Vanuatu kastom healing

Domain XI · Traditional medicine & indigenous healing · Vanuatu

What it is

Vanuatu kastom healing is not a single therapy but part of a pluralist health landscape in which people combine Indigenous (kastom), Christian and biomedical care, often in sequence or at the same time. Taylor and Elliott replaced the umbrella term "traditional healer", which they judged "locally…

Format

• This is a framework for the psychotherapist's own culturally responsive work alongside kastom, church and biomedical care, not a manualised protocol. Phase structure, session counts and transition criteria below are unless cited.
• Phase A: Engagement and cultural assessment (sessions 1-2). Goal: understand the problem in the client's terms and map every source of help already used. Tools: the core CFI (16 questions, four domains) and, where needed, its Informant Version and supplementary modules; Kleinman's explanatory-model…

Who practises it, and how they are trained or regulated

• Who holds authority. Healing knowledge is held by recognised healers and families; Tudal et al. focused on healers "recognised by their community" who treat people beyond their own families, found most knowledge-holders interviewed were women, and report that some knowledge is taboo or reserved for particular communities. Christian faith healing sits within churches. Chiefs and community leaders hold local…

Evidence status, as the guide reports it

• Phase D: Treatment alongside other care (variable; typically 6-20 sessions of whatever evidence-based therapy fits the disorder). Goal: deliver psychological treatment while revisiting the help-seeking map at each review; the CFI modules may be repeated during treatment.

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?
• 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?
• 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

• Distress after news of a death at home and talk of who is to blame; isolation. Working: the client has at least one trusted local support.
• Family members steering the meeting towards blame; a leader asking the therapist to confirm a cause. Working: the family speaks of illness and recovery rather than culprits.
• Informant accounts that name a person as responsible for the illness; treat this as a safety signal (see 4.11). Working: family and client accounts converge on a shared plan.
• Attribution of all recovery to one source in a way that would stop needed medicine later. Working: the plan includes biomedical, spiritual and family elements the client endorses.
• The client censoring themselves in front of a broker from the same island; interpreters softening sorcery content. Working: richer, more specific answers once language support is in place.

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.