Shifting the Overton Window: enhancing therapeutic outcomes for Māori experiencing Ngā Māuiui kai (eating disorders) through the integration of traditional Māori and Western healing systems in Aotearoa New Zealand.

Ngā māuiui kai (eating disorders) are understood within a Māori worldview as a manifestation of imbalance across hinengaro (mind), tinana (body), wairua (spirit) and whānau (family or support system). Prevailing Western treatment, which prioritise biopsychosocial interventions, do not address the cultural and spiritual determinants of health for Māori, creating a gap in culturally responsive care for Māori. This gap is rooted in and sustained by the enduring impacts of colonisation, which marginalised mātauranga Māori (Māori knowledge) and disrupted traditional healing systems. This paper proposes that Specialist Supportive Clinical Management, a flexible, patient-centred psychotherapy, provides a unique point of alignment for the integration of Rongoā Māori, the traditional Māori healing system. Rongoā Māori encompasses modalities such as rongoā rākau (herbal remedies), mirimiri/romiromi (physical therapies), puku kōrero (talk therapy), and karakia (incantations/prayer) and offers a framework embedded within Māori knowledge systems. We argue that rongoā-informed Specialist Supportive Clinical Management, where puku kōrero aligns with Specialist Supportive Clinical Management patient-led dialogue, can synergistically support biopsychosocial goals while ensuring a holistic, culturally grounded approach. This conceptual analysis proposes a culturally adapted intervention to enhance therapeutic engagement, improve health outcomes, and honour the treatment aspirations of Māori by addressing the whole person within their cultural context.