By Azaria Evans 

Jim Caringi is a Professor and Chair in the School of Social Work at the University of Montana. His interests are in the areas of the primary and secondary traumatic stress (STS), child welfare, work with groups and teams, as well as action research, particularly with indigenous populations as partners.

Q: Could you tell me about the work you’ve done with Tribal Communities?
A: I’ve worked with tribes for about 20 years. Started as a practitioner in Alaska working with tribes in the capacity of health care, mental health care, and community organizing. Worked with Mohawk Akwesasne Tribe in New York while completing doctorate as a researcher and professor. Also worked as Coordinator of Qualitative Research for the National Native Children’s Trauma Center (SAMHSA).

Q: What is the biggest obstacle when it comes to achieving lasting health equity?
A: Values and norms – ones we hold individually and as a society. Specifically, these ideas that are supposedly what our American society is founded on — rugged individualism and pulling yourself up by your boot straps — that ignores all of the things that have happened such as the devastation of Native Americans and slavery.

Q: Is there something about healthy equity that you think others are not noticing or paying enough attention to?
A: The rates of suicide, addictions, and ACEs that are so much higher with particular groups and communities. I don’t think a lot of people pay attention to those things. I’m always amazed when I’ll say something like, 1 in 4 kids have experienced trauma in each classroom, to a teacher, and they don’t know that, they’re surprised at that. Or, for example, the conditions of some reservations that are right up the road from where I live, but people don’t know about it. I would in general say there is a problem with knowledge of health equity.

Q: Do you have any strategies for organizations that are wanting to start talking about the effects of historical trauma?
A: It’s important to work with the groups that have experienced that trauma. For example I’m a non-Native person, I have knowledge from what I’ve taught about historical trauma and I might talk very basically about what that is, but I would never speak about a group or a population that I am not a part of unless I was invited to do so collaboratively. I would say to work with individuals who are a part of that community, that have that knowledge. There’s a growing body of literature about it, especially by Native people, that talks about the impact [of historical trauma] which is quite important.

Q: How can we make space to incorporate the people that have experienced historic trauma into the process of understanding historic trauma?
A: I think some of the philosophies like “nothing about us without us”, I think that’s huge. There’s probably some norms that need to be changed, that I need to change. The space has to be safe, I would think that we would need to collaborate more directly with the people experiencing those oppressions. One of the things I think that we could do within academia, as a participatory researcher, when I work in Native communities I would employ community based participatory research methods that not only include Native people, but have the people in the community also as co-researchers. Engaging and valuing the knowledge that those people have as valid. Broadening what we view as science as valid; [broadening the] data and knowledge to include indigenous ways of knowing and what communities have experienced.

Q: What does your work mean to you and how does it connect to health equity?
A: I’m still a LICSW and I still keep a caseload and see kids pro bono that have experienced trauma. I think before I became an academic and got my PhD it was easier to answer that question because I was working with those individuals and helping them through their trauma whether it be community organizing or things that Social Workers do. How I think it fits now — and in some ways it’s been a difficult switch for me because I never saw myself as an academic, I saw myself as a person doing the work — what I’ve realized now is if I talk about things like racism and oppression, health inequities and bring in other people that can talk about them even better than me in my classes then I can exponentially impact [health equity]. There’s a movement in Social Work to be more clinical, and my school and myself we refuse to do that because the roots of our profession are about promoting social justice, so I think that I resist. I teach clinical classes and if I teach a class on trauma I will talk about evidence based practices, but I’m also going to talk about practice based evidence and I’m also going to say that we need to look at why the trauma is happening and it’s often times because of health inequities, racism, and oppression.

Q: How can systems shift power to communities in their work for health equity?
A:  Working with constituents, and actively and fully involving service users, and not just in a cursory way but in leadership ways. Having service users on your board, in leadership positions, in paid positions. Building capacity, looking at my role as a researcher – one of the best things that I can do in working with communities is help them to build their capacity to do their own research so that the grant doesn’t come to the university and we get all of the benefits. Instead the grants go to the tribe and if they need help they can contract for that.

Q: How can we as organizations better prevent structural injustices through our health equity work?
A: We need to be advocates, we need to show up, to vote, and mobilize and employ community organizers within communities to get the word out. Awareness that leads to action – standing up to structural injustices and speaking up.