Balinese balian

Domain XI · Traditional medicine & indigenous healing · Bali, Indonesia

What it is

A balian is a Balinese traditional healer. This is a living healing tradition of Balinese Hindu communities. It is not a psychotherapy, and the psychotherapist does not practise it. Balinese authors describe several kinds of balian. The names and spellings vary between sources:

Format

• The CFI supplementary modules can be used at the first evaluation, later in care, or repeatedly during treatment. No source sets a session count for culturally responsive work with Balinese clients.

Who practises it, and how they are trained or regulated

• Provincial regulation (Bali): Pergub Bali No. 55/2019 governs "Pelayanan Kesehatan Tradisional Bali", health services rooted in the healing traditions of the Balinese people. It names the empirical Balinese traditional healer pengusada, whose knowledge comes through inheritance or non-formal study with a teacher (aguron-guron). A pengusada must hold a registration certificate (STPT). Competency certificates come…
• Limits the regulation sets: no advertising; pengusada may not use medical equipment; regulated services may not involve mystical or klenik practices or invoke unseen beings; remedies may not contain synthetic drug ingredients, narcotics or psychotropics; integrated traditional-plus-conventional services may be offered only in hospitals and community health centres (puskesmas). Whether trance healers (ketakson) fall…
• Version followed: balian as Balinese scholars and the Bali provincial regulation on traditional health services describe them (Pergub Bali No. 55/2019; Suatama 2019; Fahyan and Farhah 2024), with outsider ethnography as context (Connor, Asch and Asch 1986). The psychotherapist's own work follows the DSM-5-TR Cultural Formulation Interview (CFI) and Outline for Cultural Formulation.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• labels the client would find stigmatising. It is working when the client agrees the record is fair.
• missed sessions after a family member learns of therapy. It is working when attendance holds steady.
• the client stopping medicines quietly; physical symptoms explained only as niskala. It is working when the prescriber knows everything the client takes.
• module fatigue; spread modules across sessions. It is working when the module changes your plan, for example by showing who in the family decides on care.
• stigmatising or generalising language; DSM-5-TR revised its examples to avoid it. It is working when the idiom helps you plan rather than labelling the client.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.