Pennsylvania Dutch powwow (Braucherei)

1. Introduction

Version followed: Pennsylvania Dutch powwowing (Braucherei, Brauche) as the folklorist David W. Kriebel (Penn State University Press, 2007) and Patrick J. Donmoyer of the Pennsylvania German Cultural Heritage Center at Kutztown University (2018) document it, with present-day practice as reported in 2026. The psychotherapist's own work follows the DSM-5-TR Cultural Formulation Interview (CFI) published by the American Psychiatric Association.

What it is. Powwowing is the Pennsylvania Dutch tradition of ritual healing. Donmoyer's work and the Glencairn Museum exhibition describe it as combining prayers, gestures and everyday objects for "healing the body, protection from physical and spiritual harm" and good outcomes in everyday affairs, over roughly three centuries in Pennsylvania [source: https://www.kutztown.edu/about-ku/administrative-offices/pennsylvania-german-cultural-heritage-center/heritage-center-publications.html] [source: https://glencairnmuseum.org/exhibitions-full/2017/2/18/powwowing-in-pennsylvania-healing-rituals-of-the-dutch-country]. Its practitioners are called Brauchers or powwowers ("powwow doctors"). Healing and protection extend to people and to domesticated animals, and household and farm [source: https://www.pagerman.org/folklife-presentations/ritual-healing-traditions-of-the-pennsylvania-dutch-presentation] [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei]. The tradition is set against Hexerei, harmful magic; Kriebel calls Hexerei powwowing's "opposite" in the account of his book's reviewer [source: https://scholarworks.iu.edu/journals/index.php/jfrr/article/view/39646].

How practitioners understand healing. In Kriebel's account, practitioners understood themselves to draw on God's power to heal physical and spiritual ailments, although some people, then and now, have attributed that power to the devil [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html]. Kriebel describes a cultural model in which healing comes through spontaneous recovery (God's will), biomedicine (God-given skill) or healing power channelled from God, which includes powwowing; powwowers accept only free-will offerings rather than payment for healing [source: https://scholarworks.iu.edu/journals/index.php/jfrr/article/view/39646]. These are the tradition's own explanations, reported here as held, not as established mechanisms.

Written sources and the charm-book tradition. Kriebel traces roots to European spell collections. Johann Georg Hohman's The Long Lost Friend is the best-known charm book, a collection of charms, benedictions, remedies and protective formulas for people and animals [source: https://www.psupress.org/books/titles/978-0-271-02501-8.html]. Its first date is given as 1820 by its current publisher and as 1819 (Reading, Pennsylvania) by the Kutztown Heritage Center; Kriebel's book shows both dates [uncertain: sources give 1819 and 1820] [source: https://www.kutztown.edu/about-ku/administrative-offices/pennsylvania-german-cultural-heritage-center/heritage-center-publications.html]. Hohman's earlier 1813 manual The Friend in Need has been translated with annotations by Donmoyer. Much practice, however, was learned orally, and words were often spoken quietly so the patient could not hear them [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei]. This guide describes the tradition and does not reproduce any charm, blessing or ritual.

History and today. The 1928 killing of Nelson Rehmeyer in York County by men who believed he was using witchcraft against them, and the 1929 trial, brought national notoriety; Kriebel treats it as a turning point after which powwowing and Hexerei "faded into the background" in public life [source: https://witf.org/2017/10/29/murder_in_the_mid-state] [source: https://scholarworks.iu.edu/journals/index.php/jfrr/article/view/39646]. Kriebel nonetheless found the practice alive, if discreet, in southeastern and central Pennsylvania, including among Old Order Amish [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html]. Since about 2015 a visible revival has grown, with guilds, online training and Instagram, alongside older practitioners who keep to secrecy [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei].

The therapist's role and how change happens in this guide. A psychotherapist does not powwow and does not refer for powwowing as a treatment. The therapist's change model is their own: understanding the client's explanatory model and help-seeking, separating culturally held belief from disorder, coordinating safely with any healer the client chooses, and integrating what the tradition means to the client into ordinary evidence-based care [synthesis].

2. Framework

Powwowing is not a psychotherapy and has no published therapy phases. The tradition itself is organised around the relationship between a person seeking help and a recognised powwower, often in the powwower's home, usually for a specific complaint, with a free-will gift rather than a fee; scholars report that the substance of what is said and done is closely guarded [source: https://scholarworks.iu.edu/journals/index.php/jfrr/article/view/39646] [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei]. The framework below is the therapist's own sequence [synthesis], built on the CFI.

Who holds authority. There is no licensing body, regulator or official register for powwowers. Authority rests on recognised transmission from an established practitioner, traditionally oral, from elder to descendant or trusted community member, often across genders, and on reputation in the community [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei]. Kriebel records practitioners who had trained others and a practitioner who taught his widow before he died [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html]. Today, some practitioners organise guilds (for example the Oley Freindschaft guild), with training partly over closed video groups, while others refuse formal students [source: https://bookloft.com/book/9780738777337] [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei]. Church leaders: Kriebel reports that official Pennsylvania Dutch religious leaders have generally disapproved, and some Mennonite sources call it the devil's work [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html]. Scholarship and heritage: the Pennsylvania German Cultural Heritage Center at Kutztown University is the main public research and heritage institution; it is not a regulator [source: https://www.kutztown.edu/about-ku/administrative-offices/pennsylvania-german-cultural-heritage-center/heritage-center-publications.html].

Phases of the therapist's work [synthesis]:

Phase A: Engagement and cultural assessment (sessions 1-2). Goal: understand the problem in the client's terms, including any powwowing, fear of being hexed, church views and family stance. Format: the core CFI (16 questions, four domains) woven into the intake, adding supplementary modules as needed [source: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/DSM-5-TR/APA-DSM5TR-CulturalFormulationInterview.pdf]. Time for the CFI: [uncertain: no time given in APA forms; field-trial clinicians needed less time after their first use]. Move on when: you can state the client's explanatory model and help-seeking pathway in their words, and you know whether powwowing is past, current or wished for.
Phase B: Formulation and differential (sessions 2-4). Goal: separate culturally shared belief (God's healing power, protection, the reality of Hexerei within the community) from symptoms of a disorder; check urgent medical and safety issues. Move on when: a cultural formulation and a working diagnosis (or no diagnosis) are written, with informant or cultural-broker input where the picture is unclear.
Phase C: Plan, including the client's other sources of help (session 3 onward). Goal: agree how therapy sits alongside medical care, church and any powwower; obtain written consent for any contact. Move on when: the client agrees the plan and the safety and medical points are covered.
Phase D: Treatment (usual course of the indicated therapy). Goal: deliver the evidence-based treatment for the presenting problem, adapted to the client's frame, with periodic revisiting of the explanatory model.
Phase E: Review and integration (ongoing, and at ending). Goal: integrate experiences with powwowing or Hexerei fear; review safeguarding; plan relapse prevention consistent with the client's beliefs.

CFI supplementary modules may be used at first evaluation, later in care or repeatedly during treatment [source: https://psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM5_Cultural-Formulation-Interview-Supplementary-Modules.pdf].

3. Guiding principles

[source for tradition-specific points: https://www.psupress.org/books/titles/978-0-271-03213-9.html; https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei; principles as stated are synthesis unless cited]

Alongside, not inside. The therapist works next to the tradition and never performs, imitates or prescribes powwowing. Practical meaning: no charms, blessings or ritual in session; if asked, say this belongs to recognised practitioners [synthesis].
Describe beliefs as held. God's healing power, protection and Hexerei are reported as the client and community hold them, neither affirmed nor dismissed. Practical meaning: use phrases such as "in your family's understanding" rather than "superstition" or "real magic" [synthesis].
Respect secrecy. The tradition guards its words and practices; some charms are not to be written down [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei]. Practical meaning: never ask the client or a practitioner to recite or write down what was said; ask about meaning and effect instead.
Know who holds authority. There is no regulator; recognition comes from transmission and community reputation, while churches may disapprove. Practical meaning: ask the client whose recognition matters to them, and do not treat any individual as speaking for the whole tradition [synthesis].
Expect diversity within the tradition. Some practitioners hold that it must be Christian; others, including Donmoyer, argue it was always practised in mixed-faith settings; modern Heathen groups such as Urglaawe present themselves as separate but related [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei] [source: https://bookloft.com/book/9780738777337]. Practical meaning: ask, never assume, which form the client follows.
Label revivals accurately. Old Order family transmission, heritage-based revival guilds, and newly founded reconstructions (Urglaawe, founded by Robert L. Schreiwer) are different things. Practical meaning: record which one the client means.
Cultural formulation before diagnosis. The CFI supports, but is not the sole basis for, diagnosis [source: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/DSM-5-TR/APA-DSM5TR-CulturalFormulationInterview.pdf]. Practical meaning: a fear of being hexed is assessed in context before it is called a delusion.
Avoid both pathologising and missing illness. Practical meaning: shared, culturally consistent belief is not psychosis; idiosyncratic, escalating or impairing belief still needs assessment [synthesis].
Medical safety first. Powwowing is used alongside biomedicine in many families, but some Plain communities use professional care as a last resort [source: https://ideaexchange.uakron.edu/amishstudies/vol11/iss2/5]. Practical meaning: ask about delayed care for physical illness and route medical questions to a physician; never advise on medicines or remedies.
No health claims. Practical meaning: do not present powwowing as a treatment for any mental or physical disease; Kriebel reports that his own powwow treatments failed [source: https://scholarworks.iu.edu/journals/index.php/jfrr/article/view/39646]; outcome evidence is [uncertain: not verified].
Client choice and consent govern contact. Practical meaning: contact with a powwower only at the client's request, with written consent and agreed limits [synthesis].
Safeguarding overrides cultural deference. Practical meaning: threats, violence, coercion, neglect of a child's medical needs or exploitation are acted on whatever their cultural framing; the York case shows that fear of Hexerei has, rarely, led to lethal violence [source: https://witf.org/2017/10/29/murder_in_the_mid-state].
Touch. The therapist does not touch as part of this work. If a client describes laying on of hands or other touch by a practitioner, ask whether it was consented to and comfortable; touch must never be sexual [synthesis].
Cultural humility. Practical meaning: examine your own reactions to words like "witchcraft" and "hex", and to Plain-community life, before they shape your questions [synthesis].

4. Intervention inventory

The inventory is the psychotherapist's own culturally responsive work. It contains no powwow procedure. Example language is illustrative unless quoted. [source for CFI structure: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/DSM-5-TR/APA-DSM5TR-CulturalFormulationInterview.pdf; tradition context: https://www.psupress.org/books/titles/978-0-271-03213-9.html]

4.1 Cultural self-examination before and during the work

Purpose / when: Before seeing clients from Pennsylvania Dutch, Amish, Mennonite or revival backgrounds, and whenever you notice a strong reaction to talk of hexing or charms [synthesis].
Steps: (1) Note your own first associations with "powwow", "hex" and "witchcraft", including popular media images of the York case. (2) Note assumptions about Plain communities (education, gender roles, health care). (3) Write down what you actually know from sources versus what you assume. (4) Take recurring reactions to supervision. (5) Recheck after any session where you felt amused, alarmed or dismissive.
Example language (illustrative, to self or supervisor): "I noticed I wanted to reassure her that hexes aren't real. Whose need was that?"
Watch for: Smirking, over-curiosity about secret practices, or rushing to diagnosis. Working: you can describe the client's view in terms they would accept.

4.2 Opening the conversation about powwowing and other help

Purpose / when: At intake and when a client mentions being "powwowed", a family powwow doctor, being "hexed", or a charm book in the house. Many clients and families are wary of discussing the practice [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html].
Steps: (1) Ask about all sources of help in one list (doctor, pastor, family remedies, powwowers) so powwowing is not singled out. (2) Use the client's word (powwow, Brauche, Braucherei). (3) Ask what it meant to them, not what was said. (4) Say you will not ask for private words or details. (5) Record the client's account in their terms.
Example language (illustrative): "Some families I see go to a doctor, a pastor and sometimes a powwow doctor. Has anyone besides doctors helped you with this?" / "You don't need to tell me any of the words; I'm interested in what it meant to you."
Watch for: Hesitation, testing whether you will mock; a sudden shift to "it's just an old custom" may mean the client fears judgement. Working: the client volunteers more over time.

4.3 Core Cultural Formulation Interview (DSM-5-TR)

Purpose / when: First evaluation, or later if cultural factors appear to shape the problem. The CFI's 16 questions clarify the problem from the perspective of the person and their network, its meaning, possible help and what they expect from services [source: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/DSM-5-TR/APA-DSM5TR-CulturalFormulationInterview.pdf].
Steps: Work through the four APA domains in your own words: (1) Cultural definition of the problem (Q1-3). (2) Cultural perceptions of cause, context and support (Q4-10), including the role of cultural identity; here ask about Hexerei, God's will, church and family views. (3) Cultural factors affecting self-coping and past help seeking (Q11-13), including powwowing and barriers to care. (4) Cultural factors affecting current help seeking (Q14-16), including preferences and the clinician relationship (e.g. language, perceived disrespect). Use the official form; APA permits clinicians to reproduce it for use with their patients, but modification or translation needs APA permission [source: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/DSM-5-TR/APA-DSM5TR-CulturalFormulationInterview.pdf].
Example language (illustrative): "People explain problems like this in different ways. How would you, or your family, explain it?" / "Is there anything about our backgrounds that might make it hard for us to understand each other?"
Watch for: Short answers when clinician-client difference is large; return to domain 4. Working: you can state the problem in the client's terms and their hopes for treatment.

4.4 CFI supplementary modules and Informant Version

Purpose / when: To go deeper on topics the core CFI raises. APA lists 12 modules, usable as add-ons or alone, at first evaluation, later or repeatedly [source: https://psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM5_Cultural-Formulation-Interview-Supplementary-Modules.pdf].
Steps: Choose by issue: Spirituality, Religion and Moral Traditions (church stance on powwowing, conflict between faith and practice); Explanatory Model (hexing, God's will); Coping and Help-Seeking (powwowers, home remedies); Cultural Identity (Old Order, Mennonite, secular Pennsylvania Dutch, revivalist, Heathen); Social Network (who decides on care); Older Adults or School-Age Children and Adolescents as relevant. Use the Informant Version (17 questions) with a family member when the client agrees [source: https://psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM5_Cultural-Formulation-Interview-Informant.pdf].
Example language (illustrative): "Your church and your grandmother seem to see powwowing differently. How do you hold both?"
Watch for: Loyalty conflicts between church teaching and family practice (Kriebel reports clergy disapproval) [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html]. Working: the client can name where they stand without feeling forced to choose in session.

4.5 Explanatory-model questions (Kleinman)

Purpose / when: When the client has a clear explanation (being hexed, God's will, a physical cause) that shapes help-seeking. From Kleinman, Eisenberg and Good (1978) [source: https://www.cambridge.org/core/product/F99D9D36838A8207D377730DEB445F7B/core-reader].
Steps: In your own words ask: what they call the problem; what caused it; why it started when it did; what it does and how it works; how severe and how long; what treatment they think they should get; the main problems it has caused; what they fear most [source: https://tanenbaum.org/wp-content/uploads/2021/06/HANDOUT-Explanatory-Models-of-Illness.pdf]. Then summarise back and note where it overlaps with and differs from your clinical model.
Example language (illustrative): "If you're right that someone has put something on you, what would need to happen for it to lift?" / "What worries you most about it?"
Watch for: Explanations that blame a specific named person (escalation risk; see 4.14). Working: a negotiated plan that makes sense in both models.

4.6 Cultural concepts of distress: hexing as an explanation

Purpose / when: When a client attributes symptoms or misfortune to Hexerei. DSM-5-TR cultural concepts of distress include idioms, explanations or perceived causes, and syndromes [source: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/DSM-5-TR/APA-DSM5TR-SectionIII.pdf]. No Pennsylvania Dutch-specific entry appears among the DSM-5-TR examples [source: https://www.unmc.edu/bhecn/_documents/dsm5tr_bw_6_slides_11_pages.pdf] [uncertain: list from a secondary source].
Steps: (1) Treat "being hexed" as a cultural explanation (perceived cause) first, not a symptom. (2) Ask how common the belief is in their family or community and how others would respond. (3) Record the idiom in the cultural formulation. (4) Assess the underlying distress (anxiety, depression, trauma, psychosis) separately.
Example language (illustrative): "When you say you've been hexed, what does that feel like day to day?" / "Would your parents or neighbours see it the same way?"
Watch for: Using the idiom to close down assessment. Working: you can describe both the cultural meaning and the clinical picture.

4.7 Differentiating culturally held belief from disorder

Purpose / when: When hexing fears, protective rituals or religious experiences raise a question of psychosis, OCD or another disorder. DSM-5-TR treats possession-form identity disruption and dissociative trance as disorders only when not part of broadly accepted cultural or religious practice [source: https://umsystem.pressbooks.pub/aswbprep/?p=1299] [uncertain: exact DSM-5-TR wording].
Steps: (1) Is the belief shared by the client's group and held in the usual way? (2) Is it fixed beyond what the group holds, elaborated idiosyncratically, or spreading to new persecutors? (3) Are there other psychotic features, mood change or decline in functioning? (4) Do protective practices become compulsive, time-consuming or distressing beyond community norms? (5) Get informant or cultural-broker input (4.8). (6) Revisit over time.
Example language (illustrative): "Lots of people in your family believe in hexing. Is what you're going through like what they'd expect, or different?"
Watch for: Both errors: calling a common belief a delusion, and missing psychosis because "it's cultural". The culturally sanctioned-belief note for psychosis in DSM-5-TR is [uncertain: not verified]. Working: family members recognise your description as fair.

4.8 Consulting informants and cultural brokers

Purpose / when: When the picture is unclear or the client's community is unfamiliar to you [synthesis].
Steps: (1) Get the client's consent and agree what may be shared. (2) Ask a family member (Informant Version) or a trusted community member the client nominates. (3) For background on the tradition, use published scholarship and heritage institutions (e.g. the Pennsylvania German Cultural Heritage Center) rather than asking a practitioner to disclose practice [source: https://www.kutztown.edu/about-ku/administrative-offices/pennsylvania-german-cultural-heritage-center/heritage-center-publications.html]. (4) If language is a barrier (Pennsylvania Dutch speakers), arrange an interpreter acceptable to the client, mindful that in small communities interpreters may know the family [synthesis].
Example language (illustrative): "Would it help if I spoke with someone you trust who knows your community? You decide who and what I can share."
Watch for: Brokers who speak for the whole tradition or carry their own church or revival agenda. Working: the informant's account adds context without overriding the client.

4.9 Coordination with a powwower at the client's request

Purpose / when: Only when the client is seeing, or wants to see, a powwower and asks that you be aware of or in contact with them. Powwowing has no regulator, so there is no formal referral pathway; this is coordination, not referral for treatment [synthesis]. Outside evidence on collaboration comes from other traditions: in Nigeria and Ghana, collaborative shared care between traditional and faith healers and primary care workers (COSIMPO; Gureje et al., The Lancet 2020) reduced psychosis symptoms more than control and reduced harmful practices [source: https://pubannotation.org/docs/sourcedb/PubMed/sourceid/32861306]; in a Ghanaian prayer camp, adding psychiatric medication reduced symptoms but did not significantly reduce days in chains (Ofori-Atta et al., Br J Psychiatry 212(1)) [source: https://www.mentalhealthdataprizeafrica.aphrc.org/repository/paper/33405/joining-psychiatric-care-and-faith-healing-in-a-prayer-camp-in-ghana-randomised-trial]. Neither concerns powwowing; transfer is [uncertain].
Steps: (1) Clarify what the client wants from the contact (awareness, a shared message, nothing). (2) Obtain specific written consent: who, what may be shared, for how long. (3) Keep any contact to roles and safety (e.g. that the client is in therapy and seeing a doctor), never to clinical detail beyond consent. (4) Do not ask about words, objects or methods; Kriebel and present-day practitioners describe these as closely held [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei]. (5) Do not endorse powwowing as treatment for the presenting disorder or any physical disease. (6) Record the arrangement and review it.
Example language (illustrative): "I'm glad you have someone who comforts you. I don't do that kind of work, but I'm happy for both to happen alongside each other. Would you like me to be in touch, or keep things separate?"
Watch for: Requests for payment beyond free-will offerings, pressure to stop medical care, or a practitioner claiming to cure a serious illness; Kriebel describes free-will offerings as the norm, and a long-standing practitioner has warned that visibility attracts con artists [source: https://scholarworks.iu.edu/journals/index.php/jfrr/article/view/39646] [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei]. Working: the client experiences the two as compatible and medical care continues.

4.10 Medical safety and medicines

Purpose / when: When a client relies on powwowing or charm-book or home remedies for a physical problem, or is reluctant to see a doctor. Hohman's book includes herbal and animal-product remedies alongside charms [source: https://www.psupress.org/books/titles/978-0-271-02501-8.html]. In one Swartzentruber Amish study, home remedies came first and professional care was a last resort, with barriers including cost, communication and low trust [source: https://ideaexchange.uakron.edu/amishstudies/vol11/iss2/5].
Steps: (1) Ask about current physical symptoms and any delay in medical care. (2) Ask about remedies taken, without advising on them. (3) Encourage the client to tell their physician about remedies; route all questions about medicines and remedies to the prescriber. (4) Never advise starting, stopping or changing a medicine. (5) Where delay threatens health (especially a child's), see 4.14.
Example language (illustrative): "I'm not the person to say whether a remedy is safe with your tablets. Could we write down what you take so you can show Dr ___?"
Watch for: Worsening untreated symptoms; family pressure against medical care. Working: the client keeps both their tradition and medical follow-up.

4.11 Working with Plain-community clients and families

Purpose / when: Amish, Old Order Mennonite and related clients, among whom Kriebel also documented practice [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html].
Steps: (1) Expect health decisions to be made with family; in the Wisconsin study, families decided together and health information came mainly from within the community [source: https://ideaexchange.uakron.edu/amishstudies/vol11/iss2/5]. (2) Ask who should be involved, while protecting the individual's confidentiality. (3) Discuss cost and practical access early. (4) Respect church authority without assuming its stance; ask. (5) Use plain language and offer written summaries if wanted [synthesis].
Example language (illustrative): "Who in your family usually helps decide about care? How would you like them involved?"
Watch for: An adult client who cannot speak freely in front of family; offer individual time. Working: attendance, and the family understanding the plan.

4.12 Integrating experiences of powwowing and Hexerei fear

Purpose / when: When a client has been powwowed, grew up with it, feared being hexed, or found comfort or distress in it [synthesis].
Steps: (1) Invite the experience in the client's own frame (comfort, protection, connection with a grandparent, fear, shame). (2) Separate meaning from mechanism: work with what the experience did for them, without judging whether it "worked". (3) Where the tradition was a source of fear (being hexed, an accusation of hexing), treat the fear with the indicated evidence-based approach, adapted to their frame. (4) Where it connects to heritage and grief, use it in identity and bereavement work. (5) Where church teaching made it a source of guilt, explore this with the Spirituality module.
Example language (illustrative): "When your grandmother powwowed you, what did that tell you about how she cared for you?" / "What would feeling protected look like now?"
Watch for: Therapist steering toward or away from belief. Working: the client speaks of the experience with less shame or fear and more choice.

4.13 Clients who practise, train or join revival and reconstruction groups

Purpose / when: Clients who are Brauchers, apprentices in a guild, or members of newly founded traditions such as Urglaawe, which its authors describe as Germanic Heathenry through Pennsylvania Dutch culture, separate from but related to powwow and Braucherei [source: https://bookloft.com/book/9780738777337]. Present-day practice includes guilds teaching through closed online groups [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei].
Steps: (1) Ask which lineage, guild or group they belong to and how recognition works there. (2) Explore what the role means for identity, community and purpose. (3) Ask about boundaries: workload, others' expectations, secrecy obligations, payment. (4) Keep confidentiality about any closed teachings; you do not need to know them. (5) Assess whether the role supports or strains mental health.
Example language (illustrative): "You don't need to tell me anything you've promised to keep. How is it for you, carrying people's troubles?"
Watch for: Burnout, isolation, conflict with church or family, or a group using pressure or exclusivity. Working: the client holds the role with clear limits.

4.14 Risk assessment and safeguarding

Purpose / when: When fear of Hexerei is directed at a specific person, when there is coercion or exploitation, when touch was non-consensual, or when a child's or dependent adult's medical needs are being neglected. The 1928 York killing shows that belief in being hexed by a named person has, rarely, led to lethal violence [source: https://witf.org/2017/10/29/murder_in_the_mid-state].
Steps: (1) Ask directly about thoughts of harming the person blamed, and about threats received. (2) Follow standard violence and suicide risk assessment; plan safety and, where required, warn or protect under your jurisdiction's law. (3) For children: assess medical neglect and abuse as safeguarding bodies define them, neither assuming tradition hides abuse nor excusing abuse as tradition; report as the law requires. (4) For exploitation (large payments, sexual contact, coercion): support the client, document, and report as appropriate. (5) Inform the client, where safe, what you must do and why.
Example language (illustrative): "When you think about the person you believe did this, have you had thoughts of hurting them or of them hurting you?"
Watch for: Escalating, fixed beliefs about a single persecutor; access to weapons; isolation. Working: the client agrees a safety plan and stays in care.

5. Handling problems

The sources do not address psychotherapy with powwow users; all responses below are [synthesis] unless a source is cited.

Client will not talk about powwowing. Wariness is common and the tradition values secrecy [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html]. Response: say plainly you will not ask for words or methods, and ask only about meaning and effect. Return to it later; do not press.
Client asks you to powwow, bless them or recommend a powwower. Response: "That isn't something I do or can recommend; it belongs to people your community recognises. I can support you while you decide." Do not supply names; if they already have someone, see 4.9.
Client asks whether hexes are real. Response: neither confirm nor dismiss. "Many people in your community believe so. What matters for our work is how this is affecting you and what would help you feel safer."
Stuck in a single explanation (being hexed) and declining therapy tasks. Response: return to the explanatory model (4.5); find goals both models share (sleep, fear, functioning); frame tasks as strengthening the client, not as disproving their belief.
Resistance from family or church. Response: use the Social Network and Spirituality modules; offer a family meeting with consent; keep the client's own goals central. Kriebel reports church disapproval and family support may pull in opposite directions [source: https://www.psupress.org/books/titles/978-0-271-03213-9.html].
Non-adherence to medical treatment because powwowing is preferred. Response: never set the two against each other; explore barriers (cost, trust, communication) [source: https://ideaexchange.uakron.edu/amishstudies/vol11/iss2/5]; involve the prescriber; if serious harm is imminent, follow 4.14.
Rupture after a perceived slight (e.g. the client felt laughed at). Response: name it, apologise specifically, ask what would help; review your cultural self-examination (4.1).
Overwhelm from fear of Hexerei or of a curse. Response: stabilise first (grounding, sleep, safety), then assess for anxiety, trauma or psychosis; ask whether they have spiritual or community supports they want to use.
Possible psychosis presented as hexing. Response: assess as in 4.7 with informant input; arrange psychiatric assessment if indicated; keep the cultural formulation in the referral.
Threats to a person believed to be a hexer. Response: urgent violence risk assessment, safety planning and legal duties (4.14).
Exploitation by someone claiming to be a powwower (high fees, demands to stop medical care, sexual contact). Response: support the client, document, report where appropriate; free-will offerings, not fees, are the norm Kriebel documents [source: https://scholarworks.iu.edu/journals/index.php/jfrr/article/view/39646].
Client training as a Braucher feels burdened or isolated. Response: see 4.13; explore limits and support within their guild or family.
Therapist drawn into curiosity about secret practices. Response: notice it, take it to supervision, and keep inquiry to the client's needs.
Conflict between Christian and Heathen framings in a family or group. Response: treat both as views held; help the client articulate their own position; avoid adjudicating which is authentic [source: https://www.nationalgeographic.com/culture/article/pennsylvania-dutch-folk-magic-braucherei].

Sources

Books cited:

Kriebel, D. W. (2007). Powwowing Among the Pennsylvania Dutch: A Traditional Medical Practice in the Modern World. Penn State University Press with the Pennsylvania German Society.
Donmoyer, P. J. (2018). Powwowing in Pennsylvania: Braucherei & the Ritual of Everyday Life. Pennsylvania German Cultural Heritage Center, Kutztown University.
Hohman, J. G. The Long Lost Friend (first published 1819 or 1820 [uncertain]); current edition Penn State University Press.
Schreiwer, R. L., Jones, M. A., and Stewart, S. L. (2026). Heathen Traditions of the Pennsylvania Dutch: An Urglaawe Primer. Llewellyn.
McGinnis, J. R. (2000). Trials of Hex (as cited by WITF) [uncertain: not verified].
Kleinman, A., Eisenberg, L., and Good, B. (1978). Culture, illness, and care. Annals of Internal Medicine 88:251-258.
Gureje, O., et al. (2020). COSIMPO trial. The Lancet.
Ofori-Atta, A., et al. Joining psychiatric care and faith healing in a prayer camp in Ghana: randomised trial. Br J Psychiatry 212(1) [uncertain: year 2018 or 2019].

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