Hoodoo / rootwork

Domain XI · Traditional medicine & indigenous healing · southern United States

What it is

Conjure, also called hoodoo or rootwork, is described by the historian of religion Yvonne Chireau as "the African American tradition of healing and harming". It developed from African, European and American sources. From slavery onward it was "woven together" with Christianity to give enslaved and…

Format

• Phase 1: Engagement and safety (session 1). Goal: establish trust, screen for urgent risk (suicide, violence, medical emergency, psychosis needing urgent care) and signal that the client's beliefs and other help-seeking can be discussed. Move on once urgent risk is managed and the client has some…
• Phase 2: Cultural assessment (sessions 1–3). Goal: complete the core CFI. It has 16 questions in four domains: cultural definition of the problem; perceptions of cause, context and support; self-coping and past help-seeking; and current help-seeking. Add modules as needed (explanatory model;…

Who practises it, and how they are trained or regulated

• Version followed: hoodoo / rootwork has no codified version, governing body or licensing route. The tradition is described here through scholarly and archival accounts: Hurston 1931; Brown, Folklore Forum 23; Chireau 2003; Hazzard-Donald 2012; the Avery Research Center, College of Charleston. The therapist's own work follows the DSM-5-TR Cultural Formulation Interview (CFI; APA 2022) and the CFI supplementary…
• Who holds authority. No regulator, college or council exists. Historical accounts describe conjure doctors as "powerful, recognized men and women". Their standing rested on reputation, on signs attributed to them and on an initiation that is not described here. Many were also preachers or exhorters. The practitioner–client relationship was largely private and often paid. Today, authority is recognised within…

Evidence status, as the guide reports it

• Phase 5: Treatment, integration and review (ongoing). Goal: deliver the evidence-based treatment chosen for the disorder, revisit the explanatory model as it changes, integrate the client's experiences and review safeguarding. The CFI modules can be repeated during treatment. End or step down by…

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?
• 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?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• 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

• notes that read as dismissive if the client sees them; formulations frozen at intake. It's working when the client recognises themselves in the formulation.
• one consultant treated as speaking for every African American; confidentiality in small communities. It's working when consultation changes or firms up your formulation.
• delayed care for serious symptoms (urgent: escalate); a client who fears that doctors will mock them. It's working when medical and cultural help run in parallel without conflict.
• abuse described as tradition, and ordinary tradition misread as abuse. Consult before concluding either. It's working when the risk is reduced and the therapeutic relationship survives.
• polite compliance hiding mistrust; missed appointments after diagnostic discussions. It's working when the client corrects you, disagrees with you or adds information you hadn't asked for.

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.