The Evolution of an Indigenous Mindfulness Program: Qualitative Findings from the IndigenousMIND Study
- Open Access
- 25-02-2026
- ORIGINAL PAPER
Abstract
Delen
Indigenous worldviews across Turtle Island (North and Central America) have long emphasized relationships with the natural world, ancestors, and the Creator as foundational to health and well-being—an understanding that stood apart from the reductionist orientation of Western medicine. Over millennia, Indigenous communities developed holistic frameworks of wellness—integrating spiritual, emotional, physical, and intellectual dimensions (Duran & Duran, 1995)—so that cultural medicine was embedded into daily living and special events. Through storytelling, songs, dances, ceremonies, food, art, and physical activity, there were many ways to plug into the medicine provided by culture (Sheridan & Longboat, 2006). These cultural practices often accompanied life transitions, such as births, deaths, planting and harvest seasons, and rites of passage, serving as powerful expressions of community, identity, and spiritual continuity. While the specific forms differ across nations, ceremonies were, and are, widely regarded as central to cultural revitalization and holistic well-being (Clarke & Yellow Bird, 2021).
Hundreds of years of colonization profoundly damaged Indigenous contemplative traditions through forced assimilation, legal prohibitions on ceremony, and systematic cultural erasure (Witko, 2006). Neurodecolonization theory (Clarke & Yellow Bird, 2021; Gray et al., 2013) explained that the cumulative effects of these disruptions extended beyond cultural loss and produced intergenerational neurological and physiological harm, compounding the historical traumas of land dispossession, genocide, and systemic oppression (Conching et al., 2019)
. These legacies have often manifested as anxiety, depression, or cultural disconnection—conditions that Western clinical frameworks may overlook, pathologize, or misinterpret (Witko, 2006). In contrast, Neurodecolonization theory suggests that many of the illnesses are the embodied consequences of historical trauma, and that healing requires re-engagement, indeed immersion, with Indigenous culture as the primary path to restore wellness (Clarke & Yellow Bird, 2021; Gray et al., 2013).
In recent decades, Indigenous scholars and healers have advanced wellness frameworks—across areas such as psychology, medicine, social work, and public health—that honor sovereignty and promote healing grounded in Indigenous knowledge systems. Clarke and Yellow Bird (2021), Ody et al. (2022), Wallerstein and Duran (2006), and Gray et al. (2013) have demonstrated how collaborative research with Indigenous communities can center Indigenous conceptualizations of health and wellness within institutional settings. Similarly, Lowe et al. (2024) illustrated the effectiveness of creating culturally grounded spaces—such as talking circles—where participants feel safe discussing health behaviors (Brooks et al., 2022). These formats foster meaningful engagement and serve as catalysts for sustained commitment to positive health change. Collectively, such initiatives exemplify research as an expression of sovereignty, aligning with broader movements like food sovereignty that establish cultural self-determination as a theoretical and practical foundation for public health interventions (Jernigan et al., 2023).
Culturally adapted mindfulness-based intervention (MBI) programs rooted in Indigenous knowledge are starting to show promising outcomes. For example, Le and Gobert (2013) responded to a suicide crisis among Indigenous youth in Montana through MBIs that incorporated traditional practices of the Indigenous communities, such as berry picking and storytelling, that was co-developed with the tribe. Participants reported improvements in emotional regulation, strengthened community ties, and a renewed appreciation for quiet reflection—highlighting strong alignment of MBIs with Indigenous cultural values. Other Indigenous-centered MBIs have drawn upon frameworks, such as talking circles, as well as food sovereignty, and traditional healing practices that supported not just physical and mental health but created spaces where participants could explore cultural identity and relational well-being, which was particularly useful from an Indigenous standpoint (Clarke & Yellow Bird, 2021; Jernigan et al., 2023; Lowe et al., 2024; Wallerstein & Duran, 2006).
Indigenization is the practice of embedding Indigenous ways of knowing, being, doing, and relating into the educational, organizational, cultural, and social frameworks of an institution (Wallerstein & Duran, 2006). We became interested in building on the work other researchers had started in building MBIs in Indigenous communities to capture some of the health and psychological benefits of mindfulness. MBIs have been applied to a wide range of health concerns, including sleep, eating habits, substance use, healthy weight, trauma, depression, stress, anxiety, and burnout (Bowen et al., 2006; Carriere et al., 2018; Davis et al., 2007; de Vibe et al., 2017; Fulwiler et al., 2015; Gilmartin et al., 2017; Kristeller et al., 2006; Loucks et al., 2023; Nelson, 2017; Possemato et al., 2022; Rusch et al., 2018; Salmoirago-Blotcher et al., 2013). Although mindfulness programs have demonstrated efficacy across a broad range of mental and physical health issues, it had been inaccessible for many communities which has prompted the need for structural and cultural adaptation of mindfulness programs to meet the unique needs of diverse groups of people so that these programs are inclusive (Crane et al., 2017; DeLuca et al., 2018; Fleming et al., 2022; Green et al., 2021; Possemato et al., 2022).
While rooted in Eastern contemplative traditions, MBIs have often been translated into Western settings in ways that emphasize individualism, standardization, and secularism—frequently neglecting cultural relevance and community-centered healing (Crane et al., 2023; Fleming et al., 2022; Karelse, 2023; Olzman, 2022). Further, underrepresented people often frame MBIs as “White mindfulness” because these spaces have been historically catered to White people, which can obscure and marginalize the deep contemplative traditions already existing within non-White communities (Fleming et al., 2022; Proulx & Bergen-Cico, 2022). This has led to redesigning mindfulness programs to better resonate with diverse cultural experiences—particularly for communities with longstanding traditions of presence, awareness, and intentionality that parallel aspects of mindfulness (Proulx & Bergen-Cico, 2022).
In this paper, we describe the development of our framework for adapting an MBI for Indigenous communities. Our approach drew on the Why, When, and How to Adapt Mindfulness-Based Programs (WWHAM) framework (Loucks et al., 2022), a step-by-step model for culturally tailoring MBIs, which, in our case, we intended to integrate with Indigenous knowledge, ceremony, and community guidance. The goal was to establish sustainable, sovereign MBIs across Indigenous communities that aligned with tribal values and governance. Two guiding questions shaped our process. First, can we use community-based research methods to foster partnerships capable of co-developing culturally grounded MBIs that reflect Indigenous knowledge, traditions, and values? Second, can we construct a flexible, portable framework that we could adapt across multiple Indigenous communities while honoring the distinct cultural identities of each? Together, these questions guided the development of a scalable yet locally rooted model for Indigenizing mindfulness that we named IndigenousMIND.
The foundation of the IndigenousMIND program was based on the widely cited Mindfulness-Based Stress Reduction (MBSR) program curriculum (Kabat-Zinn, 2011), which has had well-documented effects across a range of health outcomes including in adaptations to distinct contexts and populations, but little is known about MBSR within Indigenous communities. The standard MBSR program consists of an 8-week class in which participants attend an orientation session, meet weekly for 2.5–3.0 hr, and attend an all-day silent retreat after classes 5 or 6. Participants learn a range of mindfulness practices, including body scan meditation, sitting meditation, mindful movement, and reflective exercises to explore how one perceives and copes with a stressful world (Kabat-Zinn, 2003).
Building community trust was essential to building our model, but also to ensure we were supporting tribal sovereignty, which we view as the right of each nation to sustain, adapt, and evolve mindfulness programming in ways that reflect and uphold their unique cultural traditions and ceremonies. To these ends, we wanted to identify Indigenous mindfulness teachers from each community with the hope that those teachers would continue the programming long after the research study was completed. Conversations with the tribes indicated that there could be barriers to tribal members engaging in mindfulness teacher training (cost, time commitment, availability, cultural salience), so we worked as a team to address barriers that arose. For example, we paid for teacher training through grant funding and/or and made financial arrangements to lower our costs, training schedules accommodated each trainee’s availability, significant efforts were made to create a safe space for all these conversations to occur among mostly Indigenous people, and suggestions for implementing cultural content were honored and incorporated into the evolving IndigenousMIND curriculum. Furthermore, we made an emphasis on identifying how the traditional training of Indigenous contemplative teachers is a much different process than it is for other MBI instructors and that how those differences can be influenced or constrained by systems and values of settler colonialism.
The quality of training for mindfulness teachers is significantly associated with participant outcomes and satisfaction (Ruijgrok-Lupton et al., 2017). Kenny et al. (2020) noted several domains necessary for the foundation of mindfulness teachers, including attention to teacher readiness, teacher’s previous experience with mindfulness practices, proficiency with interactive skills involved in teaching, an understanding of mindfulness and its history, flexibility to allow the class to be context-dependent, the embodiment of mindfulness values in the teacher, and continued learning by the teacher. These considerations were even more salient for our communities because they were integrating potentially sacred content and had to consider the logistics of respect, understanding the effects of settler colonialism on the community, and holding a mindfulness class and working with sacred wisdom. Thus, much effort was taken to help these individuals to empower themselves to feel confident with both the cultural and MBI aspects of IndigenousMIND as possible.
Method
We partnered with two Indigenous communities—one in southern Oregon and one in northern California—to co-develop an 8-week mindfulness program designed to be culturally resonant, acceptable, and feasible for long-term use within each community. While we deeply respected the diversity of Tribal traditions, we focused on communities within geographic proximity to Brown University to support consistent, in-person engagement and sustained relationship-building. Although the two nations shared historical and cultural connections, centuries of living in distinct environments—dry mountainous terrain in Oregon versus coastal ecosystems in California—contributed to important differences in traditions, ceremonies, and wellness needs. Our process was designed to honor these differences while sharing regional and cultural strengths.
Participants
Participants in this project included a wide range of community collaborators, beginning with local culture bearers and stakeholders who helped guide the earliest stages of curriculum development. To inform the adaptation process, individuals from both communities were invited to participate in an initial standard MBSR course. Their feedback played a pivotal role in identifying aspects of the curriculum that could be enhanced, replaced, or infused with Indigenous teachings. Based on this feedback, the curriculum was reshaped to better reflect the values, language, and spiritual frameworks of the communities. Following these adaptations, we recruited 10 participants from the alpine community and 10 from the coastal community to take part in the revised 8-week IndigenousMIND program. While qualitative results reflect the experiences of these final participants, the insights and contributions of early partners were foundational to shaping the program’s structure, tone, and content.
Procedure
Engagement with each tribal community began by building trust and assembling a local steering committee composed of community members with an interest in MBIs, including self-identified cultural experts. In both communities, the Principal Investigator (PI), Dr. Jeffery Proulx, initiated contact by emailing Tribal health leaders to introduce the project and invite potential collaborators. Each community quickly identified individuals who were not only interested in mindfulness but also well-positioned to lead this work locally. Steering committees were then formed, comprising these immediate partners and key health administrators to ensure institutional support. This included logistical considerations such as flex time to allow participants to dedicate work hours to the project. Notably, despite the PI offering to cover associated personnel costs, both tribal communities chose to absorb these expenses themselves, demonstrating a strong sense of ownership and commitment to the project.
The steering committees met regularly to establish key benchmarks, such as obtaining Tribal Council approval, securing institutional review board (IRB) approval (including Tribal IRBs), organizing community-facing mindfulness events, and identifying community members to be trained as mindfulness teachers as well as long-term recruiting for the two MBIs we anticipated delivering as part of this project. These meetings also addressed logistical and cultural considerations, such as gaining support from local agencies and ensuring that respected community members were invited to participate. Committee meetings were strategically held around major community events (e.g., craft fairs, powwows, health fairs, and tribal anniversaries), which provided opportunities to introduce mindfulness practices to the broader community and share the long-term vision of integrating mindfulness into community wellness initiatives.
We secured formal approval of the study design from both Tribal Councils. Institutional Review Board (IRB) approval was subsequently obtained from the PI’s university, as well as from the California Rural Indian Health Board and the Northwest Portland Area Indian Health Board—both of which were actively partnering with the respective tribes to support tribal public health initiatives at the time. Initial IRB approval covered the preliminary MBSR classes, during which participants provided input on how to Indigenize the course. A second round of IRB approval was obtained once the content for IndigenousMIND was finalized for each community.
Adaptation Framework
To guide the cultural tailoring of Mindfulness-Based Stress Reduction (MBSR) for Indigenous participants, we drew upon principles that would later be formalized in the “WWHAM” framework (Loucks et al., 2022). This model offers a structured approach to program adaptation by asking: Why is adaptation needed? When is it warranted based on theoretical and contextual fit? How can adaptations be made without compromising the program’s core elements? It also encourages consideration of whether effective, culturally grounded practices already exist within the community.
A central component of our adaptation process was the annual 3-day retreat, which brought together community-identified mindfulness teacher trainees, cultural experts in language and tradition, and experienced non-Indigenous MBSR teacher trainers. These retreats marked the first formal application of the WWHAM framework to the MBSR curriculum within our project. Each retreat began on Friday afternoon with participant arrivals, shared meals, and a welcome circle that introduced the overarching goals of the IndigenousMIND project. Saturday morning was held in silence, offering participants the opportunity to engage deeply with core practices such as breathing meditation, the body scan, mindful movement, and walking meditation—while reflecting on how these practices could be meaningfully adapted within their cultural contexts. Silence was broken during a shared lunch, followed by an afternoon debrief and structured dialogue on building a culturally grounded mindfulness curriculum.
Saturday afternoons were dedicated to reviewing each session of the standard MBSR curriculum, beginning with Orientation and class 1. Key questions from the “WWHAM “ framework (Loucks et al., 2022) guided the process: What would make this component more culturally resonant or inviting for your community? When is it appropriate to introduce Indigenous cultural practices based on theoretical and contextual relevance? How can we incorporate Indigenous content without compromising the program’s essential elements? How can Indigenous content enhance the program’s elements? This exercise-by-exercise, collaborative review resulted in iterative modifications informed by local cultural knowledge and values, producing a preliminary adapted curriculum tailored to each community. These retreats established a replicable model for bringing together diverse stakeholders to co-create mindfulness-based interventions in Indigenous settings. Sunday mornings were reserved for relationship-building, community reflection, and planning future benchmarks to carry the work forward. Further refinements occurred during the PI’s regular site visits, but we anticipated that the first delivery of the adapted MBSR classes would yield the most valuable insights. Participant feedback from those courses ultimately shaped the final version of the IndigenousMIND curriculum and its feasibility within each community context.
Training of IndigenousMIND teachers
Our goal was to use community members to be the mindfulness teachers for this program. We primarily elicited interest for potential teachers from health departments in the communities we worked in, such as diabetes and behavioral health departments. Because they already had experience constructing education groups, they were aware of community health concerns that could be relevant to the implementation of IndigenousMIND programming within their respective settings. Three individuals in the Oregon mountain community and two from the coastal California community volunteered as the teachers/facilitators. In addition to working with the PI on this project, they used their role to develop their own mindfulness practice.
To ensure comprehensive teacher training, we adhered to the guidelines outlined by the Mindfulness-Based Interventions: Teacher Assessment Criteria (MBI:TAC) (Crane et al., 2021). This structured evaluation tool assesses the competency and proficiency of individuals teaching MBIs. It provides a detailed framework for evaluating a teacher’s understanding, embodiment, and delivery of mindfulness practices, ensuring the quality and effectiveness of the programs taught. The MBI:TAC evaluates several key areas, including knowledge of mindfulness principles, communication skills, embodiment of mindfulness, facilitation of practices, group management, and adherence to ethical standards. By maintaining a high standard of teaching, this assessment also supports the refinement of teaching skills within the mindfulness field.
The individuals who volunteered to become teachers completed formal training in MBSR at the Mindfulness Center at Brown University (MC@B), emphasizing the interactive teaching skills mentioned above. The training included participation in an MBSR class followed by two teacher training programs and silent retreat attendance. Further, the teachers were involved in all aspects of program design, and most of them were expert clinicians who worked with cultural components of care. They co-taught the preliminary (2019) MBSR classes in these communities with an experienced Indigenous MBSR teacher (JP). All of this was in the goal of establishing qualified teachers who could train other community members in the future, fostering ownership and sovereignty for the final IndigenousMIND program. Notably, these individuals continued to provide key input on the design of the class, as well as issues related to best timing and location for a class like we imagined.
While the IndigenousMIND program was originally designed for in-person implementation in 2020, the emergence of COVID-19 required a rapid transition to virtual delivery. The classes were held via WebEx from March to May 2020. To recruit participants, we created both print and digital versions of a program announcement and distributed them across Indigenous health centers in Arcata, Smith River, Trinidad, Crescent City, and Eureka, California, as well as in Klamath Falls and Chiloquin, Oregon. We also shared recruitment materials on tribal health social media platforms, including Facebook and Twitter.
Recruitment for mindfulness participants for the 2020 program proceeded smoothly. After discussions with the tribal partners, we established the following inclusion criteria: membership of the participant tribal nations, no active heavy substance use, and 18 years of age or older. Many participants were staff members of the partnering tribal health organizations and had been eagerly awaiting the next iteration of the mindfulness program. Often, simply finding time to engage in weekly events is hard on many of the people we worked with. We worked with our partnering Indigenous agencies where we could offer flex time and compensation, enabling employees to attend sessions as part of their work responsibilities. Although childcare support was offered because of concerns that people could not find childcare, no participants made use of this option. Additional recruitment occurred organically through word of mouth within the communities. Transportation was also brought up as an issue (when we held in-person meetings), so we gave each person a gift card for gasoline purchases to get to class.
We revised our program (and budget) to create “participant kits” that included 8-in. Kindle Fire devices programmed with WebEx–which gave all participants access to a device, yoga mats with Indigenous designs, a book of poems by Indigenous author Joy Harjo, a mindfulness calendar, and culturally meaningful objects. For the California coastal community, we included local tree clippings for smudging at the beginning of each class and seaweed for mindful eating. In the Oregon mountain community, we provided sage for smudging and deer jerky from a local hunter for mindful eating. We also bottled water from sacred springs to include in the kits. These items were assembled in baskets made by a local artisan in each community. The principal investigator (PI) drove to each location to deliver the kits and collect a signed electronic copy of consent from each participant.
IndigenousMIND
The IndigenousMIND program was based on the 8-week MBSR design, including a required orientation and an all-day silent retreat between Classes 6 and 7. Each week, participants met for 2 hr in the evening via WebEx. Along with class attendance, participants were encouraged to complete 45 min of home practice per day, which is the standard for MBSR (Kabat-Zinn, 1990), including practicing with recordings of the meditation instruction created by Dr. Jeffery Proulx, who is also Indigenous. Note that we provided shorter content for participants by guiding them to other online sources of mindfulness practice. Other homework included common mindful eating and non-formal ways of being mindful in daily lives throughout the week (e.g., noticing differences in their interactions with others or paying attention to their thoughts). Each take-home recording reflected practices that were conducted in the class that week. However, we explored ways in each of the homework practices where language, or song, or a story could be included to create better context for the exercise. Notably, homework was not formally tracked by the study team although we provided a tracking form among other class-related documents for participants to track their progress.
While following the general MBSR format, we soon began Indigenizing the curriculum content weekly and sometimes daily (Indigenization is the practice of embedding Indigenous ways of knowing, being, doing, and relating into the educational, organizational, cultural, and social frameworks of an institution). Songs or prayers were incorporated at the beginning of each class. We honored the original inhabitants of the land we walked on and prayed to Tribal ancestors for guidance and wisdom. We used smudging materials to bless the physical space. The programs began to take shape differently at the two locations. The California coastal community implemented the lessons learned by shortening the length of the practices from the original MBSR program to provide time for their Indigenous cultural additions. MBSR was reported acceptable to the participants if there was time to honor local traditions. The extra space in the curriculum allowed us to include the opening ceremonies mentioned above, a tribal origin story, and a discussion of how the story was pertinent to our work in the class. This pattern was consistent with Loucks et al. (2019), who successfully condensed the length of mindful practices and discussion to allow for about half an hour each week of specific modules focused on applying mindfulness self-regulation skills to health behavior change. In our case, we were interested in creating time for cultural discussion.
In the Oregon mountain community, much more cultural content emerged. Examples included cases where the focus on the breath was scheduled in the curriculum; we introduced the Paiute word for breath (in that community) and highlighted how this word is sometimes translated as breath and enables a person to have a deeper connection with the natural world, including the Four Directions, Creator, and ancestors, and noted how each time we breathe, we connect to those entities. For the body scan (i.e., a 45-min practice of directing attention systematically through the body, from the toes to the head), we introduced the names of the body parts in the Klamath and Karuk languages so that the participants could hear the instructions in English and the local language, thereby also serving tribal priorities to transmit their language through subsequent generations. We also provided printouts of a human body labeled with the Klamath and Karuk words. Thus, while MBSR provided the scaffolding, we designed a program consistent with the mindful skills developed in MBSR, using Indigenous content as the vehicle for healing. In the California community, the participants found that the delivery of the MBSR class was appealing, but they liked having time to discuss how their predecessors had been mindful without calling it mindfulness and bringing up memories of when they felt the most present.
Notably, the teaching team held post-class debriefs to reflect on what went well and to collaboratively sketch the following week’s class while insights were still fresh. These sessions, along with 2-hr preparatory meetings before each class, created space for continual refinement of content and facilitation roles. Many sessions were co-designed during the week of delivery—or even in real time—based on emerging ideas and input from participants. This flexible, iterative process was grounded in the deep relationships cultivated with community members and supported by the cultural humility and training of the teaching team. Most importantly, community voices played a central role in shaping the class structure and content, ensuring that each session responded to cultural values, lived experiences, and not only enriched the curriculum, but also strengthened participant ownership and sovereignty.
Data Analyses
All qualitative data were collected during the delivery of the IndigenousMIND program (the second of the two times we delivered an 8-week MBI), which took place 1 year after our preliminary MBSR program had been conducted and feedback on it had been incorporated into the IndigenousMIND framework. Program sessions took place over WebEx, and recordings of the classes were stored at secure servers at Brown University. All conversations during the 2-hr WebEx sessions were transcribed and analyzed for content. All study activities were approved by both locations’ tribal and health councils, and the appropriate Indigenous and academic institutional review boards (IRBs).
The qualitative analysis was completed by a medical anthropologist trained in qualitative methodology (RC) and a public health graduate student (CC). Both coders were non-Indigenous and therefore proceeded with the understanding that their interpretations of the data and the methodology within which they were working were inherently shaped by a westernized schema that prioritizes the separation of the whole into parts and that this schema was being applied to data representing Indigenous worldviews that prioritize holism. However, the PI on this study and most of the contributors on this project were Indigenous, and our partners were specifically chosen for their expertise in cultural topics in their community. All methods and interpretations were conducted with their input. With this awareness and cultural humility, coders read three group session transcripts separately to identify codes and general concepts to apply to the remaining data. Initial code lists were subsequently refined through an iterative process of comparing coders’ interpretations. Next, using open-axial coding within the context of grounded theory, coders developed and agreed upon iterative emergent themes. Themes formed a codebook wherein broad themes were divided into more nuanced codes, and similar themes were collapsed into single codes.
Results
Primary Domains
Participants’ ages ranged from 25 to 72 years and the majority (65%) of participants were women. The coastal community included seven women and three men, and the mountain community had six women and four men. Attendance varied but 80% or more of the IndigenousMIND program sessions were 80% full (we always had at least 8 people in each class and most often all 10 in each community). The offering of classes online may have supported attendance, as previous concerns with the rural communities we were working in suggested that attracting people from far away was difficult. The IndigenousMIND program in Coastal California and the Oregon mountains produced 16 transcribed sessions for thematic analysis.
Here, we discuss the principal domains of Mental Health, Mindfulness Practices, and Religion and Tradition. Respectively, within these domains, our focus is on the themes of (a) coping strategies (for stress, anxiety, and depression); (b) mindfulness for relief of stress, anxiety, and depression; and (c) creator/creation, traditional practices, and community identity. Though many themes emerged from the class dialogue, we focus on these three specifically because they most closely reflect existing healthy stress responses and coping strategies used by participants before the IndigenousMIND classes, the impact of the specific mindfulness practices on managing stress responses, and how these practices resonate with traditional worldviews and have traditional correlates. Together, findings from these themes demonstrate the cultural connection to mindfulness practices and deep cultural meaning for Indigenous people that honors and recognizes the contemplative practices they have been cultivating for generations (Table 1).
Table 1
Themes, sub-themes, sub-theme examples
Themes | Sub-themes | Sub-theme examples |
|---|---|---|
“I had a good time thinking about the fact that…my work means something to me” [Oregon, Week 4, TIA] | ||
Coping Strategies for Stress, Anxiety, and Depression and Creator/Creation, Traditional Practices, and Community Identity | Meaning, Gratitude, and Faith | “I know that one of my purposes is… I’m a huge protector of people I love” [Oregon, Week 5, NOR] |
“Each one of us chose to come here from the other side… It helped me to understand why I’m getting all these trials…” [Oregon, Week 5, RAC] | ||
“Like DEV said earlier, it’s really about our faith and putting our faith out there and letting the process move the way it’s going to…” [Oregon, Week 2, TAY] | ||
Patience and Slowing Down | “She liked to slow down and enjoy things and take her time… the things that I’ve been implementing are slowing down, taking time… understanding that they take the time they take.” [Oregon, Week 1, RAC] | |
“I’ve been really enjoying taking my time walking… I kind of put on some music and just observe.” [California, Week 1, JAC] “Something’s been hauling me to the lake… I went out there and stood there for a while… like I need to sit there and be still and be quiet.” [Oregon, Week 1, RAC] | ||
Time in Nature | “I was just watching little chicks… I just felt real calm and relaxed there watching them… just realizing how mother nature works.” [Oregon, Week 1, TWI] | |
Self-care | “…getting enough sleep, exercising… Trying to take care of my mind, body, and spirit…” [Oregon, Week 2, RAC] | |
“I’ve been learning that it’s ok to protect myself and to take care of myself and that I can still do that while protecting those that I love.” [California, Week 5, NOR] | ||
“This class has brought me that healing… it’s ok to be angry, and it's ok to be hurt, but it’s how we deal with it.” [Oregon, Week 6, TAV] | ||
“In this class, I’m learning to deal with stressors differently… Breathing, instead of trying to think about it.” [Oregon, Week 6, KER] | ||
Mindfulness for Relief of Stress, Anxiety, and Depression | Responding Versus Reacting to Stress | “Going around grinding your teeth… I appreciate the awareness that this class has brought to me about that need to be still.” [Oregon, Week 6, RAC] |
“I thought, when I did that, I would stay there for a long time. But I didn’t… I just kind of stayed in the moment.” [California, Week 1, ROB] | ||
“When you hear these upsetting things… I don’t react as much now. I am able to calm myself.” [Oregon, Week 3, TWI] | ||
“Being as stressful as it is at work… This week, what I did was breathe more.” [Oregon, Week 2, RAC] | ||
Breath Awareness and Body Scan | “In stressful times, becoming aware more quickly… able to take a few minutes to do a breathing exercise.” [California, Week 3, TIA] | |
“I had an experience where something really upsetting happened… I didn’t stay sad for a long time… I was wondering if the body scans were helping me somehow.” [California, Week 1, RAB] | ||
“Thank you, Creator, for everything that you’ve given us… Thank you for all of the sea life, all of the earth life, all the animals on earth.” [California, Week 1, RRK] | ||
Creator/Creation, Traditional Practices, and Community Identity | Prayer, Faith in the Creator, and Ancestral Stories | “Creator’s daughter… He went to the other world after her…” [Oregon, Week 3, DON] |
Coping Strategies for Stress, Anxiety, and Depression
Despite limited financial and institutional support, we must note that our partnering communities were already implementing culturally relevant programs to improve community wellness long before our intervention. Before learning or utilizing the formal and informal mindfulness practices introduced in the IndigenousMIND program, many participants reported using their own coping strategies for negative emotions and stressful situations. These included focusing on meaning, gratitude, and faith; having patience and slowing down; spending time outdoors in nature, often near water; and practicing self-care (e.g., exercising, eating healthy, and getting adequate sleep.
Meaning, Gratitude, and Faith
The most common coping strategy practiced prior to the IndigenousMIND classes was focusing on personal meaning, gratitude, and faith. Sources of meaning included work, “I had a good time thinking about the fact that…my work means something to me” [Oregon, Week 4, TIA]; caretaking, “I know that one of my purposes is… I’m a huge protector of people I love” [Oregon, Week 5, NOR]; and the belief that things happen for a reason.
Each one of us chose to come here from the other side. We knew what our life was going to be like, and we accepted that responsibility anyway. The goal of coming here is to elevate your spirit to a higher level… It helped me to understand why I’m getting all these trials, why I have so much adversity, why I struggle [Oregon, Week 5, RAC].
Participants also reflected on their faith, “Like DEV said earlier, it’s really about our faith and putting our faith out there and letting the process move the way it’s going to, because we can’t control that” [Oregon, Week 2, TAY].
Patience and Slowing Down
Participants commonly referred to the ways of their Elders and ancestors and how their lifeways might be beneficially applied to life today. One woman spoke about learning from her mother:
She liked to slow down and enjoy things and take her time… Since her death in 2013, I’ve been trying to find some way to get myself closer to where she was in that. So, the things that I’ve been implementing are slowing down, taking time to do the things that need to get done, and understanding that they take the time they take. Not trying to do too many things in one day [Oregon, Week 1, RAC].
Along with reflecting on the way their ancestors lived, participants also discussed how they had been slowing down within their own lives, “I’ve been really enjoying taking my time walking and kind of – at least for me I don’t – it’s not so much that I’m mindful or observing my body. I kind of put on some music and just observe.” [California, Week 1, JAC].
Time inNature
Spending time outdoors, often near a body of water, was a common tool for coping. As one participant noted:
Something’s been hauling me to the lake... I went out there and stood there for a while, just looking at the mountains and feeling the wind on my skin and the waves bouncing off the dock. That was really nice, and I don’t know why I keep feeling this need to go there, like I need to sit there and be still and be quiet [Oregon, Week 1, RAC].Another participant spoke about their connection with wildlife and how they were able to relax during that time.I was just watching little chicks in the backyard and, at first, I wasn’t aware that I had been watching them. And I just felt real calm and relaxed there watching them... It’s fun just to watch and their interaction, and then just realizing how mother nature works. [Oregon, Week 1, TWI].Self-care
This coping strategy was mentioned frequently, from both a physical and psychological perspective. One participant itemized her self-care routine: “…getting enough sleep, exercising… Trying to take care of my mind, body, and spirit… Go to bed at the same time, get up at the same time. Make sure I take my lunch, go for a walk, eat something healthy” [Oregon, Week 2, RAC]. Another participant was learning to meet her own needs before focusing on others: “I’ve been learning that it’s ok to protect myself and to take care of myself and that I can still do that while protecting those that I love” [California, Week 5, NOR].
Mindfulness for Relief of Stress, Anxiety, and Depression
As a result of practices and ideas learned through the IndigenousMIND program, participants identified how practicing mindfulness helped them cope with stress, anxiety, and depression. These included specific practices such as using breathing-focused techniques for stress relief and body scan meditation for mood improvement.
Responding Versus Reacting to Stress
General mention of using mindfulness practices for coping fell into three categories: (1) focusing on the present as a way to heal from the past, “This class has brought me that healing and realization that I needed… and my grandparents, and all of my ancestors, to say that it’s ok to be angry, and it's ok to be hurt, but it’s how we deal with it” [Oregon, Week 6, TAV]; (2) letting go of a stressful situation more quickly, “In this class, I’m learning to deal with stressors differently… Breathing, instead of trying to think about it. That really helped” [Oregon, Week 6, KER]; and (3) enhancing self-control to prevent impulsive reactions, “Going around grinding your teeth and clenching your fists and trying your hardest not to snap on somebody is not the way to approach it… I appreciate the awareness that this class has brought to me about that need to be still” [Oregon, Week 6, RAC]. Participants also spoke about how they were able to return to their baseline faster after a stressful experience.
I had to say, ‘What is this that you’re feeling?’ And then I just had to allow myself to feel it. I thought, when I did that, I would stay there for a long time. But I didn’t, and I was, like I said, without effort, I came back to a very peaceful place. Somebody just mentioned ‘back in the moment,’ and I think that’s what happened. I didn’t stay in that past experience. I just kind of stayed in the moment. [California, Week 1, ROB]Another participant noted that they did not have as large an emotional reaction when hearing upsetting news.“I’m finding that the meditation and – when you hear these upsetting things, not to – I don’t react as much now. I am able to calm myself. That’s working for me.” [Oregon, Week 3, TWI].
A common theme found is that participants were able to take the time to respond rather than react to stressors in a healthy manner and use skills they learned through the IndigenousMIND program instead of impulsively reacting to the stressors.
Breath Awareness and Body Scan
Specific mention of mindfulness practices to relieve stress, anxiety, and depression usually involved breath awareness or body scan meditation. Participants mentioned focusing on breathing to prevent lashing out at others or to increase one’s threshold to manage stress. As one woman described: “Being as stressful as it is at work, I’m always walking around trying to keep myself from flipping out. I constantly talk to myself. This week, what I did was breathe more” [Oregon, Week 2, RAC]. Another participant spoke about taking measures to calm herself: “I found myself, in stressful times, becoming aware more quickly that I’ve reached a threshold and being able to take a few minutes to do a breathing exercise” [California, Week 3, TIA]. The body scan meditation taught throughout the course was also a popular modality for mood improvement. One participant described her process:
I had an experience where something really upsetting happened, and so I became really sad. And then, I expected that I would stay sad for a long time, and I didn’t. I just naturally came back to a nice peaceful state… I was wondering if the body scans were helping me somehow [California, Week 1, RAB].
Creator/Creation, Traditional Practices, and Community Identity
The Indigenization of mindfulness practices to be culturally resonant with Indigenous American worldviews was a primary focus of this study. Although participants did not frequently mention the Indigenization of MBSR, they spoke at great length about their traditional spiritual beliefs, art and ritual, and sense of tribal community.
Prayer, Faith in the Creator, and Ancestral Stories
Mention of spirituality centered on prayer, faith in the Creator, and connection with ancestral stories. One participant led a representative prayer for the group: “Thank you, Creator, for everything that you’ve given us. Thank you, Creator, for the wonderful heavens and universe that you provided. Thank you for all of the sea life, all of the earth life, all the animals on earth” [California, Week 1, RRK]. Remembering ancestors through traditional stories was another frequently mentioned practice. One man told this story:
Creator’s daughter, he made 10 dresses for her… He made her a burial dress, and she asked for it when she was still young. Then she headed off to the West, where the sunset is, and he actually went down after her. He went to the other world after her and brought her back… We talk about this stuff quite a bit, how myths and legends, creation stories, how our ancestors had those, and we’re lucky to have them printed out so we can go back and look at them [Oregon, Week 6, DEV].
Witnessing the magnitude of nature was also important:
I wanted to see if I could look at the stars, because I saw a post about the stars being in the shape of the Seven Sisters, the Big Dipper. It looked like Coyote was falling out of the sky and that it wouldn’t be seen for another 8000 years, so I thought I would get a glimpse [California, Week 5, ROB].
Traditional Practices
Many participants noted that they enjoy engaging in traditional practices, like natural medicine, ritual, and art. The most frequently mentioned practice under this theme was the intentional connection with nature, particularly with the view that food and water are sources of medicine. One woman said of her diet, “I like to eat a lot of traditional foods. I’ll probably be harvesting a lot of salmon pretty soon and working on that. I’ve already picked some blackberries down here in Humboldt” [California, Week 3, TRI]. Another man explained the importance of water: “It’s been something that is a medicine, you know. It’s one of those things scientists have tried to prove has a spirit. Indians have said it has a spirit for a long time” [Oregon, Week 1, DEV].
Ritualistic and artistic practices included smudging, “I get up in the morning, and I stand outside and say prayers, and I smudge myself” [Oregon, Week 1, RAC]; beading, “I get into my beadwork, and I don’t think about a lot of stuff. I’m looking at what I’m creating and letting that flow” [Oregon, Week 4, LAH]; and weaving, “I have some necklaces I need to make for someone, so I’ve been braiding a lot of bear-grass… This person’s an elder, and she made me some basket medallions, so I have to make her some things in return” [California, Week 5, TRI].
Community and Family
Nearly every participant reported that maintaining tribal community was of utmost importance. Ways they engaged with their community and passed on traditional values included spending a lot of time with family (including extended family and multiple generations), learning from and remembering Elders, and connecting with their tribal identities. One grandmother said that they were focused more on being present for life: “I’ve been trying to take an active role in being with my family, spending time with my family doing enjoyable things… I taught all the little great nieces and nephews and my grandchildren, some of them, how to play kickball” [Oregon, Week 1, RAC]. Related to prioritizing family and community, another person shared:
I celebrated a birthday this past Sunday. That was a lot of fun. Having a barbeque got a really nice Yeti canteen designed… Small celebration with my family. My grandpa baked a cake, that was cool [California, Week 4, TER Having a barbeque and some very meaningful gifts. My uncle painted me an awesome painting, and my cousin, I gota really nice Yeti canteen designed… Small celebration with my family. My grandpa baked a cake, that was cool [California, Week 4, TER].
Of equal significance was learning from and remembering elders. One participant said:
I mentioned when I first started this class that I really want to be an elder, because they feel really centered to me… They feel grounded. You don’t get the impression from them that they’re spread in 1000 different directions. They’re focused [California, Week 5, TIA].
Another woman remembered her late grandparents:
I knew my great-great grandparents, my great-grandparents, and then I had six grandparents… My grandmothers always talked to me about Creator God. I never felt lost in my spirituality, I never felt lost in my family. Even when I was out misbehaving, I never felt lost. I always felt like I knew who I was, like I was gifted my colors and my spirit guides when I was young, by my family [Oregon, Week 5, TAY].
Another person, whose mother and aunt died of chronic diseases relatively young, spoke about her grandmother, who lived to be much older:
I found myself wondering what her life must have been like... My mom told me she remembers grandma getting in a canoe and paddling out to the lake, and she would be gone all day. So, I was standing out there and imagining what it might have been like for her to be there with nobody around, just her family that was there. It made me think, that’s probably the difference… She was on the lake. Spent her days making baskets. My mom says she was always sitting there whittling on her leg. She probably stayed really busy and worked and ate healthier. Being out on the land was healthier for her, better for her in the long term [Oregon, Week 6, RAC].
Participants also commented on the importance of maintaining tribal identity. This included both a modern personality, “It’s Indigenous community and family. People just want to drop in on you, or they say, ‘Come over and eat’” [Oregon, Week 5, MAR], and a historic one, “I remember thinking that it was really stressful for our tribal people in certain situations, but they always seem to try to make the best of it” [Oregon, Week 6, TAY].
Discussion
This study aimed to describe the collaborative design and implementation of the IndigenousMIND program—an effort that not only adapted MBSR for Indigenous communities but also reimagined it through the lens of cultural reclamation, healing, and self-determination. The IndigenousMIND concept has evolved beyond the development of a single adapted curriculum to become a dynamic, community-led framework for uncovering and integrating community-based leadership, context, and culture to design locally specific mindfulness practices within diverse Indigenous communities. Rather than imposing a fixed model, the IndigenousMIND approach emphasizes adaptability and responsiveness, with each implementation guided by local traditions, values, and community priorities. The success of this project demonstrates that IndigenousMIND is a model that is flexible and adaptable to multiple communities.
An important outgrowth of this work has been the formation of the Indigenous Mindfulness Coalition (IMC), a grassroots network of individuals engaged in mindfulness-based intervention (MBI) development within their own tribal contexts. The IMC emerged from a shared recognition that, although many Indigenous communities were adapting mindfulness practices, these efforts were often happening in isolation. The IMC has since grown to include participants from across Turtle Island and now hosts an annual retreat, providing a space for collaboration, knowledge exchange, and collective strategizing around the spread and cultural adaptation of mindfulness within Indigenous settings. The IMC, as a collective, maintains knowledge, resources, leadership, and vision that has provided guidance to individual groups nationwide.
In New England, coalition collaborations with tribal communities have led to mindfulness programs that weave together traditional stories, languages, and spiritual practices. A unique expression of this work was mindful arts, where elders and youth engaged in traditional arts—such as moccasin making, corn husk doll crafting, and finger weaving—while practicing mindful presence, thereby strengthening intergenerational bonds and cultural transmission. Recently, we developed and held an 8-week IndigenousMIND program in the Narragansett community that introduced a novel way to do mindfulness, but also highlighted Narragansett tradition and language and was led by Narragansett teachers, all of which evolved from the IM model of engaging with Indigenous communities. In Oklahoma, partnerships with the Chickasaw Nation have focused on developing mindfulness-based interventions for pregnant women at risk of gestational diabetes, addressing a pressing community-specific health concern. This effort is now expanding to the Winnebago community in Nebraska.
This momentum has extended organically to other communities. For example, Tribes in North Carolina, including the Eastern Band of Cherokee Indians and the Lumbee Tribe of North Carolina, have already begun integrating tribal dances and music into mindful movement sessions, deepening cultural connection and embodiment. These diverse applications underscore the flexibility and strength of the IndigenousMIND process. By centering community voices and Indigenous knowledge systems, this model not only increases the relevance and sustainability of mindfulness practices, but also supports Indigenous communities in reclaiming and revitalizing their cultural traditions in the service of holistic health and collective resilience.
Our participants consistently pointed out that the IndigenousMIND program provided the opportunity to work through the meaning of suffering and healing from an Indigenous perspective. Participants were simultaneously engaging the mindfulness practices and conceptualizing their experience in terms of Indigenous perspectives and traditional practices, many of which mirrored core tenets of MBSR, such as remembering the ways of the ancestors (slowing down, non-striving, patience, letting go, trust, generosity), spending time with family (slowing down, being in the present moment, interconnection, gratitude), spending time in and revering nature (slowing down, being in the present moment, interconnection, gratitude), and making and exchanging traditional gifts (generosity). Learned mindfulness practices both complemented existing coping strategies and introduced new ways to consciously identify physical sensations associated with emotional distress and reduce the body’s stress response which can support stress and trauma recovery through the development of healthier neurocognition and neurophysiology (Bergen-Cico et al., 2014, 2021).
Contemporary Western mindfulness programs in the US context are perceived as catering too much to White population (Fleming et al., 2022) and have not as welcoming to marginalized and minoritized communities (Nagy et al., 2022; Proulx et al., 2018; Sun et al., 2022; Tenfelde et al., 2018), which can be a real barrier to engaging Indigenous persons in MBIs. Moreover, efforts to expand mindfulness may be seen as a continuum of neocolonial mindsets, particularly if mindfulness practices are reframed as appropriated from Asian cultures. Dominant Western cultures “introducing” mindfulness to marginalized and minoritized communities have largely ignored, or at best under-recognized, existing mindfulness-based cultural practices that have historically supported survival and resiliency in Indigenous communities. Without working with communities to locally adapt MBIs, implementation efforts in Indian country run the risk of replacing healthy stress responses endogenous to Indigenous communities rather than prioritizing them. Owing to the close relationship between Indigeneity and mindfulness and mindfulness, we offer that recentering mindfulness traditions already inherent to Indigenous individuals and their tribal communities has great potential to make IndigenousMIND and MBIs acceptable to many other Indigenous communities, and our hope is that further studies will continue to demonstrate similar results.
Limitations and Future Research
The current study is not without its limitations. While the final participant count of 20 is appropriate for qualitative inquiry, the insights generated are grounded in the contexts and relationships of this study and are not meant to stand in for the diverse realities of all Indigenous communities. Instead, the strength of this study lies in the depth and contextual richness of the data, which supports transferability—offering culturally grounded insights that other Indigenous communities and researchers can adapt and apply within their own unique context. Structural challenges also exist in generalizing the IndigenousMIND model across tribal communities. First, the curriculum is inherently iterative and must be co-created and adapted based on qualitative input from community stakeholders to ensure cultural specificity and relevance. This process is time- and labor-intensive, requiring sustained relationships, repeated consultation, and flexibility in both research design and delivery. However, additional structural barriers may further constrain participation and scalability. Many Indigenous communities face chronic underfunding in healthcare, education, and public health infrastructures, limiting the availability of physical spaces, digital tools, and logistical support needed to host mindfulness programming.
These inequities must be addressed through intentional investment in local capacity-building, provision of stipends or scholarships for teacher training, and the development of alternative certification pathways that value lived experience, cultural knowledge, and community leadership as equal to or more important than academic credentials. Only by directly confronting these systemic inequities can initiatives like IndigenousMIND achieve sustainable, long-term impact across diverse Tribal Nations.
Some recommendations for scaling the program to other Indigenous communities are to first identify the Elders or individuals who best represent them and their interests and let them lead the conversation in terms of determining program format and identifying individuals for whom the program would be most appropriate. Further, a team should identify what oversight and approval is necessary for their project to move forward in a community. For example, universities have IRBs, but so do tribal nations or there are organizations that oversee IRB review, and a team needs to communicate with all of the respective IRBs to be certain all documents match across IRBs and every IRB has their needs met. Further, Tribal Council is often the ultimate approval for a project, but there may be many steps before a team goes before council, so the team should inquire from their partners what steps they need to take to get approval from all required agencies. All these efforts are incumbent on the research team to initiate and to pursue until they have all approvals necessary for creating mindfulness programs that honor sovereignty, elevate cultural strengths, and promote sustainable healing. In doing so, it holds valuable insights not only for tribal nations, but for the broader field of contemplative practice—calling on us all to reimagine mindfulness as an inclusive, decolonizing, and relational path toward wellness.
Declarations
Conflict of interest
The authors declare no competing interests.
Ethics Approval
This study was approved by the Oregon Health & Science University Institutional Review Board, the Brown University Institutional Review Board, the California Rural Indian Health Board Institutional Review Board, and the Northwest Portland Area Indian Health Board Institutional Review Board.
Informed Consent
All participants provided informed consent in accordance with institutional and community ethical standards. Consent procedures were developed collaboratively with community partners to align with local cultural protocols. Participants were given detailed information about the study’s purpose, procedures, risks, and benefits both orally and in writing. Tribal health leaders and community advisory boards reviewed and approved these procedures to ensure cultural appropriateness and transparency.
Use of Artificial Intelligence
Artificial intelligence tools were used only for citation formatting and minor language editing to ensure adherence to APA style.
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