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Guide XIII-040

Pushti Marg seva

Vallabhacharya1400India
A 38 · L 49 · M 1313 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: seva (loving service of Krishna) as taught in the Pushti Marg (Pushtimarg, Vallabha Sampradaya), following Vallabhacharya's Shodasha Granthas (Sixteen Treatises) and the eightfold daily seva attributed by the tradition to Vallabhacharya and his son Vitthalnath, as summarised by the devotee-run site pushti-marg.net; supplemented by ethnographic studies of temple worship (Bennett 1983, SOAS thesis) and home worship in Gujarat and the UK (Gheewala 2023, LSE thesis). [source: pushti-marg.net Tanuja Seva; Summary of the Shodash Granth; Bennett 1983; Gheewala 2023]

Pushti Marg ("path of grace"; pushti = nourishing grace) is a Krishna-devotional (bhakti) tradition founded by Vallabhacharya in the late 15th century. Its gurus are hereditary descendants of Vallabhacharya (Gosvamis), and it has no ascetic order. [source: Bennett 1983 abstract] Its central practice is seva: devotees care for an image (svarupa), most often the child Krishna, as a living presence, at home or in temples called havelis. Seva follows the rhythm of a household day: waking, bathing and dressing, feeding, resting, singing and putting to bed. [source: pushti-marg.net Tanuja Seva; Gheewala 2023]

How change happens, as the tradition holds it: by Krishna's grace, not by the devotee's effort. Seva is the devotee's response, and through it the devotee is drawn into loving relationship with Krishna. The texts teach that the devotee should give up anxious worry (chinta), take Krishna as sole refuge (ashraya), and offer all actions and possessions to him. [source: Summary of the Shodash Granth (Navaratna, Krishnashraya, Siddhanta Rahasya)] Practitioners and ethnographers describe seva as "not quite ritual": a spontaneous, loving relationship rather than rule-bound puja. [source: Gheewala 2023 abstract]

This is a devotional practice of a living tradition, not a therapy. It involves deity worship and initiation, so this guide gives a public outline only. The psychotherapist's work is to understand what seva means to a client who already practises it, to support client-led integration, and to recognise when distress shows up in or around it. [synthesis]

2. Framework

2a. The practice as the tradition publishes it (public outline)

  • Initiation (Brahmasambandha). The tradition holds that Krishna revealed this initiation to Vallabhacharya at midnight on the eleventh of the dark fortnight of Shravan, recorded in the treatise Siddhanta Rahasya. The tradition teaches that it removes the faults that bar a soul from seva, and binds the devotee to dedicate self, family, actions and possessions to Krishna. Ethnography glosses it as a "binding to god"; it can be received in childhood. It involves formulas of refuge and of self-dedication that are given by an authorised teacher; they are not reproduced here. [source: Siddhant Rahasya page; Summary of the Shodash Granth; Gheewala 2023] Who confers it: the hereditary Gosvami gurus [source: Bennett 1983 abstract]; the precise current rules on who may confer it are [uncertain: not verified].
  • Three forms of seva. Tanuja (with the body), vittaja (with wealth or material support) and manasi (in the mind). The Siddhanta Muktavali is summarised as treating mental seva as best, since devotees spend more time outside active seva than in it. [source: Summary of the Shodash Granth; Tanuja Seva]
  • Offering before use. Initiated devotees are taught to offer things to Krishna before using them; items already offered to or used by others are not offered. [source: Siddhant Rahasya page] Offered food becomes prasad. [source: Gheewala 2023 glossary]
  • The eight daily seva periods. The tradition attributes to Vallabhacharya and Vitthalnath the counsel to serve eight times a day, treating the Lord as living: Mangala (waking), Shringar (bathing and dressing for season and festival), Gval (sending him out to herd cows), Raj Bhog (main midday meal), Utthapan (waking after rest), Bhog Arti (snacks before return from the forest), Sandhya (welcome home at dusk) and Shayan (putting to sleep). The same site warns against seva becoming mechanical. [source: Tanuja Seva] This is described here so the therapist understands a client's day; it is not an instruction to perform seva.
  • Three tenets of home seva. Ethnography names rag (song), bhog (food) and shringar (adornment). [source: Gheewala 2023, table of contents] Temple worship is described as lavish, with sacred food and feasting at its centre. [source: Bennett 1983 abstract]
  • Bhava (devotional mood). Seva may be shaped by vatsalya (parental, as Yashoda and Nanda), madhurya (as a beloved gopi), sakhya (as companion) or dasya (as servant), drawing on Krishna's play (lila) in Vraj. [source: Tanuja Seva] Devotional love is "most often performed in the role of a mother or lover." [source: Gheewala 2023 abstract]
  • Purity. Devotees bathe and dress before seva and observe rules on touch; ethnography reports that some families were very strict and that institutions are moving towards an approach where bhava matters more than rules. The glossary lists sutak, a period of impurity linked to menstruation, childbirth and death. [source: Gheewala 2023, pp. 17, 26–27, glossary] Exact current rules vary by family and guru [uncertain: not verified].
  • Who teaches it. Gosvami acharyas (descendants of Vallabhacharya), temple staff in havelis, family elders and satsang (devotee) groups; children may learn in pathshala classes. [source: Bennett 1983; Gheewala 2023 table of contents]

2b. The psychotherapist's framework

There is no published clinical protocol, session count or phase model for working with Pushti Marg seva [uncertain: not verified]. The following working phases are [synthesis]:

  1. Assessment and meaning (early sessions): spiritual history; what seva, initiation, the svarupa and bhava mean to the client; who their guru and community are; whether practice is a resource, a source of strain, or both. Move on when the client has said whether and how they want their faith included.
  2. Client-led integration (ongoing): use the client's own concepts (refuge, giving up worry, offering, grace, bhava) as coping resources within the agreed treatment, in the client's language. Move on, or step back, if religious material starts to fuel symptoms (scrupulosity, guilt, exhaustion) or if the client prefers to keep faith separate.
  3. Targeted work when needed: scrupulosity (ERP with religious consultation), grief and separation, family conflict over rules, disruption of seva by illness or migration, adverse experiences, and concerns about a teacher or group.
  4. Collaboration and referral at any point, with consent: Gosvami, haveli staff, satsang elders, the client's doctor.

Format: individual sessions, with family sessions where household seva involves several generations [synthesis].

3. Guiding principles

  • The client's tradition, the client's lead. Raise seva only as the client wishes; work in their terms (seva, Thakorji, Lalan, bhava). Practical meaning: ask before you use religious language. [synthesis]
  • Attribute, don't adjudicate. Grace, Brahmasambandha, the living presence of the svarupa and the Vraj lila are described as the tradition holds them, neither affirmed as fact nor dismissed. Practical meaning: say "in your tradition…" rather than "Krishna is…" or "the image is just…". [synthesis]
  • You are not the guru. Rulings on purity, initiation, what may be offered, or how to do seva belong to the client's Gosvami or elders. Practical meaning: refer such questions; never invent a ruling. [synthesis; Vieten et al. 2013 frame competencies for this area]
  • No restricted content. Initiation formulas are given by authorised teachers. Practical meaning: never ask a client to tell you them, and never encourage bypassing a legitimate teacher. [synthesis]
  • Seva is relational, not mechanical. The tradition itself warns against mechanical seva and sets bhava above rules. Practical meaning: when practice has become rigid, fearful or checking, that is a clinical signal and also out of step with the tradition's own ideal. [source: Tanuja Seva; Gheewala 2023; synthesis]
  • Manasi seva counts. The texts value mental seva most highly. Practical meaning: when illness, travel, hospital or impurity periods stop physical seva, the client may find continuity in mental seva, if their own authorities agree. [source: Summary of the Shodash Granth; synthesis]
  • Health questions go to the doctor. Food offering, fasting on festival days, early rising and long kitchen work can affect health. Practical meaning: raise concerns and route them to the client's doctor; do not advise on diet or medicines. [synthesis]
  • Watch power and money. Ethnography notes temple redistribution of ritual goods can be "open to exploitation for selfish ends". Practical meaning: listen for pressure around giving (vittaja seva) without assuming it. [source: Bennett 1983 abstract]
  • Competence and humility. Psychologists should hold basic spiritual and religious competencies in attitudes, knowledge and skills (16 proposed by Vieten et al. 2013). Practical meaning: learn the basics, consult, and examine your own beliefs. [source: Vieten et al. 2013 summary page]
  • Ethics. Avoid dual roles (e.g., attending the client's haveli as a devotee while treating them), manage self-disclosure of your own faith, and respect autonomy. [synthesis]

4. Intervention inventory

These are the psychotherapist's own interventions alongside a client's seva. None is a Pushti Marg technique, and none teaches seva. Steps are [synthesis] unless a source is tagged. No published secular or clinical adaptation of Pushti Marg seva is known [uncertain: not verified].

4.1 Seva-focused spiritual history

  • Purpose / when: at intake or when the client mentions Thakorji, the haveli, seva or a Gosvami. Maps the practice and its place in the client's life.
  • Steps: (1) Ask permission to talk about faith. (2) Ask what form their seva takes (home svarupa, haveli visits, satsang, mental seva) and who in the household does it. (3) Ask whether they are initiated, without asking for initiation content. (4) Ask which bhava feels closest. (5) Ask who guides them (Gosvami, elders, satsang). (6) Ask how practice feels lately: joyful, routine, burdensome, anxious, absent. (7) Ask how they want faith included in therapy. Record in their terms. [synthesis; terms from Tanuja Seva and Gheewala 2023]
  • Example language (illustrative): "Some people find their faith is a big part of how they cope, and some prefer to keep it separate. How is it for you?" / "Who looks after Thakorji in your home, and what does that time mean to you?"
  • Watch for: shame about lapsed practice; a client testing whether you will judge the image as "just a statue"; hints of anxiety or checking around purity. Working when the client corrects your terms and volunteers meaning.

4.2 Cultural formulation

  • Purpose / when: early assessment, especially with migrants, second-generation clients and families from Gujarati or Rajasthani Vaishnav communities.
  • Steps: use the DSM-5-TR Cultural Formulation Interview, including its supplementary module on spirituality, religion and moral traditions, to explore how the client and family explain the problem, what help they have sought (including from the haveli or Gosvami) and what they expect from you. [uncertain: not verified] Note household roles in seva and how migration has changed practice. [synthesis]
  • Example language (illustrative): "What would your family, or your satsang, say is going on?"
  • Watch for: competing explanations (karma, grace withdrawn, impurity) that the client holds alongside medical ones; respect both, do not argue theology.

4.3 Refuge and releasing worry as a coping resource

  • Purpose / when: for anxious, worried or overwhelmed clients who already draw comfort from their tradition. The Navaratna teaches giving up chinta and recalling Krishna as refuge when the mind is distracted; Viveka-Dhairya-Ashraya pairs discernment, patience and refuge. [source: Summary of the Shodash Granth]
  • Steps: (1) Ask what their tradition says about worry. (2) Invite them to describe, in their own words, how refuge or surrender has helped before. (3) Link this to the agreed treatment, e.g. alongside worry postponement or acceptance work: the client chooses the words and the practice. (4) Review whether it helps. [synthesis]
  • Example language (illustrative): "You said your tradition teaches letting go of worry into Krishna's care. When has that felt real for you? Would you like to bring that into how we handle the 3 a.m. worrying?"
  • Watch for: surrender turning into avoidance of needed action (bills, medical care) or into a reassurance compulsion (repeatedly recalling refuge to neutralise a fear). Working: less rumination, more engagement, practice feels warmer rather than more effortful.

4.4 Bhava as a relational resource

  • Purpose / when: for clients whose seva expresses a felt relationship (parent to child, companion, servant, beloved). The tradition describes these four bhavas. [source: Tanuja Seva] Useful in loneliness, empty nest, depression with withdrawal, and attachment work.
  • Steps: (1) Ask which bhava they live in seva. (2) Explore what that relationship gives them (tenderness, purpose, play, belonging). (3) With consent, use it as a bridge to self-compassion or to human relationships. (4) Note pain points: e.g., vatsalya seva after the loss of a child, infertility or estrangement may comfort or reopen grief. [synthesis]
  • Example language (illustrative): "When you dress Lalan in the morning, what is it like to care for him? Is there any of that tenderness you could turn towards yourself?"
  • Watch for: the client feeling you are psychologising their devotion; pull back to their framing. Working: the client finds warmth and play (which ethnography sees as central to seva) [source: Gheewala 2023] rather than duty alone.

4.5 Continuity when physical seva is disrupted

  • Purpose / when: illness, hospital, disability, travel, migration, a new baby, bereavement, impurity periods (sutak) or caring duties stop the client's usual tanuja seva and they feel cut off. Texts value manasi seva most highly and urge staying faithful when feeling cut off from grace. [source: Summary of the Shodash Granth (Siddhanta Muktavali, Antahkarana Prabodha)]
  • Steps: (1) Name the loss. (2) Ask what their tradition and elders say about such times. (3) Suggest they ask their Gosvami or elder for guidance on what is fitting. (4) Help them plan a sustainable form (e.g., another household member continues, or mental seva) as their authorities allow. (5) Process guilt. [synthesis]
  • Example language (illustrative): "You've said seva is the heart of your day and now you can't do it. Have you been able to ask anyone in your tradition how they'd see this time?"
  • Watch for: guilt or fear of punishment out of proportion to what their tradition teaches (screen for scrupulosity, 4.6); depression masked as spiritual dryness.

4.6 Scrupulosity: screening and adapted ERP

  • Purpose / when: when purity rules, offering everything before use, avoiding unoffered items, correct shringar or bhog, or fear of offending Krishna become intrusive, time-consuming or impairing. IOCDF describes scrupulosity as obsessions about sin, offence or punishment, with compulsions such as repeating prayers until they feel right, repeated cleansing and purifying, excessive confession and reassurance-seeking from religious leaders, plus avoidance of religious practice; it can "masquerade as religion", often goes beyond religious law, fixates on one area, and shows as functional impairment. [source: IOCDF What is OCD & Scrupulosity]
  • Steps: (1) Screen: time spent, distress, rebathing or redoing seva, checking, reassurance-seeking from family or haveli, avoidance of seva. (2) Psychoeducation: OCD vs faith; the tradition itself values bhava over rules [source: Gheewala 2023]. (3) With consent, consult the client's Gosvami or a trusted elder to clarify what the tradition actually requires (IOCDF supports involving faith leaders if the client wants). [source: IOCDF] (4) Build an exposure hierarchy within what the tradition permits, never asking the client to break a genuine rule; target the OCD extras (repeat baths, redoing offerings, checking). (5) Response prevention: one bath as the tradition requires, then proceed; no repeated reassurance. (6) Refer for medication assessment as needed; do not advise on medicines. [synthesis; IOCDF names CBT with ERP as the main psychological treatment]
  • Example language (illustrative): "Your tradition asks for love more than perfection. The OCD is asking for a perfection your Gosvami hasn't asked for. Shall we find out what's actually required, and practise doing just that?"
  • Exposure safety and consent: agree every step; stop if exposure would breach a rule the client and their authority hold as binding; avoid exposures during sutak or festivals without the client's choice. [synthesis]
  • Watch for: the therapist becoming the new reassurance source; family members joining in compulsions. Working: shorter seva, return of warmth, fewer reassurance requests.

4.7 Grief, longing (viraha) and loss

  • Purpose / when: bereavement, migration away from a haveli or home shrine, or a client describing longing for Krishna. Ethnography treats waiting and longing (virah) as a theme in devotional life. [source: Gheewala 2023, table of contents]
  • Steps: (1) Ask what longing means in their tradition before treating it as a symptom. (2) Distinguish devotional longing (meaningful, compatible with functioning) from depression (pervasive low mood, anhedonia, hopelessness, sleep and appetite change). (3) Support mourning rites and community as the client wishes; note sutak may pause seva after a death. [source: Gheewala 2023 glossary; synthesis] (4) Risk-assess per current standards if hopelessness is present.
  • Example language (illustrative): "In your tradition, longing for Krishna can itself be a kind of closeness. Is what you're feeling now that kind of longing, or does it feel more like everything has gone grey?"
  • Watch for: missing depression because it is framed spiritually, or pathologising devotion. Working: the client can tell the two apart and uses community support.

4.8 Family and intergenerational negotiation

  • Purpose / when: conflict over who does seva, purity rules, food (e.g., children eating outside food), or a younger member's lapse. Ethnography records strict older practice alongside a shift towards bhava over rules, and the domestic shaping of seva around a baby Krishna in the household. [source: Gheewala 2023, pp. 26–27, 41]
  • Steps: (1) Map each member's practice and meaning. (2) Separate religious disagreement from relational conflict. (3) Invite each to speak of what seva gives them. (4) Where a ruling is needed, the family consults its own guru; the therapist does not arbitrate. (5) Agree workable household arrangements. [synthesis]
  • Example language (illustrative): "It sounds like for Ba, the rules are how love is shown, and for you, love is the point and the rules feel heavy. Can we hear what seva means to each of you?"
  • Watch for: the therapist taking sides; coercion of a young person or spouse; gendered burden of kitchen seva. Working: less blame, shared plan.

4.9 Health issues routed to the doctor

  • Purpose / when: early rising for Mangala, long kitchen preparation, festival fasting, eating only offered food, or isolation during impurity periods affect sleep, nutrition, a medical diet, diabetes, pregnancy or recovery. [synthesis]
  • Steps: (1) Ask neutrally how practice fits with health needs. (2) Encourage the client to discuss with their doctor or dietitian and, if they wish, with their Gosvami or elder about permitted adjustments. (3) Do not prescribe food rules, fasting or sleep changes; do not advise on medicines. (4) In hospital, help the client ask staff about practical needs (e.g., food arrangements) [synthesis].
  • Example language (illustrative): "Would it help to talk with your doctor about how festival days fit with your insulin plan, and maybe ask your elders what adjustments are allowed?"
  • Watch for: food restriction framed as purity in a client with an eating disorder; sleep loss in bipolar disorder. Working: client has a medically and religiously agreed plan.

4.10 Unusual or adverse experiences in devotion

  • Purpose / when: a client reports intense visions, feeling Krishna's presence, overwhelming emotion, sleep loss or distress around practice. Research on contemplative practice describes challenging experiences across seven domains (cognitive, perceptual, affective, somatic, conative, sense of self, social). [source: Cheetah House VCE page; Lindahl, Fisher, Cooper, Rosen & Britton 2017] A systematic review of 83 studies (6,703 participants) found a pooled adverse-event prevalence of 8.3%, most often anxiety, depression and cognitive anomalies, including in people without prior mental health problems. [source: Farias et al. 2020, Acta Psychiatr Scand 142(5):374–393] That research concerns meditation; its application to devotional seva is [synthesis].
  • Steps: (1) Listen without pathologising; ask what the experience means in their tradition and whether it is welcome. (2) Assess function, sleep, insight, mood, and any psychotic, manic or dissociative features. (3) If distressing, reduce intensity of practice in consultation with their elder, and use grounding (orienting to the room, feet on floor, ordinary activity). (4) Refer for psychiatric assessment when warranted. (5) The DSM-5-TR includes a code for a religious or spiritual problem, Z65.8 [source: ICD-10-CM Z65.8]. (6) Cheetah House offers consultations and clinician trainings on meditation-related difficulties. [source: Cheetah House VCE page]
  • Example language (illustrative): "That sounds very powerful. How has it been for you? Is it something you welcome, or has it been unsettling, or affecting your sleep?"
  • Watch for: a welcome devotional experience being treated as illness, or mania or psychosis being missed because of religious content. Working: client feels understood and safe; symptoms settle.

4.11 Trauma-sensitive adaptation

  • Purpose / when: for clients with trauma whose practice, temple setting, purity rules or family dynamics bring up distress. Trauma-sensitive mindfulness (Treleaven 2018) is a published adaptation for meditation [uncertain: not verified]; extending its principles to devotional practice is [synthesis].
  • Steps: (1) Identify triggers (crowds at darshan, body-related purity rules, a specific person). (2) Offer choice and control in what is discussed. (3) Support the client to adjust their own practice with their authorities' guidance. (4) Use grounding and pacing. [synthesis]
  • Example language (illustrative): "You can choose how much we talk about this. What would help you feel steadier when you go to the haveli?"
  • Watch for: dissociation, hyperarousal, shame. Working: steadier engagement or chosen distance without guilt.

4.12 The guru relationship, giving and coercive control

  • Purpose / when: a client is distressed by pressure from a teacher, haveli staff or community, especially about money, service or obedience. Vittaja seva is service through wealth [source: Tanuja Seva]; ethnography notes the temple redistributive economy can be open to exploitation. [source: Bennett 1983 abstract]
  • Steps: (1) Hear the concern without assuming wrongdoing or dismissing it. (2) Screen for signs of coercive control: isolation from non-members, financial pressure beyond means, fear of leaving, threats of spiritual harm, sexual boundary violations. (3) Safeguarding and reporting duties apply as for any abuse; involve police or authorities where required. (4) Support choice, including leaving or changing community, and work with religious trauma. [synthesis] No independent investigation of misconduct in this tradition was found in the sources consulted.
  • Example language (illustrative): "You've said you feel you must give more than you can afford. What would happen if you said no?"
  • Watch for: your own bias against a tradition centred on giving and image worship. Working: client makes free choices.

4.13 Collaboration and referral

  • Purpose / when: questions on initiation, purity, permitted adaptations, or how to do seva; or when the client wants their community involved.
  • Steps: (1) Get written consent and agree what to share. (2) Help the client approach their Gosvami, haveli staff or satsang elder, or contact them jointly. (3) Keep roles clear: they advise on religious matters, you on mental health. (4) Refer to spiritually integrated psychotherapy (Domain VII) or, if the client wants a secular contemplative approach, to Domain II programmes; trauma-sensitive yoga is in Domain IV. [synthesis]
  • Example language (illustrative): "That's a question for someone in your tradition, not me. Would you like to ask your Gosvami, and we can talk afterwards about how it lands?"
  • Watch for: confidentiality in tight-knit communities. Working: the client has religious guidance and therapy that fit together.

5. Handling problems

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

  • Client wants you to tell them how to do seva or whether a rule applies. Decline warmly, explain your role, and help them take the question to their Gosvami or elder (4.13).
  • Client fears grace is withdrawn because seva lapsed. Explore the fear; note the texts urge continuing in faith when feeling cut off [source: Summary of the Shodash Granth (Antahkarana Prabodha)]; screen for depression and scrupulosity (4.6).
  • Stuck: seva has become joyless duty. Ask when it last felt alive; explore bhava (4.4); check for burnout, caring load and depression. The tradition itself warns against mechanical seva [source: Tanuja Seva].
  • Resistance to discussing faith. Respect it; say the door is open. Some clients fear judgement of image worship; name your respect explicitly.
  • Non-adherence because of practice timing (e.g., early worship, festival seasons). Schedule around festivals and seva periods; ask the client which times are protected.
  • Overwhelm during exposure work for scrupulosity. Step down the hierarchy, re-check consent and that no binding rule is breached, and recheck with the client's religious authority if needed (4.6).
  • Rupture: client felt you dismissed their devotion or treated Krishna's presence as a symptom. Acknowledge, repair, and restate that you attribute and do not judge.
  • Therapist is from the same community or tradition. Consider dual relationships (shared haveli, satsang); discuss boundaries and self-disclosure; consider referral if overlap is too great. Vieten et al. (2013) frame spiritual and religious competencies, including the therapist's own beliefs, as part of basic practice [source: Vieten et al. 2013 summary page; detail not verified].
  • Therapist from another faith or none. Learn the basics, check your assumptions about image worship, and consult.
  • Family conflict escalates over rules. Shift to family sessions (4.8); screen for coercion or abuse; follow safeguarding duties if children are at risk.
  • Unusual experiences with sleep loss or disorganisation. Same-day assessment of mania or psychosis risk; coordinate with the doctor (4.10).
  • Suicidal hopelessness framed as longing or punishment. Assess risk per current standards; involve services as needed; do not let religious framing delay safety planning (4.7).
  • Client discloses abuse or exploitation by a religious figure. Believe, document, follow safeguarding and reporting law, and support the client's choices (4.12).
  • Modality-specific: client asks you to keep their svarupa or offered items at your office, or to share prasad. Small gifts of prasad are culturally common; accept or decline in line with your gift policy and explain kindly; do not take on ritual roles.
  • Modality-specific: rules on touch or impurity affect sessions (e.g., a client during sutak). Ask what they prefer; offer remote sessions if helpful.

Sources

Web sources:

Also cited [uncertain: not verified]: Treleaven (2018), trauma-sensitive mindfulness; DSM-5-TR Cultural Formulation Interview; IOCDF page on religious scrupulosity in Hinduism; Nathdwara temple darshan schedules; current rules on who confers initiation.

ICD-10-CM Z65.8, Other specified problems related to psychosocial circumstances (includes 'Religious or spiritual problem'), https://www.unboundmedicine.com/icd/view/ICD-10-CM/945432/all/Z65_8___Other_specified_problems_related_to_psychosocial_circumstances

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