Clinical Topics & Methods Category

Content Analysis of Perceptions of Substance-Use Treatment Among American Indian People Who Have Used Opioids

1 CE Hour
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About the Course

This qualitative study uses conventional content analysis to examine perceptions of substance‑use treatment among American Indian people who have used opioids. Drawing on interviews with 45 participants residing in Cherokee Nation, the authors identify both strengths and limitations of existing substance‑use treatment programs, including the value of nonjudgmental counseling and peers with lived experience, alongside persistent logistical barriers such as cost, travel distance, and limited internet access. Participants emphasized the importance of intrinsic motivation for recovery and described substance‑use treatment as alternately therapeutic or punitive. The study further documents participant‑driven recommendations for improving treatment, including the integration of Native‑centric cultural programming, access to both individual and group counseling, incorporation of social services such as housing and vocational training, and the use of healing, nature‑based treatment environments.

This course is based on the reading online article, Content Analysis of Perceptions of Substance-Use Treatment Among American Indian People Who Have Used Opioids created by Emma Shinagawa, M.S. et al in 2025.

Publication Details

Publication Date: Cultur Divers Ethnic Minor Psychol. September 30, 2025

Course Material Authors

Course Material Authors authored the material only, and were not involved in creating this CE course. They are identified here for your own evaluation of the relevancy of the material this course is based on.

Emma Shinagawa, M.S.

Emma Shinagawa is affiliated with Washington State University in Spokane, Washington. She is the corresponding author of this manuscript and contributed to the study’s design, analysis, and interpretation of findings related to substance‑use treatment perceptions among American Indian people.

Sage Mednansky, B.S.

Sage Mednansky is a research study supervisor with Washington State University in Spokane, Washington. They are a co‑author on this study and contributed to the research examining participant experiences and recommendations for improving substance‑use treatment services.

Allison Brown, LCSW 149014591

Allison Brown holds a BS degree in Criminal Justice with a Psychology focus and a Master’s degree in Social Work from Loyola University Chicago. She is a Licensed Clinical Social Worker who currently works at a Long-Term Insurance company bringing clinical experience to claim processes. Additionally, she developed and continues to lead the Continuing Education Program for Social Workers and Nurses and often leads complex process improvement projects Prior to this, her primary focus was in mental health and worked in both the outpatient and inpatient settings providing support to adults with mental illness.

Target Audience

This course is intended for Behavioral Health and Addictions professionals, including psychologists, social workers, counselors, marriage & family therapists, art therapists, school psychologists, psychoanalysts, music therapists, behavior analysts, and school counselors. It is appropriate for intermediate and above levels of knowledge.

Learning Objectives

After taking this activity, you should be able to:

  1. 1 Describe key perceptions of substance‑use treatment among American Indian people who have used opioids, including perceived benefits and barriers.
  2. 2 Identify participant‑recommended strategies for enhancing substance‑use treatment, including culturally grounded, social‑service‑integrated, and nature‑based approaches.
  3. 3 Explain the role of intrinsic motivation and nonjudgmental therapeutic relationships in shaping treatment engagement and perceived effectiveness.

Disclosure to Learners

CE Learning Systems adheres to the ACCME's Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CE activity – including faculty, planners, reviewers, or others ― are required to disclose all relevant financial relationships with ineligible entities (formerly known as commercial interests).

The following relevant financial relationships have been disclosed by this activity's planners, faculty, and the reviewer:

Planners and Reviewers

The planners of this activity have reported that they have no relevant financial relationships.

Material Authors

Any relevant financial disclosures for course material authors can be found in the article.

Commercial support

There is no commercial support for this distance-learning course.

Course Materials

References begin on page 16

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