'We are all working toward one goal. We want people to become well': A visual exploration of what promotes successful collaboration between community mental health workers and healers in Ghana.

The practices of traditional and faith-based healers in low- and middle-income countries in Africa and elsewhere have come under intense scrutiny in recent years owing to allegations of human rights abuses. To mitigate these, there have been calls to develop collaborations between healers and formal health services to optimise available mental health interventions in poorly resourced contexts. For various reasons, attempts to establish such partnerships in a sustainable manner in different countries have not always been successful. In this article, we present findings from the Together for Mental Health visual research project to showcase examples of healer-health worker collaborations in Ghana that have been largely successful and discuss the barriers and facilitators to establishing these partnerships. Data reported in this article were collected using visual ethnography and filmed individual interviews with eight community mental health workers, six traditional and faith-based healers and two local philanthropists in the Bono East Region. The findings suggest that successful collaborations were built through mutually respectful interpersonal relationships, support from the health system and access to community resources. Although these facilitated collaboration, resource constraints, distrust and ethical dilemmas had to be overcome to build stronger partnerships. These findings highlight the importance of dedicated institutional and logistic support for ensuring the successful integration of the different health systems in pluralistic settings.

Entre zelar e cuidar: sentidos sobre saúde-doença em dirigentes da Umbanda / Entre celar y cuidar: significados sobre salud-enfermedad en los líderes de Umbanda / Between watching over and caring: meanings about health-disease in Umbanda leaders

RESUMO Por meio da antropologia da saúde, podemos compreender o terreiro de umbanda como parte de um sistema popular de cuidado. Este estudo teve por objetivo investigar as concepções de saúde e doença produzidas por zeladores de terreiro de umbanda. Participaram dez zeladores de terreiro da cidade de Uberaba (MG/Brasil), sendo três mulheres e sete homens, com idades entre 40 e 76 anos. O tempo médio de atuação como dirigente foi de 18,4 anos, variando de cinco a 43 anos. Os terreiros chefiados por esses participantes atendem entre 15 e 280 pessoas por dia de funcionamento. Pela análise das entrevistas, destaca-se que o cuidado em saúde oferecido pelos zeladores ultrapassa os limites rituais, nas cerimônias públicas, sendo prestado de modo contínuo nos terreiros. As posturas assumidas pelos entrevistados envolvem ações de escuta, acolhimento e proximidade física no momento da urgência. Pelas narrativas, pode-se concluir que o zelar, no sentido de gerenciar o espaço do terreiro, espiritual e materialmente, não pode ser dissociado do cuidar, significando os zeladores como importantes agentes populares de saúde.

RESUMEN A través de la antropología de la salud podemos entender el terreiro de umbanda como parte de un sistema de atención popular. Este estudio tuvo como objetivo investigar las concepciones de salud y enfermedad producidas por los cuidadores del terreiro de umbanda. Participaron diez cuidadores de terreiro de la ciudad de Uberaba (MG/Brasil), tres mujeres y siete hombres, con edades comprendidas entre 40 y 76 años. El tiempo promedio como gerente fue de 18.4 años, que van de cinco a 43 años. Los terreiros encabezados por estos participantes atienden entre 15 y 280 personas por día de operación. Del análisis de las entrevistas, se destaca que la atención médica ofrecida por los cuidadores va más allá de los límites rituales, en ceremonias públicas, que se brindan continuamente en los terreiros. Las actitudes asumidas por los entrevistados implican escuchar, acoger y proximidad física en el momento de urgencia. A través de las narrativas, se puede concluir que el cuidado, en el sentido de administrar el espacio del terreiro, espiritual y materialmente, no se puede disociar del cuidado, lo que significa que los cuidadores son importantes agentes de salud populares.

ABSTRACT Through health anthropology we can understand the umbanda terreiro (specific place for the religious ritual) as part of a popular system of care. This study aimed to investigate the conceptions of health and illness produced by saint keepers of umbanda terreiro. Ten leaders of the terreiros in the city of Uberaba (MG/Brazil) participated, being three women and seven men, between 40 and 76 years old. The average time of performance as a manager was 18.4 years, ranging from 5 to 43 years. The terreiros led by these participants attend between 15 and 280 people working day. The health care offered by saint keepers exceeds ritual limits in public ceremonies and is provided on a continuous basis in the terreiros. The postures assumed by the interviewees involve actions of listening, welcoming and physical proximity at the moment of urgency. From the narratives, it can be concluded that care, in the sense of managing the space of the terreiro, both spiritually and materially, can not be dissociated from caring, meaning saint keepers as important popular health.

A Testimony of Christian Drug Rehabilitation: Transformed by the Power of God.

ABSTRACT: Drug addiction is at crisis level in the United States. Nurses caring for persons affected by substance use disorder (SUD) have a resource in Mr. Ming Ho Liu's testimony on Good TV (Taiwan)-translated and summarized in this article-of his addiction experiences and successful treatment at Operation Dawn, a Christian drug rehabilitation center. Recovery from SUD is possible by God's power. In Mr. Liu's case, his recovery was accomplished without medication.

Faith healing based on narratives of healing experiences: A psycho-spiritual interpretation.

This study investigated 216 individual transcripts of faith healing experiences drawn from the healing ministries of 2 Catholic priests in the Philippines. The accounts of these healing narratives were generously provided to the researcher in hard copies for analysis by the 2 Catholic priests. The narratives were individual stories of healing experiences and written voluntarily by the healees themselves. Five themes were extracted from the narratives, namely, sensation of warmth, feeling of lightness, electrifying sensation, feeling of heaviness, and a weeping episode. Further, the study was able to unfold four themes on spiritual coping, namely, empowering faith, letting God be in control, acceptance leading to renewal, and connectedness with God. Faith healing experience begins with multisensory-physiological changes (e.g., sensation of warmth, electrifying sensation, feeling of heaviness) leading to affective/emotional, changes (e.g., weeping moment and feeling of lightness) that occur simultaneously, or in succession as antecedent conditions that awaken or activate inner adaptive spiritual coping responses with illness such as empowering faith, God being in control, acceptance leading to renewal, and connectedness with God.

Traditional and faith-based healthcare in the management of psychotic disorders in Africa: in search for synergy.

PURPOSE OF REVIEW: This review summarizes the current literature on the role of traditional and faith-based healthcare in the management of psychotic disorders in Africa. RECENT FINDINGS: In contemporary Africa, individuals with psychosis and traditional and faith healers (TFH) are pluralistic towards their understanding of psychosis and their help-seeking behaviour. Traditional healing is perceived to be helpful to patients with psychotic disorders and their family members and may have a positive influence on the course of psychosis in some selected individuals. Studies show that potentially harmful practices are commonly used by African TFH, but that these are associated with a lack of resources and are susceptible to training. Although various TFH and biomedical practitioners are open to collaboration, the many identified obstacles hinder actual partnerships. However, the few studies that have been conducted on collaborative care for patients with psychotic disorders on the continent, show positive outcomes. SUMMARY: Rather than harmonizing the two healing paradigms, synergistic collaboration between traditional/faith-based and biomedical mental healthcare in the management of individuals with psychosis seems to be possible within certain limits. Synergistic collaboration is more culturally syntonic and may actually contribute to bridging the treatment gap for mental disorders in present-day Africa.

Can you be cured if the doctor disagrees? A case study of 27 prayer healing reports evaluated by a medical assessment team in the Netherlands.

THE SETTING: between 2015 and 2020 a medical assessment team evaluated 27 reports of prayer healing in the Netherlands. OBJECTIVES: Three research questions were formulated. What are the medical and experiential findings? Are there medically remarkable and/or unexplained healings? Which explanatory frameworks can help us understand the findings? METHODS: The reported healings were analyzed using both medical files and patient narratives, as part of a case study research design compiled by a multidisciplinary research team. An independent team of five medical consultants, representing different fields of expertise, evaluated the 27 case files. According to criteria these were selected from a larger group of 83 received reports. Experiential data was obtained by in-depth interviews and analyzed. Instances of healing could be classified as 'medically remarkable' or 'medically unexplained'. Subsequent analysis was transdisciplinary. RESULTS: Eleven of the 27 healings assessed were evaluated as 'medically remarkable', none were labelled as 'medically unexplained'. Recurring characteristics were common to some degree in all healings, whether 'medically remarkable' or not: a temporal connection with prayer, instantaneity and unexpectedness of healing, strong emotional and physical manifestations, and a sense of 'being overwhelmed' and transformed. The healings were invariably interpreted as acts of God. Positive effects have persisted for 5 to 33 years, with 2 relapses. CONCLUSIONS: Our findings on remarkable healings do not fit well in the traditional biomedical conceptual framework. All healings exhibited important non-medical aspects, whether or not they were assessed as medically remarkable. We need a broader multi-perspective approach in which all relevant data is considered to be valuable, both experiential and objective. This so-called horizontal epistemology may be helpful when trying to understand the findings, and it may bring about mutual understanding between patients, health practitioners and relevant disciplines.

Explanatory models, illness, and treatment experiences of patients with psychosis using the services of traditional and faith healers in three African countries: Similarities and discontinuities.

As part of formative studies to design a program of collaborative care for persons with psychosis, we explored personal experience and lay attributions of illness as well as treatment among persons who had recently received care at traditional and faith healers' (TFHs) facilities in three cultural groups in Sub-Saharan Africa. A purposive sample of 85 individuals in Ibadan (Nigeria), Kumasi (Ghana), and Nairobi (Kenya) were interviewed. Data was inductively explored for themes and analysis was informed by the Framework Method. Across the three sites, illness experiences featured suffering and disability in different life domains. Predominant causal attribution was supernatural, even when biological causation was also acknowledged. Prayer and rituals, steeped in traditional spiritual beliefs, were prominent both in traditional faith healing settings as well as those of Christianity and Islam. Concurrent or consecutive use of TFHs and conventional medical services was common. TFHs provided services that appear to meet the therapeutic goals of their patients even when harmful treatment practices were employed. Cultural and linguistic differences did not obscure the commonality of a core set of beliefs and practices across these three groups. This similarity of core worldviews across diverse cultural settings means that a collaborative approach designed in one cultural group would, with adaptations to reflect differences in context, be applicable in another cultural group. Studies of patients' experience of illness and care are useful in designing and implementing collaborations between biomedical and TFH services as a way of scaling up services and improving the outcome of psychosis.

O cuidado em saúde promovido pelas religiões afro-brasileiras / Health care promoted by afro-brazilian religions / El cuidado en salud promovido por las religiones afrobrasileñas

No decorrer da história, sempre foram infindáveis os casos em que os sujeitos recorriam a centros espíritas ou terreiros de religiões de matrizes africanas em decorrência de problemas como doenças, desempregos ou amores mal resolvidos, com o objetivo de saná-los. Por conta disso, este artigo visa apresentar os resultados da pesquisa relacionados ao objetivo de mapear os processos de cuidado em saúde ofertados em três terreiros de umbanda de uma cidade do litoral piauiense. Para isso, utilizamos o referencial da Análise Institucional "no papel". Os participantes foram três líderes de terreiros e os respectivos praticantes/consulentes dos seus estabelecimentos religiosos. Identificamos perspectivas de cuidado que se contrapunham às racionalidades biomédicas, positivistas e cartesianas, e faziam referência ao uso de plantas medicinais, ao recebimento de rezas e passes e à consulta oracular. A partir desses resultados, podemos perceber ser cada vez mais necessário, portanto, que os povos de terreiros protagonizem a construção, implementação e avaliação das políticas públicas que lhe sejam específicas.(AU)

In history, there have always been endless cases of people turning to spiritual centers or terreiros of religions of African matrices due to problems such as illnesses, unemployment, or unresolved love affairs. Therefore, this article aims to present the research results related to the objective of mapping the health care processes offered in three Umbanda terreiros of a city on the Piauí Coast. For this, we use the Institutional Analysis reference "on Paper." The participants were three leaders of terreiros and the respective practitioners/consultants of their religious establishments. We identified perspectives of care that contrasted with biomedical, positivist, and Cartesian rationalities and referred to the use of medicinal plants, the prescript of prayers and passes, and oracular consultation. From these results, we can see that it is increasingly necessary, therefore, that the peoples of the terreiros lead the construction, implementation, and evaluation of public policies that are specific to them.(AU)

A lo largo de la historia, siempre hubo casos en los cuales las personas buscan en los centros espíritas o terreros de religiones africanas la cura para sus problemas, como enfermedades, desempleo o amoríos mal resueltos. Por este motivo, este artículo pretende presentar los resultados de la investigación con el objetivo de mapear los procesos de cuidado en salud ofrecidos en tres terreros de umbanda de una ciudad del litoral de Piauí (Brasil). Para ello, se utiliza el referencial del Análisis Institucional "en el Papel". Los participantes fueron tres líderes de terreros y los respectivos practicantes / consultivos de los establecimientos religiosos que los mismos conducían. Se identificaron perspectivas de cuidado que se contraponían a las racionalidades biomédicas, positivistas y cartesianas, y hacían referencia al uso de plantas medicinales, al recibimiento de rezos y pases y a la consulta oracular. Los resultados permiten concluir que es cada vez más necesario que los pueblos de terreros sean agentes protagónicos de la construcción, implementación y evaluación de las políticas públicas destinadas específicamente para ellos.(AU)

A importância atribuída à espiritualidade como estratégia de enfrentamento do tratamento oncológico / La importancia atribuida a la espiritualidad como estrategia de afrontamiento del tratamiento oncológico / The importance attributed to spirituality as a coping strategy for oncologic treatment

Objetivo: conhecer a importância e a experiência espiritual de pacientes em tratamento oncológico. Método: estudo qualitativo, descritivo e exploratório, desenvolvido em uma unidade de assistência de alta complexidade oncológica do sudoeste baiano. A coleta foi realizada em junho de 2019, por meio de entrevista guiada, mediante um roteiro semiestruturado, tendo a amostra final 10 pacientes em tratamento oncológico. As entrevistas foram transcritas e analisadas através da técnica de análise de conteúdo de Bardin. Resultados: evidenciou-se a importância e os benefícios promovidos pelo uso da espiritualidade durante a quimioterapia. Foi demonstrada a necessidade de uma maior e melhor abordagem da espiritualidade pelos profissionais de saúde durante a assistência. Considerações finais: diante das dificuldades encontradas durante o tratamento oncológico, a espiritualidade torna-se uma estratégia benéfica utilizada pelos pacientes. Ainda assim, o uso do cuidado espiritual como instrumento de assistência dos profissionais de saúde é um desafio a ser superado.

Objetivo: comprender la importancia y la vivencia espiritual de los pacientes sometidos a tratamiento oncológico. Método: estudio cualitativo, descriptivo y exploratorio desarrollado en una unidad de atención oncológica de alta complejidad en el suroeste de Bahia. La recolección tuvo lugar en junio de 2019, mediante una entrevista guiada, utilizando un guión semiestructurado, con la muestra final de 10 pacientes en tratamiento oncológico. Las entrevistas fueron transcritas y analizadas mediante la técnica de análisis de contenido de Bardin. Resultados: se evidenciaron la importancia y los beneficios promovidos por el uso de la espiritualidad durante la quimioterapia. Se demostró la necesidad de un mayor y mejor abordaje de la espiritualidad por parte de los profesionales de salud durante la atención. Consideraciones finales: dadas las dificultades encontradas durante el tratamiento oncológico, la espiritualidad se convierte en una estrategia beneficiosa utilizada por los pacientes. Aun así, el uso de la atención espiritual como instrumento de ayuda por parte de los profesionales de la salud es un reto a ser superado.

Objective: to understand the importance and spiritual experience of patients undergoing oncologic treatment. Method: qualitative, descriptive and exploratory study developed in a high complexity oncologic care unit in the southwest of Bahia. The collection took place in June 2019, through a guided interview, using a semi-structured script, with the final sample having 10 patients undergoing oncologic treatment. The interviews were transcribed and analyzed through the content analysis technique of Bardin. Results: the importance and benefits promoted by the use of spirituality during chemotherapy were evidenced. The need for a greater and better approach to spirituality by health professionals during care has been proven. Final considerations: in view of the difficulties encountered during oncologic treatment, spirituality becomes a beneficial strategy used by patients. Even so, the use of spiritual care as an instrument of care by health professionals is a challenge to be overcome.

Faith healers and diabetes care in South Asia: Fighting together, moving forward.

Faith healing has been prevalent in the South Asian society since time immemorial. This is often coupled with alternative and complementary systems of medicine and attract a large proportion of people belonging to different sects, religions, and organizations. Though based on blinded trust, it does address the psychosomatic component of chronic disorders and hence does make the patient feel better. In this article the authors highlight the significant role of modern medicine in patients with certain endocrine and systemic disorders but also explore futuristic options to utilize these different systems in amalgamation for the better control and treatment of endocrine disorders like diabetes.

Three cases of hearing impairment with surprising subjective improvements after prayer. What can we say when analyzing them?

AIM: to enhance the understanding of documented mismatches between 'subjective' experiences and 'objective' data in three cases of self-reported instantaneous healing of hearing impairment upon prayer. METHOD: description of three cases taken out of a larger retrospective case-based study of prayer healing in the Netherlands. In this larger study multiple reported healings were investigated using both medical files and patients' narratives through in-depth interviews. A subset of three cases with dramatic subjective reduction of hearing impairment upon prayer was studied. These patients underwent extensive additional investigations at the audiology center of the Amsterdam University Medical Centre. All data was evaluated by an interdisciplinary medical assessment team, subsequent analysis was transdisciplinary. RESULTS: the three case histories with self-reported healing after prayer demonstrated a clear mismatch between subjective experiences and objective findings. No measurable improvements were found in four different audiological testing methods. However, in-depth interviews, hetero-anamnesis and a validated questionnaire all confirmed the healings. The medical assessment team could not label these healings as 'medically remarkable' because of absence of measurable 'objective' changes, but they did consider them as 'remarkable in a broader sense'. On expert consultation no equivalents of mismatches to this extent could be found. The healing experiences of our participants involved their entire being with profound positive effects in different domains of their lives, and a perception of a benevolent God who acted upon them. There was a distinctive pattern, labelled by the participants as a healing of mind, soul and body. CONCLUSIONS: The subjective-objective incongruities that were found were not well understood. We noticed a paradox: the 'objective' measurements did not reflect hearing abilities in daily life where-as 'subjective experiential' data did. The latter could be 'objectified' and validated in various ways. In fact, a rigid distinction between 'objective' and 'subjective' was not relevant here, nor a hierarchy among them. A model leaving room for different causations (horizontal epistemology) complied best with the multi dimensionality we came across.

Contested or complementary healing paradigms? Women's narratives of COVID-19 remedies in Mwanza, Tanzania.

BACKGROUND: COVID-19 has caused worldwide fear and uncertainty. Historically, the biomedical disease paradigm established its dominance in tackling emerging infectious illnesses mainly due to innovation in medication and advances in technology. Traditional and religious remedies have emerged as plausible options for prevention and treatment of COVID-19, especially in Africa and Asia. The appeal of religious and traditional therapies against COVID-19 in the African setting must be understood within the historical, social, and political context. This study explored how women and community members dealt with suspected symptoms of COVID-19 in Mwanza, Tanzania. METHODS: This study was conducted in Nyamagana and Ilemela districts of Mwanza, Tanzania, between July and August 2020. We conducted 18 mobile phone in-depth interviews with a purposively selected sample of women aged 27-57 years participating in an existing longitudinal study. For safety reasons, smart mobile phones were used to collect the data. Each interview was audio recorded after obtaining verbal consent from the participants. The audio files were transferred to computers for analysis. Four researchers conducted a multistage, inductive analysis of the data. RESULTS: Participants reported wide use and perceived high efficacy of traditional remedies and prayer to prevent and treat suspected symptoms of COVID-19. Use was either alone or combined with public health recommendations such as hand washing and crowd avoidance. Despite acknowledging that a pathogen causes COVID-19, participants attested to the relevance and power of traditional herbal medication and prayer to curb COVID-19. Four main factors underline the symbolic efficacy of the traditional and religious treatment paradigms: personal, communal, and official reinforcement of their efficacy; connection to local knowledge and belief systems; the failure of biomedicine to offer a quick and effective solution; and availability. CONCLUSIONS: In the context of emerging contagious illnesses, communities turn to resilient and trusted treatment paradigms to quell fear and embrace hope. To tackle emerging infections effectively, it is essential to engage the broader sociopolitical landscape, including communal considerations of therapeutic efficacy.

Chronic conditions, multimorbidity, and quality of life among patients attending monk healers and primary care clinics in Thailand.

BACKGROUND: The study aimed to assess chronic diseases, multimorbidity, and QoL among patients attending two different treatment settings in Thailand. METHODS: In all, 1409 attendees of three monk healer or three health centres were assessed with self-reported measures on chronic conditions and Quality of Life (QoL). RESULTS: Results indicate that the most common chronic conditions were common mental disorder (25.2%), followed by hypertension (22.8%), high blood cholesterol (18.0%), fatigue disorder (14.4%), diabetes (14.0%), migraine headaches (13.7%), sleeping problem (12.2%), and ulcer (11.0%). In all, 40.6% had multimorbidity (two or more chronic conditions) (42.4% in the monk healer and 38.9% in the primary care setting). In ANCOVA analysis, adjusted for sex, age, employment status, marital status, education, economic status, comorbidity, and health care setting, the poorest overall QoL was found among clients with common mental disorders (58.5 mean score), followed by emphysema or asthma (60.2), sleeping problem (61.5), migraine headaches (62.7), fatigue disorder (63.3), substance use disorder (63.6) and ulcer (64.3). The overall QoL was poorer among monk healer clients (66.5) than primary care patients (68.8). In adjusted logistical regression analysis, being a monk healer attendee, older age (55-93 years), and high debt were positively, and being employed and better overall quality of life were negatively associated with multimorbidity, overall, for the monk healer and primary care setting. In adjusted linear regression analyses, primary health care attenders, older age, were employed and post-secondary education increased the odds of better overall QoL. CONCLUSION: Multimorbidity was higher among clients attending monk healers than those attending primary care facilities and QoL was poorer among clients seeking care from monk healers than those attending primary care. High multimorbidity was found and major chronic conditions were found to have poor QoL. Determinants of multimorbidity and QoL in two different treatment settings provide information to improve the management of chronic conditions.

"My Body Does Not Fit in Your Medical Textbooks": A Physically Turbulent Life With an Unexpected Recovery From Advanced Parkinson Disease After Prayer.

AIM: The purpose of this article is to enhance our understanding of prayer healing by studying a case which was described as a 'remarkable healing' by a medical assessment team at the Amsterdam University Medical Centre (UMC) in the Netherlands. METHOD: This retrospective, case-based study of prayer healing investigated numerous reported healings using both medical files and patient narratives. A medical assessment team evaluated the associated medical files, as well as any experiential data. The instances of healing could be classified as 'remarkable' or 'unexplained.' Experiential data were obtained by qualitative, in-depth interviews. The study was transdisciplinary in nature, involving medical, psychological, theological, and philosophical perspectives. The object was to understand such healings within the broader framework of the science-religion debate. RESULTS: We present the case of a female patient, born in 1959, with Parkinson disease who experienced instantaneous, nearly complete healing in 2012 after intercessory prayer. At that point the disease was at an advanced stage, rapidly progressive, with major debilitating symptoms. High doses of oral medication were required. Following this healing there was no recurrence of her former symptoms, while the remaining symptoms continued to improve. She regained all of her capacities at work, as well as in daily life. The medical assessment team described her recovery as 'remarkable.' The patient reported that she had always 'lived with God,' and that at a point when she had given up hope, 'life was given back to her.' This recovery did not make her immune to other illnesses and suffering, but it did strengthen her belief that God cares about human beings. CONCLUSION: This remarkable healing and its context astonished the patient, her family, and her doctors. The clinical course was extraordinary, contradicting data from imaging studies, as well as the common understanding of this disease. This case also raised questions about medical assumptions. Any attempt to investigate such healings requires the involvement of other disciplines. A transdisciplinary approach that includes experiential knowledge would be helpful. Against the background of the science-religion debate, we feel that the most helpful approach would be one of complementarity and dialogue, rather than stoking controversy.

Traditional Healers and Mental Health in Nepal: A Scoping Review.

Despite extensive ethnographic and qualitative research on traditional healers in Nepal, the role of traditional healers in relation to mental health has not been synthesized. We focused on the following clinically based research question, "What are the processes by which Nepali traditional healers address mental well-being?" We adopted a scoping review methodology to maximize the available literature base and conducted a modified thematic analysis rooted in grounded theory, ethnography, and phenomenology. We searched five databases using terms related to traditional healers and mental health. We contacted key authors and reviewed references for additional literature. Our scoping review yielded 86 eligible studies, 65 of which relied solely on classical qualitative study designs. The reviewed literature suggests that traditional healers use a wide range of interventions that utilize magico-religious explanatory models to invoke symbolic transference, manipulation of local illness narratives, roles, and relationships, cognitive restructuring, meaning-making, and catharsis. Traditional healers' perceived impact appears greatest for mild to moderate forms of psychological distress. However, the methodological and sample heterogeneity preclude uniform conclusions about traditional healing. Further research should employ methods which are both empirically sound and culturally adapted to explore the role of traditional healers in mental health.