Becoming a Xhosa traditional healer: The calling, illness, conflict and belonging.

BACKGROUND: Traditional healers (THs) are an important part of the healthcare system in sub-Saharan Africa. Understanding their training, experiences of becoming healers and their perceived roles in society is critical. AIM: This study aimed to explore the experience of becoming a TH, including accepting the calling, and sheds light on how the experience is conceptualised within the cultural and communitarian context of THs. SETTING: This study was conducted amongst Xhosa THs in the Western Cape, South Africa. METHODS: In-depth phenomenological interviews (n = 4) were conducted with Xhosa THs and analysed using Giorgi's descriptive pre-transcendental Husserlian phenomenological analysis. RESULTS: The experience of becoming a TH can be summarised in the context of three units of significance: (1) the gift of healing as an illness; (2) the experience of conflict (including with their families, the church and self-conflict); and (3) the experience of belonging. Familial conflict, specifically, was fuelled by the financial burden of becoming a TH and a lack of understanding of the process. CONCLUSION: To develop a workable model of collaboration in the future, it is crucial that mental healthcare providers develop a better understanding of the experiences of THs in becoming care providers. The findings highlight an appreciation of the challenging process of becoming a TH. Finally, further research and culturally appropriate psychoeducation can provide trainee THs and their family members with the skills and knowledge to support each other through a difficult process.

Adolescents' Experience of Stigma When Accessing School-Based PTSD Interventions.

This qualitative investigation, nested within a randomized controlled trial (RCT), describes the experiences of adolescent participants accessing psychotherapy for posttraumatic stress disorder (PTSD) in a school-based setting. Supervised nurses provided the psychotherapeutic interventions. Twelve participants who took part in the RCT were invited, and 10 agreed to share their experiences through recorded face-to-face, semistructured, in-depth interviews and treatment-specific focus groups. Basic thematic analysis was applied using Atlas.ti software. Adolescents described a mixed range of perceived poor, ambivalent, and good support experiences when accessing treatment, and were particularly motivated when they had access to a caring adult. During the trial, adolescents used calculated disclosure strategies to reduce their vulnerability to marginalization and stigma. School-based therapy was well received but could be improved if sessions were offered after school hours. This study provides suggestions for improvement and scale-up of school-based PTSD interventions for adolescents.

Collaboration Between Biomedical and Complementary and Alternative Care Providers: Barriers and Pathways.

We examined the scope of collaborative care for persons with mental illness as implemented by traditional healers, faith healers, and biomedical care providers. We conducted semistructured focus group discussions in Ghana, Kenya, and Nigeria with traditional healers, faith healers, biomedical care providers, patients, and their caregivers. Transcribed data were thematically analyzed. A barrier to collaboration was distrust, influenced by factionalism, charlatanism, perceptions of superiority, limited roles, and responsibilities. Pathways to better collaboration were education, formal policy recognition and regulation, and acceptance of mutual responsibility. This study provides a novel cross-national insight into the perspectives of collaboration from four stakeholder groups. Collaboration was viewed as a means to reach their own goals, rooted in a deep sense of distrust and superiority. In the absence of openness, understanding, and respect for each other, efficient collaboration remains remote. The strongest foundation for mutual collaboration is a shared sense of responsibility for patient well-being.