skills that would meet the cultural demands. When individuals engage in successful cultural interactions, they begin to develop beliefs in and about their own capabilities. Subsequently, they have a feeling that they are in control over parts of their environment; they relate to their culture. Oetting and Beauvais (1990-91) have shown that the higher the cultural identification of American Indian youths, whether American Indian, non-Hispanic White, or bicultural, the greater their self-esteem.

Family and personal connections suggest that youth, whether Indian or non-Indian, with high cultural identification would be more likely to have a family that provided stability and caring. Significant correlation between perceived family caring and cultural identification would appear logical (Oetting & Beauvais, 1990-91). Oetting and Beauvais have found that family caring is highly related to cultural identification. Females were found to have more positive relationships with their families than males, and for Indian youth, family caring is associated with both Indian and Anglo cultural identification. Thus, high identification with either culture appears to be related to greater perceived caring.

According to Oetting and Beauvais (1990-91), school adjustment would likely be related to cultural identification. Oetting and Beauvais found that females had significantly better school adjustment than males. Cultural identification was found to be related to school adjustment for both males and females, whether Indian or Anglo. Further, culturally anomic males were found almost uniformly to be failing in school and to detest school. Similarly, Pertusali (1988) has found that high cultural identification among a sample of Akwasasne Mohawk Indian youth was related to positive psychosocial characteristics. On the other hand, anomic youth showed the lowest self-esteem and the weakest links to two of the major socialization systems, the school and the family. Finally, Pertusali found that strongly bicultural youth had the highest self-esteem and the strongest socialization links.

Assessment of cultural identification. The Orthogonal Cultural Identification Model requires that individuals be allowed to independently express identification or lack of identification with multiple cultures. Thus, a measure of cultural identification must allow for identification with multiple cultures independent of their ratings of their identification with other cultures. In addition, multiple items should be used to enhance reliability of scores.

According to Oetting and Beauvais (1993), the reliability of a very short measure will probably prove to be at least in the 0.70s, if the cultural constructs for which cultural identification is rated make sense to participants. Further, they suggest that using four items within a rating scale should increase internal consistency into the high 0.80s.

Summary

The cultural and socioeconomic characteristics and tribal-specific customs of American Indian people help to distinguish them from other people. These and other factors help to contribute to the cultural definition or concept of disability. Those individuals with disabilities who reside on a reservation will be faced with the culturally influenced perception of disability and rehabilitation services and needs. According to O'Connell (1987), American Indians with disabilities are more likely to be individuals who reside on a rural reservation, who possess limited understanding and knowledge regarding rehabilitation services, and who underutilize existing rehabilitation resources. Traditional cultural values and beliefs help influence the perception of community rehabilitation needs and the ability to access rehabilitation services.

The alternation model of cultural identification suggests that an individual can alter his or her behavior to fit a particular social context. Within this model a person can maintain a positive relationship with two different cultures without compromising the sense of cultural identify. Accordingly, it is possible for individuals to assign equal status to two cultures, even though they may not value or prefer them equally and individuals may identify the manner and degree to which they affiliate with each of the cultures.

The special challenges facing American Indians with disabilities are complex. The interaction of cultural factors, residence, socioeconomic characteristics and the types of disabling conditions influence status within the community. To provide effective rehabilitation for American Indian people, professionals must recognize these differences and identify strategies for improving community-driven rehabilitation.

The Orthogonal Model of Cultural Identification offers an option that allows cultures to remain alive, healthy, and independent of each other in the same physical environment. Subsequently, minority or diverse cultures may not have to be completely absorbed by the dominant society. Individuals will be able to choose to develop high levels of cultural identification with any of the many cultures that they are exposed to, depending on their own unique values, needs, and abilities. American Indian people who reside on reservations offer an opportunity to further evaluate these possibilities. The options of the underlying philosophical tenets concerning the Orthogonal Cultural Identification Model exist to further explore the model within reservation communities. Most American Indians today are to some extent bicultural, but all the different patterns and combinations of cultural identification can exist for American Indian people (Oetting & Beauvais, 1990-91).

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Eugene F. Pichette

The University of North Carolina at Chapel Hill

Michael T. Garrett

Western Carolina University

John F. Kosciulek

University of Missouri-Columbia

David A. Rosenthal

University of Wisconsin-Stout

Eugene F. Pichette, Ph.D., CRC, Assistant Professor, Division of Rehabilitation Psychology and Counseling, Department of Allied Health Sciences, 102 Medical School Wing E, CB #7205, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7205.