Indigenous Land-based Healing Programs in Canada: A scoping review

Full text

Indigenous Land-Based
Healing Programs in Canada:
A Scoping Review
Prepared for: Hotıì ts’eeda and NWT Recreation and Parks Association
August 2019

1
About this publication
Hotıì ts’eeda is a research support centre
for community members, organizations and
researchers involved in Northwest Territories
health and health research. It is funded by the
Canadian Institutes of Health Research under
their Strategy for Patient-Oriented Research. The
organization is hosted by the Tłı̨chǫ Government
and supported by a partnership of NWT
governments and organizations. To learn more
about Hotıì ts’eeda, visit nwtspor.ca.
The NWT Recreation and Parks Association works
with communities across the NWT to promote
recreation by supporting leaders, communities,
and partners through training, advocacy, and
networking.To learn more about the NWT
Recreation and Parks Association, visit nwtrpa.org
For more information about this literature review,
contact Hotıì ts’eeda at communications@
nwtspor.ca.
Acknowledgements
This report was prepared for Hotıì ts’eeda and the
NWT Parks and Recreation Association by Crystal
Milligan (University of Toronto).

2

3
Background
Colonization of the lands now known as Canada
is widely acknowledged as the primary source
of ill health among First Nations, Inuit and Métis
peoples (1–6). Residential schools, reserves and
other colonial systems undermined Indigenous
peoples’ abilities to live healthy lives by severing
their ties with their cultures and ancestral lands
(1) and disrupting the social foundations upon
which their societies were built (3). Contemporary
symptoms of colonization include inequitable
systems that place Indigenous peoples in a
position of disadvantage and reinforce cycles
of trauma and poor health outcomes (5,7).
Furthermore, a general failure among Canadian
health and social services systems to recognize
Indigenous knowledges, ways of knowing and
cultures contributes to health policies and services
that are culturally unsafe and do little to address
Indigenous peoples’ wholistic health needs (8).
The most appropriate mechanism and site of
healing for Indigenous peoples are perhaps the
lands from which they were forcibly displaced
(9). Relationship with the land has forever been
a core aspect of health and healing in Indigenous
communities (10–12), and being on the land
is therefore key to restoring one’s connection
with traditional health knowledge and ultimately
nding means to heal (4,13,14). Yet there are
very few published studies or even evaluations
of land-based healing programs in Canada
to inform our understanding of their design
and implementation. This deciency is even
more conspicuous when considered in light of
recognition by the United Nations Declaration on
the Rights of Indigenous Peoples (UNDRIP) of the
inherent right of Indigenous peoples worldwide
to use their own medicine and health practices
(15). This imperative is reinforced by the Truth
and Reconciliation Commission (16), which
called on Canada to collaborate with Indigenous
healers and Elders to make such medicine and
healing practices available to Indigenous clients.
Others still have called for health professionals to
develop a basic understanding of the cultures and
ways of knowing that underlie Indigenous health
practices (17,18), which encompass land-based
approaches to healing.
This paper presents the ndings of a scoping
review that aimed to determine and describe what
is known in academic and grey literatures about
Indigenous land-based healing programs in Canada.
A scoping review was well-suited to this aim
given the intent to map concepts in the literature
and provide an overview of the range of current
evidence and activities (19). Following established
methodology (20), this review contributes to the
evidence base for Indigenous land-based healing
programs in Canada by synthesizing knowledge
and pointing toward future directions in research.
The term ‘Indigenous’ is used throughout this
paper to collectively refer to First Nations,
Inuit and Métis peoples. This collective term
acknowledges similarities in First Nations, Inuit and
Métis experiences with colonization and facilitates
ease of reading. It is not intended to deny the
diversity in cultures, practices or histories among
these peoples. On the contrary, this paper aims to
support a conceptualization of Indigenous healing
as an expression of the richly diverse knowledges,
identities and values among First Nations, Inuit
and Métis peoples (21,22). Wherever possible,
the name according to which an individual or group
self-identies is used.

4
Methods
Study design
A scoping review was chosen to search for
and review academic literature and other non-
academic information sources in order to
synthesize existing knowledge about the design
and implementation of Indigenous land-based
healing programs in Canada. The scoping review
is a common method for reviewing literature on a
given topic and demonstrating what is known or
not known, helping to inform policy, practice and
additional research (20). Designed according to
methodology established by Arksey and O’Malley
(20), the methods and ndings of this scoping
review are reported as per the PRISMA Extension
for Scoping Reviews (PRISMA-ScR) (23). An
academic health sciences librarian was consulted
in the planning and development of the study
design and search strategy.
Search strategy
The search strategy included an academic
database search, search engine queries, targeted
website review and reference tracking. Search
terms included several combinations, variations
and synonyms of ‘Indigenous,’ ‘land-based,’
‘healing’ and ‘Canada.’ Terms such as ‘wilderness
therapy’ or ‘outdoor behavioural healthcare,’
which appeared to be used primarily by non-
Indigenous organizations and mostly returned
examples of land-based programs that were not
connected with an Indigenous worldview, were not
included.
The initial academic search strategy was developed
for Ovid MEDLINE® using a combination of title,
abstract and subject headings in addition to text
words and then translated for other academic
databases. The full search equation for Ovid
MEDLINE® is found in Appendix A. Final searches
with no language or date limits were conducted
between November 19-December 11, 2018 in
Ovid MEDLINE®; PsycINFO; CINAHL Plus with Full
Text; Embase Classic; Bibliography of Native North
Americans; Arctic Health Publications Database;
and the University of Saskatchewan Indigenous
Studies Portal (iPortal). Eight other academic
databases or repositories were searched, but
generated no eligible citations.
Online search engines used in this review were
Google, Google Scholar and Duck Duck Go. Web
browser cookies were cleared before beginning
any searches. The review of search results
continued up to ve pages after last clicking on
a relevant item. The websites of 70 Indigenous
organizations, research centres, universities,
news agencies and governments in Canada were
also reviewed using a combination of Advanced
Google, website search bars and browsing.
Eligibility criteria
This research sought to identify work based in
empirical research, theory or actual practice
that described Indigenous land-based healing
programs in Canada. Citations had to fulll the
following criteria to be included in this study:
• Description of an actual land-based healing
program(s) led by Indigenous peoples or
organizations or discussion of Indigenous
healing in connection with the land;
• Whether it is labelled using ‘healing,’
‘recovery,’ ‘mental wellness promotion’ or
other similar terms, healing is described
as part of the program’s mandate, design
or outcomes;
• Inclusion of a Canadian setting(s); and
• Written in English or French.
Citations were excluded if they were dated before
2000, a date chosen on the basis of preliminary
searches in Scopus that indicated articles related
to ‘Indigenous healing’ increased in number after
this year. This also served to limit the number of
search results that pertained to healing programs
no longer in operation.
Study selection and data collation
Before screening began, the eligibility criteria

5
were pilot tested on a preselected list of 10
citations. A single reviewer reviewed all titles and
abstracts. Where there was not enough or unclear
information to exclude a citation, the citation was
included for full-text review. In total, 50 citations
were screened in for full-text review against the
eligibility criteria. Six additional citations were
included at this stage after reviewing the reference
lists of all citations. This process is illustrated in
Figure 1 below.
Using a chart in Excel, data were extracted with
regard to numerous variables including article
characteristics (e.g., geographic focus, funding
source, document-type); denition of land-
based healing; and program description (e.g.,
governance structure, delivery model, clients).
For a summary of data abstraction for each specic
Indigenous land-based healing program, see the
table in Appendix C. Results were synthesized
using frequencies and thematic analysis (24).
Meta-analysis was not performed.
Figure 1: PRISMA ow chart
Citations identied through academic databases
(MEDLINE, PsycINFO, CINAHL Plus, Embase,
Bibliography of Native North Americans, Arctic
Health Publications Database, iPortal)
(n=3,462)
Citations identied
through online
search engines
(n=28)
Citations identied
through targeted
website search
(n=40)
Citations after
duplicates removed
(n=2,224)
Citations screened
in (n=50)
Citations excluded
(n=2,174)
Full-text documents
assessed for eligibility
(n=56)
Citations found through
reference tracking of
relevant texts
(n=6)
Full-texts excluded
(n=12)
Full-text documents
included in synthesis
(n=44)
SEARCHSCREENINGELIGIBILITYINCLUDED

6
Results
Literature search
In total, 2,224 titles and abstracts and 56 full-
text documents were assessed for eligibility. Of
these, 44 fullled the eligibility criteria and were
included in this review. The academic database
search contributed 15 citations for full-text
review. Google Scholar did not respond to the
search terms. Google, however, contributed 15
documents that were included in full-text review.
Duck Duck Go supplemented this output with
three more. The targeted website search found
11 citations that were included in the review. The
websites that contributed the greatest number of
relevant items are included in Table 1.
Table 1: Top targeted websites (number of items
generated)
Aboriginal Healing
Foundation
ahf.ca
Cree Board of Health and
Social Services of James Bay
creehealth.org
Kwanlin Dün First Nation kwanlindun.com
Pauktuutit Inuit Women of
Canada
pauktuutit.ca
Qaujigiartiit Health Research
Centre
qhrc.ca
Thunderbird Partnership
Foundation
thunderbirdpf.
org
Characteristics of included documents
As shown in Table 2, most documents (73%) were
published in the last decade. Six (14%) documents
were undated. The majority of documents
focused on the northernmost regions of Canada:
7 (16%) documents pertained to a single land-
based healing program in Yukon; 4 (9%) pertained
to various programs in Nunavut; 7 (16%)
pertained to northern Canada generally; and 14
(32%) pertained to programs in the northern
regions of British Columbia, Ontario, Québec
and Newfoundland and Labrador. Twelve (27%)
documents focused on Canada more generally.
This review found written documentation of
Indigenous land-based healing programs in Canada
from academic and non-academic sources to be
limited. General description of each document
included in this review is provided in Appendix B.
In summary, the documents included 18 (41%)
reports or report summaries; eight (18%) journal
articles; six (14%) PowerPoint presentation
slide decks; ve (11%) workshop guides or other
manuals for land-based healing programming;
three (7%) information sheets or booklets; two
(5%) posters; one (2%) Master’s thesis; and one
(2%) video. Whereas half did not report their source
of funding for document development, 13 (30%)
indicated government funding and nine (20%)
indicated funding from a non-prot organization.
Notably, six of the nine acknowledged funding
from the Aboriginal Healing Foundation (25–30).
Among 22 (50%) documents that were specic
to a prior or currently existing program, only four
(9%) assessed or evaluated program outcomes
or impact (27,31–33). The 22 (50%) documents
that were not specic to a prior or currently existing
program nonetheless enhanced understanding
of specic programs as well as wise practices in
land-based healing. These documents included
10 (23%) literature reviews or other knowledge
syntheses; ve (11%) workshop guides or other
manuals; four (9%) articles or reports outlining
research into program outcomes or impact; and
three (7%) descriptive documents. See Appendix
B for detail on each document.

7
Year of publication 2000-2004 1 (2%)
2005-2009 5 (11%)
2010-2014 15 (34%)
2015-2018 17 (39%)
Geographic focus British Columbia 1 (2%)
Newfoundland and Labrador 4 (9%)
Nunavut 4 (9%)
Ontario 6 (14%)
Quebec 3(7%)
Yukon 7 (16%)
Northern Canada 7 (16%)
Canada 12 (27%)
Funding source Government or government agency 13 (30%)
Non-prot organization 9 (20%)
Not reported 22 (50%)
Program focus Specic to an actual program 22 (50%)
Not specic to an actual program 22 (50%)
Document type Report or report summary 18 (41%)
Journal article 8 (18%)
PowerPoint slide deck 6 (14%)
Workshop guide or other manual 5 (11%)
Information sheet or booklet 3(7%)
Poster 2 (5%)
Master’s thesis 1 (2%)
Video 1 (2%)
Document purpose Provide description 21 (48%)
Synthesize knowledge/research 10 (23%)
Assess or evaluate program outcomes or impact 8 (18%)
Guide implementation of a program or workshop 5 (11%)
Table 2: Document characteristics (n=44)

8
Denitions of land-based healing
Only four (9%) documents provided a denition
for land-based healing (31,34–36). The most
comprehensive denition, provided by Hanson
(31) and cited by Redvers (34) states that a land-
based healing program is:
“…a health or healing program or
service that takes place in a non-urban,
rural or remote location on a land base
that has been intentionally spiritually
cultivated to ensure the land is honoured
and respected. The land is understood
to be an active host and partner to the
people engaged in the healing process.
The cultivation of a land base under the
stewardship of First Nation people is
usually done through the development
of an intimate spirit-based relationship
through ceremony, offerings, expression
of gratitude and requests for permission
from the land to enter and use it for
healing purposes.” (Hanson, 2012, p.2)
Redvers (J. Redvers, 2016, p.3) offered a similar
denition of land-based healing as a “set of
culturally-dened healing practices in a non-urban
location” where “the land is a host and partner” to
healing and the focus is on “renewing a person’s
relationship and connection with the land.” She also
indicated the possibility of integrating Western
therapeutic methods into healing processes. Walsh
et al (Walsh, Danto, & Sommerfeld, 2018, p.3)
simply dened land-based healing as interventions
that address the “essential connection” between
Indigenous peoples and the land as part of
their mental health and healing. Though his
research focused on the meaning and processes
of healing generally rather than land-based
healing specically, Waldram acknowledged the
ambiguous meaning of ‘Indigenous healing,’ which
he described as occurring through relationship
with others (Waldram, 2008). Another document
described healing as “when one person speaks
and another listens” (Justice Department, 2010,
p.1). Additional authors supported the idea that
the land facilitates connection given that being
on the land is therapy in itself (39); a facilitator of
intergenerational relationships (36); and brings
people close to God (Mamakwa, Meshake, &
Macfadden, 2015).
The term ‘healing’ was not always used to describe
land-based interventions that contribute to
wellbeing among Indigenous clients. Alternative
descriptors included ‘mental health and wellness’
(32,41–45); ‘resilience promotion’ (46,47);
‘suicide prevention’ (36,47); and ‘recovery and
personal growth’ (48). Rowan et al (49) discussed
healing in terms of wholistic recovery from
addictions.
Indigenous and Western healing frameworks
In describing the foundations of land-based
healing, nine (20%) documents focused on
programming entirely built upon local Indigenous
knowledges and ways of life (43,44,46,50–
55). Notably, one program was structured on
mentoring relationships through which program
clients received traditional teachings and skills
from community volunteers (43,44,46).
By contrast, 14 (32%) documents described
a number of specic frameworks founded on a
blend of Indigenous and Western knowledges
and evidence (27,29,31–33,40–42,56–61).
Common to each framework was the integration
of Western therapeutic techniques within
Indigenous knowledges, ways and culture—
not the other way around. For example, the
Eight Ujarait (Rocks) Model, developed through
literature reviews and community consultations in
Nunavut, provides a foundation to bring Inuit and
Western knowledges together while privileging
Inuit culture (32). The Jackson Lake Land-based
Healing Program in Kwanlin Dün First Nation
(Yukon) has developed its own Building a Path
to Wellness Model that is designed according to
local knowledge and experience while aligning

9
with national guidelines for ethical healing in
Indigenous communities, frameworks to address
substance abuse, and mental health strategies
(Kwanlin Dün First Nation, n.d., p.1). The Jackson
Lake program also uses the Medicine Wheel as the
basis for its program logic model and evaluations
(33). Similarly, the First Nations Mental Wellness
Continuum (40,58,60,61) and Indigenous
Wellness Framework (41,42) hold Indigenous
values, worldviews and culture at their centre and
suggest the outcomes of healing and wellness are
hope, belonging, meaning and purpose.
The remaining 21 (47%) documents did not
specify a framework for healing.
Wise practices
Wise practices are dened as “locally-appropriate
[emphasis added] actions, tools, principles
or decisions that contribute signicantly to
the development of sustainable and equitable
conditions” (Wesley-Esquimaux & Calliou, 2010,
p.19). Wise practices—as opposed to best
practices, which may or may not be replicable
in other settings—are seen as reective of the
great diversity among Indigenous peoples and
places and therefore more relevant in Indigenous
settings (62,63). The documents considered
here cited a variety of practices attributed to
the effectiveness and overall success of land-
based healing and are therefore considered wise
practices in the context of this review. These wise
practices are represented in Figure 2 below, listed
according to the number of documents that cite
them explicitly.
A foundation in Indigenous culture and spirit was
cited as a wise practice in 26 (59%) documents.
Elders were seen as having a prominent leadership
role in creating this foundation, as cited by 20
(45%) documents. Indeed, one literature review
suggested that input from Elders is necessary
to tailor programs to local context and cultures
(64). Due to the place-based nature of Indigenous
healing practices, community direction and
ownership were also widely understood to be
essential. Fourteen (32%) documents indicated
that community-driven programs are better
able to respond to local priorities and needs and
take advantage of community strengths. In the
least, as suggested by eight (18%) documents,
consultation with the community during program
development is recommended. In Chisasibi,
Québec, the community supported the local land-
based healing program by helping to identify health
and social service needs, engage with clients
and their families, identify a pool of local cultural
resources, and strengthen aftercare (51,55).
Figure 2: Wise practices cited, by number of citing
documents
Ground the program in culture and
spirit
26
Give Elders leadership roles 20
Ensure cultural and personal safety 17
Blend mainstream and traditional
approaches, privileging Indigenous
ways
17
Have activities to build skills and facil-
itate experiential learning
17
Focus on fostering healthy relation-
ships
17
Allow the community to drive and
direct the program
14
Conduct program evaluation 12
Collaborate with families of clients 8
Develop partnerships across various
service sectors
8
Offer traditional foods 8
Consult with community to develop
the program
8

10
As mentioned in the previous section, a foundation
in Indigenous culture and spirit does not necessarily
preclude Western approaches. This is reected
in 17 (39%) documents that endorsed blending
Indigenous and Western ways. For example,
the Jackson Lake program in Kwanlin Dün First
Nation is rooted in the land, traditional knowledge,
spirituality and ceremony, but aims to balance
these cultural elements with mainstream clinical
practice. Visits by medical staff from the Kwanlin
Dün First Nation health centre are considered a
strength of the program because clients are able
to access care for underlying health issues (39). In
the same way, the Carrier Sekani Family Services
land-based healing program in central-northern
areas of British Columbia has formally adopted
a two-eyed seeing approach, which refers to
the valuing of both Indigenous and Western
ways of knowing (65,66). Over 28 days, clients
participate in traditional activities such as sweat
lodge ceremonies or talking circles, but also have
ongoing one-on-one sessions with an addictions
counsellor or therapist.
Seventeen (39%) documents cited the creation
of an environment that ensures cultural and
personal safety of clients as a wise practice.
Cultural safety refers to an environment where
the Indigenous client feels respected and safe
to be who they are, and the determination of
cultural safety can be made only be the client
(8,67). Personal safety refers to protection from
danger or injury while out on the land and can be
achieved by many logistical and risk management
measures such as prohibiting drugs and alcohol,
wilderness insurance, emergency communication
and response systems, conict resolution training
and ensuring access to drinking water. Some
programs have integrated safety measures
with their activities to build skills and facilitate
experiential learning, which is a wise practice cited
by 17 (39%) documents. The Nishiiyuu land-
based healing program in Whapmagoostui First
Nation (Québec) has incorporated canoeing skills,
water safety training and teachings from Elders
about weather forecasting as part of its three-
day preparation training for program staff (52).
Engagement and screening of incoming clients
also contribute to personal safety by ensuring
they are ready to commit to healing. Education,
support and assessment are seen as necessary
to ensure the client is mentally, emotionally and
spiritually ready to enter the program and benet
from the program as much as possible (33,39,66).
This is crucial not only for the individual client but
for other clients, especially if it is a long program.
The development of healthy relationships was
cited as a wise practice by 17 (39%) documents.
The Aullak, Sangilivallianginnatuk (Going Off,
Growing Strong) youth program in Nunatsiavut
(Newfoundland and Labrador) has found that
youth relationships with ‘harvester-mentors’
builds community resilience and connection with
culture while supporting cultural land-based
activities (46). The Jackson Lake program has
integrated days when the clients’ families can visit
camp, helping to build and rebuild relationships
for sustained healing and aftercare. Furthermore,
developing relationships and partnerships across
various service sectors and with local Indigenous
governing organizations was seen as a facilitator
of local capacity building and cited as a wise
practice by eight (18%) documents. For example,
the Chisasibi program collaborates with local and
regional health and justice service providers (55).
Relationships across service sectors and the local
community are likely to also assist in the provision
of aftercare, cited as a wise practice by seven
(16%) documents. After completing a land-based
healing program, clients require support in the
community to turn new healthy living patterns
into habit. Aftercare is considered an essential
way to ensure this support is in place, and has
been found to reduce a client’s risk of returning
to harmful practices such as substance abuse
(33). The Nishiiyuu land-based healing program
in Whapmagoostui First Nation runs an aftercare
program that includes paddle making, knife
carving, counseling, peer support, healing circles

11
and sharing circles (52). Written, personalized
aftercare plans for each client are also helpful to
guide aftercare in a relevant and impactful way
(31,33).
Another wise practice cited by 12 (27%)
documents was program evaluation. Evaluation
can be used as a tool to improve program design
and implementation by identifying areas for
improvement and areas of success. The evaluation
of program outcomes can also support efforts
to secure funding. However, there are very few
frameworks to evaluate land-based healing
programs. In the case of a women’s camp at Jackson
Lake, clients were interviewed on a weekly basis to
gather data to indicate how the program made a
difference in their lives in the short-term, and again in
the months after the program ended to get a sense
of longer-term impact (33). In a different example,
the Shibogama land-based family healing program
(Ontario) has drawn from a variety of sources for
evaluation data, including observation, video,
photo collages made by client families, and family
trees and histories painted by clients (Mamakwa
et al., 2016). The Aullak Sangillivalianginnatuk
(Going Off, Growing Strong) program recognizes
evaluation as a core component of the program. Its
evaluation team includes program team members,
harvesters, community members and university
researchers. In 2012, a postdoctoral fellow lived in
Nain for 10 months to support discussions about
the documentation and evaluation of the program
(44). Other programs have also used university
researchers to help document their work. Project
George in Moose Cree First Nation (Ontario)
recently collaborated with researchers to study
the components of land-based interventions, key
challenges, and steps in transferring knowledge
(36). In 2011, Carrier Sekani Family Services
became involved in a national research project that
aimed to gather evidence to support the idea that
reconnecting clients with culture on the land was
effective to help recovery from addictions (66).
Characteristics of specic programs
The 22 (50%) documents that were specic to
a prior or currently existing land-based healing
program permitted a deeper understanding of
the features of 11 programs located across
Canada: three in Nunavut; two each in Québec,
Newfoundland and Labrador and Ontario; and one
each in Yukon and British Columbia. Target clients
varied across programs, with four programs
serving youth only (32,36,44,46,50); one serving
families (58); one serving adults only (52); and
another serving only men aged 18-30 (51,55).
Three programs were described as serving all
demographics (27,29,57), although the Jackson
Lake program offers gender-specic programming
(31,33). One program did not specify target
clientele (66).
Six programs take place over one to four weeks
either at a land-based camp (31,33,36,55,58,66)
or journeying on the land (52). By contrast, the
other ve programs are only partially land-based
and instead integrate land-based activities within
a program held either at a residential facility (50)
or through other community-based initiatives
(27,29,32,44–46). All programs were described
as driven and directed by Indigenous community
leadership, Elders and volunteers, except two:
while the Nutshimit Program at the Charles J.
Andrew Treatment Centre (Newfoundland and
Labrador) is governed by a board of directors
representing Innu, Nunatsiavut and the Atlantic
Policy Congress (50), the curriculum of the
Makimautiksat Youth Camp (Nunavut) was
developed by the Qaujigiartiiit Health Research
Centre, which provides training to new facilitators
in communities that wish to hold the camp (32).
Six programs clearly described a blend of
Indigenous and Western approaches to healing,
integrating trauma-informed counselling and
other mental health treatments with practices
such as healing circles, storytelling, spiritual
ceremony and other Indigenous forms of therapy
(27,29,31,33,38,40,50,56–58,66,68,69).

12
Descriptions of the other ve programs
focused on traditional and cultural teachings
and practices or simply being on the land
(32,36,44,44,46,48,51,52,55).
With regard to program team composition,
all programs recognize the importance of
participation by Elders and other knowledge
keepers (e.g., Mamakwa et al., 2016; Plaskett &
Stewart, 2010). Documents pertaining to three
programs (i.e. the Nutshimit Program at the Charles
J. Andrew Treatment Centre, the Carrier Sekani
Family Services program and the Jackson Lake
program) described a combination of Indigenous-
and Western-trained staff (33,50,66), though
Plaskett and Stewart (33) acknowledged that
clients may more easily engage with healers that
resemble themselves. The program run by Carrier
Sekani Family Services does not attempt to hire
only First Nations staff but does require all staff
to understand local First Nations worldviews and
actively participate in cultural activities (66). At
Jackson Lake, the program team includes a First
Nations lead to coordinate First Nations healing
practices; a clinical lead to coordinate mainstream
healing practices; a land-based cultural program
coordinator; community outreach workers; camp
attendants; and cooks (57). Common roles across
all programs are listed in Table 3 (opposite).
Of the 11 programs nine cited having to pool
funding from various sources. Five of these
programs (programs at Carrier Sekani Family
Services, Chisasibi, Jackson Lake, Shibogama
First Nation and Project George) receive funds
from Indigenous and/or Canadian governments
(36,51,57,58,66). Project George, run entirely
by community volunteers under the guidance
of Elders, is in fact primarily funded through
fundraised donations (36). The Makimautiksat
Youth Camp appears to operate according to a
different model whereby communities that wish
to hold a camp contract the Qaujigiartiit Health
Research Centre to train facilitators. There is little
publicly available information about the costs of
land-based healing programs. A sole analysis by
Radu (2018) determined that the average cost
per client for an eight-week land-based program
is $9,200. This gure does not include start-up
costs of equipment (estimated at $500,000) or
participant travel costs. The cost of a three-week
program at Chisasibi with ve staff and seven
clients is estimated at $20,000, including gas,
food, Elder honoraria and other small contract
payments.

13
Role Brief Description
Aftercare coordinator • Help clients develop aftercare plans
• Liaise with support resources in community
• Connect clients with community support
• Follow-up with clients after program completion
Camp helpers • Complete daily camp tasks such as collecting rewood or
cleaning
Clinical counselor • Lead clinical healing practices
• Connect client with other health-care professionals as
needed
Community outreach workers • Liaise with community agencies to promote program and
identify clients
Cook and cook assistants • Plan and prepare meals
Cultural worker • Collaborate with Elders to implement cultural activities
Elders • Lead program content and strategy
• Design traditional healing plans
• Provide wholistic counseling
• Share traditional knowledge
• Advise program coordinator
Healer/cultural counselor • Lead traditional healing practices
• Support client healing processes
• Support client personal growth
Intake coordinator • Oversee client referrals, assessment, and intake
• Conduct client entry interviews
• Support potential clients to become ready for the program
Night staff • Ensure camp security at night
Ofce manager • Process program registration
• Data entry
• Support program coordinator with other administrative
tasks
Program coordinator • Oversee organization and implementation of the program
• Recruit and manage team
• Facilitate orientation and debrieng sessions
Table 3: Example roles within a land-based healing program

14
Discussion
This study set out to determine and describe
what is known about Indigenous land-based
healing programs in Canada. Rather than an
exhaustive account of knowledge about land-
based healing, this paper provides a summary
of what knowledge is available in writing—in
Canada only. The objective was to capture the
greatest possible breadth and depth of written
knowledge, regardless of document type and
without assessment of document quality, which
is not included in scoping review methodology
(20). Due to the limited availability of written
documentation, this review extended beyond
journal articles and reports to include PowerPoint
presentation slide decks, posters, video and other
types of documentation publicly available online.
Even so, it appears that land-based healing is
poorly documented, one possible reason being
that knowledge about Indigenous healing remains
held in Indigenous worldviews, language and oral-
based traditions. Furthermore, the documents
included in this review are primarily focused
on northern regions of Canada, which raises
questions about the environments that are most
conducive to implementing—or perhaps simply
documenting—land-based healing programs. As
shown in this review, programs vary according
to their local contexts. Building on this review,
consultation with Indigenous Elders, communities
and land-based healing program managers would
be invaluable to contextualize and interpret
the results from local Indigenous perspectives.
Respectful dialogue, privileging Indigenous voice,
would also help to address any biases potentially
present in this review as a result of the author’s
non-Indigenous Settler Canadian status.
While there are studies that relate to healing in
Indigenous communities and others that relate to
land-based programs, less attention is paid in the
literatures to examining land-based healing as a
single (albeit multidimensional) construct. Among
the denitions of land-based healing presented
above, key shared components include spiritual
practice, healing as a process, and relationship
with the land as both host and partner to healing
(Hanson, 2012; Health and Social Development
Department, 2013; Mamakwa, Meshake, &
Macfadden, 2015; Redvers, 2016b; Waldram,
2008). Redvers (2016a) similarly proposed that
a land-based healing program is dened by three
main elements: Indigenous healing practices;
health and wellness teachings connected to the
land; and recognition of the land as necessary for
personal and intergenerational healing. Denitions
aside, the documents in this review collectively
point to the need for Indigenous values,
worldviews and healing practices at the heart of
land-based healing programming. The Chisasibi
Land-based Healing Program, for example, has
adopted a culture-based model wherein Iiyiyiu
(Cree) methods, teachings, and perspectives
form the program’s core principles (55). Such
a strong foundation in culture and spirit seems
a standard wise practice, even where programs
or frameworks reect a blend of Indigenous and
Western knowledges and evidence (32,40–
42,57,58,60,61). Nonetheless, a dearth of
formal research or evaluation, combined with the
place-based nature of wise practices and healing
itself, make the comparative analysis of programs
in diverse settings challenging.
Moreover, healing remains a term that is
challenging to dene from a Western academic
perspective. Western denitions of healing may
not always match denitions held within Indigenous
communities. Whereas Western science tends to
view healing from a clinical, biological perspective
oriented toward the individual, Indigenous peoples
tend to view healing from a collective perspective
oriented toward repairing social relationships
(Waldram, 2008). The Royal Commission on
Aboriginal Peoples acknowledged this divergence,
describing healing as “practices designed to
promote mental, physical and spiritual well-being
that are based on beliefs which go back to the
time before the spread of western, ‘scientic’ bio-

15
medicine” (Dussault & Erasmus, 1996, p.325). It
has also been described as a continuous process
(33,71), transformative not only in the biomedical
sense, but also in terms of individual or community
empowerment (72) and applying new life skills
(3). Furthermore, the biomedical perspective may
be less inclined to recognize the systemic social
suffering that is at the source of what Indigenous
peoples are healing from (Adelson, 2001;
Adelson, 2000; Irlbacher-Fox, 2009; Waldram,
2014). Caused by the systemic oppression of
colonization, social suffering may manifest in
innumerable ways including poverty, addictions
and violence in addition to general poor physical
health (Adelson, 2009; Irlbacher-Fox, 2009). The
antecedents, practices and outcomes of healing
are thus heavily inuenced by a complex web of
social and political determinants (75), a greater
understanding of which could be attained through
further research.
A poor understanding of healing, combined with
a tendency in Western science to focus on illness
instead of strength, may play a part in the varied
terms used to describe healing programs in the
literature, such as ‘suicide prevention’ or ‘recovery
from addictions.’ There is also the question of
whether a program is a ‘healing program’ or
just a ‘land-based program.’ Although the term
‘healing’ may never be used to describe a land-
based program, many may still lead to healing.
The Makimautiksat Youth Camp in Nunavut is
one example. This program is founded on Inuit
knowledge and traditions to foster physical,
mental, emotional and spiritual wellness among
youth, and includes on-the-land components
delivered by Elders and other knowledge keepers. It
is not described as a healing program even though
participants have reported feeling happier, more
energetic, and less sad (32). Another example
is the Aullak, Sangilivallianginnatuk (Going Off,
Growing Strong) program in Nain, Nunatsiavut,
a grassroots initiative operated out of the Nain
community freezer housed in the Nain Research
Centre. This youth outreach program takes Inuit
youth onto the land but does not describe itself
as a healing program. Even so, the program was
launched in response to a cluster of school-aged
male suicides in 2011 and has contributed to what
can arguably be described as healing, reected in
a reduction in suicide rates among school-aged
males and the Nain population in general (46).
Whether or not the term ‘healing’ is used, being
on the land is central to Indigenous peoples’
healing. Redvers (2016) found that land-based
programs led to positive mental, physical,
emotional and spiritual outcomes, regardless of
program objectives. For example, residents of
Clyde River, Nunavut, report feeling safer and
more open to talking about their challenges when
out on the land (76). In Ontario, the Shibogama
Health Authority in Sioux Lookout has structured
its family healing program around the ‘stimulating
our senses model,’ which encourages people to
reect on their ve senses while on the land and
replace negative memories with positive ones,
bringing about “feelings of wellness and change”
(Mamakwa et al., 2016, p.15). In the words of
Radu (2018, p.4), “healing with the land is a
practice and knowledge system that is common
to Indigenous peoples everywhere.”
What varies is how healing with the land may be
approached via a formal program. Indigenous land-
based healing programs in Canada have adopted
numerous different models of delivery. Whereas
many programs are held entirely on the land (e.g.,
Jackson Lake), others may integrate land-based
activities within the context of a treatment facility
or organization that is off the land. In these cases,
land-based healing is considered one aspect of
a broader initiative or service. For example, the
Charles J. Andrew Youth Treatment Centre, a
residential facility, runs the Nutshimit Program to
help youth develop self-esteem and Indigenous
identity while learning life skills on the land (50).
The Makimautiksat Youth Camp is based on an
eight-module curriculum primarily implemented
in community centres or schools, with a two- to
three-day on-the-land component (32). Indeed,

16
the sustained length of time on the land also
varies by program, from a few days at a time
(e.g., the Makimautiksat Youth Camp and Aullak
Sangilivallianginnatuk) to a few weeks (e.g., the
Jackson Lake and Carrier Sekani Family Services
programs). Many informants to a Yukon report
on land-based healing programs suggested three
months would be ideal (39), though there appears
to be no consensus (or serious exploration) in the
literature regarding requisite lengths of time spent
the land. It may be that time spent on the land may
simply be a function of funding. For example, the
Shibogama land-based family healing program
has had to adapt the length of its summer healing
camps according to available funding; unlike the
rst 21-day camp in 2013, the eight-day camp in
2015 was seen by participants, resource workers
and Elders as too short (Mamakwa et al., 2016).
Regardless of time spent on the land, a program
structure that permits exibility to adapt to client
and community strengths and needs appears to
be important. The relatively well-established and
well-documented program at Jackson Lake is
structured over four weeks, with a different theme
each week (i.e., nding a sense of place, setting
goals, facing fears and developing aftercare
plans). In Chisasibi, the land-based healing program
is described as having a basic daily structure of
lectures, group discussions and bush activity at
the same time as exibility to adapt to the “natural
rhythm of life in the bush” and new circumstances
as they arise (Radu, House, & Pashagumskum,
2014, p.90). By contrast, Project George, an all-
season camp established in 2009 to address youth
suicides in Moose Factory and the Moosonee area
of Ontario, does not focus on structured learning.
The purpose of Project George was clearly
described by the program’s namesake, the late
Elder George E. Echum: “nothing fancy, just take
them out” (48).
Evidently, this is where fostering healthy
relationships—with oneself, other individuals,
the land and ancestors—comes in. Despite
their place-based nature, healing practices and
traditions among different Indigenous groups
are similar in their orientation toward communal
approaches to helping one another heal (77).
In fact, decolonization has been described as a
movement from individual to social wellness and
a shared sense of belonging and empowerment
(11,77). In other words, mending relationships is
central to healing, which also presents an entry
toward decolonization through empowerment
of individuals and communities to engage in
political resistance and transformation (55).
Human relationships have an added benet of
transmitting cultural understanding and skills
through intergenerational connections between
program clients and mentors. Interorganizational
relationships also strengthen land-based healing
programs. The program that nurtures partnerships
across various service sectors and with local
Indigenous governing organizations will identify
more support resources and points of referral in
the community. As demonstrated by the Chisasibi
program, health and social services agencies,
as well as the justice department or community
justice committees, can play important roles in
identifying and referring clients to land-based
healing programs. Relationships with individuals
and organizations throughout the community also
support the provision of aftercare.
Indigenous land-based healing programs in
Canada are thus founded in culture, spirit and
relationships. Intimately tied to their local
geography and peoples, programs are different
depending on where they are and who leads them.
Comparison and generalization across programs
and locations is challenging on account of this
diversity—which may well be a reason for the
relative scarcity of research and evaluations—and
there is also the added challenge of devising tools
to measure abstract concepts such as healing and
relationships in a way that honours Indigenous
knowledges and ways of knowing. However,
instead of insurmountable obstacles we must
conceive of these challenges as calls to engage and
act. The documents included in this scoping review

17
clearly suggest that land-based healing programs
can contribute in crucial ways to individual and
community health as well as decolonization, and
therefore merit a more robust evidence base
that blends Indigenous and Western knowledges.
The alternative to this is continued privileging of
mainstream knowledge over Indigenous healing
practices and traditions, an imposition that
amounts to systemic and epistemic racism (8).
This scoping review adds to the evidence base for
Indigenous land-based healing programs in Canada
by summarizing what is known in academic and
grey literatures and positioning this knowledge in
the greater context of healing and decolonization.
Yet there is much that remains unknown. More
research is needed to understand healing and
its various dimensions, including connections
with the land and sociopolitical relations; healing
practices; and outcomes of healing. Program
evaluations and research could contribute to the
design of two-eyed seeing knowledge frameworks
that support the implementation and evaluation
of programs in a way that privileges Indigenous
methodologies. Even in the absence of formal
research or evaluation, better documentation of
programs and their components would assist in
sharing and spreading wise practices. Documents
such as information sheets or brochures could
also be used to enhance awareness across
communities, organizations and sectors of the
modalities and positive outcomes of land-based
healing programs and increase the likelihood of
one day obtaining core funding. Looking beyond
the narrow scope of biomedicine to include the
knowledges long-held in Indigenous practices
and ceremonies—and supporting ways to restore
access to these practices and ceremonies by
those previously dispossessed of them—would be
a worthwhile goal of any health and social services
organization.
Conclusion
There is relatively little in the realms of academia
and practice that is written about Indigenous
land-based healing programs, but this does not
mean there is little known. Indigenous land-based
healing programs in Canada are founded in diverse
cultures, spirit and relationships that hold deep
knowledge about Indigenous healing. Valuing,
listening and learning from this knowledge will be
necessary for Canadian health and social services
systems to tailor strengths-based, culturally safe
interventions to contribute to breaking cycles
of trauma and poor health. Moreover, targeted
funding for land-based healing led by Indigenous
Elders, knowledge keepers and organizations is
needed not only for program sustainability, but
also for research, evaluation and progressive
improvement of programs. Such support would
align with the imperatives put forward by UNDRIP
and the Truth and Reconciliation Commission and
be considered a vital act of decolonization and
reconciliation in Canada.

18
References
1. Alfred GT. Colonialism and State Dependency. J
Aborig Health. 2009 Nov;5(1–3):42–60.
2. Czyzewski K. Colonialism as a Broader Social
Determinant of Health. Int Indig Policy J. 2011;2(1).
3. Fiske J-A. Making the Intangible Manifest: Healing
Practices of the Qul-Aun Trauma Program. In:
Waldram JB, editor. Aboriginal Healing in Canada:
Studies in Therapeutic Meaning and Practice.
Ottawa, ON: Aboriginal Healing Foundation; 2008.
p. 31–91.
4. Kelm M-E. Colonizing Bodies: Aboriginal Health and
Healing in British Columbia, 1900-50. Vancouver,
BC: UBC press; 1998.
5. McGibbon EA. Oppression: A Social Determinant of
Health. Winnipeg, MB: Fernwood Publishing; 2012.
6. Reading C, Wien F. Health Inequalities and Social
Determinants of Aboriginal Peoples’ Health. Prince
George, BC: National Collaborating Centre for
Aboriginal Health; 2009.
7. Irlbacher-Fox S. Finding Dahshaa: Self-government,
Social Suffering, and Aboriginal Policy in Canada.
Vancouver, BC: UBC Press; 2009.
8. Matthews R. The cultural erosion of Indigenous
people in health care. CMAJ Can Med Assoc J.
2017;189(2):E78.
9. Simpson LB. Land as pedagogy: Nishnaabeg
intelligence and rebellious transformation.
Decolonization Indig Educ Soc. 2014;3(3).
10. Adelson N. “Being Alive Well”: Health and the
Politics of Cree Well-being. Toronto, ON: University
of Toronto Press; 2000.
11. Kirmayer LJ. The cultural diversity of healing:
meaning, metaphor and mechanism. Br Med Bull.
2004;69(1):33–48.
12. Kirmayer LJ, Fletcher C, Watt R. Locating the
Ecocentric Self: Inuit Concepts of Mental Health
and Illness. In: Kirmayer LJ, Valaskakis GG, editors.
Healing Traditions: the Mental Health of Aboriginal
Peoples in Canada. Vancouver, BC: University of
British Columbia Press; 2009. p. 289–314.
13. Stewart S. Indigenous helping and healing in
counselor training. Cent Native Policy Res Monit.
2007;2(1):53–65.
14. Stewart SL. Promoting Indigenous mental health:
Cultural perspectives on healing from Native
counsellors in Canada. Int J Health Promot Educ.
2008;46(2):49–56.
15. United Nations Declaration on the Rights of
Indigenous Peoples: Resolution Adopted by General
Assembly [Internet]. UN General Assembly;
2007 Oct. Available from: http://www.un.org/
esa/socdev/unpfii/documents/DRIPS_en.pdf
16. Truth and Reconciliation Commission of Canada.
Calls to Action. Winnipeg, MB: Truth and
Reconciliation Commission of Canada; 2015.
17. Allan B, Smylie J. First Peoples, Second Class
Treatment: The role of racism in the health and well-
being of Indigenous peoples in Canada [Internet].
Toronto, ON: Wellesley Institute; 2015. Available
from: http://www.wellesleyinstitute.com/wp-
content/uploads/2015/02/Summary-First-
Peoples-Second-Class-Treatment-Final.pdf
18. Struthers R, Eschiti VS, Patchell B. Traditional
indigenous healing: Part I. Complement Ther Nurs
Midwifery. 2004;10(3):141–9.
19. The Joanna Briggs Institute. The Joanna Briggs
Institute Reviewers’ Manual: 2015 edition/
supplement. Adelaide, AU: The Joanna Briggs
Institute; 2015.
20. Arksey H, O’Malley L. Scoping studies: towards a
methodological framework. Int J Soc Res Methodol.
2005;8(1):19–32.
21. Adelson N. Towards a Recuperation of Souls and
Bodies: Community Healing and the Complex
Interplay of Faith and History. In: Kirmayer LJ,
Valaskakis GG, editors. Healing Traditions: The
Mental Health of Aboriginal Peoples in Canada.
Vancouver, BC: University of British Columbia
Press; 2009. p. 272–88.
22. National Aboriginal Health Organiation (NAHO).
An Overview of Traditional Knowledge and
Medicine And Public Health in Canada [Internet].
National Aboriginal Health Organization; 2008.
Available from: https://www.hhr-rhs.ca/
index.php?option=com_mtree&task=att_
download&link_id=7878&cf_id=68
23. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun
H, Levac D, et al. PRISMA extension for scoping
reviews (PRISMA-ScR): checklist and explanation.
Ann Intern Med. 2018;169(7):467–73.
24. Patton MQ. Qualitative research and evaluation
methods. Thousand Oaks, CA: Sage Publications,
Inc.; 2002.
25. Aboriginal Healing Foundation. A Healing Journey:
Final Report Summary Points. Ottawa, ON:
Aboriginal Healing Foundation; 2006.
26. Anarkaq M. The Iceberg Healing Manual.
Panginirtung, NU: Author; 2010.
27. Barlow K. Case Study Report: Healing and Harmony
in Our Families. Cape Dorset, NU: Aboriginal Healing
Foundation; 2002.
28. Castellano MB. Final Report of the Aboriginal Healing
Foundation Volume 1: A Healing Journey: Reclaiming
Wellness [Internet]. Ottawa, ON: Aboriginal
Healing Foundation; 2006. Available from: http://
www.ahf.ca/downloads/final-report-vol-1.pdf

19
39. Health and Social Development Department. Land
Based Treatment Programs: Promising Practices,
Key Considerations, and Ideas for Action [Internet].
Whitehorse, YT: Council of Yukon First Nations;
2013. Available from: http://www.kwanlindun.
com/images/uploads/CYFN%20Report%20-%20
Land%20Based%20Treatment%20Programs%20
-%20Practices,%20Considerations%20&%20
Ideas%20(2013).pdf
40. Mamakwa S, Meshake H, Macfadden L. Shibogama
Traditional Land Based Family Healing Program
[PowerPoint presentation] [Internet]. 2015.
Available from: https://thunderbirdpf.org/
wellness-on-the-land/
41. Dell CA, Dell D, Dumont J, Fornssler B, Hall L,
Hopkins C. Connecting with Culture: Growing our
Wellness. Activity Guide. Saskatoon, SK: University
of Saskatchewan, Research Chair in Substance
Abuse; 2015.
42. Dell CA, Dell D, Dumont J, Fornssler B, Hall L, Hopkins
C. Connecting with Culture: Growing our Wellness.
Facilitators’ Handbook. Saskatoon, SK: University
of Saskatchewan, Research Chair in Substance
Abuse; 2015.
43. Healey G, Cherba M, Tabish T. Pathways to Mental
Wellness for Indigenous Boys and Men: Community-
led and land-based programs in the Canadian North,
Movember Project Report. Iqaluit, NU: Qaujigiartiit
Health Research Centre; 2018 Jun.
44. Hirsch R, Furgal C, Hackett C, Sheldon T, Bell T,
Angnatok D, et al. Going Off, Growing Strong: A
program to enhance individual youth and community
resilience in the face of change in Nain, Nunatsiavut.
Études/Inuit/Studies. 2016;40(1):63–84.
45. Nain Research Centre, Nunatsiavut Government,
Sustainable Communities Initiative, ArcticNet,
Newfoundland and Labrador. Aullak,
Sangilivallianginnatuk (Going Off, Growing Strong)
“Going off” on the land helps Inuit youth improve
mental health [Poster] [Internet]. Available from:
http://www.idees-ideas.ca/sites/default/files/
rir_poster_mun_e.pdf
46. Hackett C, Furgal C, Angnatok D, Sheldon T, Karpik
S, Baikie D, et al. Going Off, growing strong: Building
resilience of Indigenous youth. Can J Commun Ment
Health. 2016;35(2):79–82.
47. Sustainable Development Working Group. Sharing
Hope: Circumpolar Perspectives on Promising
Practices for Promoting Mental Wellness and
Resilience [Internet]. Iqaluit, NU: Arctic Council;
Available from: https://oaarchive.arctic-council.
org/handle/11374/411
48. Moose Cree First Nation. Project George:
Reconnecting with the Land [Information booklet]
[Internet]. n.d. Available from: http://www.
moosecree.com/projectgeorge/donorbooklet.pdf
29. Fletcher C, Denham A. Moving Towards Healing:
A Nunavut Case Study. In: Waldram JB, editor.
Aboriginal Healing in Canada: Studies in Therapeutic
Meaning and Practice. Ottawa, ON: Aboriginal
Healing Foundation; 2008. p. 93–129.
30. Waldram JB, editor. Aboriginal Healing in Canada:
Studies in Therapeutic Meaning and Practice.
Ottawa, ON: Aboriginal Healing Foundation; 2008.
31. Hanson G. Strong Women’s Voices: Building a Path
To Wellness Final Report [Internet]. Whitehorse,
YT: Kwanlin Dün First Nation; 2012. Available from:
http://www.kwanlindun.com/images/uploads/
KDFN%20Building%20a%20Path%20to%20
Wellness%20-%20Evaluation%20Final%20
Report%202012.pdf
32. Mearns C, Healey GK. Makimautiksat Youth Camp:
Program Evaluation 2010-2015. Iqaluit, NU:
Qaujigiartiit Health Research Centre; 2015.
33. Plaskett R, Stewart B. Caring for the Circle Within:
Jackson Lake Land-based Healing Program
Program Overview & Evaluation Report [Internet].
Whitehorse, YT: The Psychology Centre; 2010
Oct. Available from: http://www.kwanlindun.
com/images/uploads/KDFN%20Caring%20
for%20the%20Circle%20Within-Evaluation%20
report%202010.pdf
34. Redvers J. Land-based Practice for Indigenous
Health and Wellness in Yukon, Nunavut, and the
Northwest Territories [Internet]. [Calgary, AB]:
University of Calgary; 2016. Available from:
https://prism.ucalgary.ca/handle/11023/2996
35. Redvers J. Study: Land-based Practice for
Indigenous Health and Wellness in the Northwest
Territories, Yukon, and Nunavut. Plain Language
Research Summary and Recommendations.
Whitehorse, YT: Author; 2016.
36. Walsh R, Danto D, Sommerfeld J. Land-Based
Intervention: a Qualitative Study of the Knowledge
and Practices Associated with One Approach to
Mental Health in a Cree Community. Int J Ment
Health Addict. 2018 Oct 4;1–15.
37. Waldram J. The Models and Metaphors of Healing.
In: Waldram J, editor. Aboriginal Healing in Canada:
Studies in Therapeutic Meaning and Practice.
Ottawa, ON: Aboriginal Healing Foundation; 2008.
p. 1–8.
38. Justice Department. Caring for the Circle Within:
Jackson Lake Land-based Healing Camps 2010.
Whitehorse, YT: Kwanlin Dün First Nation; 2010.

20
49. Rowan M, Poole N, Shea B, Mykota D, Farag M,
Hopkins C, et al. A scoping study of cultural
interventions to treat addictions in Indigenous
populations: methods, strategies and insights from
a Two-Eyed Seeing approach. Subst Abuse Treat
Prev Policy. 2014;10(1):26.
50. Charles J. Andrew Treatment Centre. Healing on
the Land [PowerPoint presentation] [Internet].
2014. Available from: https://www.slideshare.
net/NNAPF_web/charles-j-andrew-june-2014
51. House L, Pashagumskum E. Designing a Culturally
Safe Land-Based Healing Program in Chisasibi: the
importance of building partnerships with Health
Managers locally [PowerPoint presentation]
[Internet]. 2014. Available from: https://www.
fnhma.ca/archive/conference/2014/Files/
Workshop%20G%20Bill%20House.pdf
52. Mukash M. Whapmagoostui Nishiiyuu Land-based
Miupimaatisiiun Program [Internet]. PowerPoint
presentation presented at; 2018 Apr. Available
from: https://www.creehealth.org/sites/default/
files/Whapmagoostui%20Nishiiyuu%20Land-
based%20Healing%20Program.pdf
53. Pauktuutit Inuit Women of Canada. An On-the-Land
Workshop Model for Inuit Women. Ottawa, ON:
Pauktuutit Inuit Women of Canada; 2011.
54. Pauktuutit Inuit Women of Canada. A Community
Story Workshop Model: An Intergenerational
Healing Model. Ottawa, ON: Pauktuutit Inuit Women
of Canada; 2013.
55. Radu I, House LLM, Pashagumskum E. Land, life,
and knowledge in Chisasibi: Intergenerational
healing in the bush. Decolonization Indig Educ Soc.
2014;3(3).
56. Jackson Lake Wellness Team. Land & Culture-Based
Healing: Developing a program model. Whitehorse,
YT: Kwanlin Dün First Nation; 2014.
57. Kwanlin Dün First Nation. Building a Path to Wellness:
Jackson Lake Land-Based Healing Program Adult
Program Model. Whitehorse, YT: Kwanlin Dün First
Nation;
58. Mamakwa S, Macfadden L, Winter M, Anderson B,
Mamakwa R, Stoney T, et al. Reaching Wellness
Through the Land: First Nation Mental Wellness
Continuum Framework Implementation Project
Report 2015-2016. Sioux Lookout, ON: Shibogoma
Health Authority Land Based Healing Program;
2016.
59. Pulla S. Building on Our Strengths: Aboriginal Youth
Wellness in Canada’s North. Ottawa, ON: The
Conference Board of Canada; 2013.
60. Radu I. Land for Healing: Developing a First Nations
Land-based Service Delivery Model. Bothwell,
ON: Thunderbird Partnership Foundation; 2018.
61. Thunderbird Partnership Foundation. Wellness
on the Land: Land-Based Service Delivery Models
[Infographic poster] [Internet]. Available from:
https://thunderbirdpf.org/wellness-on-the-land/
62. Wesley-Esquimaux C, Calliou B. Best practices in
Aboriginal community development: A literature
review and wise practices approach. Banff Cent.
2010;
63. Churchill M, Parent-Bergeron M, Smylie J, Ward
C, Fridkin A, Smylie D, et al. Evidence Brief: Wise
Practices for Indigenous-specic Cultural Safety
Training [Internet]. Toronto, ON: Well Living
House Action Research Centre for Indigenous
Infant, Child and Family Health and Wellbeing;
2017. Available from: http://soahac.on.ca/wp-
content/uploads/2015/01/CS_WisePractices_
FINAL_11.02.17.pdf
64. Noah J. Youth Wellness and Empowerment Camps.
Iqaluit, NU: Qaujigiartiit Health Research Centre;
n.d.
65. Bartlett C, Marshall M, Marshall A. Two-eyed seeing
and other lessons learned within a co-learning
journey of bringing together indigenous and
mainstream knowledges and ways of knowing. J
Environ Stud Sci. 2012;2(4):331–40.
66. Dobson C, Brazzoni R. Land based healing: Carrier
First Nations’ addiction recovery program. J Indig
Wellbeing. 2016;2(2):9–17.
67. Ramsden I. Cultural safety. N Z Nurs J Kai Tiaki.
1990;83(11):18–9.
68. Kwanlin Dün First Nation. Design and
Implementation of Land-based Healing Programs.
Healing Together with Land and Culture: Gathering
of Wisdom [PowerPoint presentation] [Internet].
2014. Available from: http://www.kwanlindun.
com/images/uploads/HealingTogether%20
-%20Design%20and%20Implementation%20
of%20Land-based%20Healing%20Programs%20
(Gaye%20Hanson).pdf
69. Shibogama First Nations Council, Blue Earth
Photography. Reaching Wellness Through the Land
[Video] [Internet]. 2016. Available from: https://
vimeo.com/156188519
70. Dussault R, Erasmus G. Report of the Royal
Commission on Aboriginal Peoples: Volume 3 -
Gathering Strength. Ottawa, ON: Royal Commission
on Aboriginal Peoples; 1996.
71. Waldram JB. Transformative and Restorative
Processes: Revisiting the question of efcacy of
Indigenous healing. Med Anthropol Cross Cult Stud
Health Illn. 2013;32(3):191–207.
72. Adelson N, Lipinski A. The Community Youth
Initiative Project. In: Waldram JB, editor. Aboriginal
Healing in Canada: Studies in Therapeutic Meaning
and Practice. Ottawa, ON: Aboriginal Healing
Foundation; 2008. p. 9–30.

21
73. Adelson N. Re-Imagining Aboriginality: An
Indigenous People’s Response to Social Suffering.
In: Das V, Kleinman A, Lock M, Ramphele M, Reynolds
P, editors. Remaking a World: Violence, Social
Suffering and Recovery. Berkeley, CA: University of
California Press; 2001. p. 76–101.
74. Waldram JB. Healing history? Aboriginal healing,
historical trauma, and personal responsibility.
Transcult Psychiatry. 2014 Jun;51(3):370–86.
75. Reading C. Structural Determinants of Aboriginal
Peoples’ Health. In: Determinants of Indigenous
Peoples’ Health in Canada: Beyond the Social.
Toronto, ON: Canadian Scholars’ Press; 2015. p.
3–15.
76. Land Based Programming [Internet]. Ilisaqsivik.
2019 [cited 2019 Jan 3]. Available from: https://
ilisaqsivik.ca/programs-and-services/land-based-
programming
77. Schouls T. Shifting Boundaries: Aboriginal
Identity, Pluralist Theory, and the Politics of Self-
Government. Vancouver, BC: UBC Press; 2004.
78. Brascoupé S, Weatherdon M. First Nations
Land Based Healing [PowerPoint presentation]
[Internet]. Available from: https://www.
fnhma.ca/archive/conference/2015/english/
Presentations/Workshop_P.pdf
79. Hill DM. Traditional Medicine and Restoration of
Wellness Strategies. Int J Indig Health. 2009
Nov;5(1):26–42.
80. Mamakwa S, Kahan M, Kanate D, Kirlew M, Folk D,
Cirone S, et al. Evaluation of 6 remote First Nations
community-based buprenorphine programs in
northwestern Ontario: Retrospective study. Can
Fam Physician. 2017 Feb;63(2):137–45.
81. Redvers J. Kwanlin Dün First Nation Land Based
Healing Program Research Assistance. Whitehorse,
YT: Kwanlin Dün First Nation; 2013.

22
APPENDIX A: Sample Academic Database Search Equation
Database(s): Ovid MEDLINE: Epub Ahead of Print, In-Process & Other Non-Indexed
Citations, Ovid MEDLINE® Daily and Ovid MEDLINE® 1946-Present
# Searches Results
1 exp Health Services, Indigenous/ 2852
2 ethnic groups/ or exp inuits/ 60984
3Inuits/ 3816
4 (Ahtna or Ahtena or Nabesna or Anishinaabe or Oji-Cree or Anishinini or Severn
Ojibwa or Ojibwa or Chippewa or Ojibwe or Odawa or Atikamekw or Bearlake or
Chipewyan or Cree or Dakelh or Babine or Wetsuweten or Deg Hitan or Deg Xinag
or Degexitan or Kaiyuhkhotana or Denaina or Dunneza or Gwich* or Kutchin or
Loucheaux or Han or Hare or Holikachuk or Innu or Montagnais or Naskapi or Kaska
or Nahane or Kolchan or Upper Kuskokwim or Koyukon or Naskapi or Sekani or
Tagish or Tahltan or Tanana or Tanacross or Tasttine Tlicho or Tlingit or Tsilhqotin
or Tutchone or Yellowknives or Sahtu Dene or Akaitcho or Yellowknives or Dehcho
First Nations or Tlicho or T?icho or Inuvialuit or Aleut or Kalaallit or Inuit or Inupiat or
M#tis or Yupik).mp
23430
5 (Turtle Island or Canada or Arctic or Canadian Arctic or Yukon or Northwest
Territories or NT or NWT or Nunavut or Nunavik or Newfoundland or Labrador or
Northern Canada or Nunatsiavut or Nutaqqavut or Subarctic or British Columbia or
Alberta or Saskatchewan or Manitoba or Ontario or Qu#bec or Nova Scotia or New
Brunswick or Prince Edward Island or circumpolar or North America).mp
286147
6 exp INDIANS, NORTH AMERICAN/ 13654
7 Medicine, Traditional/ 10435
8 exp Culturally Competent Care/ 872
9 exp GLOBAL HEALTH/ or exp HEALTH EQUITY/ or exp HOLISTIC HEALTH/ 49347
10 (land?based or land or place or environment or tradition*).mp 1125259
11 (healing or health or health?care or wellness or medicine or therap* or mental health
or treatment or intervention or trauma or well?being or addiction*).mp
10226652
12 (indigenous or native or aboriginal or rst nation* or 1st nation or 1st nations or
inuit or m#tis or native people* or tribal or tribe* or indian people* or autochtone or
Premi#res nations or amerindien or indigene*).mp
245153
13 2 or 3 or 4 or 6 or 12 323345
14 1 or 7 or 8 or 9 or 11 10226765
15 5 and 10 and 13 and 14 1292

23
APPENDIX B: Basic Document Characteristics, by Citation
Citation Geographic
Focus
Funding
Source
Document
type Description Program
-specic?
Aboriginal
Healing
Foundation
(2006) (25)
Canada
Aboriginal
Healing
Foundation
Report
summary
Assesses/
evaluates program
outcomes/impact
No
Anarkaq (2010)
(26) Nunavut
Aboriginal
Healing
Foundation
Manual
Outlines guidance
for future
programming
No
Barlow (2002)
(27) Nunavut
Aboriginal
Healing
Foundation
Report
Assesses/
evaluates program
outcomes/impact
Yes
Brascoupé &
Weatherdon
(n.d.) (78)
Canada Not stated PowerPoint Descriptive
material No
Castellano
(2006) (28) Canada
Aboriginal
Healing
Foundation
Report
Assesses/
evaluates program
outcomes/impact
No
Charles J.
Andrew
Treatment
Centre (2014)
(50)
Newfoundland &
Labrador Not stated PowerPoint Descriptive
material Yes
Dell et al (2015)
(42) Canada
Canadian
Institutes of
Health Research
Facilitator
guide
Outlines guidance
for future
programming
No
Dell et al (2015)
(41) Canada
Canadian
Institutes of
Health Research
Activity
guide
Outlines guidance
for future
programming
No
Dobson &
Brazzoni
(2016) (66)
British Columbia
Canadian
Institutes of
Health Research
Journal
article
Descriptive
material Yes
Fletcher &
Denham (2008)
(29)
Nunavut
Aboriginal
Healing
Foundation
Report
chapter
Descriptive
material Yes
Hackett et al
(2016) (46)
Newfoundland &
Labrador Not stated Journal
article
Descriptive
material Yes

24
Citation Geographic
Focus
Funding
Source
Document
type Description Program
-specic?
Hanson (2012)
(31) Yukon
Yukon
Government,
Kwanlin Dün
First Nation and
others
Report
Assesses/
evaluates program
outcomes/impact
Yes
Healey et al
(2018) (43)
Yukon, NWT,
Nunavut,
Labrador
Movember
Foundation Report
Assesses/
evaluates program
outcomes/impact
No
Health
and Social
Development
Department
(2013) (39)
Yukon Health Canada Report Knowledge
synthesis No
Hill (2009) (79) Canada Not stated Journal
article
Knowledge
synthesis No
Hirsch et al
(2016) (44)
Newfoundland &
Labrador
Health
Canada, other
government
agencies
Journal
article
Descriptive
material Yes
House &
Pashagumskum
(2014) (51)
Québec Not stated PowerPoint Descriptive
material Yes
Jackson Lake
Wellness Team
(2014) (56)
Yukon Not stated Information
sheet
Descriptive
material Yes
Justice
Department
(2010) (38)
Yukon Not stated Information
sheet
Descriptive
material Yes
Kwanlin Dün
First Nation
(2014) (68)
Yukon Not stated PowerPoint Descriptive
material Yes
Kwanlin Dün
First Nation
(n.d.) (57)
Yukon Not stated Report Descriptive
material Yes
Mamakwa et al
(2015) (40) Ontario Not stated PowerPoint Descriptive
material Yes

25
Citation Geographic
Focus
Funding
Source
Document
type Description Program
-specic?
Mamakwa et al
(2016) (58) Ontario
First Nations
Mental Wellness
Continuum
Framework
Report Descriptive
material Yes
Mamakwa et al
(2017) (80) Ontario Not stated Journal
article
Assesses/
evaluates program
outcomes/impact
No
Mearns & Healey
(2015) (32) Nunavut
Public Health
Agency of
Canada
Report
Assesses/
evaluates program
outcomes/impact
Yes
Moose Cree First
Nation (n.d.)
(48)
Ontario Ontario Trillium
Foundation Booklet Descriptive
material Yes
Mukash (2018)
(52) Québec Not stated PowerPoint Descriptive
material Yes
Nain Research
Centre et al
(n.d.) (45)
Newfoundland &
Labrador Not stated Poster Descriptive
material Yes
Noah (n.d.) (64) Nunavut and
northern Canada Not stated Report Descriptive
material No
Pauktuutit
Inuit Women of
Canada (2011)
(53)
Inuit Nunangat Status of
Women Canada Manual
Outlines guidance
for future
programming
No
Pauktuutit
Inuit Women of
Canada (2013)
(54)
Inuit Nunangat Canadian
government Manual
Outlines guidance
for future
programming
No
Plaskett &
Stewart (2010)
(33)
Yukon Not stated Report
Assesses/
evaluates program
outcomes/impact
Yes
Pulla (2013)
(59) Canada
Conference
Board of Canada
Centre for the
North
Report Descriptive
material No
Radu (2018)
(60)
First Nations
land-based
services across
Canada
Not stated Report Knowledge
synthesis No

26
Citation Geographic
Focus
Funding
Source
Document
type Description Program
-specic?
Radu et al
(2014) (55) Québec Not stated Journal
article
Descriptive
material Yes
Redvers (2013)
(81)
Canada and
worldwide Not stated Literature
review
Knowledge
synthesis No
Redvers (2016)
(35)
Yukon,
Northwest
Territories &
Nunavut
Not stated Study brief Knowledge
synthesis No
Redvers (2016)
(34)
Yukon,
Northwest
Territories &
Nunavut
University of
Calgary
Master’s
thesis
Knowledge
synthesis No
Rowan et al
(2014) (49)
United States
and Canada
Canadian
Institutes of
Health Research
Journal
article
Knowledge
synthesis No
Shibogama First
Nations Council
& Blue Earth
Photography
(2016) (69)
Ontario Not stated Video Descriptive
material Yes
Sustainable
Development
Working Group
(2015) (47)
Arctic
Indigenous
communities
Canadian
government
agencies
Report Knowledge
synthesis No
Thunderbird
Partnership
Foundation
(n.d.) (61)
First Nations
land-based
services across
Canada
Not stated Poster Knowledge
synthesis No
Waldram (ed.)
(2008) (30) Canada
Aboriginal
Healing
Foundation
Report Knowledge
synthesis No
Walsh et al
(2018) (36) Ontario Not stated Journal
article
Descriptive
material Yes

27
APPENDIX C: Characteristics of Specic Programs
Program Authors
Fully
land-
based?
Governance
structure Delivery Model Program content/ac-
tivities Clients Program fund-
ing
Program
team
Aullak,
Sangilivallianginnatuk
(Going Off, Growing
Strong) | Newfoundland
and Labrador
Hirsch et al 2018;
Nain Research
Centre et al n.d.;
Hackett et al
2016
No Community-
directed
Weekly land-
based and
community-
based activities
Traditional and cultural
activities with focus
on learning from Inuit
harvesters about
hunting, trapping,
shing and other land
skills
At-risk youth Varied sources
Program
staff,
community
steering
committee,
volunteer
harvester
mentors
Cape Dorset Land-
based Camp | Nunavut Barlow 2002 No Community-
directed
Land-based
camps
complementary
to other activities
Healing circles,
workshops, team
building, grieving
workshops, trauma-
informed counselling
Youth, Elders,
women, men,
families
Aboriginal
Healing
Foundation
1 project
coordinator
and the
community
health team
Carrier Sekani Family
Services Land-based
Healing Program | British
Columbia
Dobson &
Brazzoni 2016 Yes
Carrier
Sekani Family
Services, a
non-prot
agency formed
by Carrier and
Sekani people
28-day land-
based session
Traditional activities
such as letting go and
sweat lodge ceremonies
or talking circles,
cultural activities and
contemporary addiction
and mental health
treatment
Not stated
Federal
government and
any rst Nation
band that joins
Carrier Sekani
Family Services
4 addictions
counsellors;
1 mental
health
professional;
1 cultural
worker; camp
staff
Chisasibi
Miyupimaatisiun |
Québec
House &
Pashagumskum
2014; Radu et al
2014
Yes
Founded and
run by Elders,
in collaboration
with local
community
committees
2 or 3-week bush
trips to land-
based camp
Cree teachings and
traditional counselling 18-30 year
old males
Local health and
social services
programs
Elder,
program
coordinator,
ofce
manager,
camp helpers

28
Program Authors
Fully
land-
based?
Governance
structure Delivery Model Program content/ac-
tivities Clients Program fund-
ing
Program
team
Jackson Lake Land-
based Healing Program
| Yukon
Jackson Lake
Wellness Team
2014; Kwanlin
Dün First Nation
n.d.; Kwanlin
Dün First Nation
2014; Justice
Department
2010; Hanson
2012; Plaskett &
Stewart 2010
Yes Directed by
Kwanlin Dün
First Nation
4-week land-
based program
First Nations therapy,
clinical therapy, circle
healing work, ceremony,
cultural and land-based
activities
Youth, family,
women, men
Predominantly
Kwanlin Dün
First Nation and
other varied
sources
First Nation
lead, clinical
lead, Elders,
social
worker,
psychologist,
community
wellness
worker, camp
staff
Makimautiksat Youth
Camp | Nunavut Mearns & Healey
2015 No
Camp
curriculum
developed and
managed by
Qaujigiartiit
Health
Research
Centre,
which trains
facilitators
8 modules
delivered over
8-10 days
including a 2-3
day on-the-land
component
Health and wellness,
positive Inuit identity,
community building and
skill building
Youth aged
9-12 in
Nunavut Varied sources Camp
facilitators
Whapmagoostui
Nishiiyuu Land-based
Miupimaatisiiun
Program | Québec
Mukash 2018 Yes
Elder and
community-
driven in
partnership and
collaboration
with Cree
institutions and
other partners
2-week journeys
on the land in
winter and fall
Pre-journey training,
land-based healing
skills and teachings,
aftercare, evaluation,
storytelling, traditional
skills training
Men and
women Not stated Not stated
Nutshimit Program
| Newfoundland and
Labrador
Charles J. Andrew
Treatment Centre
2014 No
Board of
directors
representing
Innu,
Nunatsiavut
and Atlantic
Policy Congress
50% clinical
residential and
50% cultural on-
the-land program
Storytelling, sharing
circles, spiritual rituals,
land and survival skills,
detoxing, addictions
counselling
Innu, Inuit
and FN
youth across
Canada
Not stated
Many varied
clinical and
cultural staff,
including a
land-based
coordinator
Project George | Ontario Moose Cree First
Nation n.d.; Walsh
et al 2018 Yes Community-
driven and
directed Land-based camp Traditional and
sporting/recreational
activities on the land
At-risk youth
aged 12-20
Personal
donations and
Government of
Ontario
Run by
volunteers
under
guidance
from Elders

29
Program Authors
Fully
land-
based?
Governance
structure Delivery Model Program content/ac-
tivities Clients Program fund-
ing
Program
team
Shibogama Land-Based
Family Healing Program
| Ontario
Mamakwa
et al 2015;
Shibogama First
Nations Council
& Blue Earth
Photography
2016; Mamakwa
et al 2016
Yes
Shibogama
First Nations
Council with
direction from
Elders and
community
Land-based
camp with cabin
accommodation,
length varies
as per available
funding (8-21
days)
Cultural and land-based
activities
Families
impacted by
prescription
drug abuse
Shibogama First
Nations Council
and varied
sources
Elders and
community
resource
workers
Unidentied program |
Nunavut Fletcher &
Denham 2008 No Community-
directed
Activities at
local community
centre with trips
onto the land
Healing circles,
counselling, cultural and
land-based activities
Men, women,
children
Aboriginal
Healing
Foundation and
other sources
Community
Justice
division
and other
community
organizers

30