Confession

Domain XIII · Contemplative & religious disciplines

What it is

Confession is the acknowledgement of wrongdoing, to God, to a minister, to a community or to another person, within a framework that the tradition says leads to forgiveness, reconciliation or renewal. Three broad contexts recur:

Format

• Confession is an observance, not a therapy; there is no manual, and no source gives session counts. The phases below organise the therapist's own work alongside it.
• Phase A: Frame and consent (first session, revisited as needed). Goal: the client knows what is and is not confidential in therapy before disclosing. The APA Ethics Code requires discussing the limits of confidentiality and foreseeable uses of information at the outset and again as circumstances…

Who practises it, and how they are trained or regulated

• Version followed: confession as each tradition's institutions publish it (Roman Catholic sacrament of Penance and Reconciliation in the Catechism of the Catholic Church, paras 1461–1498; the Episcopal Church's "Reconciliation of a Penitent", Book of Common Prayer 1979, p. 446ff, as quoted by an Episcopal parish; the Jewish Yom Kippur Viddui; the Theravada fortnightly Patimokkha; Step Five of Alcoholics Anonymous in…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• family or clergy feeling unkind; prepare them. Working when requests fall and the client tolerates not knowing.
• in scrupulosity, "preparing" can become a compulsion; keep to 4.8. Working when the client takes the step they chose.
• missed sessions around holy days being read as resistance. Working when treatment fits the client's religious calendar.
• isolation, community conflict, religious trauma (4.16). Working when the client uses the community as a resource on their own terms.
• the client hearing "your religion is the problem". It is working when the client can tell an OCD-driven confession from one they choose.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.