Then ceremonies (Tày, Nùng, Thái)

Domain XI · Traditional medicine & indigenous healing · Northern Viet Nam

What it is

What Then is, as its bearers' heritage file and scholars describe it. Then (thực hành Then) is a ritual practice that UNESCO describes as "an essential ritual practice in the spiritual life" of the Tày, Nùng and Thái peoples of Viet Nam. It expresses their understanding of people, the natural world…

Format

• This is a framework for culturally responsive psychotherapy with clients from Then-practising communities (in Viet Nam, in cross-border areas or in the diaspora). It is not a protocol for Then itself. Phases and session counts are. The assessment content follows the APA CFI.
• Phase 1: cultural assessment (sessions 1–2, about 50–90 minutes in all).

Evidence status, as the guide reports it

• Goal: deliver evidence-based therapy for the identified problem, adapted to the client's explanatory model. Coordinate with a Then master or family only when the client wishes. Integrate meaning from any ceremony the client attends within their community.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• 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

• an interpreter who interprets for the client or softens spiritual content out of embarrassment. It is working when the client uses their own terms freely.
• your own bias making ordinary practice look sinister, or deference making real harm look cultural. It is working when the client feels protected, not judged.
• the client's fear that therapy will be used to discredit their role. It is working when the client brings personal concerns freely while keeping ritual matters private.
• fear that disclosure will be treated as backwardness or reported; reassure about confidentiality and its limits. It is working when the client discusses ceremonies as readily as clinic visits.
• ambivalence, such as pride in heritage alongside embarrassment about ritual belief; do not resolve it for the client. It is working when the client can speak about identity without defending it.

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.