Juice fasting and the Master Cleanse

1. Introduction

Version followed: the Master Cleanse ("lemonade diet") as attributed to Stanley Burroughs's The Master Cleanser (1976) and as summarised by secondary sources, plus commercial juice-only "cleanses" and juice fasts as the US National Center for Complementary and Integrative Health (NCCIH) describes them. Sections 1 to 3 describe the method as its proponents and regulators present it; section 4 is the psychotherapist's own work with a client who is using, planning or recovering from a juice fast. The psychotherapist never prescribes, supervises, sells or recommends a fast or cleanse.

What it is. Juice fasting replaces ordinary meals with juices or similar drinks; it sits within a wider family of "detox" and "cleanse" programmes that also include eating only certain foods, supplements, herbs, colon cleansing and saunas, sold commercially, offered at health centres or used within naturopathic treatment [source: NCCIH]. The Master Cleanse is a modified juice fast that excludes all food: a lemon-based drink and a herbal tea are taken in place of meals, with an oral "flush" and laxative tea used to produce urgent bowel movements [source: Wikipedia, Master Cleanse] [uncertain: secondary, unverified]. Burroughs reportedly marketed it from the 1940s and revived it in his 1976 book [uncertain: secondary, unverified]; later popular books, for example Peter Glickman's self-published guide (3rd ed., 2011), present it as a way to "take charge of your health" [source: library catalogue record].

Core idea of change, as proponents hold it. Proponents say that removing food and taking only the drink lets the body eliminate accumulated "toxins", "tones, reduces and cleanses" itself and so heals itself; Burroughs also linked his diet to colour-light therapy and reflexology in a wider healing system presented in spiritual terms (Healing for the Age of Enlightenment, 1976) [source: Wikipedia, Stanley Burroughs] [uncertain: secondary, unverified]. These are the method's own claims, described here as attributed beliefs.

Who practises it. Mostly self-administered from books, websites, social media and celebrity endorsement (media attention rose after a 2006 television appearance by a well-known singer) [uncertain: secondary, unverified]; also sold as packaged juice-cleanse programmes by juice retailers, and offered at some health centres and by naturopaths [source: NCCIH; ASA ruling on Juice Garden Ltd].

Regulation and licensing. No licence is required to sell juices or books or to run a juice-cleanse business in the US or UK. In the US, the FDA and FTC have acted against detox and cleansing products for hidden ingredients, false claims to treat serious disease, and colon-cleansing devices marketed for unapproved uses [source: NCCIH]. In the UK, the ASA and CAP state that the liver and kidneys do the body's detoxification and that they have seen no evidence that other methods remove toxins; general "detox" claims for food are health claims, specific claims (such as cleansing the colon) are allowed only if authorised on the GB nutrition and health claims register, and disease claims for food are prohibited [source: ASA/CAP AdviceOnline; ASA ruling Juice Garden Ltd, 2017]. Other jurisdictions (Australia, Canada, EU states) [uncertain: not verified].

Regulatory status (one line): sold as ordinary food, drink and books; health and disease claims are restricted by advertising and food-claims regulators, not by licensing of the practice.
Evidence status (one line): a small number of low-quality human studies; no compelling evidence that detox diets remove toxins or produce lasting weight loss, and no studies of long-term effects [source: NCCIH].

Burroughs's own history (relevant to clients who hear of the method as a disease cure). Secondary sources report that Burroughs claimed to cure cancer and other diseases, was convicted of practising medicine without a licence (1960), and after a cancer patient died following his colour-light, lemonade and abdominal-massage treatment was convicted in California of felony murder and related offences; the California Supreme Court (People v. Burroughs, 1984) reversed the murder conviction but upheld the unlicensed-practice and illegal-cancer-treatment convictions [source: Wikipedia, Stanley Burroughs] [uncertain: secondary, unverified; court opinion not verified]. No method in this entry treats cancer or any other physical disease.

2. Framework

The method's own structure (as described). The Master Cleanse is described as a period of drink-only intake with an oral flush and laxative tea, followed by a return to food; juice-cleanse retailers sell programmes of juices to replace meals [source: Wikipedia, Master Cleanse; ASA ruling Juice Garden Ltd] [uncertain: secondary, unverified]. Lengths, quantities, schedules and contents are deliberately not given here.

The psychotherapist's framework alongside it [synthesis, built on NCCIH, NICE NG69 and Beat]. There is no manualised protocol; the work is integrated into ongoing therapy and revisited as needed.

Identify. Goal: know whether the client is fasting, cleansing or planning to, and record it. Move on once use, plans and source of the regimen are known.
Understand. Goal: meaning, hopes, expectations, explanatory model (toxins, purity, control, reset, weight, spirituality, community). Move on when you can summarise the client's reasons in words they accept.
Screen for risk. Goal: eating-disorder indicators, medical red flags, medicines, diabetes, kidney disease, pregnancy, age, unmet medical care. Move on when risk is rated; if red flags are present, go straight to step 5.
Decide. Goal: an informed, values-based decision owned by the client, without coercion. Move on when the client has stated a plan.
Coordinate. Goal: with consent, the client's doctor, diabetes team, pharmacist or eating-disorder service is involved. Urgent medical red flags override sequence.
Follow up. Goal: review effects, rebound eating, shame, mood, and whether the pattern repeats; return to step 3 if restriction escalates.

3. Guiding principles

Curious, not judgemental [synthesis]: ask the way you ask about alcohol or sleep, so the client keeps telling you.
Scope [synthesis]: you neither recommend nor forbid the fast; nutrition and medical safety belong to the doctor, dietitian and pharmacist.
Attribute claims [source: NCCIH; ASA/CAP]: describe "toxin" and "cleansing" ideas as the client's or proponents' beliefs; give the evidence status in one line if asked, without debate.
Eating disorders are serious and hide inside "health" language [source: Beat; NICE NG69 1.2.6]: restrictive dieting that worries the person or others, compensatory laxative use and "pure eating" rules are assessment triggers.
Do not rely on a single screening tool or single number [source: NICE NG69 1.2.5, 1.2.8]: no screener or BMI alone decides whether an eating disorder is present.
Physical risk first [source: NICE NG69 1.2.9; NHS Highland refeeding guideline]: compromised physical health means emergency or same-day medical care, not more exploration.
Never advise on medicines [synthesis]: any question about insulin, diuretics or other medicines during a fast goes to the prescriber or pharmacist.
No disease-treatment framing [synthesis]: if a fast is used instead of medical care, the conversation is about safety and informed choice, never about whether the fast "works".
Autonomy with safeguarding limits [synthesis]: adults may choose; children, people lacking capacity and people at acute medical risk trigger duties.
No conflicts of interest [synthesis]: never sell, refer to or profit from cleanse products, retreats or courses.
Document [synthesis]: record what was discussed, risks identified, information given and who was contacted.

4. Intervention inventory

All interventions below are the psychotherapist's own work alongside the client's fasting or cleansing. None involves performing, supervising, prescribing or recommending a fast. Sources per item; anything not drawn from a cited source is marked [synthesis].

4.1 Routine, non-judgemental enquiry and recording

Purpose / when: at intake and at review, and whenever the client mentions "detox", "reset", "cleanse", juicing, weight goals, gut symptoms or a new wellness programme. NCCIH advises people to tell their health care providers about any complementary approach, including detoxes or cleanses [source: NCCIH]; making the question routine lowers the cost of disclosure [synthesis].
Steps: (1) Ask about complementary approaches generally, then specifically about fasting, juice-only days, cleanses, laxative or "flush" products. (2) Ask where the regimen comes from (book, retailer, retreat, practitioner, social-media challenge, friend or group). (3) Ask whether it is current, planned, past or repeated. (4) Ask whether the client's doctor knows. (5) Record in neutral words: what, source, frequency pattern in general terms, who knows, risks noted, information given.
Example language (illustrative): "Lots of people try cleanses or juice fasts. Is anything like that part of your life at the moment, or something you're planning?" / "Where did you come across it? A book, a company, a group?"
Watch for: defensiveness or minimising (suggests expected disapproval); secrecy from family or doctor; repeated cleanses; laxative or flush use. Working: the client volunteers updates without being asked.

4.2 Exploring meaning, hopes, expectations and explanatory model

Purpose / when: after disclosure, before any risk talk dominates; the reasons for fasting are often the clinical material (control, purity, guilt, punishment, a fresh start, spiritual discipline, belonging, distrust of medicine) [synthesis]. Beat describes food being used to cope with difficult feelings or to feel in control, with guilt or a sense of uncleanliness after "impure" food [source: Beat].
Steps: (1) Ask what the client hopes the cleanse will do, in their words. (2) Ask how they understand "toxins" or "cleansing" and where that idea comes from; reflect it without correcting. (3) Ask what it means about them to complete or break the cleanse. (4) Ask what else in life feels out of control or "dirty" right now. (5) Ask about any spiritual or community meaning, and describe it as theirs. (6) Summarise the hopes and check accuracy.
Example language (illustrative): "If the cleanse did exactly what you hope, what would be different afterwards?" / "When you say you feel 'toxic', what is that like in your body, and what's going on in your life when it's strongest?" / "What would it say about you if you stopped partway?"
Watch for: moral language about food (clean, bad, earned); self-punishment; hopes that the cleanse will fix a medical condition; hope pinned on weight or shape. Working: the client distinguishes the goal (energy, control, calm) from the method and considers other routes to it.

4.3 Eating-disorder awareness and screening

Purpose / when: every client who fasts, cleanses or restricts, especially adolescents and young adults (NICE notes highest risk in young men and women aged 13 to 17), people in sport, dance, fashion or modelling, and people with diabetes or coeliac disease [source: NICE NG69 1.2.4, 1.2.6].
Steps: (1) Ask about weight and shape concern, rules about food, compensatory behaviours (laxatives, diet pills, vomiting, excessive exercise), avoidance of social eating, and how others react to their eating [source: NICE NG69 1.2.6]. (2) Ask about orthorexic patterns: cutting out more foods or food groups over time, personal rules about "pure" food that cannot be relaxed, anxiety or guilt after "unhealthy" food, mood resting on eating "right", judging others' eating, diet interfering with work or relationships [source: Beat]. (3) A brief validated screener (for example SCOFF) may be used as one input, never as the sole basis for deciding whether an eating disorder is present; do not rely on BMI or duration alone [source: NICE NG69 1.2.5, 1.2.8]. (4) If an eating disorder is suspected, arrange physical-health assessment and refer promptly to an age-appropriate community eating-disorder service as local pathways allow [source: NICE NG69 1.2.9, 1.2.10]. (5) Note that orthorexia is not a formal diagnosis; people with these features may meet criteria for anorexia nervosa or OSFED, and care borrows from anorexia and OCD approaches with multidisciplinary physical, dietetic and psychological input [source: Beat].
Example language (illustrative): "Some people find a cleanse is the start of a lot of rules about food. Have you noticed any rules that are hard to bend?" / "After the cleanse, how did eating feel? Any guilt, or urges to make up for it?"
Watch for: repeated or escalating cleanses; laxative or flush misuse; distress at breaking a rule; secrecy; others worried about their eating; dizziness, fainting, feeling cold, low energy [source: NICE NG69 1.2.6; Beat]. Note: NICE NG69 was updated in 2020; the 2017 numbering is cited here [uncertain: current numbering not verified]. Cross-reference Domain II for eating-disorder treatment approaches.

4.4 Recognising medical risk and responding

Purpose / when: whenever the client is fasting, has fasted repeatedly, uses laxatives or flushes, or has a relevant medical condition. You do not assess physical health; you recognise warning signs and route to medical care [synthesis].
Risks as clinical sources state them: fasting can cause headaches, fainting, weakness and dehydration; drinking large amounts of water or herbal tea while eating no food for days can cause dangerous electrolyte imbalance; juices from high-oxalate foods can threaten people prone to kidney stones; unpasteurised juice can cause serious illness, especially in children, older adults and people with weakened immunity; laxatives and colon cleansing can cause diarrhoea, dehydration and malabsorption, with higher risk in gastrointestinal disease, after colon surgery, and in kidney or heart disease; people with diabetes should follow their care team's plan and consult them before major diet change [source: NCCIH]. Secondary sources state the Master Cleanse is low in protein, fatty acids and other nutrients and that its laxative component can cause electrolyte imbalance [source: Wikipedia, Master Cleanse] [uncertain: secondary, unverified]. Hypoglycaemia and electrolyte imbalance are listed as eating-disorder indicators [source: NICE NG69 1.2.6].
Refeeding syndrome: after a period of little or no intake, restarting food can cause dangerous falls in phosphate, potassium and magnesium, thiamine deficiency and fluid retention, with risks including arrhythmia, heart failure, respiratory failure, seizures and confusion; higher-risk groups include people with very little intake over a prolonged period, low body weight, significant weight loss, eating disorders, alcohol misuse, insulin-dependent diabetes, cancer treatment, and those on medicines affecting electrolytes such as insulin or diuretics [source: NHS Highland refeeding guideline]. Normal blood results beforehand do not exclude risk [source: same].
Steps: (1) Ask about current symptoms: fainting, dizziness, palpitations, confusion, severe weakness, vomiting or persistent diarrhoea. (2) Ask about diabetes, kidney, heart or bowel disease, pregnancy, and whether they take regular medicines (do not discuss doses or changes). (3) If acute symptoms are present (fainting, chest symptoms, palpitations, confusion, severe weakness), advise urgent medical assessment that day or emergency services, in line with NICE's emphasis on emergency care where physical health is compromised [source: NICE NG69 1.2.9]. (4) If no acute symptoms but a risk group applies, encourage the client to discuss the plan with their doctor or diabetes team before starting or continuing, and offer to help them contact them (4.5). (5) Document.
Example language (illustrative): "Fainting and a racing heart during a fast can be signs your body's salts are out of balance. I'd like you to be seen by a doctor today. Can we arrange that now?" / "Because you take insulin, this is one to plan with your diabetes team first. I can't advise on your medicines, but they can."
Watch for: the client concealing symptoms to complete the cleanse; plans to "push through"; coming off a long period of very low intake in someone underweight (refeeding risk, needs medical oversight) [source: NHS Highland]. Working: the client gets medical input before or during, and reports symptoms rather than hiding them.

4.5 Coordinating with the client's doctor, diabetes team or pharmacist

Purpose / when: when a risk group applies (4.4), when the client takes regular medicines, when an eating disorder is suspected, or when the client wants a fast while under medical treatment. NCCIH advises making decisions about detoxes and cleanses together with health care providers [source: NCCIH].
Steps [synthesis]: (1) Ask for consent to share specific, limited information, and agree what will be said. (2) Prefer the client contacting the doctor or pharmacist themselves, with your support in session (writing down questions, rehearsing). (3) If you write or call, state facts (planned or current cleanse, symptoms reported, eating-disorder concerns) and ask the clinician to advise the client; do not request or relay medication advice. (4) Agree how information comes back. (5) Without consent, share only where your safeguarding or emergency duties require it.
Example language (illustrative): "Would it be okay for me to let your GP know you're planning this, so they can check it's safe with your medicines? You'd see what I write first." / "Questions about your tablets during the cleanse are exactly what a pharmacist can answer. Shall we write them down now?"
Watch for: the client asking you whether to skip or change medicines (redirect each time, never answer); reluctance to tell a doctor for fear of disapproval (explore, 4.2). Working: a medical professional knows and the client has their advice.

4.6 Supporting an informed, values-based decision without coercion

Purpose / when: when the client is deciding whether to start, continue, repeat or stop. No published decision aid specific to juice fasting is cited here [uncertain: not verified]; the steps below are general practice [synthesis].
Steps [synthesis]: (1) Ask permission to share information. (2) Give the evidence status in one neutral line (see section 1) and the regulators' position that the liver and kidneys detoxify the body [source: ASA/CAP; NCCIH]. (3) Elicit the client's values and goals (4.2), then list with them the options they see, including routes to the same goals that do not involve fasting. (4) Explore pros and cons in their terms. (5) Check that medical risks relevant to them are known (4.4) and that a doctor is involved where needed (4.5). (6) Reflect the decision back and respect it, while keeping safety duties.
Example language (illustrative): "It's your decision. Would it help to look at what you're hoping for and the different ways to get there?" / "The regulators' view is that the liver and kidneys do the detox work, and research hasn't shown cleanses add to that. You may see it differently, and I'm interested in what draws you to it."
Watch for: sliding into persuasion or argument (this hardens positions); the client deciding to please you; a decision driven by an eating-disorder rule rather than values. Working: the client can name their reasons and the risks in their own words, whatever they choose.

4.7 When a cleanse is used instead of medical care

Purpose / when: the client plans to fast or cleanse to treat a physical illness, or is delaying or stopping medical treatment. The founder of the Master Cleanse reportedly sold his methods as cancer treatments and was convicted after a patient's death [uncertain: secondary, unverified]; regulators prohibit disease claims for food and have acted against detox products claiming to treat serious disease [source: ASA/CAP; ASA ruling Juice Garden Ltd; NCCIH]. No fast or cleanse treats cancer or any other physical disease.
Steps [synthesis]: (1) Explore what the illness and medical treatment mean (fear, side effects, distrust, prior bad experiences). (2) Ask what the treating team knows. (3) Support the client to raise their concerns and questions directly with that team, with consent, rather than choosing between them. (4) In serious illness, ask about palliative and supportive-care involvement; cross-refer entry 172 (integrative oncology) for complementary-alongside framing. (5) Work with family conflict and, later, with grief or regret. (6) If a child's medical care is being withheld, follow safeguarding (4.8).
Example language (illustrative): "It sounds like the treatment frightens you more than the illness right now. Can we look at that fear together, and at what you'd want to ask your specialist?"
Watch for: pressure from a seller, group or relative; abrupt stopping of prescribed medicines (route urgently to the prescriber); rapid physical decline. Working: the client stays in contact with their medical team and makes the choice knowingly.

4.8 Children, adolescents, pregnancy and safeguarding

Purpose / when: a young person is cleansing, a parent is fasting a child or giving a child unpasteurised juice or laxative products, or a pregnant or breastfeeding client is fasting.
Facts from sources: adolescents carry the highest eating-disorder risk [source: NICE NG69 1.2.4]; children may show faltering growth or delayed puberty [source: NICE NG69 1.2.7]; unpasteurised juice can cause serious illness especially in children [source: NCCIH]. Specific guidance on fasting in pregnancy [uncertain: not verified]; route any pregnant client to her midwife or obstetric team before fasting [synthesis].
Steps [synthesis]: (1) With a young person, ask about cleansing directly and screen for eating-disorder features (4.3); involve parents or carers in line with confidentiality limits and the young person's competence and assent. (2) With a parent, ask what the child eats and who advised the regimen; explore their reasons respectfully. (3) If a child is being deprived of adequate nutrition or necessary medical care, or given harmful products, follow your local child-safeguarding procedure and consult your safeguarding lead. (4) Document the concern and actions.
Example language (illustrative): "I'd like to understand what [child] is eating and drinking during the cleanse, and who suggested it." / to a teenager: "Lots of people your age see cleanses online. What made you want to try one?"
Watch for: weight loss, faltering growth, a child's distress around food, parental beliefs overriding medical advice. Working: the child's nutrition and medical care are secured.

4.9 Commercial, social-media and group pressure

Purpose / when: the client is buying packaged cleanses, joining paid challenges, multi-level-marketing schemes or retreats, or belongs to a group where fasting is a test of commitment [synthesis].
Steps [synthesis]: (1) Ask who profits from the regimen and how much the client has spent. (2) Ask whether recruitment, selling to others or tiered programmes are involved. (3) Explore the group's response if the client stops. (4) Note claims the client has been told (e.g. that juices treat disease); UK regulators treat such claims as prohibited or as health claims needing authorisation [source: ASA/CAP; ASA ruling Juice Garden Ltd]. (5) Support the client to make purchasing and membership decisions on their own terms; offer reporting routes (4.11) if they wish.
Example language (illustrative): "What happens in the group when someone stops partway?" / "How much has this cost you so far, and how do you feel about that?"
Watch for: debt, shame about spending, isolation from non-members, escalating commitments. Conflicts of interest: never sell, endorse or receive referral fees for cleanse products or programmes [synthesis].

4.10 Health anxiety, somatic presentations and fears of "toxins"

Purpose / when: the client repeatedly cleanses because of persistent bodily symptoms, a fear of contamination or "toxicity", or attributes symptoms to environmental chemicals (idiopathic environmental intolerance).
Steps [synthesis]: (1) Validate that symptoms are real and distressing. (2) Map the cycle: symptom, worry, cleanse, short-lived relief, return of symptoms or worry. (3) Ask about checking, reassurance seeking and avoidance. (4) Agree that medical assessment has been done or arrange it via the GP. (5) Use established psychological approaches for health anxiety and persistent physical symptoms; see Domain II for those methods. (6) Consider OCD-type contamination concerns where purity rules are rigid [source: Beat notes orthorexia care borrows from OCD approaches].
Example language (illustrative): "Each time you cleanse, how long does the relief last? And what brings the worry back?"
Watch for: cleansing as a safety behaviour that maintains anxiety; restriction escalating. Working: the client tolerates uncertainty about symptoms with less need to cleanse.

4.11 Reporting routes

Purpose / when: the client or you encounter a product with disease claims, hidden ingredients, harmful effects, misleading advertising, or a practitioner acting outside the law.
Routes: US: the FDA and FTC act on unsafe or falsely advertised detox and cleansing products [source: NCCIH]; specific reporting portals (e.g. FDA MedWatch, FTC fraud reporting) [uncertain: not verified]. UK: the ASA handles complaints about advertising claims; CAP advises consulting the MHRA where detox products make medical claims [source: ASA/CAP]. A practitioner's professional or licensing board for conduct concerns, and local safeguarding for children or adults at risk [synthesis]. Other countries [uncertain: not verified].
Steps [synthesis]: (1) Support the client to report if they wish; it is their choice unless a safeguarding duty applies. (2) Help gather facts (product name, claim, where seen, date). (3) Document.
Example language (illustrative): "If you think the claims on that website were misleading, there's an advertising regulator you can complain to. Would you like to look at that together?"
Watch for: your own urge to campaign rather than support. Working: the client feels they acted, if they wanted to.

4.12 After the cleanse: rebound eating, weight regain and shame

Purpose / when: the client has finished or broken a cleanse. NCCIH notes that weight lost on restrictive "detox" diets often returns once normal eating resumes [source: NCCIH].
Steps [synthesis]: (1) Ask how eating has been since, including urges to overeat or to compensate. (2) Normalise weight return as expected after restriction, not as personal failure. (3) Explore shame and any plan to "start again"; a cycle of cleanse and rebound is an eating-disorder indicator to reassess (4.3). (4) If the client has been very underweight or eating very little for a long time, check that a doctor is involved before normal eating resumes, because of refeeding risk [source: NHS Highland refeeding guideline]. (5) Link to the original goals (4.2) and other routes towards them.
Example language (illustrative): "A lot of people find their weight comes back after a cleanse and feel they failed. What's that been like for you?"
Watch for: binge-compensate cycles; planning the next cleanse as punishment; low mood. Working: the client's self-worth is less tied to completing the regimen.

5. Handling problems

All guidance in this section is [synthesis] unless a source is named.

The client hides the cleanse or minimises it. Make enquiry routine (4.1), name that you are not there to judge, and ask again later. Concealment from family or doctor plus restriction raises eating-disorder concern (4.3).
The client wants you to approve or endorse the cleanse. Decline gently and explain scope: you can help them think it through and stay safe, not prescribe or advise on diet. Offer the regulator-level evidence line once (section 1) and return to their goals.
The client wants you to argue against it, or a family member wants you to stop them. Hold a neutral stance, keep the client's autonomy central, and focus on safety and informed choice; offer a joint session only with the client's consent.
Reactance and rupture after risk information. Acknowledge it ("That came across as lecturing; that's not what I want"), return to meaning (4.2) and ask permission before sharing information again.
Overwhelm or distress when rules are challenged. Slow down, validate, and treat high distress at breaking a food rule as clinical information pointing to an eating disorder or OCD-type rigidity [source: Beat]; assess (4.3) and plan with the client.
The client refuses medical contact despite red flags. State your concern plainly, give the reason, offer practical help to access care, and document. If physical health is acutely compromised, emergency care takes precedence [source: NICE NG69 1.2.9]; consider capacity and your duty of care according to your jurisdiction's law and your professional body's guidance.
The client asks about medicines or supplements during the fast. Do not answer; route to the prescriber or pharmacist every time (4.5).
Suspected eating disorder, client disagrees. Share your observations, not a label; explain why an assessment is worthwhile; do not rely on a screener or BMI to settle it [source: NICE NG69 1.2.5, 1.2.8]; refer per local pathway [source: NICE NG69 1.2.10].
Repeated cleanses ("non-adherence" to the client's own plan to stop). Map the cycle (4.10, 4.12), look for triggers (bingeing, guilt, events, social media), and work on the function the cleanse serves.
The client believes the cleanse will treat a disease. See 4.7; do not debate efficacy; keep the treating team involved.
Group or seller pressure, money worries. See 4.9; support the client's own decisions about spending and membership; offer reporting routes (4.11).
Your own reactions. Notice irritation or rescuing at "detox" claims, or the opposite, enthusiasm for a wellness trend. Supervision helps keep the stance neutral and the focus on the client's goals and safety.
Child involved. Follow safeguarding procedures (4.8) and consult your safeguarding lead.

Sources

Web sources:

Books cited (from catalogue or secondary records):

Burroughs, S. (1976). The Master Cleanser. Burroughs Books. [uncertain: details from secondary source]
Burroughs, S. (1976). Healing for the Age of Enlightenment. [uncertain: details from secondary source]
Glickman, P. (2011). Lose Weight, Have More Energy & Be Happier…: Take Charge of Your Health with the Master Cleanse (3rd ed.). Clearwater, FL: Peter Glickman, Inc.

Court record: People v. Burroughs (Cal. Supreme Court, 1984) [uncertain: not verified].

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