Client Background

Tribal Affiliation

  • Degree of affiliation
  • Exposure to traditional beliefs and practices
  • Acculturation level to dominant culture
  • Language spoken at home
  • Ancestral history


  • Geographic location of birth
  • Years in the primary area of residence (urban or rural village)

Historical Trauma and Generational Experiences

  • Colonization
  • Missionary era
  • Cultural disruption
  • Deprivation, and loss
  • Other socio-historical context impacting attitudes towards formal systems and health status (see Cohort Experiences)


  • Perception of role in collective society as transmitter of cultural knowledge to the young


  • Traditional church practices
  • Rituals
  • Extent of participation in church activities

Patterns of Decision Making

  • Degree of connectedness with family and community
  • Quality of the interdependent sense of self