Using Creative Arts to Train Haitian Spiritual Leaders on Therapy for “Crooked” Thoughts

By Michael-Jane Levitan, Special Advisor, Office of Transformative Global Health

Kwochi, the Creole word for “crooked,” can be used to describe problematic thinking; an underlying principle of cognitive behavioural therapy (CBT). This expression was heard many times during a recent research-based CBT training in Haiti and perfectly captures how this therapy can help to “straighten” unhealthy thought patterns.

From August 31 to September 4, CBT expert Dr. Christine Courbasson and ethnopsychiatrist Dr. Frantz Raphael paired up to engage about 50 Vodou, Evangelical and Catholic leaders around CBT for depression in a culturally sensitive way.

Each day, we convened at Le parc historique de la Canne à Sucre, an old sugarcane factory-turned-museum outside of Port-au-Prince. After participants finished their coffee, watermelon juice and an assortment of pastries, they made their way around wandering peacocks into the air-conditioned meeting space for a day of deliberations. The energy in the room was dynamic; fueled by enthusiasm and curiosity.

The facilitators used a wide range of interactive teaching tools with an emphasis on culture-infused activities. These were embedded throughout to keep the training grounded in local realities.

Dance
Popular Haitian dance music was used as a way to demonstrate the pervasiveness of cognitive distortions. After each participant was up and moving, they were encouraged to reflect on negative thoughts that may have creeped into the process – Will I be able to dance? Will people make fun of me?

Drawing
To exemplify the importance of client work between sessions, participants were given homework of their own. Tasked with creating an image that represents the marriage between Haitian culture and the therapy, here’s a collage of their artistic representations:

Drama
After a couple days of learning and interactive dialogue, each distinct spiritual group insisted on expressing their culture and practice through drama. Vodou members used dance and song to convey the experience of a woman moving from sadness to joy with the help of community.

On the final day, the 3 groups came together to tell a powerful story of a mother going through a difficult time with her son on her search for help. We followed her help-seeking journey first to a Catholic priest, then to a pastor, and a mambo until she finally stumbled onto a friend of a friend trained in CBT. After being assured that it will be able to help her manage this problem, she gives it a shot. Through this therapy, she uncovers the root of her problem and is hopeful of recovery.

Through a truly thought provoking week, it was very clear that story telling is a powerful tool to exchange perspectives in a way that is meaningful and at times funny. We’re excited to explore new and interesting avenues to embed stories in this and other capacity building efforts.

The training marks a major milestone in this innovative project funded by Grand Challenges Canada. Participants forged new bonds around a public health issue that has no geographic-spiritual-cultural boundaries. It was heartwarming to see these distinct belief systems representing a range of complicated sociopolitical dynamics, reflect deeply in a respectful and proactive way on tackling mental health problems in their communities.

For over a year, the Office of Transformative Global Health and the Commission Nationale de Lutte contre la Drogue (CONALD) have been carefully building networks of spiritual leaders and gathering information needed to culturally adapt this intervention for French- and Creole-speaking Haitians. You can read more on this process in previous blog posts reporting on the phases of this project:

• Part 1: Laying the groundwork through relationship building
• Part 2: Information sharing and cultural adaptation process

In reflection of this collaborative process, we would like to make special note of a key project advisor from the very beginning, the honorable Vodou leader Ati Max Beavouir, who sadly passed away at age 79 on Saturday, September 12.

The Ati’s openness and wisdom was invaluable to our understanding of Vodou culture and his support was instrumental for our progress. We feel incredibly blessed to have had the privilege of exchanging ideas over strong Haitian coffee during our many meetings with him surrounded by lush gardens and his beloved dogs. His passing is a great loss to the world.

Feel free to contact michaeljane.levitan@camh.ca for more information and follow us on Twitter for more updates @akwatukhenti