Pentecostal Spirit baptism and healing services

1. Introduction

Version followed: Assemblies of God (USA): its Statement of Fundamental Truths (items 7, 8 and 12), the General Presbytery position papers on Baptism in the Holy Spirit (adopted August 1999) and Divine Healing (adopted 2010), and two AG Enrichment journal articles (Hartwick, undated; Trask, 2007). Other Pentecostal, Holiness-Pentecostal and charismatic bodies teach related but differing doctrines; they are not described here [uncertain: not verified].

This is an observance, not a therapy. Pentecostal Spirit baptism and healing services are church practices led and authorised by pastors, elders and denominational bodies. This guide describes them as the Assemblies of God publishes them, then sets out the psychotherapist's own work alongside them: meaning, cultural assessment, accommodation, routing health matters to the doctor, spiritual struggle and scrupulosity, grief, collaboration with clergy, and child safeguarding. It also covers intercessory prayer for healing across traditions. [source: AG Fundamental Truths via University of Valley Forge catalog; AG News 1999; AG Divine Healing position paper 2010]

As the AG teaches it, Spirit baptism is an experience "distinct from and subsequent to" the new birth that gives believers power for life and service; speaking in tongues (glossolalia) is its initial physical evidence. Divine healing is, in the AG's words, "an integral part of the gospel", received by faith as a gift of grace, and in the church's view it does not compete with medical care. These are religious teachings, attributed to the church. They are not presented here as treatments for physical disease. [source: Hartwick, Enrichment; AG Divine Healing position paper 2010]

For the therapist, the core idea of change is ordinary good practice: understanding what these experiences mean to the client lets the therapist support the client's coping, protect their health and their children's safety, and work through distress (doubt, unanswered prayer, pressure, harm) without dismissing or endorsing the faith. [synthesis]

2. Framework

2a. The observance as the Assemblies of God publishes it

Baptism in the Holy Spirit and tongues [source: AG Fundamental Truths 7 and 8; AG News 1999; Hartwick, Enrichment]

Doctrine: a special experience following salvation (Fundamental Truth 7), which the AG lists among its four cardinal doctrines.
Evidence: the initial physical evidence is speaking in other tongues, as on the Day of Pentecost (Fundamental Truth 8). The 1999 paper calls tongues the first outward, observable sign; the fruit of the Spirit is the continuing evidence in daily life.
Purpose: an enduement of power for life, witness and service, and a gateway to a Spirit-empowered life rather than an end in itself.
Receiving: believers are urged to earnestly seek it. AG writers point to New Testament accounts in which hands were laid on recipients with prayer. After the baptism, "praying in the Spirit" (worship and intercession in tongues) is expected to continue.
Authority: the AG's own writers judge experience by Scripture, "not on experience". Doctrine is set by the General Council and General Presbytery and taught by local pastors.
Not described in the AG sources cited here: altar or "tarrying" practices, coaching, and the order of public tongues with interpretation [uncertain: not verified]. Give clients room to describe their own church's practice.

Divine healing and healing services [source: AG Divine Healing position paper 2010; Trask, Enrichment 2007]

Doctrine: divine healing of the sick is "a privilege for Christians today", provided in the Atonement (Fundamental Truth 12, also a cardinal doctrine).
Practice: following James 5:14-16, the sick may call the elders, who anoint them with oil and pray the prayer of faith; ministers lay hands on the sick; pastors are encouraged to give people, visitors included, an opportunity to be prayed for in services. A former General Superintendent writes that the Lord, not the minister, heals, and that ministers should not declare people healed.
When healing does not come: the AG describes an "already and not yet" (some are healed instantly, some gradually, some not in this life) and admits that it does not fully understand why. Sickness is not always linked to specific sin, and the amount of faith is not always decisive. Results are left "in the hands of the Lord".
Medicine: the 2010 paper states that belief in divine healing does not oppose or compete with medical care and is not a substitute for healthy living. It also acknowledges "abuses", including excessive claims and unfounded judgments by some.

Research on the experience (context only) [source: Penn Medicine news release, 2006]

Newberg and colleagues' preliminary SPECT study of five people speaking in tongues, published in Psychiatry Research: Neuroimaging, found decreased frontal-lobe activity compared with singing gospel music. The authors called it preliminary. It describes brain activity during a religious practice; it neither confirms nor refutes the participants' religious account and is not a health finding.

Intercessory prayer for healing across traditions: evidence status [source: AAFP summary of Benson et al. 2006; Cochrane plain-language summary]

STEP trial (Benson et al. 2006; 1,802 bypass patients): prayer by others did not reduce complications, and patients told they were certainly being prayed for had slightly more.
Cochrane review (Roberts, Ahmed and Davison, 2009; 10 trials, 7,646 people): intercessory prayer was neither significantly beneficial nor harmful, and the evidence did not support a recommendation for or against it.
Clinical meaning: prayer is a religious practice that many clients value for meaning and coping. It is not a substitute for medical treatment. [synthesis]

2b. The therapist's work alongside it

No source gives a session count or protocol. The work below is woven into whatever therapy the client is already receiving. [synthesis]

Phase	Goal	Move on when
1. Engage and assess	Understand the client's tradition, what Spirit baptism, tongues and healing prayer mean to them, and any distress or health risk; use the Cultural Formulation Interview and its Spirituality, Religion and Moral Traditions module	The client feels understood, and you know their church's teaching, their health situation and whether children are involved
2. Agree a plan	Agree goals, accommodations, a medical-coordination plan where illness is present, and safeguarding duties stated openly	Consent for any contact with the doctor or clergy is recorded; risks are explicit
3. Work alongside	Coping, grief, spiritual struggle, scrupulosity, pressure or harm in a church setting; prayer used as a resource where the client wishes	Distress lessens; medical care continues; the client's own faith language becomes a resource rather than a source of fear
Throughout	Child safeguarding and medical risk	Any refusal of needed care for a child triggers the safeguarding steps in 4.12 at once

[synthesis, drawing on the CFI supplementary modules (APA, 2013)]

3. Guiding principles

Attribute, do not adjudicate. Spirit baptism, tongues and divine healing are described as the church teaches them, neither stated as fact nor dismissed. In practice, say "in your church's teaching…" rather than agreeing or debunking. [source: Vieten et al. 2013 abstract; synthesis]
Prayer is never a treatment for physical disease in your work. Health questions go to the client's doctor. In practice, never suggest that prayer can replace diagnosis or treatment, and never discourage prayer alongside it. [synthesis]
Use the church's own stance on medicine. The AG's 2010 paper says healing faith does not compete with medical care. In practice, this gives most AG clients a faith-consistent reason to keep seeing their doctor. [source: AG Divine Healing position paper 2010]
Client-led, consent-based integration. Religious material enters therapy only as far as the client wishes. In practice, ask before praying, quoting Scripture or contacting clergy. [synthesis]
Children's safety overrides every accommodation. In practice, a child's need for medical care is never negotiated around religious belief; follow your local reporting law. [source: Glauser 2011 CMAJ, reporting Asser and Swan 1998; synthesis]
Normative religious experience is not a symptom. Tongues in a supportive community is culturally normative. In practice, assess distress, impairment and context before considering a disorder; DSM-5-TR lists a religious or spiritual problem as a focus of clinical attention, code Z65.8. [synthesis]
Competence and humility. Vieten et al. (2013) propose 16 basic spiritual and religious competencies (attitudes, knowledge, skills) for all psychologists. In practice, learn the client's tradition, consult, and know your limits. [source: Vieten et al. 2013 abstract]
Stay in role. You are not the client's pastor, elder, prophet or healer. In practice, do not lay on hands, anoint, pray in tongues, or pronounce healing; refer spiritual direction to the client's church. [synthesis]
Watch your own commitments. Your own belief or unbelief about tongues and healing will show. In practice, self-disclose only briefly and only for the client's benefit; follow your profession's ethics code [synthesis].
Name harm without condemning the tradition. The AG itself acknowledges abuses and excessive claims. In practice, help clients separate harmful practices they met from their faith as a whole. [source: AG Divine Healing position paper 2010; synthesis]

4. Intervention inventory

These are the therapist's interventions alongside the observance. None of them is a church rite, and none is offered as a treatment for physical disease. Sources are named per item; where none applies the item is marked [synthesis].

4.1 Exploring what Spirit baptism, tongues and healing prayer mean to the client

Purpose: to understand the experience in the client's own words (empowerment, closeness to God, belonging, assurance, or doubt and pressure) before any formulation. Use it at intake with any client who mentions Pentecostal or charismatic faith, and again whenever these themes arise. [synthesis; source for the doctrines: AG papers above]
Steps: (1) Ask permission to talk about faith. (2) Ask when and how they came to faith and whether they have received Spirit baptism, in their church's terms. (3) Ask what tongues or being prayed for is like for them and what it does in their life. (4) Ask how their church understands healing and what they have been taught about medicine. (5) Ask what their church community gives them and costs them. (6) Reflect back using their vocabulary ("Spirit-filled", "prayer language", "the elders prayed over me") and check you have it right.
Example language (illustrative): "Your faith sounds central for you. Would it help if we talked about it here? … When you pray in tongues, what is that like, and what does it give you?"
Watch for: relief and fuller disclosure when the client feels respected (working); guarded, short answers or apologising for their faith (they expect judgement, so slow down); themes of fear, shame, "not enough faith" or pressure, which point to 4.4, 4.7 or 4.9.

4.2 Cultural Formulation Interview with the Spirituality, Religion and Moral Traditions module

Purpose: a structured cultural assessment. The DSM-5 CFI has 12 supplementary modules. Module 5 (Spirituality, Religion and Moral Traditions, 16 items) explores religious identity and affiliation, the tradition's role in daily and family life, private and communal practices, how the tradition helps the person cope (leaders, texts, practices), and possible strain (the tradition contributing to the problem, distress, discrimination, conflict). The APA allows clinicians to reproduce the CFI for use with their patients. Use it at assessment and when religious themes and the presenting problem are tangled. [source: APA CFI Supplementary Modules]
Steps: (1) Run the core CFI or fold its themes into intake. (2) Add Module 5; also consider Module 1 (Explanatory Model, for beliefs about the cause of illness), Module 7 (Coping and Help-Seeking) and Module 12 (Caregivers) when the client is caring for a sick relative. (3) Paraphrase the items in natural language; do not read them like a checklist. (4) Record the client's explanatory model of any illness (for example sickness as spiritual attack, testing or plain physical illness) alongside the medical one. (5) Summarise strengths and strains with the client. [source: APA CFI Supplementary Modules; synthesis for steps]
Example language (illustrative): "Some people find their faith helps with what they're going through, and some find it adds pressure, or both. How has it been for you?"
Watch for: the client's explanation of illness differing from the doctor's (a cue for 4.5 and 4.6); church conflict or exclusion; signs that strain outweighs support. Working: a shared formulation that includes faith as a resource.

4.3 Telling normative tongues and ecstatic worship apart from psychopathology

Purpose: to avoid pathologising a normative practice while not missing psychosis, mania, dissociation or a seizure disorder. Use it when a referrer or family member raises "strange speech" or visions, or when worship experiences are part of a mental-health presentation. [synthesis]
Steps: (1) Establish context: is glossolalia taught and practised in the client's church (it is, in AG teaching), and does it happen in worship or prayer, within the client's control? (2) Ask whether co-religionists see the experience as normal for their community; the CFI explanatory-model questions help. (3) Screen for features outside the religious frame: loss of control, distress, impairment, disorganised speech or behaviour in daily life, reduced need for sleep, persecutory or grandiose beliefs that the client's own community would not share, amnesia or loss of time. (4) Seek medical assessment for episodes with features suggesting seizure or medical cause. (5) If unsure, consult a clinician familiar with the tradition and, with consent, ask the client's pastor what is usual in that church. (6) Where the issue is a religious or spiritual problem rather than a disorder, DSM-5-TR lists it as a focus of clinical attention, code Z65.8. [synthesis]
Example language (illustrative): "In your church, praying in tongues is part of worship. I'd like to understand how it is for you: does it come when you choose to pray, and does it ever happen at times you don't expect?"
Watch for: your own unfamiliarity making normal practice look odd; equally, a family attributing a manic or psychotic episode to the Spirit, or to demons, and delaying care. The 2006 Penn study describes brain changes during tongues in five healthy-seeming practitioners; it is not a diagnostic test. [source: Penn Medicine 2006]

4.4 Supporting a client who has not spoken in tongues, or feels pressure to

Purpose: the AG urges believers to seek Spirit baptism and treats tongues as its initial evidence, so some clients feel second-class, anxious or pressured when it has not happened. The AG papers cited here do not rank believers who have not spoken in tongues [source: Hartwick, Enrichment; AG News 1999]. Use when a client reports shame, doubt or pressure around receiving. [synthesis]
Steps: (1) Explore the meaning: what do they believe it says about them that it has not happened? (2) Separate their church's teaching from the pressure they have felt from particular people. (3) Ask who in their tradition they trust to talk with about it (pastor, mentor) and whether they would like to. (4) Work on the shame and anxiety with ordinary methods (cognitive work, self-compassion) in their own faith language. (5) Screen for scrupulosity (4.8) if the client is stuck in repeated checking or reassurance seeking. [synthesis]
Example language (illustrative): "It sounds as if part of you is afraid this means something is wrong between you and God. What has your church actually taught about that, and what have you told yourself?"
Watch for: reduced shame and more freedom to raise the question with a trusted church leader (working); compulsive seeking, repeated altar visits driven by fear, or panic around worship (consider 4.8); coercive group pressure (consider 4.9).

4.5 Supporting clients who rely on prayer for healing

Purpose: to respect prayer as the client's core coping resource while making sure physical illness is diagnosed and treated. Use whenever a client with a physical or mental illness says they are relying on prayer, healing services or anointing, or are reluctant to start, continue or disclose treatment. [synthesis; source for the church stance: AG Divine Healing position paper 2010]
Steps: (1) Ask what they are praying for, who prays with them, and what prayer gives them (peace, hope, community). (2) Ask directly about current medical care: diagnosis, treatment, appointments, and whether they have stopped or are tempted to stop anything. (3) Ask what their church teaches about doctors; for AG members, note that their denomination's 2010 paper says healing faith does not compete with medical care and that God may work through doctors. Invite them to say how that sits with them. (4) Frame prayer and treatment as "both/and". (5) If they are declining treatment, explore fears (lack of faith, giving up on God, side effects, cost, past experiences) without arguing theology. (6) With consent, coordinate with their doctor (4.6) and, if they wish, their pastor (4.11). (7) If they ask about research, give it in one sentence each (4.13). (8) Document the discussion and any risk. [synthesis]
Example language (illustrative): "Prayer clearly carries you through this, and I'm not going to ask you to stop. I would like to make sure your doctor is in the picture as well. Your church's own teaching says faith and medicine aren't in competition. How does that fit with what you believe?"
Watch for: working signs are continuing treatment, open talk with the doctor, and prayer described as comfort and strength. Warning signs are claims of being healed followed by stopping medication, missed appointments, hiding symptoms from the church or the doctor, and fear that seeking treatment shows unbelief. The AG's Trask notes that ministers should not tell people they are healed [source: Trask, Enrichment 2007]; a client told so by someone may need help reconciling that with their symptoms.

4.6 Coordinating with the client's doctor

Purpose: to route all physical-health decisions to medical professionals and keep the care team informed of relevant beliefs. Use whenever illness is present and treatment adherence may be affected. [synthesis]
Steps: (1) Get written consent specifying what you may share. (2) Tell the doctor, with the client's agreement, that faith is an important coping resource and whether there is any risk of stopping treatment. (3) Do not advise on medicines or doses; refer every medication question to the prescriber. (4) Encourage the client to raise their beliefs with the doctor directly; rehearse the conversation if helpful. (5) If there is imminent risk to the client's life and they have capacity, respect their right to decide while ensuring they are fully informed; if capacity is in doubt, follow local law and consult. [synthesis]
Example language (illustrative): "Would you be willing for me to let your doctor know how much your faith matters to you, so they can work with that too?"
Watch for: the client feeling the doctor dismisses their faith (support them to say so); misunderstanding of a diagnosis; your own drift into giving medical advice.

4.7 When healing does not come: grief, self-blame and spiritual struggle

Purpose: to help clients whose prayers for healing (theirs or a loved one's) were not answered as hoped, and who may blame themselves, feel abandoned or doubt. Use after a death, a worsening illness, or a failed healing service. [synthesis]
Steps: (1) Make room for grief and anger, including anger at God, without hurrying to resolution. (2) Ask what they believe the outcome means and who has told them so. (3) If the client is AG or similar, note, as their tradition does, that the AG teaches an "already and not yet", says it does not fully understand why some are healed and others not, and that sickness is not always linked to specific sin; let them weigh this. (4) Identify and gently test self-blame ("I didn't have enough faith"). (5) With consent, connect them with a pastor they trust for theological questions and with their community for support. (6) Use ordinary grief and trauma methods as indicated. [source for the theology: AG Divine Healing position paper 2010; steps: synthesis]
Example language (illustrative): "You've been carrying the thought that this happened because your faith wasn't strong enough. I notice even your church's own teaching says it doesn't know why some people are healed and others aren't. What would it be like to hold that?"
Watch for: guilt easing and the client finding a way to stay connected to faith or to leave it on their own terms (working); complicated grief, depression or suicidal thinking (assess risk under current standards); being told by others that their loved one died through lack of faith (consider 4.9).

4.8 Scrupulosity and religious OCD

Purpose: to recognise when religious fear has become obsessional and adapt exposure and response prevention (ERP) respectfully. Themes that can arise in this tradition include fear of having committed the unforgivable sin against the Holy Spirit, compulsive doubt about salvation or Spirit baptism, and checking whether one's faith is "enough" for healing. Use when religious worry is repetitive, distressing, time-consuming and relieved only briefly by reassurance, prayer repetition or confession. [synthesis]
Steps: (1) Assess with standard OCD measures and map obsessions and compulsions, including religious rituals done to neutralise anxiety rather than out of devotion. (2) Psychoeducate: distinguish the client's faith from the OCD "rules" that exaggerate it. (3) With consent, consult the client's pastor or a trusted religious authority to agree what practice their tradition actually requires, so that exposures do not ask the client to violate their faith. (4) Build a graded exposure hierarchy with the client's informed consent; begin low, never force exposures, and agree a stop signal. (5) Reduce compulsive reassurance seeking (from you, family and church leaders) gradually, with the client's agreement. (6) Keep devotional practice the client values; target only compulsive, fear-driven repetition. [synthesis]
Example language (illustrative): "Your pastor has said your faith doesn't require you to pray this again and again until it feels right. The OCD says it does. Which voice do you want to train yourself to follow?"
Watch for: contraindications to exposure (acute suicidality, active psychosis, severe untreated depression); the therapist straying into theology; reassurance from clergy feeding the cycle; exposures that feel blasphemous to the client (revise them with the religious adviser). Working: less time spent on rituals and more freedom in worship.

4.9 Harm in healing or deliverance settings, moral injury and religious trauma

Purpose: to help clients hurt by excessive healing claims, public blame for lack of faith, pressure to abandon treatment, financial exploitation or coercive leadership. The AG itself acknowledges "abuses regarding divine healing" and "excessive claims and unfounded judgments" [source: AG Divine Healing position paper 2010]. Use when the client describes such experiences, or when leaving a church is part of the presenting problem. [synthesis]
Steps: (1) Listen and believe; avoid either defending or condemning the tradition as a whole. (2) Assess for trauma symptoms, moral injury (shame or guilt for having stopped a relative's treatment, for example), depression and suicide risk. (3) Assess current coercion: isolation from outsiders, control over medical decisions or money, threats of spiritual consequences for leaving, punishment for questioning. (4) Help the client distinguish their own faith from the practices that hurt them; they may stay, change church or leave. (5) Treat trauma with evidence-based methods, adapted to their language. (6) Where abuse of a vulnerable adult or a child is disclosed, follow safeguarding law and policy. Name individual leaders as wrongdoers only where courts, regulators, independent investigations or major news report it. [synthesis]
Example language (illustrative): "What happened to you at that meeting wasn't your fault. Some people in your own denomination would call it an abuse of healing ministry. What would you want your faith to look like now?"
Watch for: self-blame, all-or-nothing rejection or idealisation, loss of community and identity on leaving, and anniversary reactions. Working: a coherent account of what happened and a chosen relationship with faith and community.

4.10 Accommodation in scheduling and treatment

Purpose: to make therapy fit the client's religious life. Use from the start. [synthesis]
Steps: (1) Ask about service times, mid-week meetings, revivals or conferences, and avoid clashes where you can. (2) Ask whether they would like faith brought into sessions and how (their own Scripture, prayer before or after a session that they lead, a faith-based coping plan). (3) If the client asks you to pray, it is the client's prayer: you may sit respectfully; whether you join is a matter for your role, ethics and conscience, and is not the same as leading it [synthesis]. Do not pray in tongues, anoint or lay hands on the client. (4) Translate techniques into faith language where it helps (for example worry postponement framed as "bringing it to God at a set time"), always with the client's agreement. (5) Respect that the client may want to attend a healing service during treatment; plan around it and debrief afterward if helpful.
Example language (illustrative): "If it would help, we can begin by giving you a moment to pray in your own way. Shall I wait quietly while you do?"
Watch for: the client feeling they must hide faith from you, or that you are performing faith you do not hold. Working: the client says therapy and church feel compatible.

4.11 Collaboration with pastors, elders and chaplains

Purpose: to coordinate when the client wishes; the AG gives elders and pastors the role of praying for the sick, anointing and pastoral care [source: Trask, Enrichment 2007]. Use when the client asks, when theological questions sit beyond your competence, or in scrupulosity work (4.8). [synthesis]
Steps: (1) Ask the client whether and why they want contact. (2) Obtain written consent stating what you may share and for how long. (3) Agree the goal of contact (supporting medical adherence, clarifying teaching on scrupulosity, supporting the client after a loss). (4) Keep roles clear: the pastor gives spiritual care; you give psychological care; the doctor gives medical care. (5) Respect a client's choice not to involve their church. (6) In hospital, the chaplaincy team can offer pastoral and sacramental care. [synthesis]
Example language (illustrative): "Would it help if I spoke with your pastor about how your church sees treatment, so you're not caught in the middle?"
Watch for: confidentiality breaches; a pastor who opposes treatment (do not argue theology: refocus on the client's health and, if a child is involved, on safeguarding); a dual relationship if you attend the same church.

4.12 Safeguarding: children and refusal of medical care

Purpose: to protect children whose carers rely on prayer instead of medical treatment. A CMAJ news report (Glauser 2011) describes a 1998 study by Asser and Swan of 172 child deaths in faith-healing contexts in the US between 1975 and 1995; according to that report, 140 of the children died of conditions that were easily curable or treatable [source: Glauser 2011 CMAJ; the original paper is not verified]. The AG's own position is that divine healing does not compete with medical care [source: AG Divine Healing position paper 2010]; the CMAJ report notes that 28 of the deaths were in Christian Science families. Use whenever a client is a parent or carer, or describes a child who is ill and not receiving care. [synthesis]
Steps: (1) At assessment, ask any parent with health-related faith beliefs how they decide when a child needs a doctor. (2) Know your local law and service policy: child-protection duties apply regardless of religious motive; legal religious exemptions differ between jurisdictions (the CMAJ report contrasts Canada, with none to criminal charges such as neglect, with some US states). (3) If a child is ill and care is being withheld or delayed, act at once: urge immediate medical assessment and, if that is refused or the child is at risk, contact child-protection services or emergency services as your law requires. (4) Do not wait for a pastor's view before acting on a risk to a child. (5) Tell the parent openly what your duty is, where safe to do so. (6) Continue supporting the parent's faith while insisting on the child's care. (7) Document and consult your supervisor. Never name children in notes shared outside the record or in teaching. [synthesis]
Example language (illustrative): "I respect how much you trust God for your child. I also have a duty to make sure every child gets medical care when they're ill. Your church itself says prayer and doctors go together. Can we get them seen today, and keep praying too?"
Watch for: vague answers about a child's symptoms; children of adolescent age being pressured to refuse care; parents under church pressure; your reluctance to report because of respect for the faith. Working: the child is seen and the alliance with the parent survives where possible.

4.13 Talking about research on prayer and healing, when the client asks

Purpose: to answer honestly and briefly without attacking faith. Use only if the client raises it. [synthesis]
Steps: (1) Ask what prompts the question. (2) State the evidence in one line each: in the STEP trial of cardiac bypass patients, prayer by others did not reduce complications, and those told they would certainly be prayed for had slightly more [source: AAFP summary of Benson et al. 2006]; a Cochrane review found intercessory prayer neither significantly beneficial nor harmful and made no recommendation for or against it [source: Cochrane, Roberts et al. 2009]. (3) Note that such studies test prayer as a medical intervention, which is not how many believers understand prayer. (4) Return to the client's meaning and medical care. [synthesis]
Example language (illustrative): "The trials didn't find that people being prayed for recovered better from surgery. Many believers would say prayer isn't a medical treatment anyway. What does praying for healing mean to you?"
Watch for: using research to argue the client out of faith (stop); the client using the absence of harm in research as a reason to delay treatment (redirect to 4.5).

4.14 Grief, ritual and community support

Purpose: to draw on the church's resources for illness and loss (prayer partners, elders' visits and anointing, community meals, funerals and memorials). Use when illness, dying or bereavement is present. [source for rites: Trask, Enrichment 2007; synthesis]
Steps: (1) Map who in the church is supporting the client and how. (2) Encourage use of supports the client finds helpful; respect withdrawal where church contact hurts. (3) Help plan rituals of goodbye that fit the client's faith. (4) Watch for community responses that add blame, and help the client respond or set limits. [synthesis]
Example language (illustrative): "Who from your church has been with you through this, and who has been hard to be around?"
Watch for: isolation, or support turning into pressure to show faith by being "fine".

4.15 Therapist role, self-awareness and self-disclosure

Purpose: to keep a clear professional role. Vieten et al. (2013) set out 16 spiritual and religious competencies for psychologists, grouped as attitudes, knowledge and skills [source: Vieten et al. 2013 abstract]. Use throughout, in supervision. [synthesis]
Steps: (1) Reflect on your own views of tongues, healing and Pentecostalism. (2) Avoid dual relationships with clients from your own congregation or seek supervision when unavoidable. (3) Disclose your faith or non-faith briefly and only for the client's benefit. (4) Know when to refer: to a therapist with religious competence, to clergy for spiritual questions, to medical care for every physical-health question. (5) Follow your profession's ethics code. [synthesis]
Example language (illustrative): "I'm not a pastor, so I won't try to answer the theological question for you. I can help with how it's affecting you, and help you find someone in your tradition to explore it with."
Watch for: proselytising in either direction; being drawn into the healer role; countertransference after a child-safeguarding case.

5. Handling problems

The sources cited describe the church's teaching, not therapy problems. All guidance in this section is [synthesis] unless a source is named.

The client believes they are healed and has stopped medication. Do not dispute the healing. Ask what their doctor said and invite a check-up "to confirm what God has done"; many clients accept this framing. Point out, if they are AG, that their denomination does not set healing against medicine [source: AG Divine Healing position paper 2010]. With consent, inform the prescriber. If the risk is serious and capacity is doubtful, follow local law.
The client fears that seeing a doctor shows lack of faith. Explore where the belief came from. Ask what their pastor would say; offer a joint conversation (4.11). Use their tradition's own sources rather than your arguments.
The client is suspicious of therapy as secular or anti-faith. Name your respect for their faith early, state your role limits (4.15), offer faith-integrated options (4.10) and, if they prefer, refer to a religiously competent or same-faith therapist.
Stuck in "not enough faith" guilt. Treat it as a belief to explore, not a theological dispute; check for depression and scrupulosity (4.8); invite a trusted pastor's view.
Overwhelm after an intense healing service or deliverance session. Ground the client in the present, assess for dissociation, panic or trauma symptoms, check physical safety, and plan for future services (whether to attend, with whom, when to step out). If psychotic or manic features appear, arrange urgent psychiatric assessment (4.3).
Family conflict over treatment (one spouse wants medicine, the other prayer). Hold both views, focus on the patient's own informed choice and, for children, on safeguarding (4.12).
A pastor or group opposes treatment. Do not argue theology. Keep the focus on the client's informed choice; if a child is involved, safeguarding duties apply regardless (4.12).
Rupture: the client feels you dismissed a religious experience. Acknowledge it plainly, apologise, ask what you missed, and repair before continuing.
Rupture: you feel drawn into the healer role or asked to pray in tongues. Decline kindly, explain your role, and offer to help the client find that support in their church.
Non-adherence to homework. Check whether the task conflicts with their practice; reframe it in faith language with their agreement, or change it.
Grief after a death despite prayer, especially a child's. Assess for complicated grief, depression and suicide risk under current standards; watch for moral injury where treatment was refused (4.9); avoid both blame and false reassurance.
Leaving the church. Expect loss of community, identity and family ties; support the client's own pace; screen for religious trauma (4.9).
Your own reaction to a safeguarding case. Use supervision; separate anger at the outcome from your stance toward the client and their faith.

Sources

Web pages:

Works cited through the web sources above:

Benson, H., et al. (2006). Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients. American Heart Journal, 151, 934-942.
Roberts, L., Ahmed, I., & Davison, A. (2009). Intercessory prayer for the alleviation of ill health. Cochrane Database of Systematic Reviews, Issue 2, CD000368.pub3.
Asser, S. M., & Swan, R. (1998). Child fatalities from religion-motivated medical neglect. Pediatrics. Figures as reported by the CMAJ news report (Glauser 2011) [uncertain: original not verified].
Newberg, A. B., et al. The measurement of regional cerebral blood flow during glossolalia: a preliminary SPECT study. Psychiatry Research: Neuroimaging (as reported by Penn Medicine, 2006).
Vieten, C., Scammell, S., Pilato, R., Ammondson, I., Pargament, K. I., & Lukoff, D. (2013). Spiritual and religious competencies for psychologists. Psychology of Religion and Spirituality, 5(3), 129-144.

Also referred to, marked [uncertain] or [synthesis] in the text: DSM-5-TR (religious or spiritual problem, Z65.8); IOCDF scrupulosity materials.

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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