Hauora Māori Models of Health in the Counselling Space

Western models of healthcare are prominent and widely used world-wide including here in Aotearoa, New Zealand.

Unfortunately, there may be times when going to a healthcare appointment, when one may be met with a cold reception, racist bias based on being Māori, no cultural considerations and if given medication or advice - no proper explanation as to why you have been given said medication or advice resulting in health literacy issues as well as trust issues in healthcare.

Within the context of the counselling space, I believe it to be of huge importance to have at least a basic understanding of some hauora Māori models of health, what models are available, why they are of importance, how they work and how to implement them in sessions with Māori clients safely and respectfully (if the client is wanting a hauora Māori approach in sessions).

There are numerous hauora Māori models, some are: Te Whare Tapa Whā, Te Pae Māhutonga, Te Wheke, Tihei-wā Mauri Ora, and many more. These models mentioned above focus on different aspects of a person's hauora (health and wellbeing) and depending on the presenting challenge/s, the clients background information and the counsellor's knowledge and skillset, an appropriate model may be integrated and used either on its own or alongside a western model of health, particularly a person-centred approach.

Te Whare Tapa Whā which is just one of Sir Mason Duries (Māori health academic) many models of health, is often taught in universities and involves looking at the wellbeing of a person physically (Taha Tinana), mentally (Taha Hinengaro), their social and family wellbeing (Taha Whānau), as well as their spiritual wellbeing (Taha Wairua). These make up the four walls of the health model which is a whare or the person. When considering a person's wellbeing, one may want to consider these four walls, identifying and exploring if one or more of these are unbalanced. If unbalanced this may be the cause of an unbalanced mauri (lifeforce), creating an unbalanced person.

Taha Wairua (Spiritual Wellbeing) is often overlooked in western models of health however for many Māori, forms a significant part of their identity.

When considering Te Whare Tapa Whā, one may also want to consider their whenua (links to a person's land and whakapapa (roots).

When considering the walls of this model along with whenua, one should take care to hear the client in these aspects of their life, slowly working to understand and balance each of these walls that is in line with the client, that is realistic and sits comfortably with them.

Te Whare Tapa Whā is just one of the many great hauora Māori models there are in Aotearoa, New Zealand and while integrating such a model in the counselling space may sound straight forward, each counsellor's approach to integrating it in sessions will be different.

Taking time when implementing such a beautiful model is key as rushing health models can often make the client feel overwhelmed, misunderstood and rushed. Also taking time to explain the model and how it works can help to make the client feel a little more at ease and create a space for the client that is about them, while ensuring that such models are delivered with respect, care and authenticity. Considering their hinengaro, tinana, wairua and whānau elements as well as their whenua, and seeking to understand these within the context of the client can make all the difference in their counselling journey.

Te Pae Māhutonga is a constellation of stars also known as the southern cross. It has long been used as a navigational aid, having been associated with the discovery of Aotearoa. Its meaning to the history of Aotearoa and also its significance as a healthcare model makes it all the more encompassing. It was again developed by Sir Mason Durie. As a healthcare model, it interprets the four central stars of the southern cross as being: Mauriora (cultural identity), Waiora (physical environment), Toiora (healthy lifestyles), and Te Oranga (participation in society). There are also two pointers which are represented as Ngā Manukura (community leadership) and Te Mana Whakahaere (autonomy). Within each of these stars, lies depth and a story is told as to why these are of importance in Māori health promotion and how you apply each task to learn more about the client. With this information, a picture is created, a story is told about the client. Working together, we can then discuss each of these tasks individually, with the aim to build the client's health and wellbeing to a level that aligns with the client and their goals.

When integrating this model in sessions (again if the client is comfortable with implementation of a Māori healthcare model), it's important to explain what this model is, a little about its history, each component and its significance. Depending on the client, their history and their goals, this model when used thoughtfully and with care can potentially bring about growth from an individual and cultural perspective.

Western approaches to counselling often place focus on the client as the individual while indigenous approaches, including Māori approaches often involve a wider lens which includes the whānau (family).

Ensuring that you build the all-important therapeutic relationship (whakawhanaungatanga) with the client and learning about whether working with them as the individual feels comfortable or whether considering the client and their cultural background and considering them in the wider context of the family is right and comfortable for them will be key in determining what models of healthcare you use and whether a hauora Māori approach may also be included when working alongside them. Manaakitanga is another important component, being respectful and hospitable in sessions.

While there are many Hauora Māori models of health available, I hope that they are utilised in sessions with kindness, aroha and care, and I also hope that they become normalised just as person-centred approaches are.

I believe that being comfortable with being open to learning more about these models as well as others is hugely important as quite often clients may be knowledgeable in areas such as this and teach me things about rongoa Māori or aspects of hauora Māori models I previously didn't know about. Being open to learning is of importance to me as a person and as a counsellor.

Taking those steps with the client in their counselling journey is always a privilege for me. It forms a part of my journey as a recent graduate and now provisional counsellor, and it creates continued growth for the client and also for myself.

I hope you found this very brief post interesting and if you would like more information about either of these hauora Māori models, please let me know and I can add links with more information.