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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.
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