During her Los Angeles childhood, psychologist Tawa Witko, PsyD, knew she was American Indian, but she didn't know much about what that meant. Now, though, both her personal and her professional life are connected to her roots.

Witko lives and works with her tribe--the Lakota Sioux--on the Pine Ridge Reservation in South Dakota, providing counseling for victims of domestic abuse. As chair of APA's Committee on Ethnic Minority Affairs (CEMA), she also works to raise awareness in APA of the mental health needs of American Indians and to support other psychologists who want to work with the American Indian community.

And, she says, living on the reservation is an education for her as well. Her father grew up on the nearby Rosebud Reservation, but left as a teenager. She grew up in Los Angeles, far from any center of American Indian life.

"Growing up, I didn't know much of our language and ceremonies and things like that," she says, "but now I'm learning, and I'm teaching my children."

Choosing psychology

Witko's path to psychology was unconventional. Her son was born right after she graduated from high school, and when she began attending Fullerton College in Fullerton, Calif., at age 23, she majored in English. But she also took psychology classes to help her understand her son, who had been diagnosed with attention-deficit hyperactivity disorder, and gradually realized that she wanted to be a psychologist.

She didn't make the connection between a psychology career and her desire to serve the American Indian community, though, until 1994, when she was selected for the first class of APA's Diversity Project 2000, a summer institute for ethnic-minority students at community colleges held at APA's Annual Convention.

"I met many people, like Dr. Joseph Trimble, who mentored me and helped me find my voice," she says. Before she met Trimble and other American Indian psychologists, she explains, she hadn't known many American Indians at all, and none who were professionals. "Just knowing that somebody else had gone that path, and had opened doors, was important."

Trimble fondly recalls the meeting and his part in Witko's professional development. "What better success story could you have, from a single parent who grew up not knowing and not believing that she could do college-level work, to getting her PhD," he says. "But in many ways she's a self-starter."

Indeed, after completing her doctorate at the California School of Professional Psychology in 2000, she began working with the United American Indian Involvement, a group whose mission is to bring educational programs and health and social services to American Indians in Los Angeles County. But Witko wanted to experience a greater connection to the American Indian community than she had as a child.

So, in 2002, she moved to Kyle, S.D., on the Pine Ridge Reservation. Now, she lives there with her son, husband, three stepchildren and 18-month-old daughter. The reservation sits in the southwest corner of South Dakota near Badlands National Park. It's nearly the size of Connecticut but much more sparsely populated--home to about 40,000 Lakota Sioux. It's also staggeringly poor: More than 50 percent of the population lives below the poverty level, according to the 2000 U.S. Census, and the median family income is $21,000.

Witko works at Cangleska Inc. (pronounced Shan-glesh-ka), which offers a shelter for victims of domestic violence, a men's re-education center and legal and other services. But because there are so few psychologists--particularly American Indian psychologists--available on the reservation, and because poverty and the problems that accompany it are so acute, Witko says that she does a little bit of everything. For example, she counsels women, refers them to legal services, conducts drug and alcohol assessments and works with children doing play therapy and other counseling.

"In L.A., I never did any drug or alcohol assessments; I'd just refer them to another part of our agency," she says. "But out here, I am the entire mental health services part of the agency."

Working on the reservation was difficult, says Witko, until she gained the community's trust. Even as an American Indian herself, she was considered an outsider, and the community's experience with psychologists had not always been positive. One person she talked to, for example, had been diagnosed by a psychologist as schizophrenic because he heard voices, especially around ceremony times. If the therapist had dug deeper, Witko explains, that person would have found that for American Indians this phenomenon is common, has spiritual meaning and does not on its own indicate mental illness.

"Sometimes as psychologists, we're taught certain key words, and they are important red flags, but you really have to try to understand what's going on in the context of a different culture," she says.

Making a difference

As CEMA chair, Witko wants to help teach other psychologists to be sensitive to such issues. One of her goals is to develop an APA resolution against the use of American Indian mascots for sports teams. The resolution will outline the negative effects on self-esteem that these mascots can have, particularly for urban youth who don't already have a strong sense of their heritage.

Inspired by a lack of available information on the topic, she is also editing a 13-chapter book on the mental health needs of urban American Indians. The book, which will be published by APA, is now in review. It will touch on topics including identity, alcohol and drug addiction, post-traumatic stress disorder and trauma, using different treatment modalities like storytelling, and even learning to ask questions to recognize when a patient is American Indian--which is not always evident in a multicultural urban environment.

Witko says that the book is only the beginning--there is much more work and research to be done.

"As I was researching, I found that almost all published research was on the reservation, usually on alcohol abuse," she says. "This is crazy, when 60 percent of American Indians live off reservation." Witko says she'd like to see more research on the strengths within the community--such as how incorporating traditional medicine and practices affects children's development.

She also says that she'd like to see more general research include American Indians. A project that looks at children's self-esteem, for example, might examine white, black, Hispanic and Asian children, but lump Native Americans under "other."

"It's almost like a feeling we don't exist in the research community," she says. "I know it's not done on purpose, but it's something we need to work on."

Overall, all of Witko's work--in APA, in the urban American Indian community and on the reservation--has served a common purpose. "I like to put myself in positions where I feel like I can make a change and make a difference not just for American Indian people, but for all people of color," she says.