Atlas›Domain XI · Traditional medicine & indigenous healing›Guide 050
Guide XI-050

Kurdish folk healing

Kurdish regions (Turkey, Iraq, Iran, Syria)
A 36 · L 53 · M 1117 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: there is no single codified "Kurdish folk healing" system and no one body that speaks for it. This guide follows (i) scholarly accounts of Kurdish religious and healing roles, chiefly van Bruinessen's The Kurds and Islam (1999 working-paper version of a 1998 article); (ii) a Turkish-language field study of Kurdish folk medicine (Dermanê Kurmancî) in Adıyaman; (iii) studies of Kurdish and Yazidi distress, trauma and help-seeking (Branam et al. 2023; Kizilhan and Weigelt 2025; Taha and Abdurrahman 2020); and (iv) the DSM-5-TR Cultural Formulation Interview (CFI) and related cultural-psychiatry tools for the therapist's own work. [source: van Bruinessen 1999; Adıyaman study; Branam et al. 2023; APA CFI]

What it is. "Kurdish folk healing" is a loose name for several overlapping help-seeking routes used in Kurdish communities in Turkey, Iraq, Iran, Syria and the diaspora. Scholars describe these routes:

  • Sufi shaykhs. Historically shaykhs of the Qadiri and Naqshbandi orders were often the most influential religious figures. Besides mediating disputes and acting as spokesmen, they were consulted as healers; van Bruinessen describes them acting as "healers of mental and physical illnesses" and as people believed to intercede with God. Some shaykh families became hereditary and quasi-tribal. [source: van Bruinessen 1999, pp. 14–16]
  • Village and town mullas (mele, mela). Trained in mosque madrasas, they served local communities and helped keep Kurdish language and identity alive. [source: van Bruinessen 1999, p. 13]
  • Sayyid and saintly lineages. These are families claiming descent from the Prophet's family or from saints (e.g. the Barzinji family). In Yezidism, Ahl-i Haqq (Yarsan) and Alevism, essential rituals are performed only by specialists from such lineages. [source: van Bruinessen 1999, pp. 5, 7]
  • Ocak families and sacred places. The Adıyaman study describes ocaklılar (people of hereditary ocak healing lines, each linked to particular illnesses). Tombs (türbe), springs, lakes and stones are held sacred, and ocaklar and türbeler are central to the belief system. Some remedies are kept to specific people; others are common household knowledge. Use has declined with modern health care but continues, especially for conditions seen as "very simple" or "hopeless". [source: Adıyaman Dermanê Kurmancî study]
  • Islamic faith healing for jinn possession. This is reported in Iraqi Kurdistan, where some patients who believe a jinn possesses them go to healing mullas instead of, or after, psychiatric care. [source: IWPR 2006] Jinn possession as an explanation for mental illness is widely used among Muslims and is linked to a preference for religious healers. [source: Shah and Carlsson 2016]

Core idea of change. In these accounts, healing comes through blessing, intercession and the hereditary or spiritual power of the healer, a saint or a place, within a religious and moral world the client shares. These are the tradition's own understandings, reported here as held, not as fact. [source: van Bruinessen 1999; Adıyaman study] For the psychotherapist, change comes from understanding the client's explanatory model, lowering stigma and other barriers, treating trauma and distress with evidence-based care, and coordinating with the client's chosen religious or folk resources when the client wishes. The therapist does not practise any of these healing roles. [synthesis]

Context the therapist must hold. Kurds are religiously plural: Shafi'i Sunni majority, plus Shi'a, Alevi, Yezidi and Ahl-i Haqq communities, and historically Christian and Jewish neighbours. [source: van Bruinessen 1999, pp. 2–10] Many Yazidis are Kurdish-speaking (Kurmanji). Whether Yazidis are Kurds or a distinct people is contested, so use the client's own self-description. [source: Kizilhan and Weigelt 2025 for Kurmanji; synthesis for self-description] Many clients carry mass trauma. The 1988 Anfal campaign against Kurds in northern Iraq left survivors with very high PTSD rates (86.2% in one Duhok sample). [source: Taha and Abdurrahman 2020] Yazidi survivors of the ISIS genocide show somatic symptoms, dissociative states and "spiritual confusion". [source: Kizilhan and Weigelt 2025] Refugees describe loss of social networks and status, and fear of gossip that blocks help-seeking. [source: Branam et al. 2023]

2. Framework

This is a field of community practices, not a therapy with phases. No source sets out a session structure for psychotherapists. The phases below are a practical frame for the therapist's own culturally responsive work alongside Kurdish religious and folk resources. [synthesis]

Phase A: Engagement and safety (sessions 1–2).

  • Goals: lower stigma and fear of gossip; settle confidentiality, interpreter and gender arrangements; screen risk (suicide, violence in the home, medical red flags).
  • Format: individual, often with a family member present for part of the session if the client wishes. Use a professional interpreter not drawn from the client's local community. [synthesis; stigma and gossip: Branam et al. 2023; Carrere 2013]
  • Move on when the client agrees to continue and immediate safety is addressed.

Phase B: Cultural assessment (sessions 2–4).

  • Goals: core CFI, chosen supplementary modules, the explanatory model, a map of healer consultations and remedies, and differential assessment of possession, trance and jinn-related experiences.
  • Format: the core CFI has 16 questions in four domains. It can be used at first evaluation or later, and modules can be repeated. [source: APA CFI and Supplementary Modules] The time needed is [uncertain: not verified].
  • Move on when there is a shared written or spoken formulation the client recognises as theirs.

Phase C: Shared plan and parallel care (from session 3–5 onward).

  • Goals: agree what therapy will address; decide with the client whether and how to coordinate with a mele, shaykh, community religious leader, GP or psychiatrist; route remedy and medicine questions to the prescriber.
  • Move on when the client is stable enough for trauma-focused or skills work, and any safeguarding concern is resolved or managed.

Phase D: Active treatment (typically weeks to months).

  • Goals: evidence-based treatment for the disorder identified (e.g. trauma-focused therapy). Use social reconnection and practical psychosocial support. Kizilhan and Weigelt suggest Narrative Exposure Therapy adapted to oral tradition, and stress that housing, income and legal documents must be addressed alongside therapy. [source: Kizilhan and Weigelt 2025; Branam et al. 2023]

Phase E: Integration and review (final sessions, then as needed).

  • Goals: help the client make sense of religious, shrine or healer experiences alongside therapy; plan relapse prevention, including which community and clinical supports to use. Repeat CFI modules if the picture has changed. [source: APA Supplementary Modules for repetition; synthesis]

3. Guiding principles

  • The therapist works alongside, never as, a healer. Do not offer blessings, prayers, amulets, shrine visits or jinn-related procedures, and do not suggest that you can. [synthesis]
  • Authority is local and plural. No council governs Kurdish folk healing. Authority rests with particular shaykh families and Sufi orders, mullas, sayyid lineages, ocak families, and the clergy of the client's own religion (Sunni, Shi'a, Alevi, Yezidi, Ahl-i Haqq). Ask the client whose guidance they accept rather than assuming. [source: van Bruinessen 1999; Adıyaman study]
  • Attribute, don't adjudicate. Describe jinn, the evil eye, saintly blessing and similar ideas as "you understand this as…". Neither confirm them as fact nor dismiss them. [synthesis]
  • No religion or dialect is assumed. Ask about the client's religion, dialect, region and identity. Kurdish, Yazidi, Alevi or other self-description belongs to the client. [source: van Bruinessen 1999; synthesis]
  • Culturally normative is not a symptom. A possession experience or trance that is part of broadly accepted religious practice is excluded from DID and from dissociative trance. ICD-11 trance and possession trance disorders require the state to be involuntary, unwanted and outside accepted practice. [source: PMC9199574; findacode ICD-11 mirror]
  • And illness must not be missed. People may turn to healers when psychiatric or medical care is distrusted. The risk is delayed treatment of psychosis, severe depression or physical disease. [source: IWPR 2006; synthesis]
  • Stigma and gossip shape everything. Expect fear that others will learn of treatment and hidden psychiatric visits in tribal or traditional families. Protect privacy actively. [source: Branam et al. 2023; IWPR 2006; Carrere 2013]
  • Trauma is collective as well as individual. Anfal, displacement and genocide pass down through family narratives and collective memory. These can increase vulnerability and also support resilience. [source: Kizilhan and Weigelt 2025; Taha and Abdurrahman 2020]
  • Practical needs come first. Psychosocial work does not succeed while housing, income and legal status are unresolved. [source: Kizilhan and Weigelt 2025]
  • Consent governs collaboration. Contact with any religious or folk healer happens only if the client asks, with explicit consent about what is shared. [synthesis; collaboration evidence from other regions: COSIMPO]
  • No advice on remedies or medicines. Ask about herbal or folk remedies and pass the information to the prescriber. Never advise starting, stopping or changing a medicine. [synthesis]
  • Safety overrides deference. Beating has been reported in some faith-healing sessions for jinn. Harm to a client or child triggers safeguarding, whatever its religious framing. [source: IWPR 2006; synthesis]
  • Gender and honour are clinical realities. Female survivors may face exclusion grounded in ideas of honour and shame. Gender of the therapist and interpreter, and who is present, matter. [source: Kizilhan and Weigelt 2025; Carrere 2013]

4. Intervention inventory

These are the psychotherapist's own interventions. None reproduces or performs a Kurdish healing practice. Example language is illustrative. [synthesis unless a source is given]

4.1 Cultural humility and self-examination

  • Purpose / when: Before and throughout work with Kurdish clients. It guards against assumptions about religion, "backwardness" of folk healing, or politics. [synthesis]
  • Steps: (1) Before the first session, note what you assume about Kurds, Islam, Yezidis, honour and faith healers. (2) Check which country, region, dialect and religion the client comes from, rather than one image of "Kurdish culture". (3) Note your reactions in supervision when a client describes jinn, shrines or a shaykh's power. (4) Learn the trauma history relevant to this client (e.g. Anfal, displacement, the ISIS genocide for Yazidis). [source for plurality: van Bruinessen 1999; trauma: Taha and Abdurrahman 2020; Kizilhan and Weigelt 2025]
  • Example language (illustrative): "I know a little about Kurdish history, but much less than you do about your own family and community. Please correct me when I get something wrong."
  • Watch for: Over-generalising (treating all Kurds as Sunni or all as conservative); explaining every symptom by culture; silent disapproval of healers, which clients often sense. It is working when the client corrects you freely.

4.2 Engagement that addresses stigma and gossip

  • Purpose / when: First contact, and whenever attendance drops. Fear of gossip and the belief that seeing a psychiatrist means being "crazy" are documented barriers. [source: Branam et al. 2023; Carrere 2013]
  • Steps: (1) Explain confidentiality and its limits in plain terms, including who will and will not know. (2) Ask who else knows the client is attending, and whether that needs protecting (appointment letters, phone calls, waiting-room encounters). (3) Frame the work in the client's terms, e.g. stress, worry, sleep, pain, family strain, rather than psychiatric labels if those are stigmatising. (4) Note that many people in the community privately support seeking help even when they believe others oppose it. [source for the norms gap: Branam et al. 2023]
  • Example language (illustrative): "Nothing you say here goes to your community, your mosque or your family unless you ask me, or unless someone's safety is at serious risk. Shall we agree how I contact you?"
  • Watch for: Hidden attendance (educated patients from tribal families may keep psychiatric visits secret) [source: IWPR 2006]; fighters or men who see admitting trauma as weakness [source: Carrere 2013]. It is working when the client comes back and talks about who knows.

4.3 Interpreters and cultural brokers

  • Purpose / when: Whenever the client's best language is a Kurdish dialect (e.g. Kurmanji) or another language. [source for Kurmanji: Kizilhan and Weigelt 2025; synthesis for steps]
  • Steps: (1) Ask which dialect and which interpreter gender the client prefers. (2) Check that the interpreter does not know the client or family, and agree confidentiality with the interpreter. (3) Brief the interpreter beforehand: interpret everything, including religious or spiritual terms, without softening. Ask them to flag a term with no direct English equivalent rather than translate it loosely. (4) Debrief afterwards on cultural meanings and on the interpreter's own reactions to trauma material. (5) A cultural broker, i.e. a trusted community member chosen by the client, may help explain religious roles, but only with the client's consent. [synthesis]
  • Example language (illustrative): "Would you prefer a Kurmanji or a Sorani interpreter, and would you be more comfortable with a woman or a man?"
  • Watch for: Interpreters from the same small community (gossip risk); family members used as interpreters, especially children; political or religious tension between interpreter and client. It is working when the client corrects the interpretation and speaks at length. The dialect name Sorani is [uncertain: not verified].

4.4 The core Cultural Formulation Interview

  • Purpose / when: Phase B, for every Kurdish client, to understand the problem from the client's and their network's view. APA says it is for any clinician, in any care setting. It supports clinical judgement and is not a sole basis for diagnosis. [source: APA CFI; APA Section III]
  • Steps: (1) Use the official DSM-5-TR form. Clinicians may reproduce it for their own patients, but translating or modifying it needs APA permission. [source: APA CFI] (2) Work through the four domains in your own conversational way: the cultural definition of the problem; perceived causes, stressors, supports and the role of cultural identity; self-coping and past help-seeking (including barriers); and current help-seeking preferences and the clinician–patient relationship. [source: APA CFI] (3) In the past-help-seeking domain, ask explicitly about mullas, shaykhs, shrine visits, ocak healers and household remedies (see 4.7). (4) In the relationship domain, ask about language barriers, discrimination and distrust of services. (5) Summarise back the client's account before giving your own.
  • Example language (illustrative): "People describe problems in different ways. How would you describe what is happening to you, in your own words or in Kurdish?"
  • Watch for: Clients giving the answer they think a clinician wants (e.g. denying healer visits). Silence about the relationship domain may mean distrust, not satisfaction. Time needed is [uncertain: not verified]; the field trial found later interviews took less time. [source: Lewis-Fernández et al. 2017] It is working when the client offers their own terms and causes.

4.5 CFI supplementary modules and the Informant Version

  • Purpose / when: When the core CFI shows a domain needs depth. Modules can be used at first evaluation, later, or repeatedly. [source: APA Supplementary Modules]
  • Steps: Choose modules by need: (1) Spirituality, Religion, and Moral Traditions when faith, a shaykh, a shrine or jinn figure in the problem or its cure. (2) Explanatory Model for a detailed account of cause and course. (3) Immigrants and Refugees for flight, detention, resettlement and loss of status. (4) Cultural Identity, since Kurdish, Yazidi, Alevi or national identity may be contested or politicised. (5) Coping and Help-Seeking, Social Network and Psychosocial Stressors for isolation after resettlement. (6) Older Adults or School-Age Children and Adolescents by age; Caregivers for family carers. (7) Informant Version (17 questions) with a family member, with the client's consent. [source: APA Supplementary Modules; APA Informant Version; refugee stressors: Branam et al. 2023]
  • Example language (illustrative): "You mentioned that your faith matters a great deal in how you are coping. Could we spend some time on that today?"
  • Watch for: Overloading a traumatised client with questions; using a relative's account to override the client's. Don't reproduce or translate module items without APA permission. It is working when the formulation changes because of what you learn.

4.6 Exploring the explanatory model (Kleinman)

  • Purpose / when: Phase B and whenever the client and clinician disagree about cause or treatment. [source: Kleinman et al. 1978 via Tanenbaum handout]
  • Steps: Ask, in your own words and over one or more sessions, about: what the client calls the problem; what caused it; why it began when it did; what it does to them and how it works; how severe it is and how long it will last; what treatment they think they should receive; the main problems it has caused; and what they fear most. [source: Tanenbaum handout, paraphrasing Kleinman et al. 1978] Then (a) note where the client's model and yours overlap (e.g. both see grief and fear as involved); (b) name differences respectfully; and (c) negotiate a plan that makes sense within the client's model. [synthesis]
  • Example language (illustrative): "Some people in your family think this is the evil eye, and the doctor said it was nerves. What do you think it is?"
  • Watch for: More than one model held at once (e.g. jinn, trauma and God's will) is common and not a contradiction. A model of jinn possession is linked to a preference for religious healers. [source: Shah and Carlsson 2016] It is working when the client can say which parts of your plan fit their understanding.

4.7 Asking about healer consultations and remedies without judgement

  • Purpose / when: At intake and at each review. Clients may consult mullas, Sufi shaykhs, sayyid families, ocak healers or shrines (türbe), often alongside medical care. [source: van Bruinessen 1999; Adıyaman study; IWPR 2006]
  • Steps: (1) Normalise the question. (2) Ask whom they saw, what the healer said the problem was, what the client was asked to do, whether it helped, cost, and anything that frightened or hurt them. (3) Ask about any herbs, oils or other remedies taken, and pass the list to the prescriber. Don't comment on whether to use them. (4) Ask whether the healer said anything about medical or psychological treatment. (5) Record the details factually and without disparaging language. [synthesis]
  • Example language (illustrative): "Many families I work with see a mele or a shaykh, or visit a shrine, as well as coming here. Has anyone like that helped you with this?"
  • Watch for: Fees and repeated sessions with no improvement (sessions cost about USD 20–33 in one 2006 report); physical harm such as beating; a healer advising against medical care; delayed care for physical illness. [source: IWPR 2006; synthesis] It is working when the client volunteers later visits without being asked.

4.8 Cultural concepts of distress and Kurdish idioms

  • Purpose / when: When symptoms are described through somatic, spiritual or moral idioms. [source: APA Section III; Kizilhan and Weigelt 2025]
  • Steps: (1) Remember DSM-5-TR's three kinds of cultural concepts: idioms of distress, explanations or perceived causes, and syndromes. [source: APA Section III] (2) Classify what you hear. Jinn possession and the evil eye usually work as explanations; pain, heart or "nerves" complaints may be idioms; possession states may be experiences that need the differential in 4.9. [synthesis] (3) Ask what the term means to the client, what follows from it, and who can help with it. (4) Don't map a Kurdish idiom onto a DSM concept from another region; no Kurdish-specific concept appears in the DSM-5-TR glossary list in the sources used here. [source: UNMC slides list; synthesis] (5) Assess for depression, PTSD and anxiety alongside, since somatic and dissociative presentations are common after mass trauma. [source: Kizilhan and Weigelt 2025]
  • Example language (illustrative): "When you say your heart is tight, what is that like, and when does it happen?"
  • Watch for: Treating idioms as literal medical claims, or ignoring them. "Spiritual confusion" after atrocity may be moral injury or grief rather than psychopathology. [source: Kizilhan and Weigelt 2025; synthesis] It is working when you and the client can use the client's term as shared language.

4.9 Distinguishing normative religious experience from disorder (possession, trance, jinn)

  • Purpose / when: When a client or family describes possession, a jinn, trance, or unusual voices or visions.
  • Steps: (1) Establish the context. Is the experience part of a broadly accepted collective religious practice in the client's own community, or does the community itself see it as an affliction? [synthesis] (2) Apply the diagnostic exclusions. Under DSM-5 and, in substance, DSM-5-TR, identity disruption in DID may be described as possession, but the disturbance must not be a normal part of broadly accepted cultural or religious practice. Dissociative trance (other specified dissociative disorder) excludes trance that is a normal part of such practice. The exact DSM-5-TR wording is [uncertain]. [source: PMC9199574; Lewis 2023 study guide] (3) Under ICD-11, 6B62 trance disorder and 6B63 possession trance disorder require the state to be involuntary and unwanted, outside accepted practice, and causing distress or impairment. [source: PMC9199574; findacode ICD-11 mirror] (4) Screen for psychosis, mania, PTSD-related dissociation, epilepsy and substance or medical causes; refer for medical assessment when indicated. (5) With consent, ask the client which religious authority in their own tradition they trust, and whether that person sees the experience as normal or afflicted. [synthesis] The DSM-5-TR note that culturally sanctioned beliefs should not count as psychotic symptoms is [uncertain: not verified].
  • Example language (illustrative): "In your family and your religious community, is what happened to you something people recognise and know how to handle, or is it something that worries them?"
  • Watch for: Pathologising accepted religious experience; or, the reverse, accepting "it is a jinn" as the whole story while a psychosis or severe depression goes untreated. The latter is the main risk when care is delayed. [source: IWPR 2006; synthesis] It is working when client, family and clinician agree on what needs treatment.

4.10 Collaboration and referral with religious or community healers (only if the client wishes)

  • Purpose / when: When the client values a mele, shaykh, imam, Yezidi or Alevi religious figure, or community leader, and wants care coordinated. Scholarship shows shaykhs held pastoral, mediating and healing roles. [source: van Bruinessen 1999] Evidence from other regions shows structured collaboration can help: in the COSIMPO trial in Nigeria and Ghana, collaborative shared care between traditional and faith healers and primary care reduced psychotic symptoms and harmful practices more than usual care. In a Ghana prayer-camp trial, adding psychiatric care reduced symptoms but did not significantly reduce days in chains. No Kurdish-specific collaboration programme is documented in the sources cited [uncertain]. [source: COSIMPO via PubAnnotation; Ofori-Atta et al. via APHRC]
  • Steps: (1) Ask whether the client wants any contact, and with whom. (2) Obtain explicit written consent stating what may be shared (usually minimal: that the client is in care, and agreed safety points). (3) Make contact as a fellow helper. Ask how they understand their role and what they advise; explain yours, including risk and the importance of medical treatment. (4) Agree on red lines: no physical harm, no restraint, no advice to stop medicines, and urgent medical care comes first. (5) Keep the client at the centre of all communication; no side arrangements with family or healer. (6) Review whether the collaboration is helping. [synthesis]
  • Example language (illustrative): "If you would like, I could speak with the mele you trust, so we are not pulling you in different directions. You decide what I may tell him."
  • Watch for: A client agreeing under family pressure; a healer who demands that treatment stop; gender or confidentiality conflicts. It is working when the client describes the two kinds of help as compatible.

4.11 Herbs, remedies and medicines: routing to the prescriber

  • Purpose / when: Whenever a client mentions herbal, household or healer-given remedies. The Adıyaman study documents widely shared household remedies alongside specialist ones. [source: Adıyaman study]
  • Steps: (1) Ask what is taken, how often and from whom, and record names as given. (2) Tell the client you will share this with their GP or psychiatrist because some remedies interact with medicines. (3) Pass it on, with consent. (4) Do not give any opinion on starting, stopping or changing a medicine or remedy. [synthesis]
  • Example language (illustrative): "I'm not the right person to advise on remedies or medicines, but your doctor needs to know everything you take. May I let them know?"
  • Watch for: Stopping prescribed medicine on a healer's or relative's advice; physical symptoms after remedies. It is working when the prescriber has a complete list.

4.12 Trauma-focused work within the client's cultural frame

  • Purpose / when: Phase D, for PTSD and related problems after Anfal, war, torture, displacement or genocide. [source: Taha and Abdurrahman 2020; Carrere 2013; Kizilhan and Weigelt 2025]
  • Steps: (1) Stabilise first: sleep, safety, practical needs (housing, income, documents). [source: Kizilhan and Weigelt 2025] (2) Choose an evidence-based trauma therapy you are trained in. Kizilhan and Weigelt suggest Narrative Exposure Therapy adapted to Yazidi oral traditions, and second-wave positive psychotherapy as a framework: validate horror and betrayal rather than offering easy optimism, reframe trauma through historical narratives of endurance, and strengthen identity through spiritual and family roles. These are recommendations, not tested treatments. [source: Kizilhan and Weigelt 2025] (3) Allow the client's religious meaning-making, e.g. God's will or martyrdom, to coexist with trauma processing. (4) For exposure-based work: obtain informed consent, check dissociation and suicide risk first, agree a stop signal, and pace sessions. [synthesis]
  • Example language (illustrative): "Your family has carried this story for a long time. We can tell your part of it here, at your pace, and you can stop at any point."
  • Watch for: Somatic flare-ups and dissociation during processing; survivor guilt; interpreter distress. It is working when intrusions fall and the client can tell the story with less physiological arousal.

4.13 Social reconnection after resettlement

  • Purpose / when: For refugees describing loneliness, loss of community and loss of professional status. Participants in Branam et al. saw social interaction itself as easing symptoms. [source: Branam et al. 2023]
  • Steps: (1) Map lost and remaining relationships. (2) Identify community spaces the client trusts (mosque, cemevi, community association, family networks). (3) Plan small, regular social contacts as behavioural activation. (4) Address loss of status: qualification recognition, language classes, meaningful work. [synthesis; status loss: Branam et al. 2023]
  • Example language (illustrative): "Back home, who did you see every day? Who could fill some of that place here?"
  • Watch for: Gossip fears that make community contact feel unsafe. It is working when the client reports regular contact and better mood.

4.14 Working with families: honour, shame, gender and secrecy

  • Purpose / when: When family members influence help-seeking, when women survivors face exclusion, or when the client hides treatment from family. [source: Kizilhan and Weigelt 2025; IWPR 2006]
  • Steps: (1) Ask who in the family makes health decisions, and whether the client wants them involved. (2) Meet relatives only with the client's consent; use the Informant Version if useful. (3) Name stigma around sexual violence and honour carefully and without blame; for Yazidi survivors, the religious leaders' call to reintegrate survivors can be a resource if the client wishes to draw on it. [source: Kizilhan and Weigelt 2025] (4) Watch for violence at home; see 4.16.
  • Example language (illustrative): "You don't have to bring your family into this. If you want them to understand more, we could think together about what to tell them."
  • Watch for: Family members speaking for the client; signs of coercion or threats. It is working when the client feels less alone without losing control of their story.

4.15 Integrating healer, shrine and religious experiences

  • Purpose / when: When a client has visited a shrine or türbe, seen a shaykh or mele, or undergone faith healing, and brings it to therapy. [source: Adıyaman study; van Bruinessen 1999]
  • Steps: (1) Invite the client to describe the meaning of the experience, not its procedure; you don't need ritual details. (2) Ask what changed, what felt supportive, and what (if anything) felt frightening or harmful. (3) Link helpful meanings (hope, belonging, blessing) to therapy goals. (4) If the experience was harmful, process it as you would any adverse experience, without blaming the client's faith. [synthesis]
  • Example language (illustrative): "What did that visit mean to you, and what did you bring back from it?"
  • Watch for: Shame about having "gone to a healer"; distress after a frightening session. It is working when the client can hold both kinds of help in one story.

4.16 Safeguarding

  • Purpose / when: When any practice, religious or not, harms the client or someone else. Beating during jinn-related healing has been reported in Iraqi Kurdistan, and patients may abandon medical treatment. [source: IWPR 2006] Clinicians in the region also describe beatings, rape, honour killings and female genital mutilation linked to untreated trauma in families. [source: Carrere 2013]
  • Steps: (1) Ask directly about physical harm, restraint, confinement, threats and pressure to marry or to stop treatment. (2) For children, follow your local child-protection procedures; never name minors in records shared outside the service. (3) For adults, follow adult-safeguarding and domestic-violence pathways, and include honour-based violence and FGM where your jurisdiction has specific duties. (4) Seek urgent medical care when physical illness is being treated only by a healer. (5) Document facts without cultural disparagement. [synthesis]
  • Example language (illustrative): "Has anyone, during any kind of treatment or at home, hit you, held you down, or kept you from leaving?"
  • Watch for: Minimisation ("it is only part of the treatment"); fear of community retaliation if reported. It is working when the client is safe and stays engaged.

4.17 Relapse prevention with community and clinical supports

  • Purpose / when: Phase E.
  • Steps: (1) List the client's warning signs in their own idioms. (2) Name which supports they will use first: family, religious figure, community group, GP, therapist. (3) Agree when religious or folk help alone is not enough, e.g. suicidal thoughts, not eating, aggression, confusion. (4) Offer review sessions and repeat relevant CFI modules if circumstances change. [source: APA Supplementary Modules for repetition; synthesis]
  • Example language (illustrative): "If the heaviness comes back, what will you notice first, and who will you turn to?"
  • Watch for: Plans that rely on one person only. It is working when the client can describe the plan in their own words.

5. Handling problems

The sources describe the barriers below (stigma, gossip, distrust of drug-only psychiatry, harm in some healing sessions, practical needs). Most responses are synthesis and are marked so.

  • Client says "this is a jinn (or the evil eye); therapy can't help." Don't argue about cause. Ask what the client's own tradition says helps, and what has been tried. Offer therapy as help with the sleep, fear, pain or family strain that come with it, and keep the door open to their religious help. [synthesis; jinn model linked to healer preference: Shah and Carlsson 2016]
  • Distrust that clinicians "just give drugs". This criticism of psychiatry is voiced in the region. [source: IWPR 2006] Explain that therapy is talking-based, show what a session involves, and let the client set the pace. [synthesis]
  • Fear of gossip or of family finding out; missed sessions. Revisit confidentiality, offer discreet contact methods and appointment times, and check the interpreter's community ties. [synthesis; barrier: Branam et al. 2023; IWPR 2006]
  • Stuck: symptoms unchanged despite good engagement. Re-run the explanatory model (4.6) and the relevant CFI modules. Check unaddressed practical stressors (housing, papers, income), ongoing threats, undisclosed remedies or stopped medicines, and whether a parallel healer is giving conflicting advice. Review the diagnosis, including psychosis, depression and medical causes. [synthesis; practical needs: Kizilhan and Weigelt 2025]
  • Overwhelm or dissociation in trauma work. Return to stabilisation, slow the pace, use grounding, and check the interpreter is coping. Resume exposure only with renewed consent. [synthesis]
  • Non-adherence to homework. Make tasks social or family-based rather than solitary, use oral rather than written formats if literacy is limited, and link tasks to the client's values and faith practices without prescribing religious acts. [synthesis; low literacy among users of folk medicine noted in the Adıyaman study]
  • Rupture over religion or politics. Name it and apologise for any slight. Ask what felt dismissive. Don't debate religious or national questions. Consider whether your own reactions, e.g. to an honour-related decision, leaked out, and take this to supervision. [synthesis]
  • A healer advises stopping medicine or therapy. Don't criticise the healer to the client. Explore what the client wants. With consent, offer a conversation with the healer (4.10), and inform the prescriber. If there is risk, act on it. [synthesis]
  • Harm during faith healing (beating, restraint, confinement) or delay of urgent medical care. Safeguarding takes priority (4.16). Support the client to stay connected to their faith while avoiding the harmful practice. [source for harm: IWPR 2006; response: synthesis]
  • The client asks the therapist to take part in, recommend or arrange a ritual, shrine visit or healer. Decline warmly, explaining that this is not your role and lies within their own community's authority. Support them in making their own choices through their community's legitimate pathways. [synthesis]
  • Family pressure on women survivors, or honour-related threats. Assess risk privately and without family members or a community-linked interpreter present; use domestic-violence and honour-based-violence pathways. [source for context: Kizilhan and Weigelt 2025; Carrere 2013; response: synthesis]
  • Men or former fighters who see help-seeking as weakness. Frame the work as dealing with sleep, anger and family strain, and as strength and duty to family. [source for barrier: Carrere 2013; response: synthesis]
  • Clinician vicarious trauma and burnout. This is reported among mental health workers serving survivors. Use supervision and caseload limits, and debrief interpreters too. [source: Kizilhan and Weigelt 2025; synthesis]
  • Uncertainty about whom the client's community recognises as a legitimate religious authority. Ask the client, and with consent a cultural broker or the client's own religious community. Don't pick an authority for them. [synthesis; plurality of authority: van Bruinessen 1999]

Sources

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