Pathways to healing: balancing the tensions between harm reduction and cultural practices in a managed alcohol program for Indigenous adults in Calgary, Canada.

Objectives: This study aimed to examine the strengths and challenges of running a managed alcohol program for Indigenous adults in a non-Indigenous organization and posit areas to embed cultural practices as a necessary aspect for healing. Methods: Grounded in a Two-Eyed Seeing approach that weaved western and Indigenous ways of knowing and a community-based research design, this project included staff group and individual interviews followed by a Knowledge Keeper review. Cultural practices and ceremony guided the project from start to finish. Researchers used reflexive thematic analysis to co-create findings with Elders and community leaders. Results: Three key themes emerged from the staff interviews (1) success and strengths (2) challenges hindering full potential, and (3) recommendations for enhancement. Following data collection, Knowledge Keepers engaged in follow-up discussions and reflections on the project results to suggest a strength-based approach to embed cultural practices and cultural safety throughout the organization hosting the program. Conclusion: This study advocates for a movement beyond cultural programming toward fully integrating Indigenous knowledges into policies and practices for non-Indigenous organizations working with Indigenous adults. Reconciliation requires acknowledgement that culture and ceremony are necessary for healing. It also necessitates that Indigenous and non-Indigenous staff can actively engage in Indigenous ways of knowing to foster a culturally safe environment.