The fasting calendar

1. Introduction

Version followed: for the Eastern (Byzantine-rite) Orthodox Churches, the Orthodox Church in America's published outline of fasting and fast-free seasons, which derives the rules from the Typikon and the liturgical books; for the Oriental Orthodox Churches, the teaching of a Coptic Orthodox parish of the Diocese of the Southern United States and H. H. Pope Shenouda III's The Spirituality of Fasting as published by the Coptic site St-Takla.org; Ethiopian Orthodox Tewahedo practice only in outline, from a secondary source. Rules, dates and dispensations differ between jurisdictions, calendars (Julian and Revised Julian) and parishes; the client's own church calendar and priest are the authority. [source: OCA outline; St Verena Coptic parish; Shenouda III ch. 10]

What it is. The fasting calendar is the cycle of fast days and fasting seasons that structures the Orthodox year alongside its feasts. The OCA outline names four or five seasons (the Nativity or St Philip's Fast, Great Lent and Holy Week with the preceding Meatfare period, the Apostles' Fast, and the Dormition Fast), weekly fast days (Wednesdays and Fridays outside fast-free weeks), several single fast days tied to feasts, and fast-free periods such as Bright Week after Pascha. The Coptic Church keeps a comparable cycle (Great Lent, the Fast of Jonah or Nineveh, the Nativity, Apostles' and St Mary's fasts, Wednesdays and Fridays) with graded levels of abstinence. The Ethiopian Orthodox Tewahedo Church is described as keeping the most extensive cycle of any church, set out in the Fetha Negest [uncertain: secondary, unverified]; see guide 180 for the Ethiopian cycle. This guide gives no fasting lengths and no food rules: the client's calendar and priest supply those. [source: OCA outline; St Verena parish; Wikipedia EOTC article]

Who leads and authorises it. The calendar belongs to the Church, not to the individual. The OCA outline states that local customs vary and that each person should consult their spiritual father in uncertain cases; the Coptic parish teaching says members keep the fasts as they are able, with the guidance of their spiritual father (in Coptic usage, the father of confession). Individual relaxation is a pastoral blessing, not a private decision. [source: OCA outline; St Verena parish; Saint John the Evangelist parish]

How change happens, as the tradition states it. In the tradition's own terms, fasting is a spiritual discipline joined to prayer, repentance and attention to others, restraining the passions and turning the person toward God and the feast that follows; it is warned against as legalism, display or pride ("the letter kills, but the spirit gives life", quoted on the OCA page). [source: OCA outline; Pravmir; St Verena parish] These are the tradition's claims, reported, not endorsed or disputed.

The psychotherapist's role. The therapist does not teach, set or dispense from the fast. The work runs alongside: understanding what the calendar means in this client's life, assessing it culturally, accommodating it in treatment, screening for health and eating-disorder risks and routing medical questions to the doctor and prescriber, recognising scrupulosity and guilt, and collaborating with clergy when the client wishes. [synthesis]

Health claims. Orthodox fasting has been studied for metabolic effects; a single-centre cohort of Ethiopian Orthodox adults with type 2 diabetes found HbA1c change similar in fasting and non-fasting groups, with more frequent and all severe hypoglycaemia in the fasting group. Evidence status: limited and mixed; the practice is not presented here as a treatment for any disease. [source: Alemayehu 2025, AAU thesis abstract]

2. Framework

This is a religious observance, not a therapy, so there are no manualised phases or session counts; none are given in the sources. The structure below is a working frame tied to the liturgical year. [synthesis]

Phase A: Orientation (any time, ideally before a fasting season). Goals: learn which church, calendar and parish the client belongs to; how they keep the fast and what it means to them; who their priest or spiritual father is; family and community context. Tools: Cultural Formulation Interview core questions and the Spirituality, Religion and Moral Traditions module. Move on when you can state, in the client's words, the role the calendar plays in their life and any tensions around it.

Phase B: Health and safety screen (before each season, or when health changes). Goals: identify medical conditions, pregnancy or breastfeeding, medications, age-related needs, and eating-disorder history or current symptoms; route each to the doctor, prescriber or eating-disorder team; encourage the client to seek the priest's guidance where a modification may be needed. Move on when medical questions have a named owner (doctor, prescriber, dietitian) and the client knows what to ask their priest.

Phase C: Accommodation during the season. Goals: adapt session times, homework, group activities and any meal-based interventions; monitor mood, sleep, energy, eating-disorder cognitions and scrupulosity. Continue throughout the season, with brief check-ins each session.

Phase D: Review at the feast (e.g. after Pascha or the Nativity). Goals: review what helped, any health events, guilt or shame about the fast, community and family experience; adjust the plan for the next season.

Criteria for moving or pausing. Pause Phase C and return to Phase B if there are signs of medical instability, escalating eating-disorder behaviour, or rising scrupulosity; escalate urgently to medical care for red-flag symptoms. [synthesis; eating-disorder and treatment-team points from NEDA and the National Alliance for Eating Disorders]

Format. Integrated into ordinary individual sessions; family sessions where children or mixed households are involved; joint conversation with clergy only with the client's consent. [synthesis]

3. Guiding principles

The Church sets the fast; the therapist does not. Practical meaning: never give fasting lengths, food rules or dispensations; ask what the client's calendar and priest say. [source: OCA outline; Saint John the Evangelist parish]
Dispensation is a pastoral act within the tradition. Practical meaning: help the client take health questions to their priest or spiritual father rather than deciding privately; the parish page cited here explicitly discourages private determinations. [source: Saint John the Evangelist parish; Pravmir]
The tradition itself relaxes the fast for the vulnerable. Practical meaning: you can reflect back, accurately and with attribution, that church sources say the rules should be relaxed for the elderly and those in poor health (OCA), that the very young and the sick are typically exempt (Coptic parish), and that small children, the sick, the very old and pregnant or nursing mothers are exempt from strict fasting, with medical exceptions such as diabetes allowed (Pravmir). [source: OCA outline; St Verena parish; Pravmir]
Health questions belong to the doctor; medication questions to the prescriber. Practical meaning: you screen and route; you do not advise on doses, meal timing for medicines, or nutrition. [source: National Alliance for Eating Disorders; synthesis]
Meaning before management. Practical meaning: start from what the fast means to the client (repentance, belonging, discipline, preparation for a feast) before discussing any adjustment. [source: CFI Module 5; synthesis]
Religion can protect or harm in eating disorders. Practical meaning: screen everyone who fasts for eating-disorder risk without assuming religiosity causes it; NEDA notes intrinsic faith tends to be protective while fasting used for weight control raises risk, and a Finnish twin-cohort study found religiosity was not a central factor in anorexia nervosa. [source: NEDA; University of Helsinki release on Sipilä et al. 2017]
Distinguish devotion from compulsion. Practical meaning: the tradition itself warns against legalism and pride; rigid, fear-driven checking of rules points toward scrupulosity, not piety. [source: OCA outline; Pravmir; Huppert, Siev and Kushner 2007]
Client-led, consent-based collaboration with clergy. Practical meaning: contact a priest only with written consent and a clear question; respect the priest's role as confessor. [synthesis]
Attribute religious concepts. Practical meaning: speak of "what your Church teaches about the fast", neither endorsing nor dismissing it. [synthesis]
Stay in role. Practical meaning: you are not the client's confessor or spiritual father; avoid dual relationships, think carefully about self-disclosure of your own faith or practice, and follow your profession's ethics code and spiritual-competency guidance (e.g. Vieten et al. 2013 [uncertain: not verified]). [synthesis]
Children need safeguarding and assent. Practical meaning: church sources exempt the young; if a child is fasting in ways that harm growth or health, or is pressured, involve parents, the paediatrician and, where required, safeguarding procedures. [source: St Verena parish; Pravmir; synthesis]

4. Intervention inventory

All interventions below are the therapist's own work alongside the observance. None of them sets, shortens, lengthens or dispenses from a fast.

4.1 Mapping the client's fasting calendar and its meaning

Purpose / when: At intake for any Orthodox client, and before each major season. Establishes what the calendar means and how it shapes the client's year, relationships and identity. [synthesis]
Steps:
1. Ask which Church and jurisdiction the client belongs to (for example Greek, Russian, Antiochian, OCA, Serbian, Romanian; or Coptic, Ethiopian, Eritrean, Armenian, Syriac, Malankara) and which calendar their parish follows.
2. Invite the client to sketch the year as they live it: the seasons and feasts that matter most, and when the next one begins. Use the client's own terms (e.g. Great Lent, Pascha, the Nativity Fast, Abiy Tsom).
3. Explore meaning: repentance, preparation for a feast, family memory, belonging to a parish or diaspora community, discipline, solidarity.
4. Explore the social side: who fasts with them, who does not (the OCA outline itself names households with non-Orthodox members and school or workplace meals as situations needing consideration).
5. Note the client's priest or spiritual father and how they relate to him.
6. Summarise back and record key dates in the clinical plan.
Example language (illustrative): "Can you walk me through your Church's year as you actually live it? Which seasons matter most to you, and what do they mean for you?"
Watch for: Pride or shame linked to how strictly the client fasts; isolation in a non-Orthodox household; meaning that has collapsed into rule-keeping (possible scrupulosity, see 4.7); talk about the fast that centres on weight or body shape (see 4.5). Working when the client can name what the fast is for in their own life and the plan reflects their calendar. [source: OCA outline; synthesis]

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

Purpose / when: For structured cultural assessment at intake or when religious practice is linked to the presenting problem. The APA describes the module as clarifying how spirituality, religion and other moral traditions influence the person's problems, stresses and coping. [source: APA CFI Supplementary Modules]
Steps:
1. Use the core CFI to explore the client's definition of the problem, cultural perceptions of cause and context, coping and help-seeking, and expectations of care.
2. Add Module 5 (Spirituality, Religion and Moral Traditions), which covers four areas: spiritual, religious and moral identity; the role of these traditions in daily, family and community life; their relationship to the problem, including help from community leaders, texts and practices; and potential stresses or conflicts.
3. Where relevant add Module 7 (Coping and Help-Seeking), which includes religious practices and help from other healers, and Module 6 (Cultural Identity) for migration and language.
4. Paraphrase or use the APA forms as published; the APA states the material may be reproduced by clinicians for use with their patients.
5. Write a short formulation linking the fasting calendar to the problem: is it a resource, a stressor, a trigger or neutral?
Example language (illustrative): "Some people find the fasts give them strength when things are hard; for others they bring extra pressure. How is it for you this year?"
Watch for: Conflicts within the family or parish about how to fast; experiences of discrimination; the client deferring to you as if you held religious authority. Working when the formulation names the fast's role and the client agrees with it. [source: APA CFI Supplementary Modules]

4.3 Accommodation in scheduling and treatment

Purpose / when: Before and during fasting seasons, so treatment fits the client's observance. [synthesis]
Steps:
1. Note services and fast days that affect attendance (e.g. Holy Week, major feasts) and offer alternative session times.
2. Review any treatment component that involves food: exposure with eating, behavioural activation built around meals out, group sessions with snacks, meal plans in eating-disorder treatment. Discuss with the client and the treatment team how to adapt these, without giving food rules yourself.
3. Ask whether fasting affects energy, sleep or concentration in a way that should change session pacing or homework load.
4. Flag to the prescriber any question about medicines and meal timing; the National Alliance for Eating Disorders advises including the prescriber because fasting can affect timing, absorption and mood. Do not advise on medicines yourself.
5. Record agreed accommodations in the treatment plan and revisit at the feast.
Example language (illustrative): "Holy Week is coming up. Would it help to move our session, or keep it as an anchor in a busy week?"
Watch for: Accommodation that silently drops essential treatment (for example abandoning a meal plan without team agreement); fatigue that looks like worsening depression; missed sessions not discussed. Working when attendance and engagement hold through the season. [source: National Alliance for Eating Disorders; synthesis]

4.4 Health screen and routing to the doctor

Purpose / when: Before each season and whenever health changes, for clients with diabetes or other chronic illness, pregnancy or breastfeeding, older age, frailty, heavy physical work, children and adolescents, or on medication. [source: Saint John the Evangelist parish lists diabetes, heart disease, Crohn's, coeliac disease, pregnancy, breastfeeding, children, the elderly and physically demanding work as circumstances complicating fasting]
Steps:
1. Ask briefly about health conditions, pregnancy or breastfeeding, and current medicines.
2. For any condition, ask whether the client has discussed the fast with their doctor this year. If not, encourage them to, and offer (with consent) to write a short note to the GP or specialist naming the season and asking for individual advice.
3. For diabetes specifically, route to the diabetes team. Clinical evidence is limited: an Ethiopian Orthodox cohort with type 2 diabetes found frequent and severe hypoglycaemia concentrated in the fasting group and recommended individual risk assessment, structured education and treatment adjustment by clinicians. You do not give that education or adjust treatment. [source: Alemayehu 2025 abstract] Clinical guidance written for Ramadan fasting (for example the IDF-DAR diabetes and fasting guidelines) is something the client's doctor may draw on; it was not written for the Orthodox calendar and is not presented here as Orthodox guidance [uncertain: not verified].
4. Reflect the Church's own position accurately: church sources say the rules are relaxed for the elderly and those in poor health, that the sick and the very young are typically exempt, and that medical exceptions such as diabetes are allowed; Pope Shenouda III notes in passing that sick people who cannot fast are excused in the context of the sacrament of Unction. [source: OCA outline; St Verena parish; Pravmir; Shenouda III ch. 10]
5. Encourage the client to take both the doctor's advice and their situation to their priest or spiritual father for a blessing on any modification.
6. Know the red flags that need same-day medical attention (fainting, confusion, chest pain, signs of dehydration or of low or high blood sugar in a person with diabetes) and say so plainly. [synthesis]
Example language (illustrative): "Your Church's own guidance makes room for people with health conditions. Would you be willing to ask your doctor what is safe for you this Lent, and then talk it over with your priest?"
Watch for: Hiding symptoms to avoid being told not to fast; a sense that accepting a relaxation is spiritual failure (see 4.8); pregnancy or breastfeeding without medical input. Working when the client has medical advice and, if needed, a pastoral blessing before the season begins. [source as above; synthesis]

4.5 Eating-disorder screening and fasting decisions

Purpose / when: Screen every client who fasts, at intake and before each season; act more closely for clients with a current or past eating disorder. NEDA states that fasting practices including Lent can be triggering, and that risk rises where symptoms already exist or fasting is used for weight control rather than only for religious reasons. [source: NEDA]
Steps:
1. Ask neutral screening questions about weight and shape concern, loss of control over eating, compensatory behaviours and recent weight change; a validated brief screen such as the SCOFF can structure this [uncertain: not verified]; Do not reproduce instrument items in handouts unless licensed.
2. Ask what the fast is for, in the client's words, and whether thoughts about weight, calories or "earning" food come up during fasting seasons.
3. Check the warning signs the National Alliance for Eating Disorders lists for fasting that serves the disorder: renewed calorie counting or restriction; binges when food becomes available, or purging; fasting used as purging; rising "good" and "bad" food thinking; physical strain such as dehydration or electrolyte problems; guilt or anxiety around communal meals; a sense of failing a sacred duty if not fasting.
4. If the client is in treatment, take any fasting decision to the full team (therapist, physician, dietitian, prescriber) before the season, as the Alliance advises, and reassess during the season.
5. Support the client in speaking with their priest about whether, and how, to keep the fast; NEDA and the Alliance both note that many traditions make provision for illness and that religious leaders can validate a health-based decision. Church sources cited above relax or exempt the sick.
6. If a substitute observance is wanted (NEDA and the Alliance suggest non-food "fasts" such as from screens, with more prayer, almsgiving or service), make clear this is a matter for the client and their priest: one Orthodox source warns that a personal substitute should not replace the Church's rule. [source: NEDA; National Alliance for Eating Disorders; Pravmir]
7. If fasting goes ahead with team agreement, the Alliance describes a plan with structured meals around the fast, coping strategies for urges, non-food activities at high-trigger times and peer support; the dietitian, not the therapist, sets the eating content.
Example language (illustrative): "Sometimes the fast and the eating disorder start to sound alike. When you think about Lent, whose voice is it: your faith, or the part of you that wants to restrict?"
Watch for: Enthusiasm for stricter fasting than the parish expects; secrecy about eating; weight loss during the season; refusal of a priest's relaxation. Working when the client can keep faith practices that do not feed the disorder and the team agrees the plan is safe. [source: NEDA; Alliance; synthesis]

4.6 Preparing the pastoral conversation

Purpose / when: When a health or mental-health need may call for a modified fast and the client is unsure how to raise it with their priest. Church sources direct such questions to the priest or spiritual father. [source: OCA outline; Saint John the Evangelist parish; Pravmir]
Steps:
1. Clarify what the client wants to ask and what they fear the answer will be.
2. Help them write down, in their own words, the relevant medical facts (as their doctor gave them) and the question.
3. Rehearse the conversation if anxiety is high.
4. Afterwards, review what the priest said and how the client feels about it; do not reinterpret the blessing.
Example language (illustrative): "What would you like your priest to understand about your health before you ask him about Lent?"
Watch for: Avoidance of the conversation; selective reporting to the priest; distress when a relaxation is given. Working when the client has a clear, blessed plan they can keep without distress. [synthesis]

4.7 Recognising and treating scrupulosity around the fast

Purpose / when: When fasting rules become the focus of obsessive doubt: repeated checking of ingredients or calendars, fear that a trace of forbidden food has spoiled the fast or one's salvation, repeated confession or reassurance-seeking about minor lapses. [synthesis]
Steps:
1. Assess for OCD with a standard clinical interview; ask how the client's priest and fellow parishioners keep the fast, to calibrate what is normative.
2. Use the tradition's own warnings as a reference point: the OCA outline cautions against "dour and pedantic legalism"; another source urges people to keep their eyes on their own plates. [source: OCA outline; Pravmir]
3. Offer exposure and response prevention adapted to the client's values. Huppert, Siev and Kushner (2007) describe adapting ERP so it is acceptable to and consistent with the values of a strictly observant religious community; the principle is that exposures target the OCD's demands, not the religion's actual requirements. [source: Huppert et al. 2007 abstract; specific adaptations not verified]
4. With consent, consult the client's priest to agree what the Church actually requires, so exposures stay within religious law and reassurance-seeking from clergy can be reduced. [synthesis]
Example language (illustrative): "Your priest says a mistake made in good faith is not a sin against the fast. The OCD says it is. Which one are we going to practise listening to?"
Watch for: Exposures that would require the client to break the fast as the Church actually teaches it (avoid); confession used as compulsive reassurance; therapist drift into theological argument. Working when time spent checking falls and the client keeps the fast as their priest advises. [source: Huppert et al. 2007; synthesis]

4.8 Guilt, shame and moral injury around keeping or breaking the fast

Purpose / when: When a client feels like a failure for not fasting (because of illness, pregnancy, work or family), or judged by family or parish. [synthesis]
Steps:
1. Explore the meaning of the lapse or relaxation in the client's own theology.
2. Distinguish guilt that the tradition addresses through its own means (repentance, confession) from shame and self-attack that the therapist can work on.
3. Encourage the client to bring theological questions to their priest; reflect accurately what church sources say about relaxation for the sick.
4. Use compassion-focused or cognitive approaches for self-criticism where appropriate.
Example language (illustrative): "You are carrying this as a failure. How does your Church itself speak about people who cannot keep the fast because of illness?"
Watch for: Depressive guilt that persists after pastoral reassurance; harsh judgement from others in the community. Working when the client can hold the relaxation without self-condemnation. [synthesis; Church positions from OCA outline, St Verena parish and Pravmir]

4.9 Grief, family and community through the seasons

Purpose / when: When a fasting season or its feast coincides with bereavement, migration, family conflict or estrangement from the parish. [synthesis]
Steps:
1. Ask how the season and feast were kept with the person who has died or with family left behind.
2. Plan for the feast (for example Pascha night) as a possible high point of grief or loneliness.
3. Explore community supports the client values, such as the parish, fellow fasters, diaspora networks.
4. In mixed households, explore negotiation about meals and respect for different practice.
Example language (illustrative): "This will be your first Pascha without your mother. What would help you get through the night, and the meal after?"
Watch for: Withdrawal from the parish masking depression; conflict at shared meals. Working when the client has a plan for the feast and a person to be with. [synthesis; mixed households named in OCA outline]

4.10 Collaboration with clergy

Purpose / when: When the client wishes, for health-related modification of the fast, scrupulosity, or coordinated support. [synthesis]
Steps:
1. Obtain written consent specifying what may be shared and the purpose.
2. Agree with the client what you will ask; keep the question practical (e.g. what the Church requires of a person in their situation).
3. Respect the separate roles: the priest gives pastoral guidance and blessing; you provide psychological care; the doctor gives medical advice.
4. Feed back to the client and document.
Example language (illustrative): "With your permission, I'd like to ask Father what your Church expects of someone recovering from an eating disorder during Lent, so we are not working against each other."
Watch for: The client feeling outnumbered; confidentiality slips; pressure from any side. Working when the client experiences the team as aligned. [synthesis]

4.11 Children and adolescents

Purpose / when: When a child or adolescent fasts, or family expectations around fasting cause distress. [synthesis]
Steps:
1. Note that church sources exempt or relax the fast for the very young and stress adequate nutrition for growing children. [source: St Verena parish; Pravmir]
2. Seek the young person's assent and the parents' consent for any discussion of fasting; explore the child's own wishes.
3. Screen for eating-disorder signs, particularly in adolescents who adopt stricter fasting than the family expects.
4. Involve the paediatrician or GP for any growth, weight or health concern; follow local safeguarding procedures if a child is harmed or coerced.
Example language (illustrative): "What does fasting mean for you, not for your parents or your church, but for you?"
Watch for: Weight loss, faltering growth, secrecy, or fasting used as punishment. Working when the family's practice fits church guidance for children and the young person is well. [source as above; synthesis]

4.12 The therapist's own position

Purpose / when: Throughout. [synthesis]
Steps: Reflect on your own relationship to fasting and Orthodoxy; avoid giving religious rulings; disclose your own practice only if it serves the client; avoid dual roles (e.g. treating a fellow parishioner) where possible; follow your profession's ethics code and spiritual-competency guidance; seek consultation when unsure. [synthesis]
Example language (illustrative): "I'm not the right person to say what the Church requires. I can help you think through the question and take it to your priest."
Watch for: Being asked to rule on religious questions; your own views (for or against fasting) colouring advice.

5. Handling problems

Most of this section is [synthesis]; source-based points are tagged.

The client refuses to consider any change to the fast despite medical risk. Stay with meaning first; reflect that the Church's own sources relax the fast for the sick and elderly and direct questions to the spiritual father [source: OCA outline; Pravmir; Saint John the Evangelist parish]; ask permission to involve the doctor and, if the client wishes, the priest. If there is imminent medical danger, prioritise medical safety and document. [synthesis]
Eating disorder dressed as piety. Signs: fasting stricter than the parish norm, refusal of a priest's relaxation, weight loss, secrecy, compensatory behaviour. Take it to the treatment team before the season and reassess during it [source: National Alliance for Eating Disorders]; name the pattern gently and separate the disorder's voice from the faith (see 4.5). Arrange medical review if there are physical warning signs. [synthesis]
The client asks the therapist to rule on the fast. Decline the role and redirect to the priest (see 4.12); offer to help prepare the question. [synthesis]
Conflicting advice from doctor and priest. Help the client lay out both positions accurately; with consent, facilitate communication so each knows the other's view; the client decides. Do not take sides on theology or medicine. [synthesis]
Scrupulosity reinforced by repeated pastoral reassurance. With consent, agree with the priest a consistent approach that limits reassurance and supports ERP [synthesis, consistent with the values-based ERP adaptation described by Huppert et al. 2007].
Non-adherence to treatment during the season (missed sessions, abandoned homework or meal plans). Explore whether it reflects the observance, fatigue, or avoidance; renegotiate accommodations (4.3); involve the team where meal plans are affected. [synthesis]
Mood, sleep or energy deteriorate during a fasting season. Distinguish expected tiredness from depression or medical problems; route physical symptoms to the doctor; monitor risk as usual, using standard suicide and self-harm risk assessment if indicated. [synthesis]
Rupture over religion (the client feels judged for fasting, or for not fasting). Acknowledge, repair, and return to the client's own meaning; check your own reactions (4.12). [synthesis]
Family or parish pressure. Explore pressure on children, people in recovery, or those with health conditions; reflect that church sources make room for them; support the client to seek pastoral guidance; follow safeguarding procedures where a child is at risk. [source: St Verena parish; Pravmir; synthesis]
Feast-day overeating or binge after a season. Normalise feast customs without endorsing harmful patterns; for clients with binge-eating risk, plan the transition with the dietitian [source: Alliance notes bingeing when food becomes available after fasting; synthesis].
Religious or spiritual distress as a focus of care. Where the main problem is a crisis of faith or conflict with the Church rather than a mental disorder, record it as such; DSM-5-TR provides a category for a religious or spiritual problem (Z65.8) among other conditions that may be a focus of clinical attention. Do not pathologise devout practice and do not miss illness. [synthesis]

Sources

Web sources:

Also referred to [uncertain: not verified]: SCOFF questionnaire; Vieten et al. 2013 spiritual and religious competencies; the APA Ethics Code (https://www.apa.org/ethics/code).

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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