This hypotheses article presents understandings and practices of tohu (signs) in the personal, eco-environmental, and spiritual wellbeing of Māori. Tohu can be observed in the natural, social, physical, or spiritual environment, and within a Māori worldview provide important ways of understanding and responding to phenomena. Wānanga (shared dialogue and debate) were held with seven Māori clinical psychologists from He Paiaka Tōtara (Māori Psychologist Network) and two mātauranga Māori specialists to explore their experiences, knowledge, and perspectives about tohu, with their insights collected through online information sharing. Our wānanga goals were to inform the creation of a therapeutic framework to address patu ngākau, psychological and spiritual trauma experienced by Māori. The results identified that tohu are located within the person and their environment, and the importance of exploring how tohu are interpreted. We propose a TOHU acronym as a framework for understanding and addressing the multifaceted impacts of patu ngākau.