Icon painting as prayer

1. Introduction

Version followed: the Byzantine-Russian iconographic tradition of the Orthodox Church, as described by Orthodox church sources (Seventh Ecumenical Council teaching as presented by an Antiochian Orthodox page; a Greek Orthodox parish leaflet in the Archdiocese of Thyateira; the Russian Orthodox Book of Needs; a 1990 dialogue with Archimandrite Zinon of the Pskov-Caves Monastery) and by the Prosopon School of Iconology, which was organised with the blessing of hierarchs of the Orthodox Church in America. The clinician material in sections 2 to 5 is a role guide for therapists. It is not a therapy protocol. [source: Antiochian Patriarchate page; Fr Nikitas leaflet; azbyka.ru Trebnik; roca.org; St Mary's OCA Prosopon brochure 2024]

What it is. Icon painting (Orthodox usage often says icon writing) is a sacred art of the Orthodox Church, and also of the Eastern Catholic Churches that share the Byzantine tradition. It is not a psychotherapy, an art-therapy technique or a contemplative exercise that anyone may borrow. Orthodox sources describe the icon as "theology in color" and say that an icon "does not depict; it reveals" (Archimandrite Zinon). One iconographer told a reporter, "It is not 'painting,' it's theology" (Theodoros Papadopoulos). Students who are Byzantine Catholic and Roman Catholic described the work as prayer. [source: roca.org; Religion News Service 2016]

Who holds authority. Religious authority belongs to the Church: its councils, its bishops and clergy, and the iconographers and schools it recognises. Nicaea II (787) upheld the making and veneration of icons. The iconographic canon is described as "conciliar", formed over centuries, with deviations corrected through Church councils. Blessing of icons is a priestly act; the Russian Book of Needs contains a rite performed by a priest, and practice varies between Orthodox jurisdictions. A Greek Orthodox priest-iconographer said that non-Orthodox people may learn iconography for their own spiritual practice, but that iconographers should be "Orthodox church members designated by the church". [source: Antiochian Patriarchate page; roca.org; azbyka.ru Trebnik; Fr Nikitas leaflet; RNS 2016 quoting Rev. Aristidis Garinis]

How change happens (attributed, not clinical). In Orthodox teaching, the icon serves communion with the person it depicts and with God. Veneration given to the icon "passes" to that person, the prototype. The iconographer's work is presented as spiritual growth "within the guidelines of the Orthodox Church teaching" (Prosopon School). This is the Church's theology, stated here as the Church's own account. It is not a mechanism of psychological change, and this guide makes no therapeutic claim for it. One Orthodox theology faculty author (Kochan, University of Prešov) describes iconography courses used in prisons, hospitals and work with homeless people, presenting them within a Church framework. [source: Antiochian Patriarchate page; Fr Nikitas leaflet; Prosopon brochure 2024; Kochan, Acta Patristica] [uncertain: Kochan's publication year and the full text were only partly legible]

What a therapist actually does. A therapist does not teach, perform, bless or imitate icon-making. The therapist's tasks are to: (1) respect the practice and its authorities; (2) support a religious client who practises it; (3) refer to clergy, a chaplain or a recognised school; (4) coordinate spiritual care; and (5) give materials-safety advice. Any secular art exercise inspired by it must be labelled clearly as an adaptation and must not be called an icon. [synthesis]

Professional frame. There is no regulated profession or clinical credential for iconography. Training happens in Church-blessed schools and workshops and through apprenticeship to iconographers. One example is the Prosopon School: in its brochure, it describes week-long workshops open to people of any faith, run by Vladislav Andrejev's school with Deacon Nikita Andrejev as master iconographer. Therapists who use art-making must hold their own arts-therapy registration, for example HCPC registration with BAAT membership in the UK, or ATCB credentials with AATA in the US. That registration does not make anyone competent to teach iconography or speak for the Church. [source: Prosopon brochure 2024; roca.org (Zinon: "there isn't a proper school for iconographers" in 1990 Russia)] [synthesis: the arts-therapy registration note]

2. Framework

Icon painting has no clinical phase model, and none should be invented. The two structures below are the Church tradition's own published sequence, described only at the level schools publish for the public, and a clinician's role pathway.

A. The tradition's own structure (for orientation only; not to be delivered by the therapist).

Format published by a recognised school: the Prosopon workshop at St Mary's Orthodox Cathedral, Minneapolis, runs for seven days (one evening, five full days, one half day). It combines lectures on theology, theory and technique, demonstrations of egg tempera and gold-leaf application, working time and individual instruction. Beginners paint a set image (the Theotokos of Tenderness), and advanced students paint another set image. The school presents its method as steps that are "concrete and definite", like the Church's services. [source: Prosopon brochure 2024]
Craft stages: the making of an icon, its materials, sequence and canonical forms, is taught within Church-blessed schools and by iconographers working under Church authority. It belongs to those teachers and is not set out here. A client who wants to learn should learn from a recognised school (4.3). The materials matter to the clinician only for safety (4.7). [source: TMORA, Techniques of Icon Painting; Prosopon brochure 2024; roca.org]
Spiritual frame: classes reported in the press open with a prayer read together. Blessing of finished icons is a matter for clergy, and practice varies by jurisdiction. Prayer texts and rites are not given here; a client should get them from their own priest or school. [source: RNS 2016; Fr Nikitas leaflet; azbyka.ru Trebnik]

B. Clinician role pathway [synthesis].

Phase	Goal	Typical format	Move on when
1. Recognise and ask	Learn what the practice means to this client, who guides it (priest, spiritual father, teacher) and whether the client wants it in therapy at all	Part of the assessment or of a spiritual history; 10–20 minutes, revisited later	The client has said whether and how they want it included
2. Agree the frame	Set boundaries: the therapist supports, the Church guides; no shared prayer, teaching or painting in session	One conversation, with the agreement written in the plan	The client agrees, and the therapist has checked their own competence and any countertransference
3. Support and coordinate	Treat the practice as a resource; with consent, link with clergy, a chaplain or the school; give materials-safety advice	Woven into ordinary sessions; coordination by letter or call, with consent	Contact with the spiritual-care person is set up, or the client has declined it
4. Optional secular adaptation	Only if the client wants an art activity and the method is clinically indicated; labelled as non-sacred	One or more sessions by an arts therapist working within their registration	The client says it feels respectful and useful; if not, stop
5. Review	Check that the practice is helping and that clinical and religious roles are still separate	At regular plan reviews	Ongoing

Session count: none is published for icon practice in therapy. Fit the work to the client's main treatment plan. [synthesis]

3. Guiding principles

From the Church tradition (attributed).

Veneration, not worship: Orthodox teaching holds that "we do not venerate the matter" but the person depicted, and that worship belongs to God alone. In practice, never describe a client's icon devotion as idol-worship or as magical thinking. [source: Antiochian Patriarchate page]
Honour passes to the prototype: in Orthodox teaching, the icon is a pattern of its prototype. In practice, treat the client's icon as a holy object to them, not as art material or a projective drawing. [source: Antiochian Patriarchate page; Fr Nikitas leaflet]
The icon is written "in spirit": this is the Church's language for the work. In practice, use the client's own word (painting or writing) without correcting it. [source: Antiochian Patriarchate page]
Conciliar canon: imagery must agree with Church teaching. Some subjects, such as certain depictions of the Trinity, were forbidden by Russian councils. In practice, questions about what may be depicted go to the client's clergy or teacher, never to the therapist. [source: roca.org]
Holiness is threefold: one Orthodox leaflet says an icon's holiness lies in what it depicts, in its making, and in its use in liturgy and prayer. In practice, do not treat the making as separable from the faith it serves. [source: Fr Nikitas leaflet]
Blessing is clergy's role, and practice varies: the same leaflet says that blessing is not strictly necessary but that "it is not so simple as that". In practice, a client who worries about blessing or validity should take that question to their priest. [source: Fr Nikitas leaflet; azbyka.ru Trebnik]
Who may paint is a Church matter: sources differ. Prosopon welcomes people of any faith, while some Orthodox voices hold that iconographers should be designated by the Church. In practice, do not settle this for a client; name the difference and refer them. [source: Prosopon brochure 2024; RNS 2016] [uncertain: no single binding rule across all jurisdictions was found]

For the clinician [synthesis].

Authority sits outside the room: the therapist is not a religious teacher. In practice, refer theological, liturgical and canonical questions to clergy.
No performing, copying or leading: in practice, do not paint icons with clients, lead prayer or stage a "blessing".
The client is the expert on their own practice: in practice, ask rather than assume. Practice differs between Orthodox jurisdictions and between Eastern Catholic Churches.
No proselytising and no undermining of faith: the Royal College of Psychiatrists position statement, as quoted in a published letter, says psychiatrists should not use their position "for proselytising or undermining faith". In practice, keep your own beliefs out of the room. [source: Cambridge Core eLetter citing the College position statement] [uncertain: the position statement itself]
Never read the icon diagnostically: icons follow a fixed canon, so their content reflects tradition, not the client's unconscious. In practice, do not interpret faces, colours or mistakes as symptoms.
Label every adaptation: in practice, any secular exercise is called something like "slow layered painting (secular adaptation)", never an icon.
Safety first with materials: in practice, check pigments, solvents, oily rags and food hygiene whenever a client paints at home or in a service. [source: South Texas College; University of Oregon EHS; Peter Murphy]

4. Intervention inventory

None of the sources describes a clinical procedure for icon painting as prayer. Kochan describes Church-framed iconography courses in prisons, hospitals and social settings, but not a therapist-led method. So the items below are clinician-role procedures [synthesis]. They draw on the Church facts in sections 1 to 3. No prayer, rite or liturgical step is given. A client who wants those should get them from their priest, spiritual father or school.

4.1 Spiritual history focused on sacred-arts practice

Purpose / when: at intake, or when a client mentions icons, a parish workshop or prayer through painting. It shows whether the practice is a resource, a stressor, or both. [synthesis]
Steps: (1) Ask an open question about religious or spiritual life and whether the client wants it to be part of therapy. (2) If the client mentions icons, ask about their tradition and Church (Orthodox jurisdiction, or Eastern Catholic Church), who guides the practice (parish priest, spiritual father or mother, teacher or school), and how often and where they paint. (3) Ask what the practice gives them and what, if anything, troubles them about it. (4) Ask how they would like it held in therapy, from "not at all" to "as a resource we talk about". (5) Record the answers in the client's own words, without interpretation.
Example language (illustrative): "Some people's faith is a big part of how they cope. Is that true for you, and would you like it to have a place in our work?" / "You mentioned you paint icons. Who guides you in that, and what does it mean for you?"
Watch for: the client checking whether you will judge or pathologise them. Watch also for signs of guilt or fear about the practice (see 5.4). It is working when the client talks freely and names their own spiritual guides.

4.2 Respectful, client-led inquiry into the practice

Purpose / when: when the client brings the practice into sessions. It honours the practice as the client understands it and keeps the therapist in a learning role. [synthesis]
Steps: (1) Let the client describe the practice in their own terms, for example "writing" or "painting". (2) Reflect what it does for them (calm, discipline, closeness to God, community) without recasting it in therapy jargon. (3) If you need background, read Church-published sources rather than asking the client to teach you at length. (4) Do not ask the client to bring the icon to be "processed". If they choose to show it, receive it as they wish it to be received, and ask how they would like it handled. (5) Keep theological questions out of your remit: "That sounds like one for your priest."
Example language (illustrative): "What happens for you during the hours you spend on the gold and the layers?" / "I'm not the right person to say what is correct in the tradition, but I'm interested in what this time means to you."
Watch for: any slide into interpreting the image. Icons follow a canon, so their content is not projective material. [source: roca.org on the conciliar canon] It is working when the client experiences the practice as respected, not studied.

4.3 Referral to clergy or to a recognised iconography school

Purpose / when: when the client asks about the theology, the canon, blessing, who may paint, or how to start; or when a non-Orthodox client is drawn to icon-making. [synthesis]
Steps: (1) Name the limit of your role. (2) For Orthodox or Eastern Catholic clients, suggest their own parish priest or spiritual father. Blessing of icons is done by clergy, and practice differs between jurisdictions. [source: Fr Nikitas leaflet; azbyka.ru Trebnik] (3) For people wanting to learn, point to schools and workshops run under Church blessing, which publish their own terms. For example, Prosopon workshops are open to people of any faith and need no prior experience. [source: Prosopon brochure 2024] (4) Tell non-Orthodox clients that Orthodox views differ on non-members painting icons, and that the school or parish is the place to ask. [source: RNS 2016] (5) Follow up on how the contact went, if the client wants to.
Example language (illustrative): "Questions about blessing really belong with your priest. Would it help to think together about how you might raise it with him?" / "If you'd like to learn, Church-run workshops are the right place. They can tell you how they see someone outside the Orthodox Church taking part."
Watch for: a referral that feels like a brush-off. Pair it with continued interest in the client's experience. It is working when the client has a named person to ask and feels supported.

4.4 Spiritual-care coordination with chaplains and clergy

Purpose / when: in hospital, hospice, prison or mental-health inpatient settings, or whenever religious questions are part of the distress. One published letter suggests that referral to a suitably qualified mental-health chaplain may help some religious patients with questions they have not felt able to raise elsewhere. [source: Cambridge Core eLetter]
Steps: (1) Get explicit consent for any contact and agree what will be shared. (2) Ask the client whether they want an Orthodox or Eastern Catholic priest specifically, or the setting's chaplaincy team. The chaplaincy can often reach clergy of the client's own tradition. (3) In the referral, give the reason and the client's wishes, for example the wish to keep painting icons on the ward or questions about worthiness. Do not share clinical detail beyond what was agreed. (4) Agree who covers what: clergy and chaplain take spiritual and liturgical matters, the therapist takes psychological ones. (5) For ward or prison iconography groups, the Church-affiliated teacher and the chaplain lead. Clinical staff handle risk, materials safety and care-plan links (see 4.9).
Example language (illustrative): "Would you like me to ask the chaplaincy team to contact an Orthodox priest for you?" / "I'll mention that painting your icon helps you, and that you'd like to keep doing it here. Is that all right?"
Watch for: role blur, for example staff treating a chaplain visit as a clinical intervention or a therapist commenting on doctrine. It is working when the client gets timely spiritual care and the roles stay clear. [synthesis]

4.5 Supporting a religious client's existing practice as a resource

Purpose / when: when the client says icon work steadies them, gives structure, links them to community or helps their prayer, and wants this recognised in treatment. Students in one report named meditative focus, patience, prayer for others and learning a discipline as what they gained. [source: RNS 2016]
Steps: (1) Ask what supports the practice (time, space, parish workshop, teacher) and what gets in its way (symptoms, workload, illness). (2) With the client, plan practical ways to protect it: regular time, a safe workspace, transport to a parish class. Treat this like any valued activity the client chooses. (3) Link it to goals only in the client's terms, for example "I feel steadier on the days I paint". (4) Never set targets for prayer or devotion, and never make the practice a homework task scored by you. (5) Review at plan reviews.
Example language (illustrative): "You said your Tuesday class keeps you anchored. What would help you keep going while things are hard?"
Watch for: the therapist co-opting the practice as a technique. Watch also for the practice turning into avoidance, which the client should judge with their spiritual guide (see 5.5). It is working when the client keeps up the practice in their own way and links it to steadier functioning.

4.6 Separating religious material from symptoms without pathologising

Purpose / when: when religious themes appear alongside possible scrupulosity, perfectionism, depression or psychotic experience, for example intense fear of "spoiling" a holy image. [synthesis]
Steps: (1) Start from the view that devotion and religious language are normal for the client's community. (2) Ask how the client's priest or fellow parishioners would see the concern. This is the cultural norm check. (3) With consent, consult clergy or a chaplain about what is usual in the tradition. (4) Assess the symptom on its own terms (distress, impairment, compulsions, fixed beliefs not shared by the community) using your usual tools. (5) Treat the symptom with standard methods. Leave religious guidance on the practice itself to clergy.
Example language (illustrative): "Would others in your parish see this the same way, or does it feel different for you?"
Watch for: labelling ordinary faith as illness, and the opposite error of missing illness because it is phrased in religious terms. It is working when the client feels their faith is respected and the symptom gets treated.

4.7 Materials-safety guidance (egg tempera, gesso, gilding, oils and solvents)

Purpose / when: whenever a client paints at home, on a ward or in a group, or a service hosts a workshop. Icon materials include toxic pigments, solvents and oils that can cause fires. [source: Peter Murphy; TMORA; South Texas College; University of Oregon EHS]
Steps: (1) Pigments: iconographers note that lead white and vermilion or cinnabar red are "derived from toxic substances". Titanium white is a safer substitute for lead white. [source: Peter Murphy] Studio guidance links lead to anaemia and nerve damage, and to brain damage in children, and some cadmium and chrome pigments to lung cancer; it advises the least toxic pigments possible. [source: South Texas College] (2) Dry pigment dust: dry pigments are "easily inhaled and ingested". Do not blow dust off; tap it down and wet-wipe surfaces. Grinding or mulling powders should follow the teacher's dust controls. [source: South Texas College] [synthesis: the grinding note] (3) No eating, drinking or smoking while painting, and wash hands afterwards. Hand-to-mouth contact is the main way pigments are swallowed, and this matters more because egg tempera is mixed near food items such as eggs and cups. [source: South Texas College] [synthesis: the egg context] (4) Egg hygiene: egg medium is made from separated yolk diluted with water, sometimes with a little alcohol as a preservative. Throw away old medium and wash utensils, and do not reuse food dishes as palettes or food containers for paint. [source: Peter Murphy; South Texas College] [synthesis: discard and hygiene advice] (5) Gesso and glues: traditional grounds use animal glue with chalk over linen, in many layers. Sanding gesso makes fine dust, so ask about dust control and allergies to animal glues. [source: TMORA] [synthesis: the dust and allergy note] (6) Gilding: gold or silver leaf is laid for backgrounds and haloes. Ask the teacher which adhesive, size or bole is used, and follow the product safety data. [source: TMORA; Prosopon brochure 2024] [uncertain: specific gilding chemicals were not described in the sources] (7) Olifa, oils and solvents: rags soaked in linseed oil or solvents can heat up and ignite. Store them in a sealed container or oil-waste can; one 1991 studio fire spread across eight floors. [source: University of Oregon EHS; TMORA on olifa] Prefer low-odour mineral spirits to turpentine, keep containers closed and labelled, ventilate, and wear neoprene gloves for brush cleaning. [source: South Texas College] (8) Pregnancy and nursing: studio guidance advises avoiding solvent exposure. [source: South Texas College] (9) Historic fire methods: restorers once softened old olifa with alcohol set alight. This is a historic restoration practice and must not be tried. [source: TMORA] [synthesis: the warning]
Example language (illustrative): "Can I check how you're storing the oily rags after varnishing? They're a known fire risk."
Watch for: clients with self-harm risk or cognitive impairment, who may need supervised storage of solvents and toxic pigments (see 5.8). It is working when the client can name the safe-storage and hygiene steps they use.

4.8 Secular adaptation: "slow layered painting" (clearly labelled adaptation, not icon painting)

Purpose / when: only when a client wants a slow, layered painting activity, the method is indicated, and an arts therapist works within their own registration. It borrows only general craft features (a prepared surface, a line drawing, thin layers built from dark toward light) and nothing sacred. [synthesis; craft features from Peter Murphy and TMORA]
Steps: (1) Say plainly that this is a secular art exercise inspired by a craft method. It is not an icon, not prayer and not part of the Church's practice. (2) Ask any Orthodox or Eastern Catholic client whether even this feels inappropriate. Offer something else if it does, and suggest they ask their priest if unsure. (3) Choose a non-sacred subject, such as a stone, leaf or object from daily life. Do not use holy figures, haloes, gold-leaf backgrounds, inscriptions or icon compositions. (4) Use non-toxic water-based paints instead of traditional pigments and solvents. (5) Work in short periods, with breaks and a closing check on how the client is feeling. (6) Keep and treat the artwork like any other therapy artwork, and do not interpret it as diagnostic.
Example language (illustrative): "This is just a painting exercise using thin layers. It isn't an icon and it isn't religious. Does it feel okay to you to try?"
Watch for: drift toward imitation, for example a client adding a halo or wanting it blessed. In that case, pause and refer the religious question to clergy (4.3). It is working when the client finds the pace calming and still sees the exercise as separate from sacred practice.

4.9 Working alongside a Church-run iconography group in a hospital, prison or community setting

Purpose / when: Kochan describes iconography courses in prisons, hospitals, academic settings and work with homeless people, and reports that participants may feel anxiety, nervousness or fear before calm comes. [source: Kochan, Acta Patristica] [uncertain: details of Kochan's procedures were only partly legible]
Steps: (1) The Church-affiliated iconographer leads, under their own Church authority. The clinician does not co-teach. [synthesis] (2) The clinician advises on who can join safely: current risk, cognitive state, and access to sharp tools, solvents and toxic pigments. (3) Agree a plan for distress during sessions, including who is called and where the person can go. (4) Arrange safe storage and supervised handling of materials (see 4.7). (5) Respect participants' choice to attend or not; there must be no pressure linked to privileges or care plans. (6) Ask permission before any clinical note refers to the group, and document attendance as a chosen activity.
Example language (illustrative): "The course is run by the iconographer from the parish. I'm here for anyone who finds it stirs things up."
Watch for: coercion in closed settings, and participants feeling expected to adopt the faith. It is working when attendance is voluntary and distress is managed calmly.

4.10 Children and young people

Purpose / when: when a child or adolescent takes part in parish or school iconography, or a family brings the practice into therapy. [synthesis]
Steps: (1) Get the young person's assent and the consent of a parent or carer, and respect the family's faith and Church. (2) Make sure only child-safe materials are used, with no lead, cadmium or similar pigments and no solvents, because lead harms children in particular. [source: South Texas College] (3) Keep usual safeguarding and mandatory-reporting duties for any disclosure, in parish settings too, and know the parish or diocesan safeguarding contact. (4) Never read a child's icon or drawing as evidence of abuse or disorder.
Example language (illustrative): "It's your choice whether we talk about your icon class. Your mum and dad know we might."
Watch for: a child who feels pressure to perform devotion, and any safeguarding concern. It is working when the young person takes part freely and safely.

5. Handling problems

The Church and school sources do not address therapy problems. Except where cited, everything below is [synthesis].

5.1 The client asks you to paint, pray or bless with them. Decline warmly and explain why: it belongs to their Church, and you are not the right person. Offer to help them reach their priest or teacher (4.3). (Illustrative: "I'd be stepping into something that isn't mine to lead. Your priest is the right person for that.")
5.2 You are not Orthodox, or you hold strong views of your own. Take this to supervision. Stay curious and keep your beliefs out of the room. The RCPsych position statement, as quoted in a published letter, says clinicians should not use their position "for proselytising or undermining faith". [source: Cambridge Core eLetter] If you can't work neutrally, refer the client on.
5.3 Rupture over a perceived slight, for example calling the icon "art" or "a picture", or suggesting it be interpreted. Name it, apologise, ask how the client would like it referred to, and use their words from then on. Repair is working when the client brings the subject up again on their own.
5.4 Worthiness, fear of "spoiling" a holy image, or anxiety about blessing. Separate the theological question, which goes to clergy (blessing practice differs, and one Orthodox leaflet calls the question "not so simple"), from the emotional pattern, which goes to therapy. [source: Fr Nikitas leaflet] Explore perfectionism or scrupulosity with standard methods. With consent, coordinate with the client's priest so the messages agree (4.4, 4.6).
5.5 The practice becomes avoidance or overload, for example hours of painting in place of other needs, or exhaustion. Raise it gently in functional terms (sleep, work, relationships), not spiritual ones, and suggest the client talk over the right rhythm with their spiritual guide. Do not prescribe less devotion.
5.6 Overwhelm during or after painting. Kochan reports anxiety, nervousness or fear during iconography courses before calm comes. [source: Kochan] Agree grounding steps the client already uses, a contact person at the class, and a check-in at the next session. If faith-related distress is intense, involve a chaplain or the client's priest with consent.
5.7 Conflict with the Church community, for example over whether a non-Orthodox person may paint icons, or a dispute with a teacher. Sources record real differences of view on this. [source: RNS 2016; Prosopon brochure 2024] Don't take sides on doctrine. Help the client think through their options and voice their concerns, and point them to the right Church authority.
5.8 Risk: self-harm, suicidality or cognitive impairment with access to materials. Include toxic pigments, solvents, scalpels or needle tools for incising, and oily rags in the safety plan. Agree supervised storage or safer substitutes, framed as lethal-means safety (storage and removal only). Follow your service's standard risk-assessment procedure. [source: South Texas College; University of Oregon EHS for the material hazards]
5.9 A non-religious client wants "icon therapy". Explain that icon painting is a sacred practice of the Orthodox and Eastern Catholic Churches, not a therapy. Offer a labelled secular adaptation (4.8) or point them to an open Church-blessed workshop, whose own terms apply (4.3). Do not present a borrowed version as the real practice.
5.10 Religious content that may be part of illness. Use the community norm check and clergy or chaplain consultation (4.6). Do not assume that devotion is pathology, and do not miss real symptoms.
5.11 Non-adherence to safety advice. Go back to the concrete risks: rag fires, lead, and children in the home. Agree one change at a time, such as a sealed rag can or swapping out lead white. [source: University of Oregon EHS; Peter Murphy; South Texas College]
5.12 Damage to, or loss of, a client's icon. Treat this as a possible spiritual loss as well as a material one. Ask what it means to them, and suggest they ask their priest how the tradition regards it. Do not offer religious reassurance yourself.

Sources

Sources:

Further reading (not drawn on): Royal College of Psychiatrists position statement on spirituality and religion (Cook) [uncertain: known only through the eLetter]; full Stoglav Council (1551) text on icon painters [uncertain: only the Rublev excerpt is drawn on].

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