Education issues include:

1. Decline in education is due to exposure of negative stereotypes. These feelings produce hopelessness and despair in Native American children.
2. An inability to complete an educational cycle perpetuates poverty and the lack of opportunities.
3. Youth learn by observing their elders and members of the extended family.

When counseling youth and children:

1. Incorporate a discussion of Native American/Caucasian relationships. This allows the client to be aware of potential problems if the counselor is Caucasian, and it allows the client to consider self-identity.
2. Different sets of values must be discussed with expectations, and compromises will be made on the part of the therapist and client.
3. Native Americans have a difficult time with assertion and/or the expression of strong emotions.
4. Counseling may be more effective with family members or friends present.
5. Utilize the extended family; trust must be developed. Many times the client will present from a dysfunctional perspective, yet the extended family may be intact and fully functional.

Counseling issues include:

1. Native Americans will usually not display emotions, make good eye contact, or verbalize concerns.
2. Interdependence within the extended family might be a goal.
3. It is critical to identify and respond to the individual needs of the Native American client.
4. Non-directive counseling may prove to be more effective than directive.
5. Do not expect Native Americans to discuss feelings in a meaningful way until specific levels of trust have been established.
6. Native Americans expect counselors to offer solutions and alternatives. A combination of client-centered and behavioral approaches may be very effective.

Additional concerns to be considered include:

1. Native American families will have problems with the 50 minute sessions.
2. Strengthen the dysfunctional family by using the extended family.
3. Keep a low profile during the first session; don't press the client.
4. Allow the client time to finish statements and thoughts; don't interrupt.
5. Confrontation is considered to be rude and should be kept at a minimum.
6. Whenever possible, use a family or group treatment modality.
7. Respect the values of Native Americans. Remember to respond to them as individuals first.