Transformative and restorative processes: revisiting the question of efficacy of indigenous healing.

Studies of the efficacy of 'traditional' Indigenous healing often fail to consider the epistemologies that underlay specific healing traditions, especially intrinsic notions of efficacy. In this article, I critically engage the concept of efficacy by identifying two somewhat different approaches to the issue of outcome. In 'transformative' healing processes, healing is conceptualized as a journey in which the outcome goal is a transformed individual. Efficacy, then, is about incremental changes toward this goal. In 'restorative' healing processes, the goal is termination of the sickness and the restoration of health; efficacy is conceptualized as a return to a presickness state. These healing processes are illustrated with examples from the Q'eqchi Maya of Belize and Aboriginal peoples of Canada.