📝 Worksheet 10.4: Care, Safety, Referral, and Belonging Plan

Purpose

This worksheet helps Christian leaders prepare a respectful and accountable ministry response for a current, questioning, disaffiliating, or former Scientologist.

The goal is not to pressure religious change, investigate Scientology, diagnose a person, or take control of someone’s decisions.

The goal is to:

• understand the person’s actual situation

• identify spiritual, relational, practical, and safety concerns

• remain within appropriate ministry boundaries

• make responsible professional referrals

• protect privacy and personal testimony

• provide patient Christian community

• proclaim Jesus Christ without coercion

• trust the Holy Spirit with the outcome

Complete this worksheet using only information the person has freely shared or information that is publicly and responsibly available.

Part 1: Ministry Situation

Person or Case Identifier

Use initials or a confidential ministry reference rather than a full name when appropriate.

Date

Ministry Leader or Team

Ministry Setting

Check the setting that applies.

☐ Local church
☐ Church plant
☐ Soul Center
☐ Chaplaincy
☐ Christian life-coaching ministry
☐ Community outreach ministry
☐ Small group
☐ Personal Christian friendship
☐ Other: __________________________________

Current Ministry Situation

Check the description that best fits the person’s present situation.

☐ Current Scientologist who remains committed
☐ Current Scientologist who is open to Christian conversation
☐ Questioning Scientologist
☐ Person privately reconsidering Scientology
☐ Person beginning to disaffiliate
☐ Person actively leaving Scientology
☐ Former Scientologist exploring Christianity
☐ Former Scientologist who professes faith in Christ
☐ Family member of a current or former Scientologist
☐ Situation is still unclear

How Does the Person Describe the Situation?

Do not impose a label the person has not chosen.

What Has the Person Asked From the Ministry?

☐ Someone to listen
☐ Christian explanation
☐ Scripture study
☐ Prayer
☐ Help exploring Christianity
☐ Practical assistance
☐ Church connection
☐ Safety support
☐ Professional referral
☐ Discipleship
☐ Other: __________________________________

Describe the request in the person’s own words when possible.

Part 2: Permission and Freedom of Conscience

Permission Review

Has the person given permission for the following?

Permission-Based Ministry Statement

Write a brief statement that communicates freedom of conscience.

Example:

I am glad to listen and explain the Christian perspective when you would find that helpful. You are free to ask questions, disagree, pause, or end the conversation.

Your statement:

Christian Standpoint Disclosure

Write a transparent statement explaining that you approach the conversation as a Christian rather than from a religiously neutral position.

Pressure Check

Check any behavior the ministry team must avoid.

☐ Demanding an immediate decision
☐ Claiming that God has privately revealed what the person must do
☐ Treating doubt as proof of conversion
☐ Using fear to motivate religious change
☐ Requiring church attendance in exchange for help
☐ Requiring public criticism of Scientology
☐ Pressuring the person to leave relationships immediately
☐ Using practical assistance as leverage
☐ Repeatedly asking whether the person has converted
☐ Treating the person as an outreach project

What safeguards will prevent pressure?

Part 3: Whole-Person Care Review

A person’s situation may involve many dimensions of created life. Do not reduce every concern to doctrine, trauma, sin, or spiritual deception.

Complete only the sections relevant to the person’s situation.

Spiritual Beliefs and Questions

What does the person currently believe about:

God

Jesus Christ

The human spirit or thetan

Salvation or spiritual freedom

Sin, suffering, and human brokenness

Life after death

Religious Practices and Commitments

What Scientology practices, relationships, courses, responsibilities, or commitments remain important to the person?

Family and Marriage

Are there concerns involving:

☐ Spouse
☐ Children
☐ Parents
☐ Extended family
☐ Shared religious practices
☐ Family conflict
☐ Possible separation
☐ Parenting disagreements
☐ Family pressure
☐ No known family concerns

Describe only what the person has shared.

Friendship and Community

What relationships or communities could be affected?

Does the person have supportive relationships outside Scientology?

☐ Yes
☐ No
☐ Uncertain

Who provides dependable support?

Employment and Vocation

Are there concerns involving:

☐ Employment
☐ Employer relationships
☐ Clients
☐ Professional reputation
☐ Business networks
☐ Career advancement
☐ Job loss
☐ Vocational identity
☐ No known concerns

Describe the concern without reaching legal conclusions.

Housing and Financial Stability

Are there possible concerns involving:

☐ Shared housing
☐ Temporary housing
☐ Access to money
☐ Shared bank accounts
☐ Loss of income
☐ Transportation
☐ Food security
☐ Childcare
☐ Debt
☐ Insurance
☐ No known concerns

Physical and Emotional Well-Being

Has the person described:

☐ Stress
☐ Fear
☐ Grief
☐ Anxiety
☐ Depression
☐ Sleep difficulty
☐ Exhaustion
☐ Bodily symptoms
☐ Isolation
☐ Confusion
☐ Trauma concerns
☐ Substance misuse
☐ Suicidal thinking
☐ No known concerns

Ministry leaders should not diagnose.

Record the person’s description.

Identity and Belonging

What identities, roles, relationships, or communities may be changing?

What does the person fear losing?

What new forms of identity or belonging is the person seeking?

Part 4: Safety Review

This section is not a professional threat assessment. It helps ministry leaders recognize when immediate action or qualified assistance may be necessary.

Immediate Safety Questions

Ask calmly and directly when safety concerns are present.

Do you believe you are in immediate danger?

☐ Yes
☐ No
☐ Uncertain

Has anyone directly threatened you, your children, your property, your employment, or your housing?

☐ Yes
☐ No
☐ Uncertain

Are you afraid to return home?

☐ Yes
☐ No
☐ Uncertain

Do you have access to a safe place if circumstances become urgent?

☐ Yes
☐ No
☐ Uncertain

Are there children, vulnerable adults, or dependent persons whose safety may be affected?

☐ Yes
☐ No
☐ Uncertain

Are you thinking about harming yourself or someone else?

☐ Yes
☐ No
☐ Uncertain

Immediate Response

When there is immediate danger, suicidal intent, serious violence, suspected abuse, or another emergency, follow applicable emergency procedures, mandatory-reporting laws, and ministry safeguarding policies.

Action taken:

Basic Safety Considerations

Check the areas that may require planning with qualified support.

☐ Safe communication method
☐ Emergency contact
☐ Transportation
☐ Temporary housing
☐ Access to identification documents
☐ Medication access
☐ Child safety
☐ Workplace safety
☐ Digital privacy
☐ Financial access
☐ Legal consultation
☐ Domestic-violence resource
☐ Emergency services

The ministry team must not conduct an investigation or advise the person to break the law.

Part 5: Ministry Boundaries

What the Ministry Can Appropriately Offer

Check all that apply.

☐ Respectful listening
☐ Prayer with permission
☐ Scripture reading
☐ Gospel explanation
☐ Pastoral encouragement
☐ Church connection
☐ Meals
☐ Transportation
☐ Short-term practical help
☐ Friendship
☐ Small-group participation
☐ Help locating professional resources
☐ Accompaniment to an appointment
☐ Follow-up contact
☐ Discipleship
☐ Other: __________________________________

What the Ministry Must Not Attempt Without Proper Qualifications

☐ Psychotherapy
☐ Trauma treatment
☐ Mental-health diagnosis
☐ Medical diagnosis
☐ Medication advice
☐ Legal advice
☐ Financial planning
☐ Domestic-violence investigation
☐ Criminal investigation
☐ Crisis intervention beyond training
☐ Deprogramming
☐ Secret surveillance
☐ Extraction of confidential Scientology information
☐ Promises of guaranteed safety
☐ Promises that leaving will be easy

Boundary Statement

Write a statement that explains the ministry’s role.

Example:

We can provide spiritual care, Christian community, and practical support within our ministry role. We will help connect you with qualified professionals when legal, medical, clinical, financial, housing, or safety needs exceed our training.

Your statement:

Part 6: Professional Referral Plan

A referral is an act of responsible care, not abandonment.

Referral Assessment

Referral Conversation

Write how you will recommend referral without shaming or abandoning the person.

Ministry Support During Referral

How can the ministry remain appropriately present?

☐ Prayer
☐ Transportation
☐ Appointment support
☐ Meals
☐ Follow-up conversation
☐ Church connection
☐ Help organizing questions
☐ Practical assistance
☐ Other: __________________________________

Part 7: Privacy and Confidentiality Plan

Information the Person Has Given Permission to Share

Information That Must Remain Private

People Authorized to Receive Information

☐ Lead pastor
☐ Designated ministry supervisor
☐ Safeguarding officer
☐ Care-team leader
☐ Qualified professional
☐ No one beyond the current ministry worker
☐ Other: __________________________________

Privacy Safeguards

Check the safeguards that apply.

☐ Use initials in team notes
☐ Store records securely
☐ Avoid unnecessary written details
☐ Do not discuss the case in public areas
☐ Do not share information in general prayer groups
☐ Obtain permission before involving another leader
☐ Explain limits of confidentiality
☐ Follow mandatory-reporting responsibilities
☐ Do not contact family members without permission
☐ Do not contact Scientology representatives
☐ Do not post anything online
☐ Do not record conversations without informed consent

Limits of Confidentiality

Explain any applicable safeguarding or mandatory-reporting responsibilities.

Part 8: Testimony Protection Plan

The person’s story belongs to the person.

Has the Person Asked to Share a Testimony?

☐ Yes
☐ No
☐ Not discussed

Has Anyone in the Ministry Requested the Person’s Story?

☐ Yes
☐ No

Describe the request.

Public Testimony Readiness Review

Before any testimony is shared, consider:

Testimony Safeguards

☐ No testimony at this time
☐ Private testimony only
☐ Small-group testimony with limits
☐ Congregational testimony
☐ Written testimony
☐ Recorded testimony
☐ Online publication
☐ Public media use

Specific permissions and limitations:

Part 9: Gospel Conversation Plan

The Person’s Spiritual Question

What question has the person actually asked?

Shared Religious Words That Need Clarification

☐ God
☐ Jesus
☐ Spirit
☐ Salvation
☐ Freedom
☐ Truth
☐ Eternal life
☐ Transformation
☐ Sin
☐ Grace
☐ Other: __________________________________

Choose one word and record the person’s meaning.

Word: __________________________________

Person’s understanding:

Christian Meaning

Explain the Christian meaning under Scripture and God’s revelation.

Gospel Bridge

Identify the human longing beneath the person’s question.

☐ Freedom
☐ Forgiveness
☐ Knowledge
☐ Identity
☐ Healing
☐ Control
☐ Belonging
☐ Purpose
☐ Eternal life
☐ Hope
☐ Other: __________________________________

How does the gospel address this longing?

Brief Gospel Explanation

Write a permission-based explanation of the gospel that includes:

• God the Creator

• humanity made in God’s image

• sin and separation from God

• Jesus Christ as the incarnate Son

• Christ’s death for sin

• Christ’s bodily resurrection

• salvation received by grace through faith

• new life through the Holy Spirit

• hope of bodily resurrection and new creation

Invitation Without Pressure

Write an invitation that preserves freedom of conscience.

Possible invitations include:

☐ Read a Gospel together
☐ Attend worship
☐ Meet with a pastor
☐ Study a Christian doctrine
☐ Ask further questions
☐ Pray with permission
☐ Join a meal or small group
☐ Take time before continuing

Part 10: Christian Community and Belonging Plan

Christian community should provide belonging before demanding usefulness.

Immediate Welcome

How can the person participate without pressure?

☐ Community meal
☐ Worship service
☐ Small group
☐ Bible reading
☐ Pastoral conversation
☐ Social gathering
☐ Service opportunity
☐ Prayer gathering
☐ Other: __________________________________

Relationship Network

Avoid making one ministry worker the person’s only source of support.

Potential supportive relationships:

Ordinary Belonging

What ordinary activities could help the person form healthy relationships?

☐ Shared meals
☐ Walking or recreation
☐ Church fellowship
☐ Volunteer service
☐ Family activities
☐ Bible study
☐ Community events
☐ Mentoring
☐ Other: __________________________________

Christian Formation

When the person is ready, the church may provide:

☐ Gospel foundations
☐ Scripture reading
☐ Christian doctrine
☐ Prayer formation
☐ Worship participation
☐ Baptism preparation
☐ Communion instruction
☐ Church membership preparation
☐ Christian ethics
☐ Spiritual gifts discernment
☐ Stewardship
☐ Vocation and service

Pace of Participation

What should not be rushed?

☐ Public profession
☐ Baptism
☐ Church membership
☐ Testimony
☐ Volunteer service
☐ Scientology-related outreach
☐ Ministry credentials
☐ Leadership
☐ Public interviews

Explain the reasons for patience.

Part 11: Practical Assistance Plan

Identified Need

Assistance the Ministry May Provide

☐ Food
☐ Transportation
☐ Clothing
☐ Temporary financial help
☐ Housing referral
☐ Employment resources
☐ Childcare support
☐ Appointment accompaniment
☐ Communication support
☐ Other: __________________________________

Conditions and Safeguards

Practical assistance must not require:

☐ Conversion
☐ Baptism
☐ Church membership
☐ Worship attendance
☐ Public testimony
☐ Criticism of Scientology
☐ Participation in Christian outreach
☐ Disclosure of private information

Who has authorized the assistance?

What financial or ministry accountability is required?

How long will the assistance continue before review?

Part 12: Team Leadership Plan

Ministry Supervisor

Team Members With Approved Roles

Team Behaviors to Encourage

☐ Patient listening
☐ Accurate language
☐ Prayer with permission
☐ Respect for privacy
☐ Appropriate referral
☐ Practical care
☐ Gospel clarity
☐ Freedom of conscience
☐ Accountable communication
☐ Trust in the Holy Spirit

Team Behaviors to Correct

☐ Mocking Scientology
☐ Pressuring immediate departure
☐ Collecting confidential information
☐ Sharing rumors
☐ Diagnosing the person
☐ Giving unqualified legal advice
☐ Promising easy outcomes
☐ Seeking publicity
☐ Treating the person as a ministry trophy
☐ Becoming the person’s sole source of support
☐ Claiming divine authority over personal decisions

Team Communication Guideline

What may the team discuss?

What should the team not discuss?

Part 13: Follow-Up Plan

Next Agreed Contact

Date: ______________________________________

Purpose:

Follow-Up Questions

1. What has changed since our last conversation?

2. What support has been helpful?

3. Are any new safety or practical concerns present?

4. Would you like continued Christian conversation?

5. Have referrals been useful?

6. Do you want any change in who is involved?

7. Are the current boundaries still appropriate?

Review Date

Changes to the Care Plan

Part 14: Ministry Leader Self-Examination

Answer honestly.

Am I Listening to the Person or trying to control the outcome?

Have I assumed experiences the person has not described?

Am I presenting disputed claims as established facts?

Have I clearly disclosed my Christian standpoint?

Have I asked permission before offering prayer, Scripture, or gospel explanation?

Am I remaining within my training and role?

Am I protecting privacy?

Am I tempted to use the person’s story for ministry promotion?

Am I confusing urgency with faithfulness?

Am I helping build Christian community rather than dependence upon me?

Am I trusting the Holy Spirit rather than using pressure?

Part 15: Final Care Summary

Person’s Present Situation

Primary Ministry Need

Primary Safety or Practical Concern

Primary Referral Need

Privacy Safeguard

Gospel Opportunity

Christian Belonging Plan

Next Faithful Ministry Step

Ministry Care Covenant

As a Christian ministry leader, I commit to:

• treat this person as an image-bearer

• listen before drawing conclusions

• speak accurately about Scientology

• disclose my Christian standpoint honestly

• request permission before religious explanation or prayer

• protect freedom of conscience

• maintain appropriate confidentiality

• follow safeguarding and mandatory-reporting responsibilities

• remain within my training

• make responsible professional referrals

• provide assistance without religious manipulation

• protect personal testimony

• encourage patient Christian belonging

• proclaim Jesus Christ clearly

• avoid controlling the outcome

• trust the Holy Spirit

Ministry Leader Signature:

Date:

Supervisor Review, When Required:

Closing Prayer

Triune God, give us wisdom to speak truthfully, humility to listen carefully, courage to protect those who may be vulnerable, and love that does not manipulate. Help us recognize the limits of our ministry role and guide us toward responsible care and referral. Make our churches and ministries communities of grace, truth, safety, and patient belonging. Give us clarity to proclaim Jesus Christ and faith to trust the Holy Spirit with each person’s journey. Amen.