Practitioners’ experiences of collaboration, working with and for rural Māori

Full text

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Addressing the cultural beliefs and
practices of Māori with substance use
problems has been referred to as the ‘crux’ of
effective treatment (Huriwai, Robertson,
Armstrong, Kingi & Huata, 2001) and the
‘path to wellness’ (Huriwai, Sellman,
Sullivan, & Potiki, 2000). Contemporary
Māori models of health and wellbeing, such
as Te Whare Tapa Whā (Durie, 1994), Te
Wheke (Pere, 1984), and Ngā Pou Mana
(Henare, 1998), highlight the symbiotic
relationship between the individual, the
collective (whānau, hapū and iwi), the
environment, and te ao Wairua (the spiritual
world) (Huriwai, 2002). An attempt to
encapsulate these principles can be seen in
the recent major health initiative ‘Whānau
Ora’ (family wellbeing). The initial task force
report noted that “assurances will be required
from a number of government departments
and a spirit of collaboration must be
embedded between funders, providers,
practitioners and whānau” (Whānau ora
Taskforce, 2009, p. 5).
In its most basic form, collaboration is
“the act of working with another or others on
a joint project” (Collins English Dictionary,
2009, p. 338). Craig and Courtney (2004)
suggest that collaboration exists as part of a
Partnering Continuum that spans coexistence
through to partnership (Figure 1). Partnering
was proposed to differ according to the
purpose, focus, governance, range of
participants, timeframes or funding
arrangements. This Continuum has been used
widely within the voluntary and community
social service sector (Public Health Advisory
Committee, 2006; Walker, 2006).
Despite the popularity of the model,
Craig and Courtney identified that for many
Māori, the term relationship was preferred to
partnership, which was seen as akin to the
Practitioners’ experiences of collaboration, working with and for rural Māori
Andre D. McLachlan
University of Otago; Pai Ake Solutions Ltd, New Zealand
Ruth L. Hungerford
Momentum Research & Evaluation Ltd, New Zealand
Ria N. Schroder
Simon J. Adamson
University of Otago, New Zealand
To understand the unique experiences of collaborating across health and social services
in a rural setting with and for Māori with substance use and related problems, two focus
groups were undertaken. This preliminary study used qualitative methods, following
theory and practice informed by Māori values. Three culturally relevant themes were
identified: collaboration as a tikanga (practice informed by Māori values) based
practice, whanaunga (relative) or kupapa (traitor)?, and whanaungatanga
(relationships) as collaborative practice. These themes highlighted the importance of
Māori values in collaborative relationships, and the positive benefits for clients and
practitioners collaborating to meet the holistic needs of whānau (family). Several
unique experiences of Māori practitioners working and at times living in small rural
communities were identified; these included the tensions associated with practitioners
who may have existing relationships with clients through roles as family members,
tribal members or within the wider community. Enablers to collaboration were argued
to exist within the dynamic of whanaungatanga. Understandings and skills in applying
tikanga, whakapapa (genealogy), confidentiality, and connecting clients with broader
community activities were identified as important aspects in the practice of
whanaungatanga.

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partnership principle within the Treaty of
Waitangi (the original treaty signed between
Māori and representatives of the British
crown). Therefore the term partnership was
seen as more relevant to relationships
between Māori and the crown, as opposed to
relationships between agencies and
communities.
The Māori concepts and terms most
closely aligned with the basic definitions of
collaboration are mahi tahi (working
together) and kotahitanga (unity). As
collaboration is a social concept, a wide
range of Māori values inform and guide
behaviour around relationships, these include
what is and is not appropriate in certain
contexts and relationships, engaging in new
relationships, status within relationships,
behaviour that enhances relationships, and
practices that address problems in
relationships. Ritchie (1992) argued that it
was difficult to portray Māori values in
simple or analytic terms. This reflects the
interrelated and symbiotic nature of Māori
indigenous beliefs. Collectively the beliefs
and concepts inherent in Māori values and the
practices informed by these values are termed
tikanga (practice informed by Māori values)
(Mead, 2003). These values both transcend
the material world (Ritchie, 1992) and
provide the central tenant for maintaining the
socially mediated model of health. Māori
values relevant to relationships include
whakapapa (geneology), whanaunagatanga
(relationships, kin and non-kin),
manaakitanga (hospitality), wairuatanga
(spirituality), rangatiratanga (status) and
kotahitanga (unity). Each of these values and
concepts also include and relate to other
values and concepts. As an example, Mead
(2003) identified that the terms tika (right/
correct) and pono (honest/true) were
important concepts that underpinned values,
and were important evaluative principles for
behaviour. Whanaungatanga (relationships)
has been cited as the “the basic cement that
holds things Māori together” (Ritchie, 1992,
p. 67), in fact understanding the dynamics of
whananaungatanga and whakapapa
(genealogy) have been cited as integral for
working with Māori in substance abuse
treatment although Huriwai et al. (2001)
cautioned that “not all Māori have been
raised or live in a ‘customary’ context and the
relevance of ‘traditional’ values is not the
same for all” (p. 1035). This highlights the
diverse realities that Māori live in, and the
importance of understanding that Māori
practitioners and those Māori accessing
services may have different understanding,
experience and comfortableness with the use
of tikanga (practice informed by Māori
values).
While the value of collaborative
relationships in a therapeutic environment are
widely acknowledged, there is a lack of
research identifying the specific barriers and
enablers to effective collaborative
Working with and for rural Māori
Figure 1. Partnering Continuum (adapted from Craig & Courtney, 2004, p. 38).

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relationships between substance abuse
treatment and ancillary health and social
services, particularly for Māori, and Māori in
rural communities. A study by Holdaway
(2003) on collaboration across primary health
and mental health providers captured the
unique experiences of Māori community
support/health workers in rural and urban
areas. Māori community support/health
workers reported several barriers to
collaboration, including a lack of recognition
or respect for “our knowledge and skills from
mainstream and others”(Holdaway, 2003, p.
13); a lack of information sharing within and
across the sectors, contributing to whānau
“falling through the cracks” (Holdaway, 2003,
p. 13), and a lack of commitment from all
parties in integrating care. This study
identified the importance of “partnerships to
solve the problems of resources,
communication, and coordination in health
and social care” (Holdaway, 2003, p.18).
According to the literature, and current
national service provision models (Whānau
ora) there are strong arguments for addressing
the interrelated social needs and cultural
needs of those with substance use and related
problems. This research project aims to
extend upon Holdaway’s (2003) work by
documenting and discussing the experiences
of practitioners from a range of social services
that work with Māori with substance use and
related problems in a predominantly Māori
rural community in New Zealand.
Methods
This study uses qualitative methods that
are guided by Kaupapa Māori Research
(KMR) principles. KMR was developed by
Māori, as a transformative process in order to
assert self-determination in responding to the
negative health, education and social
outcomes of Māori (G. Smith, 1997; Walker,
Eketone, & Gibbs, 2006). KMR is beyond a
simple description or definition as it has been
described as a philosophical framework and
theory, a set of methodological principles and
processes, and as an intervention strategy (G.
Smith, 1997; L. Smith, 1999). KMR does not
preclude other methodologies, in fact G.
Smith (2000) argues for the utilitarian value
of western research practice, arguing for
being “open to using any theory and practice
with emancipator relevance to our Indigenous
struggle” (p. 214). Therefore KMR can be
used to shape and inform different research
methods. As a theory, KMR engages in a
rigorous critique of western theories and
practices impacting on Māori, and has the
explicit goal of improving outcomes for
Māori (L. Smith, 1999). As a guide to
research practice, tikanga (practice informed
by Māori values) can be seen in each step of
the research practice. This includes, the
research being undertaken for Māori by
Māori; Māori direction, guidance and
participation across the focus, design,
application, analysis and dissemination of
research; and the use of Māori rituals of
engagement and hospitality within the
research.
Participants
The host Iwi (tribal) service provided a
list of key stakeholders (personnel and
agencies) operating within the local rural
community to be invited as research
participants. The stakeholders came from
within its services, and collaborative partners
from statutory, district health board and non-
Governmental health, mental health and
social service providers that operated within
the local community. Stakeholders were sent
an introduction to the study and an invitation
to participate. Participants were required to
work as paid or volunteer staff members of
health and/or social services that work
directly with adults 18 years and older who
have substance use problems and/or their
family members. By recruiting groups with a
history of working together there was the
opportunity to observe naturalistic exchanges
(Freeman, 2006) which underpin
collaborative relationships.
Participants completed a group
demographics form at the start of each focus
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group which included a range of questions
related to their demographic status, roles,
workplace and length of service in the
community. The majority of the 21
participants were either in the 36-50 year old
age band (n = 10, 48%) or 50-65 year age
band (n = 9, 43%), female (n = 16, 76%), and
identified as Māori (n = 13, 62%). The largest
proportion of participants identified their
profession as ‘whānau/family support
(n = 12, 57%), with an even spread of small
groups within nursing, counselling, and
education (n = 9, 43%). Most worked in non-
governmental organisations (n = 13, 62%),
with the remainder working in public health
(n = 3, 14%), an Iwi based social service
(n = 3, 14%), and an alcohol and drug service
(n = 2, 10%). Participants could identify more
than one work role, with most engaged in
direct client contact (n = 17, 81%), and small
numbers providing supervision of other staff
(n = 6, 29%) and management roles (n = 4,
19%). Participants identified a significant
history of working in the geographical area,
with 33% (n = 7) reported working in the area
for five to ten years, and 29% (n = 6) for
more than ten years.
Data Collection
Two focus groups were held at the local
Iwi providers offices, for approximately one
and a half hours each, co-facilitated by
authors AM and RH. There were 15
participants in the first focus group and six in
the second. Digital audio recordings were
made of both focus groups. Each session,
following the principles of tikanga was
facilitated by a staff member from the host
Iwi (tribe) service provider chosen by the
host organisation due to their knowledge and
skills in Māori protocol. This process was
termed a whakatau (settling), and included
practices at the opening and closing of each
session, such as acknowledging the important
spiritual and cultural features and people of
the area (whai korero); greeting the
participants and researchers (mihimihi);
prayer (karakia), song (waiata), and a shared
meal.
We utilised a semi-structured interview
format to guide discussions. Questions were
developed in response to the literature
reviewed and the experience of the primary
researcher who has a 20 year history of
working in community development and
clinical settings in the capacity of a youth
worker and then alcohol and drug clinician.
This included five years working within the
geographical area the study was conducted
in.
Questioning followed a logical
progression starting from (1) a general
discussion in response to ‘what is
collaboration?’. This was scribed on the
whiteboard; (2) Participants were then asked
to categorise the data on the whiteboard
according to whether they viewed them as
values or practices. Additional prompt
questions were used in these discussions to
identify participants’ views on any issues
which may have been specific to living or
working in a rural community, and working
with whānau/family with substance use and
related problems; and (3) In each focus
group, a small group exercise was conducted,
with participants forming groups of between
two and three people, and discussing and
writing a group response to the following
three questions:
 What are the barriers to collaboration?;
 What are the barriers to collaboration in
relation to working with whānau with
substance use problems?; and
 What are the barriers to collaboration
for staff and agencies in rural
communities?
Groups reported back to the larger
group, and written responses were handed to
the researcher. All whole group discussion
was audio recorded and transcribed verbatim.
Data Analysis
Our analysis of data followed that
suggested by Marshall and Rossman (2011).
All focus group data (audio transcripts and
participant notes) were read and reread
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(organising the data and emersion in the
data). This was followed by generating
categories and themes, coding the data,
offering interpretation through analytical
memos, and searching for alternative
understandings. A constant comparative
method was used (Glaser & Strauss, 1967)
with authors AM and RH comparing
comments for similarities and differences
over a series of three meetings. This process
was strengthened by undertaking a member
checking process which included forwarding
typed audio transcripts and preliminary key
themes to participants for comment. The acts
of peer debriefing, member checking and
reviewing national and international literature
on collaboration supported the process of
triangulation; that is, using multiple methods
to “generate and strengthen evidence in
support of key claims” (Simons, 2009, p.
129). Finally, a written report and physical
presentation was provided to the host
organisation and participants.
Findings
There were three key themes identified
from the focus groups that represented the
participants’ views of and experiences with
collaboration. These were: Collaboration as a
tikanga (practice informed by Māori values)
based practice, Whanaunga (relative) or
kupapa (traitor)?, and Whanaungatanga
(relationships) as collaborative practice.
Collaboration as a Tikanga (Practice
Informed by Māori values) based Practice
It was evident that participants viewed
collaboration through the lens of
relationships established and maintained
through Māori values, as opposed to
collaboration being a simple set of practices,
such as having a meeting. The beginning of
each focus group involved a brain storming
session on what collaboration was. Principles
of aroha (love), tika (doing what is right) and
pono (honesty) were proposed as
cornerstones of collaboration.
Whakawhanaungatanga (creating
relationships) was also used to express
collaboration. These values were proposed to
have been handed down through whakapapa
and from nga atua (gods). “Nga kete e toru
iho mai no Rangiatea” (The three baskets of
knowledge passed down from the heavens)
(Participant Focus Group 1, PFG1). These
values were also proposed to be interrelated
to spirituality and Māori worldviews.
“Something that we haven’t got up there is
spirituality, and when you talk about a
Māori....a lot of those things had to do with a
Māori world view” (PFG1). Participants
related collaboration to a social model of
care, and an holistic approach. One
participant reflected this in her comment “It’s
that saying of, it takes a village to raise a
child” (PFG1).
This social model of care was argued to
provide positive benefits for both the workers
and the whānau (families) they work with.
“I'm not sure how to say it succinctly, but the
work that you can do together has a bigger
effect than the work that you can do
separately or apart from each other” (PFG1).
Collaboration was argued to require
concerted effort “We’re stronger as a group,
so there’s strength in numbers
essentially” (PFG2) and planning:
Planning for the whānau should
be together, not as individual
agencies or me. Because
collaboration can only work for
the whānau ... if you’ve got 60
organisations banging on your
door, I’d be pretty pissed. I would
rather meet with the organisations
that are working with the whānau,
plan together, go with one plan to
the whānau and work it that way.
(PFG2)
The act of planning was also proposed
to contribute to improved outcomes “and
maybe when it comes together it’s stronger
too, because the focus is common” (PFG1).
The strength that participants gained
from collaboration, that is working together,
was argued to come from the sharing of
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expertise and the sharing of responsibility.
“It’s less stressful I think, sharing that
responsibility, because you don’t have to try
and be an expert at everything” (PFG1).
Whereas another practitioner identified that
sharing was a key value for Māori. “Yeah,
shared burden or shared load, because that’s
the basis in some ways of kotahitanga [unity]
and manaakitanga [hospitality], is around
sharing loads” (PFG2). A participant
highlighted the practical challenges of
working with whānau (families) with
complex problems, and the benefit of this
sharing for improved outcomes for whānau:
I have 24 hours in the day and
even then I struggle to make it
through, and so if I’m the only
person dealing with that one
whānau and yet .... might have 16
or 17 or 20 whānau, how am I
supposed to do everything for
them without some help
essentially? It’s kind of... I know
what I know, but I also know what
I don’t know and by
collaborating.... in the real sense
of the word, for me it’s about I
can’t do everything because I
don’t know everything. (PFG2)
It was evident from the above
discussion that collaboration was a strongly
endorsed, and culturally relevant approach to
working with whānau experiencing complex
difficulties. However, when the participants
in focus group two were asked what the costs
of collaboration to them as practitioners were,
several participants stated that there were no
costs, just benefits. However one participant
stated “There must be a cost because it’s not
happening...there’ll be a trade-off” (PFG2).
This highlights the dichotomy between
wanting to collaborate, and actually
collaborating. This provided the rational for
exploring the barriers to collaboration.
Whanaunga (Relative) or Kupapa (Traitor)?
This theme reflected several unique
challenges of rural Māori communities, in
which service users and staff members
interact, live in close proximity and are often
whānau (family). Therefore these staff can
wear many hats in the community, that is,
they have roles within whānau (family),
services, marae (meeting area of local sub-
tribe, made up of communal buildings), and
sports clubs. The question a service user is
potentially faced with is; are you (the staff
member) here as a family member focused on
the best interests of the whānau? Or will you
be a traitor (kupapa) and breach my trust and
confidentiality?
One of the positive implications of
being related to a client was that this
relationship could provide a foundation for
engagement: “It gets you in the
door” (PFG1). These relationships can also
place workers in positions of discomfort
when working with a whānau whom they
may interact with and have responsibilities to
within the broader social and cultural context.
The term tau kumekume (tension) was
presented by a participant in the second focus
group, acknowledging the tensions inherent
when having the responsibility to manage
commitments in personal and professional
worlds.
A participant in focus group one stated
that one of the discomforts faced by
practitioners when entering collaboration was
related to the cultural concept of kupapa
(traitor):
Every time I keep thinking
collaboration, I keep thinking
kupapa [traitor]. Kupapa [traitor]
was in the times of war, that’s
what they used to do is they used
to use their own people to work
out how they could beat them.
That’s what I always looked at as
what collaboration was about.
(PFG1)
This sense of being a traitor represents a
real challenge for practitioners, as they may
be in a position where sharing information is
disallowed, (even if sharing this may address
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a problem), or conversely where sharing
information may contribute to further distress
for the whānau.
Another participant identified that
negative past experiences can contribute to
the ongoing fears and apprehension inherent
with practitioners not wanting to be a traitor,
and in turn this can act as a barrier to
collaboration.
It’s doing things that are close to
you that you’ve shared with
people that you thought you
trusted that have absolutely been
destroyed .... So you may have
gone in to the collaboration with
an open and honest... but
suddenly that kupapa thing comes
in too, because you don’t want it
to be as collaborative as... and it
might be a personal or it might be
a provider organisation or
whatever, because you keep
things close to you. (PFG2)
This experience was also proposed to
be a real problem for service users: “If people
have let you down in the past because of not
carrying out their end of the deal or
breaching confidentiality, you’re not going to
have that trust, so you’re not going to be able
to move forward” ( PFG2). Addressing the
existing issues between agencies and the past
experiences of service users was seen as a
first step in developing a platform of trust
with whānau (families) and other services:
Yeah, because it is our
‘take1’ [issue/problem] and if we
take our ‘take’ [issue/problem] to
the whānau, the whānau’s already
messed up. They don’t need us to
be messing their heads again. So
collaboration for me is doing
things together and what’s best
for our community and our
whānau. (PFG2)
Confidentiality was argued to be
another challenge to addressing issues of
mistrust in collaborative relationships with
whānau (family) and other services:
“Because often we will talk around it, but we
won’t actually say that this is what we won’t
be confidential about and so everybody’s just
skirting on the outside and nobody’s actually
saying anything” (PFG2).
Whanaungatanga (Relationships) as
Collaborative Practice
A range of issues in working
collaboratively with people with substance
use and related problems within a rural
context were identified. It was stated that
many of the people with complex substance
use and related problems in the area came
from outside of the area: “Connectiveness in
the community. Not knowing anyone, no
whānau” (PFG1). This could leave this group
feeling isolated from important factors of
wellbeing, including whānau (family), hapū
(sub-tribe) and whenua (land). Another
participant summarised many of the common
rural barriers identified by participants:
... it’s a number of things that are
sort of interlinked where we've
got lack of services, this is talking
rurally, distance, staffing levels
or qualified staff, coming through
lack of knowledge across to no
ability to change by the whānau,
shared information; all these
things, sort of looking in and just
putting up huge barriers. (PFG2)
The comment ‘no ability to change by
the whānau’ within the above quote
reinforced comments from participants in
both focus groups that people with substance
use problems were either not able to change
or “not ready to change” (PFG1). Participants
related part of this inability to change to the
ingrained nature of substance use problems in
families, proposing that there is a
“normalisation of substance abuse” (PFG2)
in families. This normalisation was proposed
to impact on the fabric of the values of
families that have substance use problems
and sometimes acted as a barrier to
collaboration:
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And it becomes a value [substance
use]. It becomes what a whānau
instilled value into, which can distort
other values, and we see that a lot.
Their children’s health is no longer a
priority. Or their children’s
education. It’s just no longer a
priority to send your kids to school
because the whole value system
changes. (PFG2)
One participant identified that engaging
with whānau in relation to substance use and
related problems was a sensitive issue, and that
there were important steps to take place before
discussing confidentiality and before attempting
to collaborate with other agencies involved with
a particular family:
One that we had was whakamā
[shame]. .... it’s quite intense and
painful......you’ve got mamae [hurt]
in there and they won’t feel
comfortable to divulge that
information anyway......before you
begin to even start talking about
confidentiality. You know, it’s about
working first, what’s happening for
the... not just that individual, but also
in the whānau as well. (PFG1)
As has been identified, there are several
barriers to collaboration, including the multiple
and complex relationships held between staff and
service users in this Māori rural community,
confidentiality, the ingrained nature of substance
use and related problems in families, practical
barriers related to rurality, such as transient
families, travel and staff recruitment, and the
sensitive nature of engaging with families about
substance use and related problems. Solutions to
several of these barriers were also located within
or associated to the barriers, that is whakapapa
(kin relationships) and the natural resources and
cultural history of the area.
One of the key barriers to collaboration
involved the proposed ingrained nature of
substance use in families. The following
comment identifies how practitioners and
families can engage with the broader family
system in order to access activities that can
encourage and support wellbeing, and re-
connect families:
... in the substance abuse area, is
actually using the kaupapa (issue) in
terms of other members of that
whānau who may be either
connected to a religion or connected
to a sports club where there's not
that usage, but the usage has
actually moved them apart and so
it’s the actual substance that's
actually moved the whānau apart,
and trying to look, trying to move, I
guess, move that to the side and
saying, “Hey, we’re still whānau.
(PFG2)
One participant identified that even those
Māori families with substance use and related
problems that come from outside of the area,
have a cultural and family history that can be
used to connect them to the area and people
within it:
And that comes back to what .......
said… certain people get certain
things, and that’s where him and I
fit in terms of our, how we can
make the connections. And you
know, if they’re from Kahungunu [a
tribe located on the central eastern
shores of the North Island], we talk
about Mahinarangi [name of a
female ancestor from the
Kahungungu tribe] and Turongo
[name of a male ancestor of the
Tainui tribe], when we make that
connection through the whakapapa
[genealogy] lines, then they feel
comfortable enough to start
sharing… (PFG1)
This highlights the importance of
practitioners having an understanding of the
whakapapa of the area, and of other tribal areas
in order to effectively build these connections
through whakapapa (genealogical) lines.
Another practitioner extends upon this theme by
highlighting the specific cultural history of the
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area, and the importance of exploring how
this history can be used to inform
practitioners practice:
They know their history from
around here with regards to what
their tupuna [ancestors] went
through with regards to
kingitanga [the history of Māori
kingship], the wars, confiscation,
the awa [river]... I think one of
the questions is, how do we as
social service practitioners
operate in a model of a
kingitanga framework? (PFG1)
The above themes reinforces the
complex interrelated nature of history,
context and people; and how these factors
can influence both staff and those with
substance use and related problems in
engaging in collaborative practice. The
responses to these barriers reinforce the
indigenous beliefs of the participants around
individual wellbeing coming from collective
relationships, and that healing comes through
making connections between service users,
the community and the environment – a
process of connection guided by culturally
competent practitioners.
Discussion
This research project set out to identify
the unique experiences of practitioners from
a range of health and social services that are
engaged in collaborative relationships for and
with Māori with substance use and related
problems in a predominantly Māori rural
community in New Zealand. Qualitative data
were collected from two focus groups
involving a total of 21 participants.
Participants predominantly self-identified as
Māori, female, with a significant service
history of working in the geographical area.
These participants were in the most part
engaged in direct client contact in whānau/
family support roles. A limitation of the
current research project was that there were
no mental health or primary care general
medical practitioners that were available to
attend the focus groups. This reduced the
input of two particularly important sectors
involved in collaborative practices with those
with substance use and related problems.
The focus group methodology, guided
by tikanga (practices informed by Māori
values) provided the opportunity to see how
cultural processes such as a whakatau
(settling) contributed to an atmosphere of
safety and unity, a necessary foundation for
open discussion within the focus groups, an
activity in itself which is collaborative in
nature. The findings from the study identified
three broad themes. The first of these
revealed that collaboration was viewed by
participants through the lense of Māori
values, that is, viewing collaboration as
relationship guided by values such as aroha
(love), tika (doing what is right) and pono
(honesty). These values were also proposed to
be interrelated to spirituality and Māori
holistic and socially mediated views of
wellbeing. Collaboration was proposed to be
a preferred model of practice that contributed
to benefits for practitioners such as strength
in numbers, shared responsibility, and shared
resources. These benefits were proposed to in
turn contribute to better outcomes for
whānau.
Whanaunga (relative) or kupapa
(traitor)? revealed a unique set of experiences
under-reported in the literature, that is, the
benefits and challenges of living in a
predominantly Māori rural community.
Participants revealed how working, and in
some cases living, in a small rural community
increased the likelihood that service users and
staff would be either related or have
interacting community roles. As a result some
service users avoided local service providers
due to fears of confidentiality. In a reciprocal
nature, these shared relationships were
proposed to place staff in a precarious
position of kupapa, that is, a potential traitor
due to holding information that may be
beneficial or harmful to one or more of the
groups or persons that they have relationships
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with and in some instances responsibilities
too (i.e., whānau or employers).
Healing through whanaungatanga
(relationships) also highlighted the shame and
embarrassment that some whānau (family)
experience when talking about their
problems, further complicated by fears of
confidentiality. Several barriers to working
with people with substance use and related
problems were identified in addition to
confidentiality concerns. Some of these were
related to rural realities, such as lack of
service options and difficulties in attracting
qualified staff, and people moving into the
area with little social or cultural connections
in the area; whereas other barriers related to
the impact of the negative experiences of
staff working with people with chronic and
complex substance use and related problems.
The strategies to respond to several of
these barriers were in many ways found in
the location of the barriers, that is, through
relationships. Acknowledging the sensitive
nature of substance use and related problems
with whānau, and the underlying fears
associated with confidentiality and past
negative experiences with services, was
argued as a first step in working towards
collaboration. Reconnection through
whanaungatanga (relationships) reflected
what Huriwai and colleagues (2001) called
‘the path to wellness’. Knowledge of
community resources, whakapapa
(genealogy), and tikanga (practices
influenced by Māori values) were argued to
be important skills that enabled practitioners
to connect people that have moved in from
outside of the area to make cultural
connections to the area, and to reconnect
people with whānau (families) and
community based activities that can
contribute to wellbeing.
Of particular note in this research was
the observation that the host Iwi (tribe)
organisation had staff from a range of
services participating in the focus groups,
including social workers, educators and
addiction therapists. This organisation
reflected Māori models of health, taking a
holistic approach, one focused on the broad
needs of whānau. The staff also had long
histories of working in the area, increasing
the likelihood that staff were in tune with the
social and cultural context their clients lived
in.
The findings of this research can assist
agencies and practitioners working with
Māori experiencing substance use and related
problems, and those working in rural
communities to understand some of the
unique barriers to collaboration, and
culturally relevant responses to these barriers.
This research project provides a platform to
further explore, understand and interpret key
factors associated with collaboration for and
with Māori with substance use problems in
rural communities. Areas that warrant further
exploration include: the strategies used to
increase the awareness, knowledge and skills
of non-substance abuse specialists in working
with people with substance use problems; the
strategies used to increase the awareness,
knowledge and skills of practitioners in
working with Māori; the strategies used to
develop shared inter-agency understandings
and processes in relation to working with the
privacy code when sharing information; and
the perspectives of those with substance use
and related problems and their whānau of
collaboration with health and social services.
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Acknowledgements
This project was supported with funding by
the Ministry of Health Māori Providers
Development Scheme, and a Henry
Rongomau Bennett Scholarship awarded to
the first author.
Author Biographies
Andre McLachlan (PGDipClinPsych;
PGDipHealthSci) is of Ngāti Apa and
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The Australian Community Psychologist Volume 24 No 1 June 2012
© The Australian Psychological Society Ltd
MacLachlan decent. He is a clinical
psychologist and clinical coordinator at Pai
Ake Solutions Limited, a tikanga Māori dual
diagnosis service. Andre is completing his Phd
at Otago University.
Email: andre@paiake.co.nz
Ruth Hungerford (MSocSc
(Hons1);PGDipPsych(Comm), identifies as
Pākehā of Irish, German and English descent.
She is the Director and Principal Researcher of
Momentum Research & Evaluation Limited,
which was established in 1997 and undertakes
social research and evaluation throughout
Aotearoa New Zealand.
Email: ruth@momentumresearch.co.nz
Dr Ria Schroder (PhD) is a Research Fellow at
the National Addiction Centre, University of
Otago, Christchurch with a particular interest
in qualitative research. She identifies as
Pākehā New Zealander of German and
Scottish descent.
Dr Simon Adamson (DipClinPsych, PhD) is
Deputy Director (Research) at the National
Addiction Centre and a clinical psychologist
specialising in addiction. He is of Scottish and
English descent with strong ties to Southland/
Murihiku.
Address for Correspondence
Andre McLachlan
andre@paiake.co.nz
Working with and for rural Māori