Spiritual disciplines (Foster, Renovaré)

1. Introduction

Version followed: Richard J. Foster's Celebration of Discipline (twelve classical disciplines; HarperSanFrancisco edition of 1998 as catalogued in a published review) and the Renovaré movement he founded, as Renovaré publishes it today: the six streams (Streams of Living Water), the Renovaré Covenant, A Spiritual Formation Workbook (James Bryan Smith and Lynda L. Graybeal, 2007), Fellowship of the Burning Heart Listening Groups and the two-year Renovaré Institute. [source: Renovaré author, book, Covenant, FAQ pages; Spirituality & Practice review]

What it is. This is a modern Protestant spiritual-formation movement and its teaching, not a therapy. Foster, a pastor educated at George Fox University and Fuller Theological Seminary, is credited by Renovaré with bringing ancient Christian practices back to many contemporary evangelicals and other Protestants; Renovaré describes itself as "a community of Christians seeking continual spiritual renewal in Christ." [source: Renovaré author page; Institute FAQ] Nothing in it is secret or initiatory: the books, the Covenant and group materials are publicly available, and Renovaré does not certify teachers or train spiritual directors.

Core idea of change, as the movement states it. The disciplines are not achievements that earn favour with God; in the Covenant's framing, a person, in dependence on Christ, intends to seek continual renewal through spiritual exercises, spiritual gifts and acts of service (paraphrased), and signing marks an intention to seek renewal rather than to try harder. Change is understood by the tradition as God's work of grace, which the disciplines place a person in a position to receive; Foster's image is that the disciplines "beckon us to the Himalayas of the Spirit." [source: Renovaré Covenant page; Spirituality & Practice review] These are theological claims of the tradition, reported here, not clinical claims.

For the therapist. Your work is not to teach the disciplines but to understand them as the client lives them, support client-led integration where the client wants it, notice where a practice is serving or harming wellbeing, and collaborate with or refer to the client's pastor, group or spiritual director. [synthesis]

2. Framework

The movement's own structure [source: Renovaré pages and review cited]:

Twelve disciplines in three groups (Foster). Inward: meditation, prayer, fasting, study. Outward: simplicity, solitude, submission, service. Corporate: confession, worship, guidance, celebration. Foster does not present these as a fixed sequence of stages [uncertain: not verified for the whole book]; they are a repertoire.
Six streams (Foster, Streams of Living Water; Renovaré). Contemplative: the prayer-filled life. Holiness: the virtuous life. Charismatic: the Spirit-empowered life. Social justice: the compassionate life. Evangelical: the Word-centred life. Incarnational: the sacramental life. Renovaré presents these as six dimensions of faith and practice seen across church history and embodied in Christ; the aim is balance across streams rather than mastery of one. [source: Spiritual Formation Workbook page; Six Streams page]
Renovaré Covenant. A personal statement of intention made between the believer and God (not a contract with Renovaré), naming Christ as Saviour, Teacher, Lord and Friend; Foster pairs it with "common disciplines" drawn from the six streams as the means of living it out. It is made individually but assumes community, local and dispersed. [source: Covenant page; the list of common disciplines per stream: uncertain: not verified]
Groups. A Spiritual Formation Workbook gives guidelines for starting a Renovaré Spiritual Formation Group, study plans for the first nine sessions, and a questionnaire to map the way ahead. Today Renovaré also runs Fellowship of the Burning Heart Listening Groups: members commit to the Covenant, the group's core values and a monthly meeting (a one-year group is described), following a set Order of Meeting with extended prayerful silence, listening without interrupting or advising, praying aloud for others and receiving prayer. Entry is by a drop-in group, application, a discernment meeting with a Coordinator and registration; there is no charge for approved applicants. [source: Workbook page; FBH FAQ]
Renovaré Institute. A two-year cohort (up to 45 students) leading to a certificate in Christian Spiritual Formation: four mandatory one-week residencies, online coursework (roughly a book a month and an article a week), reading notes, exercise journals, papers, a final project, small groups of 5–6 meeting monthly by video, and required spiritual direction for the last 18 months. It states it is not a programme for training spiritual directors. [source: Institute FAQ]

Therapist's framework alongside it (no published clinical protocol exists for this movement; phases below are [synthesis]):

Phase	Goal	Format	Move on when
1. Assessment	Understand the client's tradition, which disciplines and streams they practise, group involvement, and how practice relates to the presenting problem	Part of intake; use cultural formulation questions	Client has said whether and how they want faith in therapy
2. Consent and contract	Agree the role of faith in treatment, limits of the therapist's role, and any contact with pastor, group or director	One explicit conversation, revisited	Written or recorded consent; roles clear
3. Integration	Client-led use of chosen disciplines as resources (e.g. solitude for reflection, service for behavioural activation), alongside the evidence-based treatment	Woven into ordinary sessions	Practice is helping, not driving symptoms
4. Review	Check for scrupulosity, perfectionism, over-fasting, isolation, coercive dynamics or adverse contemplative experiences	Periodic	Problems addressed or referred

No session counts or durations are given by Renovaré for therapy use; the group and Institute figures above are the movement's own. [source: as cited; table: synthesis]

3. Guiding principles

[source: Covenant, Institute FAQ, FBH FAQ, IOCDF, Vieten et al. 2013 where stated; otherwise synthesis]

Grace, not effort, is the tradition's frame. Practical meaning: when a client treats disciplines as a performance test, reflect back the movement's own language of intention and dependence rather than arguing theology. [source: Covenant page]
Client-led integration. Practical meaning: the client chooses whether any discipline enters therapy, and in their own words and tradition. [synthesis]
Attribute, do not adjudicate. Practical meaning: speak of "what your tradition teaches" or "what you experienced as God's voice"; neither affirm nor dismiss religious claims. [synthesis]
The therapist is not a spiritual director. Practical meaning: no assigning of disciplines as spiritual tasks, no discernment of God's will on the client's behalf; refer to a spiritual director, pastor or group. Renovaré itself separates formation from spiritual direction training. [source: Institute FAQ; synthesis]
Competence in religion and spirituality is a professional duty. Practical meaning: know the basics of the client's Protestant subtradition and examine your own attitudes; Vieten et al. (2013) proposed 16 basic spiritual and religious competencies (attitudes, knowledge, skills) for psychologists. [source: Vieten et al. 2013, via IONS page]
Balance across streams. Practical meaning: a client locked in one stream (e.g. holiness as relentless self-scrutiny) may welcome, from their own tradition, the counterweight of another (celebration, contemplative rest); explore, do not prescribe. [source: six streams as published; application: synthesis]
Encourage often, advise rarely, condemn never. Practical meaning: this Listening Group value overlaps with good therapeutic listening and can be named as common ground. [source: FBH FAQ]
Faith is not the enemy of treatment. Practical meaning: for scrupulosity, frame ERP as separating OCD from faith, as IOCDF does. [source: IOCDF]
Health questions go to the doctor. Practical meaning: fasting, sleep and exertion questions are routed to the client's physician; no practice is presented as treating physical disease. [synthesis]
Power is watched. Practical meaning: submission, guidance and confession involve other people's authority; check that the client's practice is freely chosen and safe. [synthesis]

4. Intervention inventory

Part A gives each discipline and Renovaré practice as the movement publishes it, with how a psychotherapist meets it in a client's life. Part B gives the psychotherapist's own procedures. The steps under each discipline are the therapist's steps, not instructions for performing the discipline. Descriptions of individual disciplines draw on a published review of Celebration of Discipline; where only the name is verified, the gloss is marked. [source: Spiritualityandpractice.com review; Renovaré pages]

Part A. The disciplines and Renovaré practices

A1. Meditation (inward)

Purpose and when to use: Foster defines Christian meditation as "the ability to hear God's voice and obey his word"; it involves entering God's presence and positive use of the imagination, often with Scripture. [source: review] Relevant when a client names meditation or Scripture reflection as a resource, or when imaginative prayer is linked to distress.
Steps: (1) Ask what form the client uses (Scripture reflection, imaginative entry into a Gospel scene, silent attention). (2) Ask what it is like, and what they do with what they sense. (3) If the client wishes, agree how the practice may sit alongside treatment (e.g. a reflective time they already keep, used for noticing feelings). (4) Leave method and content to the client and their tradition. [synthesis]
Example language (illustrative): "When you meditate on a passage, what tends to happen for you, in your body and in your thoughts?"
Watch for: vivid imagery turning into intrusive or traumatic memory; hearing "God's voice" as harsh commands (explore gently, assess for depression, OCD or psychosis without pathologising ordinary religious experience); critics within evangelicalism object to imaginative prayer, so some clients feel guilt about it (see 5). Working: the client reports steadiness, clarity or comfort and no rise in symptoms. [synthesis; critique: Reachout Trust 2012]

A2. Prayer (inward)

Purpose and when to use: Foster presents prayer as leading into "perpetual communion with the Father" and describes brief spontaneous "flash prayers" for people one meets or thinks about. [source: review] A critic reports that Foster also teaches complaint prayers and short "breath prayers" (a brief prayer phrase prayed with the breath); these are mentioned here only as a public outline. [source: Reachout Trust 2012, critical source]
Steps: (1) Map how the client prays and how often. (2) Ask whether prayer brings relief, connection or pressure. (3) With consent, identify forms that already support coping (e.g. lament or complaint prayer as a culturally congruent way to voice anger and grief). (4) Do not lead prayer in session unless your setting, role and the client's explicit request make that appropriate; most therapists should not. [synthesis]
Example language (illustrative): "Some people in your tradition bring complaint and grief straight to God. Is that something that fits for you?"
Watch for: prayer that has become ritualised checking (repeating until it feels "right", fear that a prayer was invalid), which suggests scrupulosity (see B4); prayer used only to avoid feared situations. Working: prayer described as relational and freeing rather than compulsive. [source: IOCDF on excessive prayer as an OCD ritual]

A3. Fasting (inward)

Purpose and when to use: Foster includes fasting among the inward disciplines; the review reports he holds it can open spiritual insights that might not otherwise come. [source: review] Relevant whenever a client fasts, plans a fast, or has a history of disordered eating, diabetes, pregnancy, or medication affected by food.
Steps: (1) Ask neutrally what kind of fast, how long and how often; record without advising on lengths. (2) Screen for eating-disorder history, low weight, pregnancy and medical conditions. (3) Route all health questions to the client's doctor, with consent to coordinate if needed. (4) Where fasting overlaps with restriction, explore with the client and, if they wish, their pastor, whether the tradition offers non-food forms of fasting [uncertain: not verified in Foster's text]. No fasting schedule or food rule is given here. [synthesis]
Example language (illustrative): "Before we go further, would you be willing for us to check this with your doctor, given your health history?"
Watch for: fasting that becomes a route to weight loss, self-punishment or proving devotion; dizziness, fainting, mood swings; secrecy. Working: fasting stays a freely chosen, medically cleared practice with no escalation. [synthesis]

A4. Study (inward)

Purpose and when to use: Study covers Scripture and other books, and also nature and other areas of life, as the review reports. [source: review] Useful as a familiar, structured activity; also a place where rigid reading fuels guilt.
Steps: (1) Ask what the client studies and with whom. (2) With consent, link study to therapy goals (e.g. reading on lament during grief). (3) If texts are used to condemn the self, ask whether a pastor or study group reads the passage differently, rather than offering your own exegesis. [synthesis]
Example language (illustrative): "When you read that passage, which voice do you hear it in?"
Watch for: study replaced by compulsive reassurance-seeking (searching texts to settle doubts); intellectualising as avoidance. Working: study widens perspective. [synthesis]

A5. Simplicity (outward)

Purpose and when to use: Foster frames simplicity as holding the kingdom of God "as the number one priority of our lives." [source: review] Fits values work, overload, consumer debt or acquisitiveness, when the client raises it.
Steps: (1) Invite the client to describe what simplicity means for them. (2) If they wish, use it as a values anchor in values clarification or problem solving. (3) Keep concrete decisions (giving, possessions) with the client. [synthesis]
Example language (illustrative): "If simplicity guided this week, what would you drop first?"
Watch for: austerity or self-denial driven by shame or scrupulosity; pressure from others to give money away. Working: decisions feel freer and lighter. [synthesis]

A6. Solitude (outward)

Purpose and when to use: Solitude is withdrawal from pressure and busyness, which Foster links to greater sensitivity and compassion for others. [source: review] Useful for rest, reflection and boundaries; ambiguous with depression or social withdrawal.
Steps: (1) Distinguish chosen solitude from avoidance: ask what the client returns to afterwards. (2) With consent, plan solitude as restorative time alongside social contact. (3) Before any intensive silent retreat, screen (see B5). [synthesis]
Example language (illustrative): "After time alone, do you come back more connected to people, or further away?"
Watch for: withdrawal, rumination, low mood framed as spiritual; long silence in someone with trauma or psychosis history. Working: solitude is followed by re-engagement. [synthesis]

A7. Submission (outward)

Purpose and when to use: Submission in Foster is giving oneself freely to others. [source: review] Explore with any client in a relationship, family or church where submission language is used, and especially where there is abuse or control.
Steps: (1) Ask what submission means in the client's words and community. (2) Ask whether it is mutual and freely chosen. (3) Screen for domestic abuse and coercive control; safety comes first. (4) If the client wishes, involve a trusted pastor in exploring their tradition's teaching on mutual submission. [synthesis]
Example language (illustrative): "When you give way to others, is that something you choose, or something you feel you can't refuse?"
Watch for: submission language used to keep someone in an abusive situation; inability to say no; fear. Working: the client can describe choice and limits. [synthesis]

A8. Service (outward)

Purpose and when to use: Service in Foster's account includes common courtesy, hospitality and listening. [source: review] Congruent with behavioural activation and with the social justice stream; risky in burnout and caregiver strain.
Steps: (1) With consent, include chosen acts of service in activity scheduling for low mood. (2) Check for over-commitment. (3) Pair service with rest and celebration. [synthesis]
Example language (illustrative): "Which small act of service would actually feel good this week, not just required?"
Watch for: compulsive caretaking, resentment, exhaustion, inability to receive help. Working: service lifts mood without depletion. [synthesis]

A9. Confession (corporate)

Purpose and when to use: Confession is one of Foster's four corporate disciplines. [source: review] Its content in Foster's chapter is [uncertain: not verified]; in Protestant practice it generally means acknowledging wrongdoing to God and, at times, to a trusted fellow believer or pastor [synthesis]. Relevant with guilt, shame, moral injury and scrupulosity.
Steps: (1) Ask whether the client practises confession, with whom, and what follows. (2) Distinguish healthy guilt and repair from compulsive confessing. (3) For moral injury, support the client's own route to repair, including their pastor if they wish. (4) For repeated confessing to relieve doubt, assess for OCD (see B4). [synthesis; IOCDF names excessive confession as a possible OCD ritual]
Example language (illustrative): "After you confess, how long does the relief last?"
Watch for: confessing the same thing repeatedly; confession to someone who misuses the information. Working: confession brings lasting relief and repair. [source: IOCDF; synthesis]

A10. Worship (corporate)

Purpose and when to use: Worship is a corporate discipline in Foster's scheme [source: review]; chapter content [uncertain: not verified]. Relevant as a source of community, meaning and positive emotion, and as a place of distress after church conflict.
Steps: (1) Ask what worship is like now compared with before the problem. (2) Note avoidance of church due to anxiety, shame or harm. (3) If attendance is a goal, plan graded return collaboratively, respecting choices to step away. [synthesis]
Example language (illustrative): "What would a manageable first step back into worship look like, if you want one?"
Watch for: panic or flashbacks in church settings after religious harm; pressure to attend. Working: worship restores connection. [synthesis]

A11. Guidance (corporate)

Purpose and when to use: Guidance is the fourth corporate discipline [source: review]; chapter content [uncertain: not verified]. Renovaré's Listening Groups include sharing what members sense God is saying and receiving prayer. [source: FBH FAQ] Relevant when decisions are being made through group discernment or a leader's direction.
Steps: (1) Ask how decisions are made and who has a say. (2) Support the client's own judgement and values, without discerning God's will for them. (3) Check freedom to disagree with the group. [synthesis]
Example language (illustrative): "If you sensed something different from what the group sensed, what would happen?"
Watch for: decisions about money, relationships or medical care handed to others; fear of leaving. See B7. Working: the client weighs input and decides freely. [synthesis]

A12. Celebration (corporate)

Purpose and when to use: Celebration completes Foster's list of corporate disciplines [source: review]; chapter content [uncertain: not verified]. Clinically congruent with positive activity scheduling and savouring, especially for clients whose faith has become joyless duty.
Steps: (1) Ask where joy and gratitude appear in the client's faith. (2) If they wish, schedule celebratory activities as part of activation. [synthesis]
Example language (illustrative): "Your tradition counts celebration as a discipline too. Where could that fit this week?"
Watch for: celebration felt as another obligation; anhedonia (assess depression). Working: some pleasure returns. [synthesis]

A13. The six streams as a reflective map

Purpose and when to use: Renovaré offers the six streams (contemplative, holiness, charismatic, social justice, evangelical, incarnational) as dimensions of a balanced life with God. [source: Workbook page; Six Streams page] Useful for a client who wants to reflect on where their faith life feels full or depleted.
Steps: (1) Invite the client, if they wish, to describe which streams feel familiar and which feel distant. (2) Explore whether imbalance links to the problem (e.g. holiness-only practice and perfectionism; social justice burnout). (3) Leave choices about practice to the client and their community. A Spiritual Formation Workbook includes a questionnaire for mapping the way ahead; do not reproduce it, but the client may bring it. [source: Workbook page; synthesis]
Example language (illustrative): "Of those six, which ones give you life right now, and which feel like weight?"
Watch for: using the map as a new checklist to fail. Working: the client finds a gentler, more varied rhythm. [synthesis]

A14. The Renovaré Covenant

Purpose and when to use: A personal statement of dependence on Christ and intention to seek continual renewal, signed online; Renovaré stresses it marks intention, not trying harder, and is not a contract with the organisation. [source: Covenant page] Relevant when a client feels they have "broken" commitments.
Steps: (1) Ask what the Covenant means to the client. (2) Where guilt about failing it drives distress, reflect the movement's own framing of intention and grace. (3) Encourage conversation with their group or pastor if they want theological reassurance (avoid becoming the reassurer in OCD; see B4). [source: Covenant page; synthesis]
Example language (illustrative): "From what you've said, the Covenant is about intention rather than a pass–fail test. How does that sit with you?"
Watch for: the Covenant treated as a vow that must be perfectly kept. Working: less guilt, steadier practice. [synthesis]

A15. Spiritual Formation Groups and Listening Groups

Purpose and when to use: Small groups for mutual encouragement in formation. The 2007 workbook supports starting a group with plans for the first nine sessions; current Listening Groups meet monthly with a set Order of Meeting, prayerful silence, listening without advice and prayer for one another, in a confidential culture, after a discernment step with a Coordinator. [source: Workbook page; FBH FAQ] Relevant for clients seeking faith community, or experiencing difficulty in a group.
Steps: (1) Ask about the group: size, commitments, how disagreement is handled. (2) Where isolation is a problem and the client wants it, a group may be a reasonable resource to explore. (3) Clarify that a formation group is not therapy and does not replace treatment. [synthesis]
Example language (illustrative): "What's it like for you to share in that group, and to listen?"
Watch for: confidentiality breaches; shame after disclosure; social anxiety. Working: the client experiences being heard and supported. [synthesis]

A16. Renovaré Institute and other formation training

Purpose and when to use: Information for referral or for understanding a client's formation pathway: a two-year cohort with four residencies, online study, small groups and required spiritual direction in the last 18 months; it gives a certificate in Christian Spiritual Formation and is not training in spiritual direction. [source: Institute FAQ]
Steps: (1) If a client is in the Institute, ask about workload and how residencies affect sleep, mood and family. (2) If they seek spiritual direction, help them find a director through their church or a directors' network. [synthesis]
Example language (illustrative): "How is the programme load sitting alongside work and family?"
Watch for: overload; intense experiences on retreat (see B5). Working: formation supports wellbeing. [synthesis]

Part B. The psychotherapist's own procedures

B1. Spiritual and cultural assessment

Purpose and when to use: At intake and whenever faith is raised, to understand what the disciplines mean in this client's life. The DSM-5-TR Cultural Formulation Interview, with its supplementary module on spirituality, religion and moral traditions, is the standard structured option [uncertain: not verified]; do not reproduce its items.
Steps: (1) Ask an open question about the role of faith. (2) Ask which practices and communities matter (church, Renovaré group, director). (3) Ask how faith helps and how it may hurt with the current problem. (4) Ask whether the client wants faith included in therapy, and how. (5) Record the client's own terms (e.g. "the disciplines", "formation", "streams"). [synthesis]
Example language (illustrative): "Some people find their faith is a big part of how they cope; for others it's complicated. How is it for you?"
Watch for: assuming all evangelicals share views; missing religious harm because the client presents as devout. Working: the client corrects and expands your understanding. Vieten et al. (2013) list knowledge of diverse beliefs and assessment skill among basic competencies. [source: Vieten et al. 2013 abstract; synthesis]

B2. Consent, roles and self-disclosure

Purpose and when to use: Before any explicit use of religious material.
Steps: (1) Explain that you are not a pastor or spiritual director and will not instruct in disciplines or discern God's will. (2) Agree what the client wants (e.g. using their faith language, linking values to goals). (3) Decide in advance how you will handle questions about your own beliefs: brief, client-centred disclosure or a reasoned decline. (4) Avoid dual relationships, e.g. joining the client's Listening Group or church role. (5) Follow your profession's ethics code on competence, respect for religion and multiple relationships. [synthesis]
Example language (illustrative): "I'm glad to make room for your faith here. I'm not trained as a spiritual director, so for questions about practice itself I'd encourage your pastor or a director."
Watch for: the client seeking your spiritual approval; your own religious or secular commitments shaping advice. Working: clear roles, client at ease. [synthesis]

B3. Client-led integration of a discipline into the treatment plan

Purpose and when to use: When the client asks to use a discipline as a resource alongside an evidence-based treatment.
Steps: (1) The client names the discipline and how they already practise it. (2) Link it to a treatment goal in plain terms (solitude as reflective journaling time; service or celebration in behavioural activation; simplicity as a values anchor; study of lament texts during grief). (3) Agree how to check its effect. (4) Review at set points; drop it if it adds pressure. Keep the practice content in the client's hands. [synthesis]
Example language (illustrative): "You said service matters to you. Would you like to put one small act on this week's plan and see how your mood responds?"
Watch for: the discipline becoming homework the client "fails"; spiritualising avoidance. Working: improved mood or functioning with the practice feeling owned. [synthesis]

B4. Scrupulosity: adapting ERP with faith in view

Purpose and when to use: When prayer, confession, Covenant-keeping, study or self-examination become compulsive. IOCDF describes excessive prayer and confession as rituals OCD can mimic, doubt framed as life, death, morality or salvation, and ERP as first-line treatment for scrupulosity. [source: IOCDF]
Steps: (1) Assess for OCD formally; distinguish devotion from rituals by function (anxiety relief, time, impairment). (2) Explain, in IOCDF's terms, that ERP aims to separate OCD from faith, not to oppose it. (3) With the client's consent, consult their pastor about which practices are required by the tradition and which are OCD-driven, so exposures do not ask them to violate sincere beliefs. (4) Build a graded hierarchy with consent (e.g. tolerating uncertainty about a prayer's adequacy, delaying reassurance-seeking); include safety and the right to pause. (5) Ask the pastor and group, if the client agrees, not to provide repeated reassurance. Medication questions go to the prescriber. [source: IOCDF; steps 3–5 synthesis]
Example language (illustrative): "Feeling afraid during this exercise doesn't mean you're betraying your faith. It may mean you're standing up to OCD." (paraphrasing IOCDF)
Watch for: reassurance-seeking moved onto you; faith leaders who frame OCD as lack of trust in God, which IOCDF notes can add stigma. Working: less time on rituals, more freedom in worship. [source: IOCDF]

B5. Screening and response for adverse contemplative experiences

Purpose and when to use: Before and during intensive solitude, silent retreats, extended prayer or Institute residencies. Evidence comes from meditation research rather than Christian practice specifically: Lindahl et al. (2017, PLOS ONE) documented meditation-related challenges in Western Buddhist practitioners, and Farias et al. (2020, Acta Psychiatrica Scandinavica) found adverse events across 83 studies (overall rate about 8%, most often anxiety, depression and cognitive anomalies), including in people with no prior mental health history. Applying these to Christian contemplative prayer is [synthesis].
Steps: (1) Ask about past trauma, psychosis, bipolar disorder, dissociation and current state before intensive practice. (2) Discuss reducing intensity (shorter periods, open-eyed or spoken prayer, walking) and grounding (orientation to the room, contact with people) if difficulties arise. Trauma-sensitive adaptations of the kind Treleaven describes for mindfulness may help [uncertain: not verified]. (3) Distinguish a spiritual crisis or "dark night" experience from psychosis, mania, depression or dissociation by careful assessment, neither pathologising faith nor missing illness; DSM-5-TR lists a religious or spiritual problem as a focus of clinical attention, code Z65.8. (4) With consent, coordinate with the retreat leader or spiritual director. (5) Cheetah House offers consultation and clinician training ("First Do No Harm"). [source: Cheetah House VCE page; PubMed abstract of Farias et al. 2020, Acta Psychiatrica Scandinavica; synthesis]
Example language (illustrative): "Sometimes deep silence brings up hard things. If that happens, it's fine to shorten it and come back to the room."
Watch for: sleep loss, fear, depersonalisation, unusual perceptions, elated mood. Working: experiences settle with reduced intensity and support. [synthesis]

B6. Referral and collaboration with pastor, spiritual director or group

Purpose and when to use: When questions are about practice or theology, or the client wants their faith community involved.
Steps: (1) Get specific written consent. (2) Agree with the client what will and will not be shared. (3) Keep roles distinct: you hold mental health treatment; they hold spiritual guidance. (4) Renovaré enquiries go to the organisation; it does not train spiritual directors, so find directors through the client's church or a directors' network. [source: Institute FAQ; FBH FAQ; synthesis]
Example language (illustrative): "Would it help if, with your permission, I spoke with your pastor about how best to support you?"
Watch for: confidentiality creep; collaborators who oppose treatment. Working: aligned support. [synthesis]

B7. Recognising coercive dynamics and supporting religious trauma

Purpose and when to use: Disciplines such as submission, guidance and confession place authority with others; any congregation can misuse them. Independent investigation, court or regulator finding of misconduct concerning Renovaré: none found in the sources consulted. Public controversy is doctrinal: some evangelical critics (e.g. Reachout Trust, 2012) object to Foster's use of contemplative prayer, imagination and mystical and Catholic sources. [source: Reachout Trust]
Steps: (1) Ask about freedom to question, disagree, leave, and keep money and relationships outside the group. (2) Note signs of coercive control (isolation from outsiders, monitoring, punishment for doubt, leader control of key decisions). (3) For clients leaving a church or group, normalise grief and identity disruption, and support them in deciding what of their faith to keep. Cheetah House lists religious-trauma resources. (4) Address safeguarding if children are at risk. [source: Cheetah House page; steps synthesis]
Example language (illustrative): "Can you question things in your group without paying a price for it?"
Watch for: fear of divine punishment for leaving; your own bias for or against religion. Working: the client makes free choices. [synthesis]

5. Handling problems

Renovaré's materials do not address psychotherapy problems; the guidance below is [synthesis] unless a source is named.

"I'm failing at the disciplines." Perfectionism and shame are common. Response: explore the standard the client holds; reflect the Covenant's own framing of intention rather than effort [source: Covenant page]; consider CBT for perfectionism; suggest the client discuss expectations with their group or director.
Stuck client who spiritualises avoidance ("I'm waiting for guidance"). Response: respect discernment while asking what small, values-consistent step is possible meanwhile; ask what their pastor would say about acting while waiting.
Resistance to therapy as "secular". Response: name respect for faith openly, ask what the client fears therapy will do to it, offer to involve their pastor with consent, and point out common ground (e.g. Listening Group values of encouraging often and condemning never [source: FBH FAQ]). Offer referral to a therapist of their tradition if they prefer.
Overwhelm during contemplative practice or retreat. Response: reduce intensity, ground, increase social contact, assess for psychiatric emergency, coordinate with the retreat leader if the client wishes (see B5) [source: Farias et al. 2020, Acta Psychiatrica Scandinavica; Cheetah House].
Non-adherence to an agreed discipline-linked task. Response: treat it as information, not failure; check whether the task was the client's idea; shrink it or drop it.
Scrupulosity loops (confession, prayer repetition, Covenant anxiety). Response: ERP with faith consultation, refuse to become the reassurer (see B4) [source: IOCDF].
Fasting and health. Response: no advice on fasting practice; coordinate with the doctor; screen for eating disorders; involve the pastor if the client wishes to explore alternatives within the tradition.
Submission and abuse. Response: safety planning and domestic-abuse assessment take priority over theological discussion; involve specialist services; involve clergy only with consent and only if safe.
Guilt about Foster's teaching after critical sermons or websites. Some evangelical critics describe imaginative and contemplative prayer as dangerous or unbiblical [source: Reachout Trust 2012]. Response: do not take sides; help the client clarify their own convictions and, if they wish, talk with a trusted pastor.
Rupture over the therapist's beliefs. Response: acknowledge the impact, re-state your role and respect, repair; consult supervision; refer if your views limit your objectivity.
Client wants the therapist to pray or direct practice. Response: decline warmly where your role and setting do not allow it, explain why, and refer to a director or pastor; some settings permit client-requested prayer, which needs explicit policy and consent.
Leaving church or faith. Response: support grief and identity work at the client's pace; avoid pushing toward either staying or leaving; use religious-trauma resources (e.g. Cheetah House listings) where relevant.
Children in the family. Response: where children are pressured into fasting, harsh discipline or frightening religious practices, follow local safeguarding procedures; seek assent as well as parental consent.

Sources

Web sources:

Books and papers cited:

Foster, R. J. Celebration of Discipline: The Path to Spiritual Growth. HarperSanFrancisco, 1998 edition (ISBN 9780060628390), as catalogued in the review above; original publication date [uncertain: not verified].
Foster, R. J. Streams of Living Water.
Smith, J. B., & Graybeal, L. L. (2007). A Spiritual Formation Workbook: Small Group Resources for Nurturing Christian Growth.
Lindahl, J. R., et al. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLOS ONE.
Farias, M., et al. (2020). Adverse events in meditation practices and meditation-based therapies: a systematic review. Acta Psychiatrica Scandinavica, 142(5), 374–393. doi:10.1111/acps.13225
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.
Treleaven, D. A. Trauma-Sensitive Mindfulness. [uncertain: not verified]
American Psychiatric Association. DSM-5-TR: Cultural Formulation Interview; religious or spiritual problem, Z65.8.
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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