Academic journal article American Journal of Psychotherapy

Treating Haitian Patients: Key Cultural Aspects

Academic journal article American Journal of Psychotherapy

Treating Haitian Patients: Key Cultural Aspects

Article excerpt

The Haitian community in the United States is growing steadily. They make up a significant portion of many cities. As a group, Haitian immigrants are a challenge to mental health professionals. Their view and concepts of the world are unique. Non-Haitian clinicians need to be knowledgeable of the culture in order to provide competent care. The goal of this article is to help clinicians understand aspects of Haitian culture that will facilitate mental health treatment. A historical perspective is offered since the history of Haiti has shaped society, families and therefore individuals. The role of the supernatural is addressed to provide a better understanding of the Haitian psyche. The political and economic climate in Haiti has led to a significant increase in the number of Haitians migrating to the United States. Haitians are faced with the challenge of adapting to a new culture, they experience stress and become vulnerable to mental illness. As a result, there is increasing demand for mental health services. This article highlights aspects of Haitian culture relevant to mental health clinicians. It provides an overview of Haitians' attitudes toward mental health and the utilization of psychotherapy. Concepts relevant to Voodoo beliefs and practices are discussed since these beliefs can shape attitudes, and compliance with treatment. Recommendations for engaging and maintaining Haitian clients in psychotherapy are made. Case vignettes are provided for illustration.

This paper provides information, which will help clinicians work successfully with the growing Haitian population in the United States. The impact of religion and Voodoo, history and migration is examined in relation to Haitians' perception of mental health.

In order to work with Haitians, one needs to understand the influence of religion and history on the Haitian psyche and how their belief in Voodoo made this history possible. It also helps to be aware of some essential characteristics of the psychological make-up of the Haitian people. Haitians usually are a complex mixture of courage, optimism, pride, and shame. They have a deep faith that the future will be better, and this conviction compels Haitians to risk their lives and their children's lives by taking rickety boats to come to the United States to educate their children. For the Haitian, education equals success. The belief in Voodoo also contributes to the sense of optimism because it provides many Haitians with a sense of control over their destiny.


The majority of Haitians are Catholic, but there are also a number of Protestant religions practiced. Haitian society is stratified with a small upper and a somewhat larger middle class. The lower class, which comprises about 85% of the population, is more likely to acknowledge belief and practice of Voodoo, but in times of stress, members of other classes may also turn to Voodoo for help. Many people maintain their Christian beliefs while practicing Voodoo.


The Haitians' concept of the real world contains not only what is visible but also the invisible or spiritual world. The invisible world is made up of good and evil spirits, the spirits of the deceased and many deities. Voodoo ceremonies are devoted to the worship and invocation of the invisible world (1). This belief in the supernatural promotes a sense of superstition and mistrust of others. At any time one's enemy may attempt to use the supernatural to cause harm.

Voodoo is a religion of African origins with some contribution from the Native Indians who populated the Island prior to the arrival of the Hispanic population. The Gods of Voodoo, called Loas, are mostly the spirits of African ancestors. Once Christianity was introduced by the Spaniards to the native Indians and to the African slaves, it was incorporated into the Voodoo belief system; therefore the Loas, represent the spirits of African ancestors, deceased family members as well as Biblical figures. …

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