Atlas›Domain XI · Traditional medicine & indigenous healing›Guide 019
Guide XI-019

Malay bomoh and main puteri

Kelantan, Malaysia
A 35 · L 55 · M 1016 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: main puteri as described by the Malaysian cultural organisation Pusaka and by Carol Laderman's ethnography Taming the Wind of Desire: Psychology, Medicine, and Aesthetics in Malay Shamanistic Performance (University of California Press; a library record gives 1991, the publisher's paperback page gives March 1993); Malaysian regulation as the Ministry of Health (MOH) Traditional and Complementary Medicine (T&CM) Division publishes it under the Traditional and Complementary Medicine Act 2016 (Act 775); the psychotherapist's own work follows the DSM-5-TR Cultural Formulation Interview (CFI).

What this is. This is a living healing tradition, not a psychotherapy. A psychotherapist does not perform it. Bomoh is the Malay word that clinical researchers in Malaysia use for a traditional healer; Razali and Najib (2000) use it for the healer whom psychiatric patients most often consulted before psychiatry, and Abdullah et al. (2017) use "bomoh" and "pawang" for traditional healers [source: Razali & Najib 2000 abstract; Abdullah et al. 2017]. Main puteri (also called main teri) is, in Pusaka's words, "a healing performance tradition found mainly in the north-eastern Malaysian state of Kelantan". It brings together dance, music, trance and ritual to treat people with emotional or spiritual illness [source: Pusaka; The Rakyat Post 2020].

How change is understood within the tradition (attributed). Pusaka reports that Kelantanese understanding traces such illness to three possible causes: attack by malignant or unsettled spirits, loss of semangat (soul or life-essence), or imbalance of angin (inner wind). When the cause is semangat or angin, the patient is encouraged to take part in the performance for emotional and spiritual release [source: Pusaka]. Laderman, an outsider anthropologist who was accepted as an apprentice to a Malay shaman, describes the healer as restoring harmony by enabling the patient to express the "Inner Winds" (talents, drives and personality traits) within a "total performance" [source: UC Press book page]. In a 1988 paper she argues that main peteri holds an indigenous, nonprojective theory of psychic functioning that is comparable to Western theories and no less rational [source: Laderman 1988 abstract]. These are the tradition's concepts and one scholar's interpretation, and are presented here neither as fact nor dismissed.

The therapist's change model. Change in the therapist's own work comes from understanding the client's illness as the client and family understand it, reducing delay and conflict between help-seeking routes, telling culturally normative experience apart from disorder, and coordinating care with healers the client trusts [synthesis, built on the CFI and on Razali & Najib 2000].

2. Framework

Who holds authority.

  • Within main puteri: according to Pusaka, the tok puteri is the central figure, acting as spirit medium and healer, and the tok minduk assists as the one who questions the spirit and usually leads the music on the rebab (spike fiddle). Authority sits with these tradition-bearers and their communities, not with outside clinicians. How practitioners are trained or recognised is a matter for the tradition, and this guide does not describe it [source: Pusaka].
  • Public performance in Kelantan: the state government controls this. Mustafa and Abdullah (2018) report that a 1991 state decision imposed a total ban on several traditional performances in public, citing Hindu and animist elements and concerns about morality, and they name the Kelantan Entertainment Control Enactment 1998 as the legal basis. In 2017 a UN Special Rapporteur, Karima Bennoune, called for the bans on mak yong, wayang kulit, main puteri and dikir barat to be lifted [source: Policy Forum 2017]. Kelantan lifted the mak yong ban in 2019 under guidelines. In August 2020 the State Community Unity, Culture, Heritage and Tourism Committee said main puteri would be studied to decide whether it is suitable for public viewing and to "correct" elements it considers un-Islamic [source: The Rakyat Post 2020]. Its status after 2020 is [uncertain: not verified].
  • UNESCO: mak yong was proclaimed a Masterpiece in 2005 and inscribed as Intangible Cultural Heritage in 2008 [source: Policy Forum 2017; The Rakyat Post 2020]. Whether main puteri itself has any UNESCO listing is [uncertain: not verified].
  • Health regulation: Act 775 recognises seven T&CM practice areas, including Traditional Malay medicine and Islamic medicine practice. Since 1 March 2025 it has been an offence to practise in these areas without registration and a valid practising certificate [source: Malay Mail 2025]. The MOH registration guideline for Malay traditional medicine lists herbal medicine, Malay massage (urut), cupping (bekam) and postnatal care, and describes the practice as holistic across body (jasmani) and spirit (rohani) [source: MOH gp-ptm]. For Islamic medicine practice (Amalan Pengubatan Islam), applicants without a recognised qualification must first pass i-Syifa' screening at the State Islamic Religious Department (JAIN) [source: MOH gp-api]. Whether bomoh spirit-healing or main puteri falls under any registered category is [uncertain: not verified].

Phases of the therapist's work [synthesis; no source sets session counts]:

  1. Preparation (before or at intake): examine your own assumptions; arrange an interpreter (for example, for Kelantanese Malay) or a cultural broker if needed. Move on once you can name your own likely biases and the language plan is in place.
  2. Cultural assessment (sessions 1–2, about 15–20 minutes for the core CFI [uncertain]): core CFI, chosen supplementary modules and the explanatory model. Move on once you can state the client's and family's names for the problem, its cause, and the help already sought.
  3. Differential understanding (sessions 1–3): normative experience versus disorder, risk screening and medical review. Move on once you have a working formulation that the client recognises.
  4. Shared plan (from session 2–3): agree what psychotherapy offers alongside any healer, religious or medical care, with consent for any contact between them. Move on once the client has agreed to the plan.
  5. Parallel care and integration (ongoing; weekly or fortnightly individual sessions, with family sessions as needed): review how each kind of help is working, integrate healing experiences, and watch for delay to urgent care.
  6. Safeguarding (throughout): act at once if any practice harms the client.

3. Guiding principles

  • Alongside, not instead of. You do not perform, imitate or direct bomoh or main puteri healing. Your role is assessment, psychotherapy, coordination and safety [synthesis].
  • Attribute, don't adjudicate. Describe spirits, semangat, angin, saka and santau as the client and the tradition hold them. Practical meaning: use phrases such as "in your family's understanding" and do not take a position on whether they are real [synthesis].
  • Expect prior and parallel healer use. In one Malaysian clinic, 69% of first-time psychiatric patients had seen a bomoh for the current illness, and this was linked to delay in starting psychiatric treatment [source: Razali & Najib 2000]. Practical meaning: ask every Malay client about it, routinely and without judgement.
  • Supernatural attribution is common and not itself a symptom. At an Islamic healing centre, 58.8% of attenders attributed their illness to supernatural causes, with no significant difference between those with and without a psychiatric disorder [source: Abdullah et al. 2017]. Practical meaning: do not read the belief as delusion.
  • Respect religious diversity within Malay Muslim life. Some Kelantanese see these practices as un-Islamic, and the state has restricted them on religious grounds [source: Policy Forum 2017; The Rakyat Post 2020]. Practical meaning: never assume where a client stands, and ask.
  • Community authority over the tradition. Questions about the tradition belong with its tradition-bearers. Questions about religion belong with the religious authority the client chooses [synthesis].
  • Regulated pathways only. If the client wants a healer referral, the MOH T&CM register and Islamic practitioners screened by JAIN are the regulated routes [source: Malay Mail 2025; MOH gp-api].
  • No advice on herbs or medicines. Route any question about herbal use or medication changes to the prescriber or doctor [synthesis].
  • Touch. You do not provide touch-based practices. If a client uses urut or bekam, the practice requires explicit consent, the right to stop, and never sexual or genital touch [synthesis].
  • Safety overrides culture. Restraint, beating, sexual contact, starvation, or delay of urgent care is never treated as tradition [synthesis].
  • Cite the CFI correctly. The CFI supports clinical decisions and is not the sole basis for a diagnosis [source: APA CFI].

4. Intervention inventory

All the interventions below are the psychotherapist's own. None of them reproduces or stands in for bomoh or main puteri healing. The CFI material follows the APA forms [source: APA CFI; APA Supplementary Modules; APA Informant Version]. The Malaysia-specific applications are [synthesis] unless a source is cited.

4.1 Cultural humility and self-examination

  • Purpose: to stop your own views on spirits, Islam, healers or "superstition" from shaping the assessment. Do this before the first session and again whenever you feel judgement or fascination [synthesis].
  • Steps: (1) Write down your own beliefs about spirit illness and traditional healers, and how you think psychiatric care compares with them. (2) Note any pull either to dismiss the tradition or to romanticise it, including treating main puteri as exotic, which Laderman notes earlier Western anthropologists did [source: UC Press book page]. (3) Note what you know of the political and religious disputes over these practices in Kelantan, and keep that knowledge out of the room unless the client raises them. (4) Arrange supervision or consultation with a Malaysian clinician or cultural broker [synthesis].
  • Example language (illustrative), for supervision: "I notice I'm curious about the performance itself. I want to keep my focus on what it means to my client."
  • Watch for: asking about the ritual out of interest rather than for the client's sake, and arguing about religious legitimacy. It is working when your questions follow the client's priorities.

4.2 Core Cultural Formulation Interview

  • Purpose: to clarify the problem as the client and their social network understand it, including its meaning, possible sources of help, and expectations of services. Use it at intake with every client, and especially when the client mentions spirits, angin, semangat or a bomoh [source: APA CFI].
  • Steps: Work through the 16 questions in the four APA domains: (1) cultural definition of the problem; (2) cultural perceptions of cause, context and support, including the role of cultural identity; (3) cultural factors affecting self-coping and past help-seeking, including barriers; (4) cultural factors affecting current help-seeking, including preferences and the clinician–patient relationship. Use the client's own words for the problem throughout. Clinicians may reproduce the form for use with their own patients, but translating or modifying it needs APA permission [source: APA CFI].
  • Example language (illustrative): "People describe problems like this in different ways. How would you describe it to your family?" / "Some people go to a bomoh, an ustaz or a doctor first. Who have you seen so far?"
  • Watch for: short, guarded answers when the client expects disapproval of healer use. It is working when the client corrects or adds to your summary.

4.3 Supplementary modules and the Informant Version

  • Purpose: to go deeper where the core CFI points. The modules can be used as add-ons or on their own, at the first evaluation or repeatedly during care [source: APA Supplementary Modules].
  • Steps: Choose modules according to the core CFI answers: Explanatory Model (spirit attack, semangat, angin); Spirituality, Religion, and Moral Traditions (how Islam and these practices sit together for the client); Coping and Help-Seeking (bomoh, Islamic healers, clinics); Social Network and Psychosocial Stressors; Cultural Identity; Immigrants and Refugees for Malay clients abroad; Older Adults and School-Age Children and Adolescents where they apply; the Caregivers module for family carers. Use the Informant Version (17 questions) with a family member, with the client's consent [source: APA Supplementary Modules; APA Informant Version].
  • Example language (illustrative): "Some people feel their faith and traditional healing fit together, and others feel torn. How is it for you?"
  • Watch for: module fatigue, so split the modules across sessions. Watch also for an informant who speaks over the client. It is working when the client's and the family's views are both on record.

4.4 Explanatory-model inquiry in Malay idiom

  • Purpose: to map the client's own theory of the illness, which shapes adherence and choice of healer [source: Kleinman et al. 1978, as paraphrased in Tanenbaum handout].
  • Steps: Paraphrase Kleinman's eight areas: what the client calls the problem; its cause; why it started when it did; what it does and how it works; how severe it is and how long it will last; what treatment the client should receive; the main problems it has caused; and what the client fears most. Let the client introduce local terms. Terms reported in Malaysia include disturbance by jinn, saka (jinn believed to be inherited through the family line) and santau (a form of black magic believed to cause illness) [source: Abdullah et al. 2017], and loss of semangat or imbalance of angin [source: Pusaka]. Ask what each term means to this client rather than assuming the textbook meaning.
  • Example language (illustrative): "When you say it is saka, what does that mean in your family? What do you think would help it?"
  • Watch for: a split between the client's model and the family's. It is working when you can explain the plan in the client's own terms.

4.5 Non-judgemental mapping of the healer pathway

  • Purpose: to learn who has been consulted, in what order and with what results, because consulting a bomoh first is common and has been linked to treatment delay [source: Razali & Najib 2000].
  • Steps: (1) Ask about each route: bomoh, pawang, Islamic healers (for example, a centre such as Darussyifa), herbalists, GP and hospital. (2) Ask what each said the cause was and what it advised, without asking for ritual details. (3) Ask whether the client means to continue each one. (4) Note any herbs, fasting, restriction of movement, or instructions to stop medicines, and pass medical questions to the prescriber. (5) Record the timeline [synthesis; healer types from Abdullah et al. 2017].
  • Example language (illustrative): "You don't need to tell me anything private about the treatment. It helps me to know who you've seen and what they told you."
  • Watch for: concealment. Abdullah et al. note that some patients keep seeing healers after starting psychiatric treatment, which can affect adherence [source: Abdullah et al. 2017]. It is working when the client tells you about new consultations without being asked.

4.6 Working with Malay idioms and cultural concepts of distress

  • Purpose: to use local idioms as the client's language for suffering, not as diagnoses in themselves [synthesis].
  • Steps: (1) Note that DSM-5-TR describes cultural concepts of distress as idioms, explanations or causes, and syndromes [source: APA DSM-5-TR Section III]. The DSM-5-TR examples listed in a secondary source (ataque de nervios, dhat syndrome, hikikomori, khyâl cap, kufungisisa, maladi dyab, nervios, shenjing shuairuo, susto, taijin kyofusho) include no Malay concept [source: Szepe & Fritson slides]; the exact DSM-5-TR list is [uncertain: not verified]. Whether older DSM editions listed Malay syndromes is [uncertain: not verified]. (2) Treat angin, semangat, saka, santau and spirit disturbance as explanations or idioms, and explore each with the CFI. (3) Then assess separately for depression, anxiety, bipolar disorder, psychosis and trauma. At one Islamic healing centre, depressive disorders (41.5%) and anxiety disorders (28.3%) were the most common among attenders with a psychiatric disorder [source: Abdullah et al. 2017].
  • Example language (illustrative): "You've told me the cause may be angin. Alongside that, I'd like to ask about sleep, mood and worry, so we don't miss anything else that could help."
  • Watch for: turning an idiom into a label, or using it to explain away clear depression or psychosis. It is working when the formulation holds both the idiom and any disorder.

4.7 Distinguishing normative trance and spirit experience from disorder

  • Purpose: to avoid both pathologising trance or spirit experiences that occur within an accepted practice and missing a dissociative, psychotic or mood disorder [synthesis].
  • Steps: (1) Establish the context. Was the trance or "possessed" state part of a collective, accepted cultural or religious practice, such as a healing performance led by recognised practitioners? DSM-5 dissociative trance (under other specified dissociative disorder) does not apply when the trance is "a normal part of a broadly accepted collective cultural or religious practice". ICD-11 6B62 trance disorder and 6B63 possession trance disorder both require the state to be involuntary, unwanted and outside accepted practice [source: PMC9199574 review; ICD-11 text via findacode mirror]. (2) Ask about episodes outside any ceremony: when, how often, how long, whether they were wanted, and the distress or impairment they cause. (3) Screen for psychotic symptoms, mood episodes, substance use, epilepsy and other medical causes. DSM-5-TR keeps the DSM-5 points on possession-form DID and dissociative trance in substance [source: https://umsystem.pressbooks.pub/aswbprep/?p=1299]; whether it keeps the exact wording is [uncertain]. (4) Check your reading with a cultural broker or community member, with the client's consent.
  • Example language (illustrative): "When this happens outside the healing sessions, does it feel like something you choose or something that takes you over? How does it affect your days?"
  • Watch for: episodes that are unwanted, recurrent and disabling, and new beliefs the client's own community does not share. It is working when your view and the community's view of what is "ordinary" line up, or when you can explain why they differ.

4.8 Interpreters and cultural brokers

  • Purpose: to communicate accurately, including in Kelantanese dialect, and to understand local meanings [synthesis].
  • Steps: (1) Use a trained interpreter rather than family where possible. (2) Brief the interpreter on confidentiality and on translating terms like semangat without explaining them away. (3) Choose a cultural broker the client accepts (from their community, not necessarily their mosque or village), and confirm consent for what will be shared. (4) Debrief with the interpreter or broker after the session.
  • Example language (illustrative): "If a word doesn't translate well, please give me the Malay word and the client's meaning."
  • Watch for: brokers bringing their own religious or political views on the practice, and fear in small communities that word will spread. It is working when the client says they felt understood.

4.9 Collaboration and referral with community-sanctioned or registered practitioners

  • Purpose: to support care the client wants from a healer while keeping it safe and coordinated. Abdullah et al. recommend collaboration between mental health services and spiritual healing practitioners. They suggest working with healers registered with the MOH T&CM division, visiting psychiatrists at healing centres and visiting healers on psychiatric wards [source: Abdullah et al. 2017].
  • Steps: (1) Collaborate only if the client asks for it or agrees. (2) Get explicit written consent naming what may be shared, and with whom. (3) If the client is choosing a new practitioner, point to regulated routes: Act 775 registration and practising certificates for Traditional Malay medicine and Islamic medicine practice, and i-Syifa' screening via JAIN for Islamic practitioners [source: Malay Mail 2025; MOH gp-api]. (4) For main puteri, recognise that the tradition-bearers hold authority and that public performance has been restricted in Kelantan. Do not arrange or recommend performances, and do not steer clients to practitioners outside the community's own pathways [source: The Rakyat Post 2020; synthesis]. (5) Share risk information and agree who to call in a crisis. (6) Review together whether the collaboration is helping.
  • Example language (illustrative): "Would it help if I spoke with the healer you see, so we're not pulling you in different directions? I'll only share what you agree to."
  • Watch for: a healer advising the client to stop medication or psychotherapy, unregistered practitioners, and costs that are pressuring the client or family. It is working when advice is consistent and the client stays engaged with both.

4.10 Parallel care and preventing harmful delay

  • Purpose: to stop healer-first pathways delaying needed psychiatric or medical care. Razali and Najib found that patients who had seen a bomoh were significantly delayed in starting psychiatric treatment [source: Razali & Najib 2000].
  • Steps: (1) Present psychiatric or medical care as an addition to the client's chosen help, not a replacement for it. (2) Agree on specific warning signs that mean seeing a doctor promptly: not eating or drinking, suicidal thoughts, confusion, seizures, mania or psychosis. (3) Agree a review date for checking whether things are improving.
  • Example language (illustrative): "You can keep seeing the healer. Let's also agree that if you stop sleeping or eating, we'll get a doctor involved the same week."
  • Watch for: the family waiting for a healing outcome while symptoms worsen. It is working when the warning-sign plan is used.

4.11 Herbs, medicines and physical practices: routing, not advising

  • Purpose: to keep the client safe when Malay herbal medicine, urut, bekam or postnatal practices (listed by MOH as Malay traditional medicine) are part of their care [source: MOH gp-ptm].
  • Steps: (1) Ask whether the client uses any herbal or traditional remedies, and record what you are told. (2) Tell the prescriber or GP. Never advise starting, stopping or changing a medicine or remedy. (3) If massage or cupping is involved, confirm the client knows they can refuse or stop at any time, and that sexual or genital touch is never part of legitimate practice. (4) After childbirth, coordinate with maternal health services about postnatal mood alongside confinement practices [synthesis].
  • Example language (illustrative): "I can't advise on remedies, but your doctor should know about them so they can check everything works safely together."
  • Watch for: physical complaints after treatment, or a client who feels unable to refuse touch. It is working when the prescriber has a full list.

4.12 Integrating healing experiences

  • Purpose: to help the client make sense of a healing session or performance in their own terms, and to link it to their goals [synthesis].
  • Steps: (1) Invite the client to share what they choose about the meaning of the experience, not its procedure. (2) Explore what changed in feelings, relationships and sense of self. Laderman's account frames the healing as concerned with relationships among people, between humans and spirits, and within the self [source: UC Press book page]. (3) Link insights to everyday steps. (4) Tend to any distress or fear that followed.
  • Example language (illustrative): "You don't need to describe the ceremony. What feels different since then, with your family or in yourself?"
  • Watch for: interpreting the client's experience for them, and distress after the experience. It is working when the client links the experience to their own goals.

4.13 Working with families

  • Purpose: to engage family decision-makers. Bomoh consultation was more common in families who believed in supernatural causes of mental illness and in patients with major psychiatric illness [source: Razali & Najib 2000].
  • Steps: (1) With the client's consent, use the CFI Informant Version. (2) Acknowledge the family's explanation. (3) Agree a shared plan and the warning signs from 4.10. (4) Clarify that the client, if an adult, decides what is shared.
  • Example language (illustrative): "You've worked hard to find help. I'd like us to work on the same plan so nothing important is missed."
  • Watch for: coercion, and hidden decisions about treatment. It is working when the family brings concerns to you.

4.14 Holding religious and cultural tension

  • Purpose: to support clients who feel caught between Islamic teaching, family tradition and state restrictions on practices such as main puteri [source: Policy Forum 2017; The Rakyat Post 2020].
  • Steps: (1) Ask how the client themselves sees the practice. (2) Do not rule on what is religiously permitted, and offer referral to a religious adviser the client trusts if they want one. (3) Address any shame, secrecy or fear of judgement from the community.
  • Example language (illustrative): "It sounds as if part of you trusts this healing and part of you worries about what others would say. Can we look at both?"
  • Watch for: guilt that turns into depression, and secrecy that blocks safety planning. It is working when the client can talk openly.

4.15 Safeguarding

  • Purpose: to act when any practice causes harm. A recorded Malaysian example: in 2012, a two-year-old girl suffocated during an hours-long prayer session held by her family, who believed she was possessed. A Penang High Court sentenced family members in 2013 [source: Malay Mail 2013]. Press reports of healers being prosecuted for sexual offences against patients are [uncertain: not verified].
  • Steps: (1) Screen for restraint, beating, confinement, food or fluid restriction, sexual contact presented as treatment, and urgent medical care being withheld. (2) For a child, follow local child protection reporting duties; the specific Malaysian statutory duties are [uncertain: not verified]. (3) For an adult, plan for safety with the client, and report where the law requires. (4) Record what you were told, factually.
  • Example language (illustrative): "Healing should never involve being hurt, held down or touched sexually. Has anything like that happened?"
  • Watch for: harm presented as tradition, and fear of reprisal. It is working when the client can disclose and is safe.

4.16 Suicide and risk assessment in context

  • Purpose: to assess risk in line with standard practice, without letting spirit explanations mask suicidality [synthesis].
  • Steps: (1) Ask directly about suicidal thoughts and plans. (2) Ask what the client's beliefs, faith and family mean for their safety. (3) Build a safety plan that includes the people the client trusts, and talk about safe storage or removal of lethal means.
  • Example language (illustrative): "Sometimes people with this kind of suffering think about ending their life. Has that crossed your mind?"
  • Watch for: hopelessness about healing failing. It is working when the client agrees to the plan.

5. Handling problems

The sources do not address most of these problems directly. Guidance is [synthesis] unless a source is cited.

  • The client conceals healer use. Start from the fact that healer use is common in Malaysia (69% of first-time psychiatric patients in one study) [source: Razali & Najib 2000]. Normalise it by asking routinely, and make clear you will not judge. Illustrative: "Many people I see have also seen a bomoh or an ustaz. It's helpful for me to know."
  • Stuck: the client sees no point in talk therapy because the cause is spiritual. Agree on goals that make sense within the client's model, such as sleep, family conflict or worry about recurrence, and offer psychotherapy for those goals rather than for the "cause". Revisit the explanatory model (4.4).
  • The family wants to wait for a healing outcome while the client gets worse. Return to the warning-sign plan (4.10), meet the family (4.13), and escalate to medical or psychiatric care where risk requires.
  • A healer advises stopping medication. Do not argue with the healer's authority. With consent, raise the concern with the prescriber and, if agreed, with the healer (4.9). Support the client's own decision within safety limits.
  • Overwhelm or fear after a ritual or spirit experience. Use grounding and stabilisation, assess for dissociation or psychosis (4.7), and slow the pace. Do not interpret the experience for the client.
  • Possible psychosis or a manic episode framed as possession. Assess against the criteria (4.7), consult a cultural broker, and arrange urgent psychiatric review if risk or impairment is high, while keeping the family's framing in view.
  • Rupture: the client feels judged as "superstitious" or un-Islamic. Name the rupture, own your part, and restate that you respect the client's views and do not rule on religion (4.1, 4.14).
  • Conflict over Kelantan's restrictions or religious disputes about the tradition. Stay out of the policy argument and attend to the client's own experience of it [source: The Rakyat Post 2020; Policy Forum 2017].
  • The client asks you to find a bomoh or arrange main puteri. Explain that you do not arrange or recommend ceremonies. Point to regulated routes (MOH T&CM register, JAIN-screened Islamic practitioners) and to the client's own community [source: Malay Mail 2025; MOH gp-api].
  • Unregistered practitioners, or exploitative fees. Explain what registration under Act 775 means, and support the client to raise concerns with the MOH T&CM Division where appropriate [source: Malay Mail 2025].
  • Disclosure of abuse in a healing context. Follow 4.15. Act on safety first, and document.
  • Non-adherence to appointments during healing periods. Agree flexible scheduling and check in by phone if consented. Do not treat attendance at healing as resistance.
  • Interpreter or broker problems (bias, breaches of confidentiality). Change the interpreter or broker, and debrief with the client.
  • Your own discomfort or fascination. Take it to supervision (4.1).

Sources

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