Atlas›Domain XIII · Contemplative & religious disciplines›Guide 131
Guide XIII-131

Inner-work neidan as popularised by the salvationist societies

Li YujieChina
A 27 · L 58 · M 1512 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: a public outline only. The historical picture follows scholarship on the Republican-era "redemptive societies" (Palmer, Katz and Wang 2011; Broy 2015; Sasa on the Daoyuan / Red Swastika Society). The one openly published, present-day manual drawn on is Chinese Original Quiet Sitting (正宗靜坐), credited to Li Yujie (李玉階, Dao name Jichu, self-styled Hanjing Laoren) and published by the Lord of Universe Church (Tiandijiao 天帝教, Taiwan). Breath, qi-circulation and visualisation content is left out on purpose throughout.

What it is. Neidan (內丹, "inner elixir", or internal alchemy) is a Daoist family of seated and meditative self-cultivation methods. In the late Qing and Republican periods, lay religious movements that scholars call "redemptive societies" or "salvationist religion" brought simplified versions of it to large lay memberships. These movements included the Tongshanshe (同善社, Fellowship of Goodness), the Daoyuan (道院, School of the Way) with its Red Swastika Society (紅卍字會), and other groups in the Xiantiandao (先天道, Way of Former Heaven) lineage. They paired this inner work with spirit-writing, morality books, philanthropy and a universalist teaching that united the "three teachings". The introduction to a scholarly special issue calls these groups precursors of the later qigong movement. It describes their practices as spirit-writing and/or "the breathing and meditation techniques which would later be called qigong". [source: Palmer, Katz and Wang 2011]

How change happens, as the traditions frame it. The goal is two-sided:

  • Inner cultivation (修道 or 內修) of one's nature and life.
  • Outer moral action, such as charity. The Daoyuan's motto 內修外慈 ("inner cultivation, outer charity") treated the two as inseparable, and it held that faith without charitable action was not true faith. [source: Sasa]

The Lord of Universe Church manual states its aims in two tiers. The foundational goals are:

  • calming the mind and reducing desires;
  • transforming one's temperament;
  • helping oneself and others.

The higher goals are:

  • passing from the mundane to the sacred;
  • returning to unity with nature;
  • eternal life among other eternal spirits.

The higher goals rest on the foundational ones and on building moral character. [source: tienti.org, "The Six Goals of Quiet Sitting"] These are religious claims. This guide attributes them to the tradition and neither affirms nor disputes them.

What this guide is for. The psychotherapist does not teach this practice. The guide equips you to work with a client who already practises it in their own society or hall. You can support integration that the client leads, adapt your approach for trauma, recognise adverse effects, and refer to or coordinate with the client's own teachers. [synthesis]

2. Framework

2a. The tradition's own structure (public outline)

  • Membership and initiation. In the Daoyuan, members were called 修方 (practitioners). On joining they received a religious name (道名), which Sasa compares to an initiation name. Inner practice was a seated method called the "Former-Heaven sitting method" (先天坐法). Spirit-writing sessions (扶鸞) set the society's decisions and produced its scriptures, including the Taiyi beiji zhenjing (太乙北極真經). [source: Sasa]
  • Restricted transmission. Scholars distinguish two sources of secrecy in these groups. One is ordinary esoteric transmission to initiates, comparable to clergy traditions. The other was imposed by state labelling and persecution, which made some secrecy "a matter of survival". Broy notes that many local groups showed no social exclusivity. [source: Broy 2015] Some societies still transmit core methods only at initiation. Yiguandao's Three Treasures are the best-known example. Such content is not described here. [uncertain: not verified for each society]
  • Present-day form (Lord of Universe Church). The publisher presents two levels:
    • A simplified "serene quiet sitting" that anyone can learn. It combines a set posture, unforced sitting, and silent or quiet recitation of the church's Twenty Watchwords (a "Code of Life" of twenty virtues).
    • The full Chinese Original Quiet Sitting class. Entry requires a preliminary interview, followed by a supervised training period under the teacher. The publisher says applicants judged unlikely to keep the rules may be asked to reconsider or come back later. [source: tienti.org, chapters 6 and 8]
  • Who teaches. Teaching happens within each organisation's halls and classes, under its recognised teachers. In the Lord of Universe Church this means the classes Li Yujie began in 1979. [source: tienti.org, preface] Today, Tongshanshe (also known as Shengdao) halls are reported in Taiwan, Hong Kong and Southeast Asia. In mainland China the group is reported to be proscribed. [uncertain: secondary, unverified]

2b. The therapist's work in phases [synthesis]

No source gives session counts or a phase structure for psychotherapy with practitioners of this tradition. The phases below are a working structure, not a protocol.

  1. Engagement and assessment.
    • Goal: understand the client's affiliation, the practice's meaning for them, their level of training and their current dose, and screen for risk.
    • Move on when you have a shared formulation and the client has consented to bring the practice into therapy (or chosen to keep it separate).
  2. Client-led integration.
    • Goal: use the client's own concepts (cultivation, virtue, naturalness, repentance) to support treatment goals.
    • Move on when the practice supports functioning without signs of adverse effects.
  3. Monitoring and safety. This runs throughout and becomes the main focus if adverse experiences arise.
    • Goal: notice adverse effects early, reduce dose, ground the client, and tell spiritual experience apart from illness.
    • Move on when symptoms are stable and a plan exists with the client, and with the teacher or doctor if the client wishes.
  4. Collaboration and consolidation.
    • Goal: refer to, or coordinate with, the client's hall or teacher and their doctor, and plan how the client will keep practising safely.

3. Guiding principles

  • Client-led, in the client's own tradition and language. In practice, you work with the terms the client uses (修道, 靜坐, 正氣) and never import or rank another tradition's framework. [synthesis]
  • Concepts are attributed, not asserted or dismissed. In practice, you say "in your tradition, qi…" or "your teacher says…". You neither treat qi or immortality as fact nor debunk them. [synthesis]
  • You are not the teacher. In practice, you give no meditation, breath, energy or visualisation instructions, even when asked, and refer method questions to the client's recognised teacher. [synthesis; see Vieten et al. 2013 on competencies]
  • Respect restricted transmission. In practice, you do not ask the client to reveal initiatory content, and you never suggest bypassing legitimate teachers. [source: Broy 2015 on esoteric transmission; synthesis]
  • Naturalness over force. The tradition itself warns against straining, haste and deliberate qi-guiding, and calls being natural the central "secret". In practice, this lets you endorse slowing down in the tradition's own words. [source: tienti.org, chapter 8]
  • Ethics before experience. The tradition puts moral conduct first: precepts, the Code of Life, and building character before the higher goals. In practice, its moral content can support values-based work. [source: tienti.org, chapters 6 and 8; "Six Goals"]
  • Inner work and outer service go together. In the Daoyuan model, charity is part of practice. In practice, you can explore the client's prosocial commitments as part of their spirituality. [source: Sasa]
  • Safety first: adverse effects are real. Meditation-related challenges, including qigong-associated syndromes, are documented. In practice, you screen, monitor and act early. [source: Lindahl et al. 2017; Farias et al. 2020; Shan 2000]
  • No medical claims. In practice, the publisher's health statements stay attributed, and any physical symptom goes to the client's doctor. [source: tienti.org, chapters 1 and 6; synthesis]
  • Context of persecution. Some of these groups have faced state repression and learned to "keep a low profile". In practice, guarantee confidentiality explicitly and expect caution about disclosure. [source: Palmer, Katz and Wang 2011]
  • Competence and humility. In practice, know the limits of your knowledge and consult or refer as needed. Vieten et al. propose 16 basic spiritual and religious competencies (attitudes, knowledge, skills) for all licensed psychologists. [source: Vieten et al. 2013]

4. Intervention inventory

The first item outlines the openly taught practice so you know what the client is doing. It is not for you to teach. Items 4.2 to 4.12 are the psychotherapist's own work.

4.1 Public outline of the openly taught practice (for orientation only)

  • Purpose and when to use. Read this before working with a practitioner so you can follow what they describe. Do not use it to instruct. The only elements given here are those the publisher presents openly, and none of them concern breath, qi-circulation or visualisation. [source: tienti.org, chapters 6 and 8]
  • What the publisher describes, in outline (not a sequence to follow or teach). The manual sets general conditions for sitting (not when over-full, exhausted or forcing oneself), moral precepts of moderation and avoiding anger, an upright seated or cross-legged posture, a natural and unhurried attitude, silent or quiet recitation of the Twenty Watchwords as a prompt to self-reflection and repentance, and a gentle close. It is summarised here only so you can follow what the client tells you. [source: tienti.org, chapters 6 and 8]
    1. Content not given here. The manual also contains material on breathing and qi. It explicitly calls deliberate qi-guiding risky and says it can cause blockages. That material belongs to the teacher and is not reproduced or summarised in this guide.
  • Example language (illustrative). "I'm not a teacher of quiet sitting, so I won't coach the method. I'd like to understand what your practice means to you and how it's going."
  • Watch for. Clients asking you to check or correct their technique: refer them to their teacher. Signs they are practising the full method without the interview and supervision their organisation requires. Straining or haste, which goes against the tradition's own advice. [synthesis]

4.2 Respectful assessment of the practice and affiliation

  • Purpose and when to use. Use at intake, or whenever the client mentions quiet sitting, a hall, a society or spirit-writing. It establishes meaning, dose and risk without interrogating the client. [synthesis]
  • Steps.
    1. Ask permission to discuss their spiritual life.
    2. Ask which organisation or hall they belong to and who their teacher is, accepting "I'd rather not say". Given the history of repression, state your confidentiality limits clearly. [source: Palmer, Katz and Wang 2011; synthesis]
    3. Explore what the practice means to them: its goals, the ethical code, their community, and any charity or service. [source: Sasa; tienti.org]
    4. Ask about dose and setting: how often and how long they sit, whether alone or in class, and whether they are supervised. Do not ask about restricted content.
    5. Screen for past and current psychiatric history, trauma, dissociation, psychosis, bipolar disorder and substance use, and for any unusual experiences during practice. [source: Farias et al. 2020; Shan 2000; synthesis]
    6. Use the DSM-5-TR Cultural Formulation Interview, including its supplementary module on spirituality, religion and moral traditions, to structure the conversation. [uncertain: not verified]
  • Example language (illustrative). "Many people find their sitting practice central to who they are. If you're comfortable, tell me what you practise, where you learned it, and what it gives you. You never need to tell me anything you were asked to keep private."
  • Watch for. Guardedness or fear linked to past persecution, which is a reason to go slowly. Practice that has become private and intensive without a teacher, a risk pattern in the qigong literature. Recent changes in practice that coincide with new symptoms. [source: Shan 2000; synthesis]

4.3 Client-led integration within spiritually integrated psychotherapy

  • Purpose and when to use. Use when the client wants their practice to be part of therapy. It draws on their tradition's resources (calming the mind, reducing desires, transforming temperament, helping others) in support of treatment goals. [source: tienti.org, "Six Goals"; synthesis]
  • Steps.
    1. Obtain explicit consent to bring the practice into therapy, and record it.
    2. Ask the client to name which teachings help them, and in their own words.
    3. Link those teachings to treatment goals. For example, the tradition's warning against anger fits work on anger regulation, and "helping oneself and others" fits behavioural activation through service. [synthesis]
    4. Let the client decide whether and when they practise. Do not prescribe sitting as homework.
    5. Review at intervals whether the practice still helps.
  • Example language (illustrative). "You said the Code of Life reminds you to forgive. Would it help to bring that into how we work on the conflict with your brother?"
  • Watch for. The therapist steering the practice: stop and hand control back to the client. The client feeling that therapy competes with their teacher. Spiritual bypassing, where practice is used to avoid painful material. [synthesis]

4.4 Values and ethics work using the tradition's moral teaching

  • Purpose and when to use. Use when the client draws strength from the precepts and the Code of Life. In this tradition, moral conduct is the foundation of practice, so it can anchor values clarification. [source: tienti.org, chapters 6 and 8; "Six Goals"]
  • Steps.
    1. Ask the client which virtues matter most to them right now. They name these; you do not list them.
    2. Identify one concrete behaviour that expresses each chosen virtue this week.
    3. Review what happened without moral grading, and attend to self-compassion. [synthesis]
    4. Where the client's tradition includes charity or service, as in the Daoyuan's "outer charity", explore meaningful service as an activation step. [source: Sasa; synthesis]
  • Example language (illustrative). "Your tradition puts character before attainment. Which one quality would you most like to live out this week, and what would that look like?"
  • Watch for. Perfectionism or harsh moral self-accounting (see 4.10). Values work turning into a duty the client feels they are failing at. [synthesis]

4.5 Screening before intensive classes or retreats

  • Purpose and when to use. Use when a client plans to join an intensive class, such as the full quiet-sitting class with its interview and supervised training, or a retreat. Intensity and isolation are associated with more adverse effects. [source: Shan 2000 on over-practice and self-teaching; Lindahl et al. 2017; synthesis]
  • Steps.
    1. Review the client's history of psychosis, mania, severe dissociation, recent trauma, severe depression or suicidality, and substance use. [synthesis]
    2. Discuss what the programme involves, without asking for restricted content.
    3. Agree warning signs, and a plan for what the client will do if they appear.
    4. With consent, encourage the client to be honest in the organisation's own intake interview. [source: tienti.org, chapter 8; synthesis]
    5. If risk is high, discuss postponing. The publisher itself sometimes asks applicants to return later. [source: tienti.org, chapter 8]
  • Example language (illustrative). "Before you start the class, could we make a short plan for what you'd do if sitting stirred up something difficult?"
  • Watch for. Pressure from the group to attend regardless of health. A client minimising past episodes in order to be accepted. [synthesis]

4.6 Monitoring adverse effects, dose reduction and grounding

  • Purpose and when to use. Use throughout, and actively when the client reports distress linked to practice.
  • What the evidence shows.
    • Farias et al. 2020 reviewed 83 studies with 6,703 participants. They found a pooled adverse-event prevalence of 8.3%. The most common events were anxiety, depression and cognitive anomalies. Adverse events also occurred in people with no previous mental health history. [source: Farias et al. 2020]
    • The Varieties of Contemplative Experience study interviewed more than 100 Western Buddhist meditators and teachers. It built a taxonomy of challenging experiences, of the factors that influence them, and of remedies. [source: Lindahl et al. 2017; Cheetah House]
    • Cheetah House offers resources on "energy-like somatic experiences", which are directly relevant to qi-oriented practice. [source: Cheetah House]
    • For qigong specifically, a review describes three patterns: acute psychotic reactions, affective (depressive or manic) syndromes, and neurotic or dissociative states. The neurotic states often centre on a felt rush of qi to the head, with headache, dizziness, health anxiety and sometimes suicidal ideas. Reported risk factors were rushing to advanced practice, over-practice, being unable to stop, and self-teaching without a qualified master. [source: Shan 2000]
  • Steps.
    1. Ask about unusual experiences at each review: perceptual, energetic, emotional, sleep-related and dissociative.
    2. Rate how distressing and impairing they are, and how long they have lasted.
    3. If the client is distressed, discuss reducing practice: shorter or fewer sittings, or a pause. This matches the tradition's own warnings against forcing and haste. [source: tienti.org, chapter 8; synthesis]
    4. Offer grounding the client chooses: eyes open, attention on the room, feet on the floor, ordinary physical activity, sleep regularity, and contact with other people. Give no breath or energy techniques. [synthesis]
    5. With consent, involve the teacher. Involve a doctor for physical symptoms, and urgent psychiatric care for psychosis, mania or suicidality.
  • Example language (illustrative). "Your own teaching says not to force the practice. While these head sensations are strong, would you be willing to sit less, or pause, and check with your teacher?"
  • Watch for. Escalating practice to "push through". Sleep loss. Grandiosity or messages felt to come from deities outside the group's sanctioned spirit-writing. Feelings of qi "out of control". Signs it is working: distress falls as the dose comes down, and the client can describe their experiences calmly. [source: Shan 2000; synthesis]

4.7 Telling spiritual experience apart from psychiatric illness

  • Purpose and when to use. Use when the client reports unusual experiences: visions, voices, energy movement, contact with deities or immortals. The aim is neither to pathologise religious experience nor to miss illness.
  • Background.
    • The DSM-IV recognised a time-limited "qi-gong psychotic reaction", and the Chinese CCMD-2 also lists qigong deviation. [source: Shan 2000]
    • The DSM-5-TR offers a code for a "religious or spiritual problem" (Z65.8) for distress that is not a mental disorder. [source: ICD-10-CM Z65.8]
  • Steps.
    1. Ask how the client's tradition understands the experience. Spirit-writing and descending deities are normative in some of these societies. [source: Sasa]
    2. Ask whether co-religionists and the teacher see it as expected.
    3. Assess function, insight, sleep, mood, thought form, risk and duration.
    4. Consider psychosis, mania, depression and dissociation when the experience is not culturally shared, causes impairment, persists after practice is reduced, or brings risk. [source: Shan 2000; synthesis]
    5. Refer for psychiatric assessment when indicated, and explain to the client why in respectful terms.
  • Example language (illustrative). "In your tradition, experiences like this can have spiritual meaning, and I take that seriously. I'm also responsible for your health. Can we check how you're sleeping and coping, and what your teacher makes of it?"
  • Watch for. Culturally normative experiences being dismissed. Illness being explained away as spiritual. In the review, a recovered patient relapsed after starting a different qigong method, so monitor any change of method. [source: Shan 2000]

4.8 Trauma-sensitive adaptation

  • Purpose and when to use. Use for clients with trauma histories, including persecution, detention or displacement linked to religious affiliation. Inward attention can bring up traumatic material.
  • Steps.
    1. Discuss choice and control: the client sets the pace and can stop at any time. [synthesis]
    2. Encourage practice options the client finds stabilising, such as eyes open, shorter sittings, or recitation-focused practice. Stay within what their tradition allows, and confirm with their teacher. [synthesis]
    3. Use the trauma-sensitive mindfulness principles Treleaven (2018) publishes: staying within the window of tolerance, shifting attention, and keeping relationship and safety in focus. [uncertain: not verified]
    4. Treat trauma memories with established trauma therapy, not through intensifying practice. [synthesis]
  • Example language (illustrative). "If sitting brings back memories of what happened, you're allowed to open your eyes, stop, or do the recitation instead. Your practice should serve you, not overwhelm you."
  • Watch for. Dissociation during or after sitting, flashbacks, numbing, and practice used as avoidance. [synthesis]

4.9 Referral and coordination with teacher, hall, doctor and clinical programmes

  • Purpose and when to use. Use when method questions arise, when adverse effects need the teacher's input, when physical symptoms need a doctor, or when a secular alternative fits better.
  • Steps.
    1. Send method questions to the recognised teacher of the client's own organisation. Never suggest bypassing them or learning restricted content elsewhere. [synthesis]
    2. With signed consent, coordinate with the teacher on reducing dose or pausing. [synthesis]
    3. Send all physical symptoms, including qi-related sensations with bodily features, to the client's doctor. [synthesis]
    4. Where a secular approach fits the client's wishes, cross-refer to Domain II (MBSR, MBCT, MSC, CFT), Domain VII (contemplative psychotherapy, spiritually integrated psychotherapy), Domain IV (trauma-sensitive yoga), and the qigong guide in Domain X. [synthesis]
    5. For specialist help with meditation-related difficulties, Cheetah House offers consultations and training for clinicians. [source: Cheetah House]
  • Example language (illustrative). "Your teacher is the right person to adjust the method. Would you like me to speak with them, or would you prefer to raise it yourself?"
  • Watch for. Teachers who discourage medical or psychiatric care. Clients caught between loyalty to the group and their health. [synthesis]

4.10 Scrupulosity in moral self-accounting and repentance

  • Purpose and when to use. Use when the client's practice of precepts, self-reflection and repentance through the Code of Life becomes compulsive. Signs include repeated recitation to undo "bad" thoughts, fear of having broken a precept, or reassurance seeking. [source: tienti.org on the Code of Life as a prompt to repentance; synthesis]
  • Steps.
    1. Separate devotion from compulsion. Devotion is chosen, bounded and meaningful. Compulsion is driven by anxiety, repetitive, and relieved only for a short time.
    2. With consent, consult the client's teacher about what the tradition actually requires. Teachers often confirm that the tradition does not demand perfection. [synthesis]
    3. Use exposure and response prevention adapted to religious OCD, with exposures agreed so they do not breach the client's real religious obligations. The IOCDF describes such adaptations. [uncertain: not verified]
  • Example language (illustrative). "Your teaching asks you to be natural and not force things. When the recitation starts to feel like something you must get exactly right or else, that sounds more like OCD than your practice."
  • Watch for. Escalating time spent on rituals, avoidance of sitting out of fear of "doing it wrong", and guilt after any lapse in precepts. [synthesis]

4.11 Group dynamics, leaving, and religious trauma

  • Purpose and when to use. Use when the client describes pressure, conflict or departure involving a society or hall, or a history of persecution.
  • Background.
    • Initiation and restricted transmission mark a boundary between inside and outside. Scholars caution against assuming these groups are secretive or socially exclusive. [source: Broy 2015]
    • State repression has shaped how these groups present themselves. [source: Palmer, Katz and Wang 2011]
    • Independent investigations of teacher misconduct in these societies: none found in the sources consulted. No organisation or teacher is characterised here.
  • Steps.
    1. Explore the relationship with the teacher, including how power is used, without assuming harm. [synthesis]
    2. Assess for signs of coercive control: isolation from family, control of money or medical decisions, punishment for doubt, or threats about leaving. [synthesis]
    3. Support a client who wishes to leave, or to stay on changed terms. Expect grief, identity disruption and loss of community. [synthesis]
    4. For persecution histories, attend to fear of disclosure, documentation, and trauma treatment. [synthesis]
  • Example language (illustrative). "It sounds as if your hall has been family to you. Whatever you decide about staying, we can make room for both the gratitude and the hurt."
  • Watch for. Shame, fear of spiritual consequences, and loss of social support. [synthesis]

4.12 Role boundaries, health claims and the therapist's own beliefs

  • Purpose and when to use. Use throughout, and especially when the client asks for spiritual guidance, for your view on qi or immortality, or about health benefits.
  • Steps.
    1. State your role: you are not a teacher, master, confessor or spiritual director. [synthesis]
    2. Avoid dual relationships, such as joining the client's hall or classes. [synthesis]
    3. Self-disclose your own religious commitments only if it serves the client, and consult if unsure. [synthesis]
    4. Keep health claims attributed. The publisher links quiet sitting to longevity and to relieving the causes of illness, and draws on legendary accounts of long life. These claims are not established by clinical evidence, and no practice here should replace medical care. [source: tienti.org, chapters 1 and 6; synthesis]
    5. Follow your profession's ethics code. For psychologists this is the APA Ethics Code. [synthesis] Build the spiritual and religious competencies set out by Vieten et al. 2013. [source: Vieten et al. 2013]
  • Example language (illustrative). "I can't tell you whether sitting will cure your blood pressure. That's a question for your doctor. What I can do is help with the stress and sleep that come with it."
  • Watch for. Clients stopping medication because of practice-based health beliefs: route this urgently to their doctor. Your own enthusiasm or scepticism leaking into sessions. [synthesis]

5. Handling problems

All of the guidance in this section is synthesis unless a source is shown.

  • Stuck client ("my sitting has stopped working").
    • Explore the client's expectations against the tradition's own frame: skill builds over time and haste is discouraged. [source: tienti.org, chapter 8]
    • Shift therapy goals away from attainment and towards functioning.
    • Suggest they discuss plateaus with their teacher. [synthesis]
  • Resistance to bringing the practice into therapy.
    • Respect it. Integration is optional.
    • Name confidentiality, and acknowledge any history of persecution. [source: Palmer, Katz and Wang 2011; synthesis]
  • Client asks you to teach or check breath or qi technique. Decline kindly and refer to their recognised teacher. Never improvise instructions. [synthesis]
  • Overwhelm, or "qi rushing" during sitting.
    • Pause or reduce practice, ground the client, and involve the teacher with consent and the doctor for physical symptoms.
    • Assess for psychosis, mania, dissociation and suicidality, and arrange urgent care where indicated. [source: Shan 2000; Farias et al. 2020; synthesis]
  • Non-adherence to the agreed dose reduction.
    • Explore the meaning of the practice and any group pressure.
    • Frame reduction in the tradition's terms: naturalness, not forcing. [source: tienti.org, chapter 8; synthesis]
  • Rupture over perceived disrespect for beliefs.
    • Acknowledge it, clarify that you are not judging the tradition, and return to the client's own language. [synthesis]
  • Self-taught or online practice without a teacher.
    • Note the higher risk in the qigong literature. Suggest finding a recognised teacher or a clinical programme. [source: Shan 2000; synthesis]
  • Client practising methods from several groups at once.
    • Changing methods has been linked to relapse. Advise checking with the teacher and monitor closely. [source: Shan 2000; synthesis]
  • Children and adolescents in practising families.
    • Assess assent and age-appropriateness, and watch for any harsh discipline or austerity. Follow local safeguarding procedures. [synthesis]
  • Family conflict over membership.
    • Use culturally informed family work. Do not take sides on doctrine. [synthesis]

Sources

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