American Indian & Alaska Native Tribes

The Restoring the Sacred Circle Toolkit is designed to support healthy development of youth in Indian Country.

American Indian & Alaska Native Tribes

When we have a direct connection to our traditions and culture it helps us build a solid foundation of where we come from. - Kaycee Martinez

The Sacred Circle refers to the balance of mind, body, spirit and emotional/relational aspects of life. The history of colonization, boarding schools, trauma, violence and abuse has created an imbalance in the Sacred Circle.

In partnership with the Indian Country Child Trauma Center (ICCTC), the Restoring the Sacred Circle Toolkit was developed for Tribal communities to support healthy development of youth and responses to PSB of youth that promote healing. Drawing from previous experience with tribal communities, we describe barriers and strategies to overcome these barriers, utilizing existing resources and tribal knowledge. Youth’s sexual behavior can range from normal, typical, concerning, problematic, harmful and illegal. Understanding the continuum of sexual behavior is essential to effective community prevention and treatment.

“Healing from sexual trauma…it is important for the entire community. Generations of sexual trauma has impacted the well-being of all.“ — Charlene LaPointe, Former Project Coordinator White Buffalo Calf Women's Society

Download this toolkit here:


Restoring the Sacred Circle Podcast

This podcast aims to promote understanding of Problematic Sexual Behavior (PSB), describe current research on PSB, outline the risk and protective factors, and support communities as they address PSB. Click here For the Podcast link.


Juvenile Justice & Courts:

Much of Native culture is based on the Circle of Life. Culture teaches us that we are all relatives to all things in creation. Some of the threads in the Circle have become broken. Law enforcement can help mend the Circle by understanding the needs of youth and families.

The juvenile justice system works with youth who have failed to follow required laws and policies and require rehabilitative approaches. Child protective systems may also be involved. The systems overlap to provide services for youth with problematic sexual behaviors (PSB) and impacted children and siblings. The process includes reporting, investigating, arresting, and making decisions on whether to prosecute, defer prosecution, divert, or use other triage pathways.

Some cases may involve a trial, adjudication, hearing, and sentence, with investigations that may include interviews/testimony, medical exams, and victim services. If a youth is arrested for illegal sexual behavior, a decision on whether to proceed with adjudication is made. Other triage pathways may be utilized, depending on factors such as the crime, context, responsibility, risk, and needs, as well as protective factors, including deferred prosecution and referral for treatment.

To learn more, view our fact sheet here:

Law Enforcement:

Federally recognized tribes have the authority to create and enforce their own laws. However, jurisdiction varies depending on the type of crime, characteristics of individuals involved, and the location of the crime. Law enforcement officers often have the responsibility of determining whether a criminal violation of the law has occurred. In cases where illegal sexual behavior is suspected, law enforcement may conduct investigations. They can also participate in mentoring programs and connect community members to available resources. To learn more, view our fact sheet here:

Mental Health Providers:

Much of Native culture is based on the Circle of Life. Culture teaches us that we are all relatives to all things in creation. Healthy development of our children integrates emotional, behavioral, physical and spiritual growth.

A crucial aspect of addressing problematic sexual behavior (PSB) in youth is providing them with education about healthy relationships and a trusted individual to talk to about relationships, friendships, and sex. This helps reduce the likelihood of them turning to peers or the internet for resources. Healing from trauma and building on resilience is needed.

Community- based treatment is generally effective for youth with PSB and allows them to stay in their home and community, with treatment lasting between three and six months based on changes in their knowledge, skills, and behavior. For the most severe cases with significant psychological concerns , more intensive short-term treatments may be needed. Advocating for public policies that support treatment for youth with PSB is important, along with using people- first language and treating them as children first. Consider collaborative care to address specific needs, including family resources and support, youth programming support, connection with traditional activities, suicide prevention, and substance abuse.

To learn more, view our fact sheet here:

Multidisciplinary Teams:

A group of professionals known as MDTs collaborates to respond to reports of child abuse, neglect, and problematic sexual behavior (PSB) in youth. Some MDTs are associated with children's advocacy centers and often include members such as tribal program staff, law enforcement, child protective services, clinicians, school staff, prosecutors, and representatives from other agencies. Some tribes have MDTs or child protection teams in place to respond to youth with PSB, while others do not.

MDTS can help mend the Circle by understanding how to help youth with problematic sexual behavior (PSB), impacted children, siblings, and caregivers..

Successful tribal MDTs have key elements, such as community ownership and involvement, resources to support team functions, integration of tribal culture and tradition in team process and decision making, development of clear protocols, participation and commitment of MDT members, adequate training and support, confidentiality, and individual member and team accountability.

To learn more, view our fact sheet here:

Parents & Caregivers

Parents and caregivers can help mend the Circle by understanding sexual development, healthy relationships, healthy interpersonal behavior and problematic sexual behavior (PSB).

If you are concerned that your child may be showing problematic sexual behavior (PSB) or has been impacted by another child’s PSB, it is important to connect with support people who are knowledgeable about PSB, trauma, and healing. They can help you determine the next steps for your child and identify the best treatment options available. The risk factors for youth with PSB are universal and not based solely on any demographic, psychological, or social factors. To build resilience and protective factors in youth, tribal protocol, practices, and ceremonies play an important role.

To learn more, view our fact sheet here:

Schools & Educators

To support the prevention of problematic sexual behavior (PSB) in schools, classes with children as young as pre-K and through high school can offer programming to teach and reinforce privacy, boundaries, consent, rules about sexual behavior, and responses to PSB in developmentally appropriate ways. See page 65 of the Restoring the Sacred Circle for an example.

Teachers, counselors, and other staff play a crucial role in ensuring the safety, health, and wellbeing of students. They provide support for healthy decisions and prevention of problematic sexual behaviors (PSB). When students do cross the line and have PSB, school personnel help to identify those students with PSB and impacted children and respond to link them with therapy services.

To learn more, view our fact sheet here:

Two-Spirit Youth

Native American LGBTQ+ communities have reclaimed the contemporary umbrella term that refers to the historical and current American Indian and Alaska Native people whose individual spirits were a blend of female and male. They have done so to honor their heritage and provide an alternative to the Western labels of gay, lesbian, or transgender.

PSB rates are not higher among two-spirit youth. However, LGBTQ+ youth are more likely to be charged and adjudicated for sexual offenses for developmentally appropriate and legal sexual behaviors. This is because professionals perceive LGBTQ+ behaviors more harshly and aberrant, not because the actual sexual behavior is problematic or illegal.

Due to stressors they may experience, LGBTQ+ youth are at a higher risk for behavioral health problems. Mental and behavioral health issues such as depression, anxiety, self-harm, and substance use are some of the most mentioned adverse outcomes experienced by LGBTQ+ youth. Other adverse outcomes include family rejection, bullying, homelessness, prostitution (typically survival-driven work due to homelessness), and general discrimination.

To learn more, view our fact sheet here:

episode 1

Dolores Subia BigFoot, PhD., is a child psychologist by training who hold the Presidential Professorship within the Centre on Child Abuse and Neglect at the University of Oklahoma Health Sciences Centre. Since 1994, she has directed Project Making Medicine, a clinical training program to train mental health providers in the treatment of child maltreatment using culturally based teachings. In 2020 she was awarded the National Suicide Prevention Resource Centre, providing training and technical assistance throughout the country on suicide prevention efforts. With the establishment of the Indian Country Child Trauma Centre in 2004, she was instrumental in the cultural adaptations of evidenced-based child treatment protocols. Under her guidance, four Evidenced Based Treatments were enhanced for American Indian and Alaska Native families in Indian Country, titled the Honoring Children Series. One of the four treatment models is Honoring Children – Mending the Circle, a cultural enhancement of Trauma Focused Cognitive Behavior Therapy, for use with American Indian and Alaska Native children and their families. Dr. BigFoot is a member of the national TF-CBT Trainer Network.

Honoring Children, Honoring the Future is a suicide prevention toolkit.

She has over 15 published articles and chapters, including serving as the lead author of the recent publication, Adapting Evidence- Based Treatments for Use with American Indians and Native Alaskan Children and Youth. Dr. BigFoot has served as PI on sixteen federally funded projects. She currently serves on the federal Commission on Native Children, whose mission is to make recommendations to improve conditions affecting American Indian, Alaska Native, and Native Hawaiian children and their families. Dr. BigFoot has over 30 years of experience and is knowledgeable about the concerns of implementation and adaptation of evidenced based practices being introduced into Indian Country. Dr. BigFoot is an enrolled member of the Caddo Nation of Oklahoma with affiliation to the Northern Cheyenne Tribe of Montana where her children are enrolled members and the recognition that her children were raised in the Cheyenne traditions and ceremonies. Equity, inclusion, cultural identity, and belonging are values she promotes and practices. She values her role as mother, grandmother, sister, daughter, auntie and mentor as being her calling and the pathway that brings others into the circles of cultural teachings. Her faith sustains her as she is a disciple of Christ. She was the wife of the late Cheyenne Chief and tribal historian John L. Sipe Jr. and the mother of C. Ah-in-nist Sipes and his siblings.


episode 2

David has worked on the White Earth reservations as a law enforcement officer for many years. He is advocating for the community to come together and use traditions, culture, and community-based services to help youth get back on the right path and promote the safety and wellbeing of our Native children.


episode 3

Regina S. Ertz, Ph.D. is an enrolled member of the Cheyenne River Sioux Tribe in north central South Dakota and is a licensed health service psychologist. She started her work with school-aged children and adolescents who have engaged in problematic sexual behaviors (PSB) when she completed her internship/residency with the University of Oklahoma Health Sciences Centre (OUHSC). Dr. Ertz is currently working at an outpatient tribal clinic located in central Oklahoma and has continued working with American Indian children/youth who have engaged in PSB. It is not uncommon for these issues to be highly present within Native communities as this behavior has been present within intergeneration trauma. American Indian cultural and traditional teachings/methods are often incorporated in services, if appropriate. Dr. Ertz is honored to be able to provide effective evidenced-based treatment for children/youth and their families to offer healing from this cycle of PSB and promote the concept of wellbeing.

Dr. Dewey Ertz began providing mental-health services in 1974. He began working with children and adolescents who display problematic sexual behaviors in 1985 and he gained his clinical membership in ATSA during 1994. Treatment has been provided to both victims of abuse and abusers by Dr. Ertz. He is the current Chairperson of the Great Planes Region Indian Health Services Institutional Review Board (IRB), and he is a member of the National Indian Health Service IRB. Dr. Ertz is an enrolled member of the Cheyenne River Sioux Tribe in northcentral South Dakota. One of his current research interests is to develop and validate culturally appropriate interviewing techniques for American Indian children and adolescents who are victims of inappropriate sexual activities and/or individuals who display problematic sexual behavior.


episode 4

Bridget Williams was raised in Wagner SD, one of ten children. Having been exposed to trauma both in her childhood and adult life, Bridget has personal experience with how horses can help us heal from trauma. Horses have been a part of part of Bridget’s life as long as she can remember. Bridget is very familiar with reservation life and Native culture and is honored to have experience working with many children, families, and communities on the Rosebud, Pine Ridge, and Yankton Reservations. She holds a master's degree in Community Mental Health and School Counseling from the South Dakota State University and is a licensed mental health professional in the state of SD. Bridget specializes in working with individuals with trauma. She is certified as a Trauma Focused Cognitive Behavioral therapist, is certified in Project Making Medicine, a culturally adapted (Native American) TFCBT, trained in treating Youth with Problematic Sexual Behaviors, and has certification in EAGALA, an equine assisted growth and learning association.

Her career includes assisting in the development and implementation of the Lakota Circles of Hope, a 2nd to 5th grade prevention program that targets drug and alcohol addiction, violence, and promiscuity. Bridget also served as clinical director of Tiwahe Glu Kini Pi for five years and was a critical player in the program’s start-up and development as a Lakota Based Mental Health Program, developing the clinical manual and helping start and maintain the equine assisted psychotherapy groups for youth and families. Her work includes veteran's program's and law enforcement agencies from Pine Ridge, Rosebud, and Rapid City. Red Horse Healing’s main focus is on helping children, individuals, families, and communities heal from trauma, encompassing the imp act of historical, generational, and vicarious trauma. Bridget also works at the Trauma Center through Youth and Family Services in Rapid City and provides mental health services through White Buffalo Calf Women’s Society on the Rosebud reservation.

Bridget currently lives in Piedmont, SD, where she established Red Horse Healing, a program providing equine-assisted learning and therapy to individuals and organizations in western SD. Bridget and her husband, Dr. Mike Williams are proud parents of 5 children and 2 grandchildren.

episode 5

C. Ah-in-nist Sipes, is by profession a Youth Engagement Specialist for the Oklahoma Department of Mental Health and Substance Abuse Services Administration. He has extensive experience in establishing, recruiting, preparing, mentoring, sustaining, facilitating, and training youth advisory participants at the local, state, and national level. All the youth that are part of the advisory youth boards he has responsible for are those with lived experiences. As a youth he worked with the DOJ Office of Juvenile Justice and Delinquency Prevention (OJJDP) tribal youth programs, Garrett Lee Smith (GLS) grantees, IHS Meth-Suicide programs, B&G Clubs, cultural camps, and trauma treatment programs. In his current position, he recruits, screens, and works intensely with youth to develop leadership and advocacy skills as well as promotes trauma informed principles, and supports safe and growth enriching environments as youth with lived experiences find their voice and passion. He is not a therapist but is a great youth facilitator and trainer. He is the Youth Advisory Board facilitator for the National Center on Sexual Behavior of Youth. This center is a comprehensive program for children and adolescents who have engaged in problematic or illegal sexual behaviors and those youth who are involved in the courts or probation. He established the first youth advisory board with the center which has created many products and policy changes. As the son of a Cheyenne Chief and Pipe Carrier John L. Sipe Jr, his own lived experience is of traditional teachings and being raised on the stories of his elders. He is a husband to Megan and the father to their two children. He lives in Oklahoma and is active in his faith.