Wird and hizb litanies (Shadhili Hizb al-Bahr)

1. Introduction

Version followed: the Hizb al-Bahr ("Litany of the Sea") of Abu al-Hasan al-Shadhili (d. 1258) as transmitted in the Shadhili order, read through Ahmad Zarruq's commentary (trans. Khalid Williams, Visions of Reality Books) and the Shadhili awrad collection published by Nuh Ha Mim Keller (AlFath, 2010). General teaching on keeping a wird (timing, persistence, making up missed portions) is drawn from Habib Umar bin Hafiz of the Ba'Alawi path, a related but distinct tradition, and labelled as such. [source: Mecca Books listings; Muwasala]

What it is. In Sufi usage a wird (plural awrad) is a person's regular, fixed portion of devotional recitation, and a hizb (plural ahzab) is a composed litany, usually attributed to a master, made of Qur'anic verses, divine names and supplications. Orders also use the term wazifa for an assigned daily recitation. [synthesis: glosses; the structure is visible in the Shadhili awrad collection, which contains a "general litany" (wird al-'amm), several ahzab including Hizb al-Bahr, Hizb al-Kabir and Hizb al-Nur, and a wazifa; source: Mecca Books listing of Keller 2010]

The Hizb al-Bahr. It is a litany of Qur'anic verses and supplications that, as the tradition reports, the Prophet taught to al-Shadhili while he was travelling to Hajj; al-Shadhili is reported as saying he recited it only as he received it, and that he was told to guard it because it contains the greatest name of God. The tradition attributes to its daily recitation, especially at sunrise, answered prayer, relief from distress, ease in one's affairs, protection from harm by people and jinn, and security for the place where it is recited. These are the tradition's own claims, reported as such. [source: Mecca Books listing of Zarruq's commentary] It is still taught and transmitted with ijaza (authorisation by chain of transmission) at public gatherings, for example a 2025 mosque event in England offering a complete recital "with Ijaza connecting to Imam Hassan al-Shadhli" alongside teaching on its meanings. [source: Banbury Madni Masjid event page]

The order. Encyclopaedia Britannica dates al-Shadhili's birth to 1196/97 near Ceuta, Morocco, places the founding of the order in Egypt after his exile from Tunisia, and states he left no writings, his sayings and prayers being preserved by disciples. It notes he discouraged monasticism and told followers to keep their ordinary lives, and that the order produced many sub-orders (e.g. the Jazuliyya and Darqawa in Morocco). [source: Britannica, al-Shadhili; Britannica, Shadhiliyah]

How change happens, in the tradition's terms. The aim is constant remembrance of God (dhikr) and a transformed heart, not symptom change. Habib Umar, citing Imam al-Haddad, teaches that devotions without presence of heart bring no benefit and devotions without persistence do not affect the heart. [source: Muwasala] For the psychotherapist, the litany is the client's religious practice, not a technique the therapist prescribes. The therapist's work is to understand it, support client-led integration where wanted, guard against scrupulosity and adverse effects, and refer religious questions to the client's own teacher. [synthesis] No practice here is a treatment for physical or mental illness; protective and healing benefits are the tradition's claims and have not been tested clinically. [synthesis]

Recitation counts. Awrad and ahzab are typically set by the order or shaykh with fixed times and, for some formulae, fixed numbers of repetitions. Any count belongs to the tradition and the client's teacher. This guide gives none, and the therapist should never set, raise or reduce a count as a clinical target. [synthesis]

2. Framework

This is a devotional practice, not a therapy. It has no phases, session count or manual. The framework below is for the psychotherapist working alongside it and is [synthesis] throughout unless tagged.

Phase A: Understand (early contacts, within ordinary assessment).

Goal: learn what the wird or hizb means to the client, who gave it (shaykh, order, family, self-taught), whether it came with idhn or ijaza, the times and amount the client keeps, and how the client feels when it is kept or missed.
Tools: spiritual history; the DSM-5-TR Cultural Formulation Interview and its spirituality, religion and moral traditions module [uncertain: not verified].
Move on when you know whether the practice is a resource, a neutral background, a source of distress, or several of these.

Phase B: Agree a stance (consent).

Goal: agree with the client whether and how the practice will enter therapy: not at all, as context, as a client-chosen resource, or as a focus (e.g. scrupulosity about omissions).
Move on when the client has said in their own words what they want, and you have said what you will not do (give a wird, rule on Islamic law, change a count).

Phase C: Work. Client-led integration, meaning-making, scrupulosity work (ERP with religious consultation), monitoring adverse effects, coordinating with the teacher where the client wishes. Format: ordinary individual sessions; no session count is given by any source.

Phase D: Review. Check whether the practice feels freer, more meaningful or less distressing by the client's own report; whether time spent and checking are falling (if scrupulosity was a focus); and whether religious guidance comes from the client's teacher rather than from therapy.

Criteria for moving between phases are the client's consent and the clinical picture, not the tradition's stations of the path.

3. Guiding principles

The practice belongs to the client and the tradition. Do not prescribe, compose, extend or shorten a wird. [synthesis]
Counts and times are the tradition's. Report them as the client or the teacher states them; never use them as therapy targets or homework. [synthesis]
Authority sits with the teacher. In the tradition, litanies are taken with guidance; SeekersGuidance advises that litanies should not be taken without guidance and counsel, and that someone with no guide keep to the well-known morning and evening remembrances. Practical meaning: refer questions about what to recite to the client's shaykh or a qualified scholar. [source: SeekersGuidance, Wird without the permission of a spiritual guide]
Respect transmission. Hizb al-Bahr is transmitted with ijaza; do not hand clients printed texts or encourage bypassing a teacher. [source: Banbury Madni Masjid; synthesis]
Attribute, do not adjudicate. Describe protection from jinn, the greatest name or the litany's blessing as the tradition holds them; neither affirm them as fact nor dismiss them. [synthesis]
Not a medical treatment. The tradition's claims of relief and protection are reported claims; evidence status: untested clinically. Route health questions to the client's doctor. [synthesis]
Value-driven versus fear-driven practice. IOCDF distinguishes ego-syntonic religious practice from ego-dystonic OCD. Practical meaning: ask whether the client recites from love and commitment or from terror of omission. [source: IOCDF, Living with OCD & Religious Traditions]
The tradition already builds in flexibility. Habib Umar teaches that a busy person may recite before or after the set time, may choose a different fixed time, and may recite silently in the heart while working; missed awrad are made up. Practical meaning: the client's own tradition offers more latitude than a scrupulous mind allows; let the teacher, not the therapist, apply it. [source: Muwasala]
Presence over quantity. Imam al-Haddad, as cited by Habib Umar, links benefit to presence of heart and persistence. Practical meaning: when anxiety drives speed or repetition, the tradition's own ideal (presence) can be a shared reference point. [source: Muwasala]
Consent and client-led integration. Use religious material in therapy only when the client asks for it and in the client's own language and frame. [synthesis; IOCDF lists ethical integration of faith in therapy as a provider topic]
Role clarity. You are not a shaykh, imam or mufti. TIIP training explicitly distinguishes the roles of murabbi, shaykh, faqih and psychologist. [source: Khalil Center TIIP course schedule] Professional spiritual competencies (Vieten et al. 2013) [uncertain: not verified] and the APA Ethics Code on competence and multiple relationships [synthesis] apply.
Watch power. Shaykh-disciple relationships carry authority; ask about it without presuming harm. [synthesis]

4. Intervention inventory

The recitation itself is taught by the client's shaykh or a teacher holding ijaza; it is described in Section 1 and not instructed here. The interventions below are the psychotherapist's own work alongside it. They are [synthesis] unless tagged.

4.1 Spiritual history focused on the wird

Purpose / when: At assessment, or when a client mentions a litany, a shaykh, an order or distress about devotions.
Steps: (1) Ask open questions about the client's religious life before narrowing to devotions. (2) Ask what the client recites, when, who gave it, and whether it came with permission (idhn) or ijaza. (3) Ask what it gives them, and what happens inside when it is missed. (4) Ask how their teacher or community regards missing it. (5) Note time spent, any repetition beyond what was assigned, and any avoidance of the practice. (6) Use the Cultural Formulation Interview's spirituality, religion and moral traditions questions if your service uses it [uncertain: not verified].
Example language (illustrative): "You mentioned the Hizb al-Bahr. Would you tell me what it means to you and how you came to recite it?" / "When a day goes by without it, what happens for you?"
Watch for: Ease versus dread when talking about it; vagueness about who authorised it (may signal self-taught practice from print or online); signs of a rigid or punitive group context. It is working when the client feels understood rather than assessed.

4.2 Agreeing the place of the practice in therapy (consent)

Purpose / when: After 4.1, before using any religious material.
Steps: (1) Offer options: leave it as context, draw on it as the client chooses, or address distress around it. (2) State limits: you will not give or alter a wird, rule on what is valid, or set counts. (3) Ask whether the client wants you to coordinate with their shaykh or imam, and get written consent for any contact. (4) Record the agreement and revisit it.
Example language (illustrative): "I'm not a religious teacher, so I won't tell you what to recite or how much. What I can do is help with how this practice sits with you emotionally. How would you like it to come into our work, if at all?"
Watch for: Clients who feel the therapist must share their faith to help; clients who want the therapist to replace a teacher. Working when the client sets the terms.

4.3 Client-led use of the litany as a resource

Purpose / when: The client says the litany steadies them and wants to draw on it, e.g. before hard sessions, in grief, or in fear.
Steps: (1) Ask the client which part or theme helps (e.g. refuge, trust in God, protection as they understand it). (2) Let the client decide whether to recite it privately, mention it, or recite in session; you do not recite it or join in. (3) Explore what the theme says about their values and coping, in their words. (4) Pair it with ordinary coping skills rather than substituting for them. TIIP lists muraqaba/dhikr among spiritually oriented interventions in Islamically integrated psychotherapy. [source: Khalil Center TIIP course schedule] Cross-refer Domain VII (spiritually integrated psychotherapy), Domain II for secular contemplative methods, and 239 (dhikr) in this family.
Example language (illustrative): "When you say the hizb helps you feel held, what is that like in your body and in your thoughts? How might we let that feeling sit alongside the plan we made for Thursday?"
Watch for: Recitation used to escape all distress (avoidance); litany substituting for medical care or safety planning; growing amounts. Working when the client uses it flexibly and still engages with the problem.

4.4 Meaning-making with the litany's themes

Purpose / when: Grief, fear, loss of control, moral pain, where the client finds the litany's themes meaningful.
Steps: (1) Invite the client to name a phrase or theme that matters (in their own language; do not supply text). (2) Ask what it says about their situation and about God as they understand Him. (3) Explore conflicts (e.g. "protection" versus a loss that happened anyway) without resolving them theologically. (4) Refer theological questions to their teacher.
Example language (illustrative): "You recited for protection, and still this happened. That's a painful question. What does your tradition offer you here, and who would you want to talk it through with?"
Watch for: Spiritual struggle (anger at God, sense of abandonment); self-blame ("I missed my wird, so it's my fault"). Working when the client can hold the question without collapsing into blame.

4.5 Screening for scrupulosity around recitation and omissions

Purpose / when: Any sign of repeated recitation, fear about pronunciation, excessive time, or distress about missed portions.
Steps: (1) Ask about intrusive doubts (did I say it right, did I miss a word, is my wird still valid, will harm come because I missed it). (2) Ask about compulsions: repeating verses until it feels right, restarting the litany, mentally replaying, asking scholars or family for reassurance, self-criticism. IOCDF's Islam page lists repeating Qur'an verses until sure every letter was correct, repeating prayers, repeating wudu until it feels "just right", and repeated reassurance-seeking about rulings. [source: IOCDF, Islam and OCD] (3) Ask whether the practice now conflicts with the client's own values (ego-dystonic). [source: IOCDF, Living with OCD & Religious Traditions] (4) Estimate time and impairment; consider a standard OCD assessment.
Example language (illustrative): "Some people find that a doubt like 'did I say that properly?' sticks and they have to start again. Does anything like that happen with your litany?"
Watch for: Self-shaming as a compulsion, which IOCDF notes gives brief relief because shame feels certain. [source: IOCDF, Islam and OCD] A positive screen means referral to or delivery of ERP (4.6).

4.6 ERP for recitation scrupulosity, with religious consultation

Purpose / when: OCD scrupulosity attached to the wird, hizb or other devotions. ERP is the first-line treatment. [source: IOCDF, Living with OCD & Religious Traditions]
Steps: (1) Assess intrusive thoughts, distress and compulsions. (2) Build a hierarchy from least to most distressing. (3) With the client's consent, consult a scholar the client trusts to confirm which exposures stay within Islamic law; IOCDF describes clinicians consulting an Islamic scholar to design permissible exposures. (4) Begin low: e.g. complete the assigned portion once, at ordinary pace, without going back over a word that felt imperfect. (5) Response prevention: limit time, stop restarting, stop asking scholars or family for reassurance, reduce mental replaying. (6) Expect self-shaming to rise and treat it as part of the process. [source: IOCDF, Islam and OCD] (7) Never set a recitation count; work only with the client's assigned practice as their teacher defines it. Keshavarzi, Khan and Syed (2020) describe an Islamically integrated treatment of waswasa scrupulosity [uncertain: not verified; listed in the Khalil Center TIIP schedule].
Example language (illustrative): "Your teacher confirmed that one recitation at your usual pace is complete. This week, the exposure is to say it once and let the doubt stay without going back. The doubt will shout. We're practising letting it."
Watch for: Reassurance compulsions moving to the therapist; exposures the client experiences as sinful (stop and re-consult); clients appealing to the scholar repeatedly (itself a compulsion, per IOCDF). Working when distress falls with repetition and the client's practice regains meaning. Many imams in one study did not recognise scrupulosity as possible OCD or know ERP, so prepare the scholar with information. [source: Jones, Harris & Esfahani 2019]

4.7 Working with guilt about omissions

Purpose / when: The client is distressed by missed portions, broken streaks, or not reciting at sunrise, without full OCD.
Steps: (1) Ask what their teacher has said about missed awrad. (2) Learn what the tradition already provides: in Habib Umar's teaching, awrad may be recited before or after the set time, at a different fixed time, or silently in the heart, and missed awrad are made up. [source: Muwasala] Do not apply these rulings yourself; ask the client to confirm with their own teacher, since orders differ. (3) Distinguish making up an omission as the tradition directs (once, then done) from repeatedly making up, re-counting or doubling as a fear-driven ritual. (4) Explore beliefs that harm will follow an omission; attribute the protective beliefs to the tradition and examine the client's fear separately. (5) If guilt is persistent and global, assess depression and moral injury.
Example language (illustrative): "What did your shaykh say to do if you miss it?" / "So the tradition has a way to make it up. What's it like for you when you've done that? Does it settle, or does the worry keep going?"
Watch for: The client recruiting you as a religious authority ("so it's OK, right?"): redirect to the teacher. Working when omissions lead to the tradition's remedy and then to rest.

4.8 Monitoring adverse effects of intensified practice

Purpose / when: The client has greatly increased litany or dhikr practice, joined intensive gatherings or retreats, or reports unusual experiences.
Steps: (1) Ask about changes in sleep, anxiety, mood, perception, sense of self, and functioning since practice intensified. (2) Know the evidence: in a study of Western Buddhist meditators, Lindahl et al. 2017, PLOS ONE, catalogued 59 kinds of challenging experience across cognitive, perceptual, affective, somatic, conative, sense-of-self and social domains, lasting from days to over a decade, and not confined to people with psychiatric histories or intensive retreats. [source: Brown University news, 2017] Farias et al. 2020, Acta Psychiatrica Scandinavica, found a pooled adverse-event prevalence of 8.3% across 83 meditation studies, most often anxiety, depression and cognitive anomalies, including in people without prior mental-health history. [source: Coventry University portal] Neither study examined Sufi litanies, so applying them here is [synthesis]. (3) If difficulties appear, the client may choose to ask their teacher about reducing to their basic assigned portion; you do not set the amount. (4) Offer grounding (orienting to the room, feet on the floor, ordinary activity, sleep, food, company). (5) Before intensive retreats or gatherings, screen for recent psychosis, mania, severe sleep loss, and trauma activation [synthesis]. Britton's Cheetah House resources address meditation-related difficulties [uncertain: not verified].
Example language (illustrative): "Since you started the longer recitations, how have you been sleeping? Any experiences that felt strange or hard to come back from?"
Watch for: Insomnia, derealisation, panic, grandiosity or loss of function. Working when the client stays connected to daily life and can discuss experiences with both you and their teacher.

4.9 Distinguishing spiritual experience from illness

Purpose / when: The client reports visions, hearing voices, sensing jinn, unusual blessings, or profound distress linked to practice.
Steps: (1) Ask how the client and their community interpret the experience; record it in their terms (e.g. protection from jinn as the tradition holds it). (2) Assess separately for psychosis, mania, depression, dissociation and substance use: onset, sleep, function, insight, risk. (3) Ask whether the community regards the experience as ordinary or concerning; a teacher's view can help with cultural norms (with consent). (4) Where criteria are not met, DSM-5-TR lists a religious or spiritual problem as a focus of clinical attention, code Z65.8; do not pathologise normative experience. (5) Where illness is present, treat it and route medical questions to the doctor; never advise on medicines.
Example language (illustrative): "In your community, how would people understand what you're describing? And how is it affecting your sleep and your work?"
Watch for: Missing illness because it has religious content, or pathologising faith. Working when the client feels respected and risk is managed.

4.10 Referral and collaboration with the shaykh, imam or scholar

Purpose / when: Questions about what to recite, validity, making up omissions, idhn or ijaza; designing permissible exposures; client wants coordinated care.
Steps: (1) Ask whether the client has a teacher and wants contact. (2) Get specific written consent and agree what will be shared. (3) Frame the consultation narrowly (e.g. "Is a single recitation at normal pace complete?"). (4) For scrupulosity, share brief information on OCD and ERP, as many imams may not know them. [source: Jones, Harris & Esfahani 2019] (5) Where the client has no guide, the tradition's own advice is to keep to the established morning and evening remembrances and find guidance; refer to a qualified local scholar rather than recommending a litany. [source: SeekersGuidance]
Example language (illustrative): "Would it help if, with your permission, I spoke briefly with your shaykh about the doubts so we're working in the same direction?"
Watch for: The teacher's advice contradicting ERP (discuss with the client and re-consult); repeated reassurance from the teacher. Working when religious and clinical guidance line up.

4.11 Health, protection beliefs and medical care

Purpose / when: The client relies on the litany's protective or healing claims for a health problem, or delays care.
Steps: (1) Acknowledge the tradition's claims (relief, protection) as the tradition's. [source: Zarruq listing] (2) Ask how the client's tradition sees using medicine alongside prayer; refer the question to their scholar if unsure. (3) Route all health questions to the client's doctor. (4) State in one line, if asked, that the litany has not been tested as a medical treatment.
Example language (illustrative): "Many people pray and see their doctor. How does your teacher see the two together?"
Watch for: Delay in seeking care; distress when "protection" seems to fail (see 4.4).

4.12 Trauma-sensitive adaptation

Purpose / when: The client has trauma and finds devotions activating (e.g. dark early-morning recitation, themes of danger, a harsh teacher, group intensity).
Steps: (1) Ask what makes recitation feel safe or unsafe. (2) Explore choices the client can raise with their teacher (place, company, lighting, eyes open, pace). (3) Teach grounding to use before and after. (4) Treat trauma with an evidence-based trauma therapy; the litany is not a trauma treatment. Treleaven's trauma-sensitive mindfulness (2018) describes comparable adaptations for meditation [uncertain: not verified]; cross-refer Domain IV (trauma-sensitive yoga).
Example language (illustrative): "What would make that time of recitation feel a bit safer for you? Is that something you could ask your shaykh about?"
Watch for: Flashbacks, dissociation, avoidance of all devotion. Working when the client can choose how close to come to the practice.

4.13 Role clarity, self-disclosure and dual relationships

Purpose / when: Throughout; especially if you share or do not share the client's faith, or move in the same community or order.
Steps: (1) Decide in advance what you disclose about your own faith and why. (2) Avoid dual roles (e.g. attending the same hadra or being the client's fellow disciple) or discuss them openly and seek supervision. (3) Do not recite with the client, give ijaza, or comment on the shaykh's spiritual rank. (4) Seek consultation when out of your competence. APA Ethics Code standards on competence and multiple relationships apply [synthesis].
Example language (illustrative): "I'm glad your faith matters so much to you. My role is to help with the emotional side; your shaykh is the one to guide the recitation."
Watch for: Pressure to act as a religious guide; your own reactions to the tradition. Working when the client keeps two clear relationships.

5. Handling problems

No source addresses therapy problems with litany practice directly; responses below are [synthesis] unless tagged.

Client asks you to give them a wird or tell them how much to recite. Decline warmly and refer to a qualified teacher; the tradition itself advises taking litanies with guidance. [source: SeekersGuidance] (illustrative) "That's a question for someone with authority in your tradition. Can we think together about who that might be?"
Client took up Hizb al-Bahr from print or online without a teacher and now feels anxious about doing it wrong. Do not correct the recitation. Note that the litany is transmitted with ijaza in the tradition [source: Banbury Madni Masjid] and support the client in finding a teacher; screen for scrupulosity (4.5).
Reassurance loops ("Is my wird still valid?"). Do not answer. Name the loop, link it to ERP, and agree with the client and their scholar on one clear ruling to rely on. [source: IOCDF, Islam and OCD]
Omission spiral: missed portions pile up, the client tries to make up everything at once, sleep suffers. Ask what their teacher says about making up; Habib Umar's teaching allows flexibility in time and silent recitation and directs that missed awrad be made up [source: Muwasala], but the amount and pace are for the teacher to set. Protect sleep; refer the plan to the teacher. Never set a catch-up count.
Belief that harm came because a wird was missed. Attribute the protective belief to the tradition; explore the fear and self-blame; assess guilt, depression and moral injury; offer the client the choice of talking to their scholar about it.
Non-adherence to ERP because exposures feel sinful. Stop that exposure, re-consult the scholar on what is permissible, and rebuild the hierarchy from permissible items. [source: IOCDF, Islam and OCD]
Teacher's advice conflicts with treatment (e.g. "repeat until it is perfect"). Explore with the client; with consent, share information with the teacher; respect the client's final choice and document risks. Many imams in one survey gave ERP-inconsistent advice. [source: Jones, Harris & Esfahani 2019]
Overwhelm or unusual experiences after intensifying practice. Grounding, sleep, ordinary routine; the client may ask their teacher about returning to their basic portion; assess for psychiatric illness (4.8, 4.9).
Spiritual dryness, loss of meaning or loss of faith. Normalise as a common human and religious experience without diagnosing; explore what the client wants; refer to the teacher for spiritual counsel; assess depression.
Rupture over religious difference (client senses judgment, or the therapist's faith differs). Name it, invite feedback, repair; seek supervision on your own reactions.
Power and coercion in the shaykh relationship. Ask about freedom to question, contact with family, money, sexual boundaries, and fear of leaving. Signs of coercive control (isolation, threats of spiritual harm for leaving, financial or sexual exploitation) call for safety planning and, where relevant, safeguarding or legal reporting. Do not label any group; describe behaviour. Independent investigations naming wrongdoers in this order: none found in the sources consulted.
Leaving an order or stopping a wird. Support the client's choice either way; grief, guilt and fear of spiritual consequences are common; religious trauma may need specific trauma work.
Family or community pressure (e.g. parents insisting on a litany). Explore the client's own wishes; for minors, consider assent and safeguarding where pressure is harsh.
Litany used to avoid medical or psychiatric care. Respect the practice, keep care going, route to the doctor, and involve the scholar if the client wishes (4.11).

Sources

Web sources:

Books and papers cited:

Zarruq, Ahmad. Commentary on the Hizb al-Bahr, trans. Khalid Williams. Visions of Reality Books, ISBN 9781909460027.
Keller, Nuh Ha Mim. 2010. Invocations of the Shadhili Order (Awrad). AlFath Research and Publishing.
Jones, M. K., Harris, L. M., & Esfahani, R. S. 2019. Imams' experience with and response to mosque-goers with OCD scrupulosity. Behaviour Change 36(1), 29–40.
Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. 2017. The varieties of contemplative experience. PLOS ONE.
Farias, M., Maraldi, E., Wallenkampf, K. C., & Lucchetti, G. 2020. Adverse events in meditation practices and meditation-based therapies: a systematic review. Acta Psychiatrica Scandinavica 142(5), 374–393.
Keshavarzi, H., Khan, F., Ali, B., & Awaad, R. (Eds.). 2020. Applying Islamic Principles to Clinical Mental Health Care: Introducing Traditional Islamically Integrated Psychotherapy. Routledge [as listed in the Khalil Center schedule].
Keshavarzi, H., Khan, F., & Syed, B. 2020. Islamically integrated treatment of OCD scrupulosity (waswasa) in Muslim patients [uncertain: not verified; as listed in the Khalil Center schedule].
Also cited [uncertain: not verified]: DSM-5-TR Cultural Formulation Interview and the religious or spiritual problem code, Z65.8; Vieten et al. 2013 spiritual competencies; Treleaven 2018 Trauma-Sensitive Mindfulness; Cheetah House resources.
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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