Aboriginal and Torres Strait Islander Peoples share rich cultural traditions unrivalled across the world, however, the continued impact of colonisation has led to sustained and profound trauma spanning generations. This intergenerational trauma is noted as a significant contextual factor that contributes to the disproportionately elevated rates of self-harming behaviours in Aboriginal and Torres Strait Islander young people compared to those from non-Indigenous backgrounds. This discrepancy is only further compounded for those who live in rural Australian communities. With Aboriginal and Torres Strait Islander people presenting 2.9 times higher for suicidal behaviour than non- Indigenous people, there is a distinct need to develop a culturally appropriate therapeutic intervention to address this growing problem (Costa, Sullivan, Walker, & Robinson, 2008; Stapelberg, Sveticic, Hughes, & Turner, 2020).
Therapeutic Assessment (TA) is a brief therapeutic intervention based on cognitive analytic therapy delivered during the initial self-harm assessment (Ougrin, Zundel, & Ng, 2009). TA has been associated with a significant increase in treatment engagement of adolescents who present with self-harm with a Cochrane review finding that young people who receive the TA are five-times more likely to attend follow-up appointments (Hawton et al., 2015; Ougrin, Zundel, Ng, Banarsee, Bottle, & Taylor, 2012; Ougrin, Boege, Stahl, Banarsee, & Taylor, 2013). Given the successes of implementing TA, and the increasing self-harm presentations of Aboriginal and Torres Strait Islander people in Emergency Departments, a pilot cultural adaption of TA for trial in Western Australia was recommended.
Historically, Aboriginal and Torres Strait Islander people have been left out of the research process; having contributed substantial knowledge with little gain. Considering this, the process of culturally adapting TA was centred on a community-based participatory research paradigm. Over 12-18 months, our team has been partnering with the Geraldton Regional Aboriginal Medical Service to co-design the cultural adaptation process from the ground up, ensuring a culturally safe research process. Aboriginal and Torres Strait Islander young people and Elders with lived experience of self-harm will participate in a series of Advisory Groups, Yarning Circles, and interviews aimed to identify what they believe requires adaptation to fit the needs of their community. Clinical training of staff in ED’s of this culturally adapted TA may result in increased engagement from the young person post a self-harming admission, decreasing recurrent presentations. We will discuss the foundational process of engagement for non-Indigenous researchers working with Aboriginal communities and the preliminary findings from our cultural adaption of TA.