River of Life Ministries Deliverance and/or Counseling Preparation Form, written by Pastor Dr. Rosemary Barnes, edited 4 15 09



Part one:  Introduction: What we believe has everything to do with what is in our body, soul, and spirit both of the good things of the Lord and the bad things of the devil.  

 Although our church brochure needs some updating (basically in adding some topics; e.g., Sabbath and our Jewish roots, not an “updating” in regard to doctrines already established in there), we will still use the current one for the questions in this first part. Thoroughly study once more the River of Life Ministries Brochure and then answer (and comment if appropriate) on the questions below. Our belief statement is on riveroflifegrmi.org.

The people we can effectively help with the issues addressed here in this paper in part two   are those who believe in the Lord Jesus Christ as their Lord and Savior and those who believe the Bible to be the infallible Word of God.

  Please include the question on your response paper so the reader does not have to refer back to the paper to understand what you are answering

 A) Do you give tithes and offerings faithfully? If not, Why?

 B) Do you operate in any of the Gifts of the Spirit?  -Which one(s)?  What Gift () are you asking the Lord for?   Why? If you are not asking God for any Gifts(s), why not?

 C) When we worship together as a Church, do you actively clap, make a joyful noise unto the Lord, dance, raise your hands in Worship?  If not, why not?

 D)  -How often do you pray in the Spirit?  Daily? Hourly? How many minutes or hours per day (make an estimate)? If you do not, why not? Since you have been baptized in the Holy Spirit, have you walked in that boldness to be a witness to others that has been place by God inside of you?  If not, why not?   If you have not yet received the baptism in the Spirit, how diligently are you seeking the Lord for Him to fill you to overflowing with His Spirit with the evidence of speaking in tongues?  If you have not persisted in asking for Him to do this, why not?

E) How many hours a week do you have devotions?  Do you have a normal time and place for this?  Do you have a good balance of prayer, praise and Bible study?  Do you pray for others--even those outside your own little personal world more often than you do for yourself?

 Do you ever go into travail in your prayer time?  How often? Are there ever times when the Bible is totally "closed" to your understanding? What do you do if this happens?

 F) As you read about our policy on Pastoral Counseling time, what is your response to our stand? Do you agree or disagree with it?  What role do you believe you have in "working out your own salvation with fear and trembling?" What role does the Body of Christ have in assisting you?  What role do the pastors and other leadership have in helping you? Even if you do agree with the truth of our stand, is there anything within you that resents the responsibility that gives you?  If so, why do you suppose you feel this way?   G) Do you get up periodically in open pulpit?  Are you glad to do this?  If you do not, why not?  Are there gifts/talents that you know are within you to bless the Body of Christ that you are not sharing?  What are they? Why do you suppose you are withholding them?  Do you have problems with the fact we want you to dress a certain way before getting on the platform?

H) If you are a woman, do you really believe that you are free to become anything in the Body of Christ? Are there any roles you feel inhibited in because you are a woman? If so, what are they?   Do you have any resentment concerning your womanhood and the barriers society sometimes places in your path?  Do you resent (or judge to be “out of order”) other women who seem to feel no inhibitions about coming forth boldly in the Christian gatherings?    Do you quietly defer to a man to do something even when you (humbly) know what you have to offer would better serve the Body of Christ?

Is there anything in you that would want to enter into an aggressive contest with men and you gleefully keep score whenever a woman is "one up" on a man?

Do you enjoy "woman only" groups and settings so as to avoid any God-given, proper male authority?

Do you see your brothers with compassion, knowing that they too hurt and need acceptance and encouragement, or do you think of them as having everything and trying to keep them from the satisfaction of getting any more success and recognition that they already enjoy?  

When you think of having a (or your) husband,                -do you think mainly of what you can get from him (home, children, financial security, etc.)?

Or, do you think what you can give to him (nurturing, a home, love, physical love, joy, communication, companionship, understanding, etc)?

If you are a man, answer the above two questions with a wife in mind.

If you are a man, do you have any reservations about a woman being anything she has the gifts, talents, and character to be in the Body of Christ?

Question for everyone: Would you find it hard to take orders from a woman (e.g., on your secular job or in the military or in church)?

Men:  Do you have a need to put women in a certain inferior place (i.e., to make less money, to have less to say, to get lower grades, or to receive less favor than you or another man)? 

Is there anything in you that would rather just let a woman take responsibility for most everything even if that means her getting all the rewards due her for being the more responsible person?

If married, do you find it hard to respect the wishes, feelings, and opinions of your wife?

Is it hard for you to treat a woman as a person as opposed to a role (mom, homemaker, secretary, etc.)?  and/or a sexual object?

If a woman is "right" in public when you were one who expressed a contrary opinion, would you find yourself becoming angry to be "shown up" by a woman or would you be glad that truth was arrived at?

Brother, or sister, pray and ask the Lord --even beyond these brief questions--to examine your heart and show you any deep seated gender issues that you may be harboring which may be keeping you and/or others in bondage!

 I) Do you really believe all believers have been given a role in the Body of Christ or do you tend to believe it is alright for some to "watch" while others "perform"?

What is the role (or roles) that the Lord has called you to in His Church? Are you either working on coming forth in your place or are you basically doing it already?  If not, what are you waiting on?

 J) Do you sincerely believe that Christians have been given the power to expel evil spirits from others?

Do you believe that a Christian can need deliverance?

Do you believe in actual evil personalities, called demons, in and around us at work to propagate the kingdom of darkness in the world today?

Do you fully understand what the armor of the Lord is? See Ephesians 6.  Do you know how to keep (ALL the time) each part of the armor on yourself?

Are you aware daily of the need to be sober and watchful in your life to guard against the attacks of the enemy?

Are you aware of the presence of the Lord and His Angels to protect you?   Are these things real to you?


Part two: Introduction:

There will be times we only ask you to fill out part two of this paper and other times we will want both parts fully completed.  We will always want you to review part one as a tool of examination.
Sometimes we will ask you to meditate on everything in here, but, then fill out only what you believe currently applies to your situation.  

Always complete # 3.

There may be things you do not want in print for anyone to see. In that space write, “I want to tell this part in person. It is highly confidential”.


Say if you are uncomfortable with any particular person talking/praying with you!

If there is a person in our church who you feel at this particular time would be inappropriate for you to share with, let me, Rosemary, know.  E.g., sometimes gender is an issue if the problem is related to highly personal things.


Leaders must explain that the confidentiality shared with them will also be shared with the senior pastors.  If the counselee is unwilling for the senior pastors to be informed, then the leader is to refrain from dealing with that person in the area that the person is unwilling to open up the information to the Pastors.

(That counselee could, at that point, be referred to any Christian counseling agency to go to share their secrets.)


All of our leadership is instructed to tell us, Robert and Rosemary, of all counseling and/or deliverance encounters that have to do with ongoing Christian maturity and/or character issues. We have told them to say “If you are telling me, you are telling Robert and Rosemary too because I will be sharing these things with them”.

  If we ever have a leader who does not make that plain (in what is obviously a special time of counsel and/or deliverance), tell us!  Furthermore, any leader who is friends (close or not so close) with a fellow leader and/or ROL member who has confided serious issues that could be “leaven” in the whole church  (see 1 Corinthians 5), they are expected to tell that to Robert and Rosemary.  Robert and Rosemary are ultimately responsible to give an account to the Lord concerning ROL members (and those only coming to ROL as their local church even if they have not formally “joined”).  Therefore, the leadership must keep Robert and Rosemary informed; but, Robert and Rosemary may or may not inform the leaders of what all are going on within ROL (as the other leaders don’t have to give “an account “ to the Lord for all the sheep at ROL).  Robert and Rosemary most always inform the pastor(s) of the group that the counselee is in of any significant issues regarding that person.


If a leader is uncomfortable with sharing relevant information with the pastors, then that leader should inform their friends and others not to share things in a “counselor/counselee” time that they will be accountable to share with the pastors in accordance with the above statements!


Extreme “secrets” – both from the past and in the present

There are some things the local church people simply never have to know – e.g., if a woman had an abortion when she was 16, has now repented (and she is now a grown woman), the senior pastors may be told that in a counseling session and they would chose (as they have in the past) to never tell anyone that information.  The same could hold for a homosexual encounter that is now being told years after it happened. We can also keep totally confidential any reoccurring perverse, sinful fantasies that have never been acted upon nor is the person even expressing a temptation to start acting on these thoughts. They simply want freedom from sinful thinking!

But, active child molesters, murderers, etc. will be reported to the proper authorities. We have not taken the same vow of confidentiality that some human services professionals or clergy have taken.   

Rosemary, as a certified social worker professional, is legally bound to report (immediately) both suspected and actual child abuse awareness, i.e., an adult perpetrating abuse on a child! Report YOURSELF BEFORE anyone else is forced to do so!  

Even as pastors, whether we “had to” or not, we do NOT want to be responsible for the well being of a child in a home where abuse has been suspected or reported!  The legal folks have the authority to command the abuser to leave the home; we don’t.

Other examples that we would probably report, e.g., to parents and/or spouses (or we would INSIST the person report it):  Active fornication (or adultery), abortion, strong thoughts and/or actions leading to suicide, or any other issues that obviously put the young ones or a home in grave spiritual and/or natural danger. If the parent(s) or spouse are definitely abusers themselves (or have demonstrated repetitive, very foolish response to crisis situations), we will have to seek the Lord for wisdom concerning whether or not to report serious issues to them.

We will take ALL complaints of sexual molestation seriously.  At the same time, we will seek earnestly to discover if the complaint is a vengeful lie against the accused -- that HAS happened before! 

We will also stand WITH the one we think to be abused through all the accusations commonly brought against the one who “blows the whistle”, e.g., that they, in fact, brought a disaster on the household by telling the problem.

Counseling hazards:

We are painfully aware of some of the issues arising from people unveiling issues. People can lose their positions (in the world, in church, as spouses, etc.), their belongings, and many valuable assets in life simply because they exposed themselves or someone else. But, to carry around awareness of danger to self and others as well as a guilty conscience is not worth ANYTHING!

It is better to go to jail for life for a murder we confess to than keep a secret that could land a person in Hell!

Pray for the ROL ministers too – we often go through intense spiritual warfare often when we deal with serious issues in the lives of the saints!

You do not "have to" share anything you are not ready to share; however, realize that the thing you are keeping a secret may be the very key to the "River of Life" flowing from you freely and your walking total victory!

 This form as a tool:

Anyone may use this form as a tool to counsel others or to minister deliverance; however, no information can be withheld from the local church pastors if that information is relevant to the counselee's position and/or influence in the local church, courtship, pending marriage, potential legal difficulty, serious health consideration, etc.


"Therefore confess your sins to each other and pray for each others so that you may be healed.  The prayer of a righteous man is powerful and effective."  James 5:16

 "For everyone born of God has overcome the world.  This is the victory that has overcome the world, even our faith." 1 John 5:4  


Questionnaire regarding deliverance needs

 1) Age       Age saved      Age Baptized in the Holy Spirit

 2) (Outstanding) previous counseling or deliverance incidences.


3) Current reasons for need for counsel or deliverance (always answer this one thoroughly).

 4) What have you done to deal with these things already?

 5) Have you (or are you) gotten (getting) any counsel (secular or Christian) from another source that ROL?

Would you go to a new source for help when you have ignored the Godly advice given you already? Have you ever?  Do you get angry when Godly people keep telling you the same, wise solution to your problem(s)?

 6) Are there people (dead or alive) whom you have not forgiven?  Pray earnestly that the Lord reveal to you anyone whom you still have not released.   It does not matter if they have never said, "I am sorry"; it does not matter how terribly wrong they were --you must forgive everyone to be free from demons!

 7) Have you been exposed to or participated in the occult? Have you read books, Internet material, or went to movies concerning the occult? E.g., the Harry Potter series? Occult subject material examples:  Astrology, auras, astral projection, hypnotism, past lives (reincarnation), witchcraft, voodoo, Eastern Religions, Mormonism, necromancy (this includes the Catholic practice of praying to dead saints and to Mary!!), African drumming /dancing pagan ceremonies, Pow Wows, casting spells, “white magic”, etc.

Have you engaged in occult practices such as             -going to a fortune teller, palmist, spiritualist reader or church, séance, table tipping/raising, astrology, Ouija board, tarot cards, tea leaves reading, etc.  Or, being part of a live audience in a magic show (including “Christian”), cultural art demonstrations that contain demonic drawings, demonic rituals that can be in some native dances, etc.

 8) Optional and confidential (parts or all)

(You may choose to discuss rather than record. Consider carefully as strongholds can enter with types of activity described!) 

Were you sexually abused as a child? Raped at any time? Involved in perversity? Pornography? Prostitution?  Any other sexual irregularities which would leave a deep scar? 

Do you watch movie scenes depicting fornication, adultery, and/or perverse sexual practices even in “mainstream” theaters (as opposed to “adult “ theaters)? Do you have an addiction to masturbation accompanied by perverse and/or illicit sexual mental images?  If married, do you have long (over two weeks) periods of time that you have little or no sexual energy or desire?  Or, do you have so much that it causes your spouse to feel used (several times per day).  Is the temptation and/or activity of adultery/fornication an ever-present reality in your life?   Are you guilt ridden due to illicit sexual fantasies?

9) Are you adopted or did you spend time in foster care?   Were you unwanted as an infant?  Did your parents conceive you before they were married (even though they did eventually marry)?

Have you been part of a broken home?  Has there been a broken relationship in your life that caused you deep pain?

10) Have you been physically abused or neglected?

 Have you physically abused or neglected someone else? Are you violent – or, do you have very strong urges to be violent? 

Are there people (or a person) you abuse verbally?  Do you call anyone cruel or unloving names? Is there someone you want to see suffer?

 11) Have you been suicidal? Have you had reoccurring, strong thoughts of suicide or wishing you were dead? Do you know why?   Are you deeply depressed – do you know why?    Do you abuse yourself, e.g., through cuttings or burning? Or, pulling out your hair? Or in any other way?

Do you have any secret tattoos and/or markings on your body that speak of self-hatred and/or destruction? Or, are you often tempted to have such markings? Have you ever allowed anyone else to put degrading marks on you?

12) Have you had serious illnesses, operations, handicaps of any sort?

Are you addicted to “doctoring”?  Do you think you prefer being sick and home bound (much of the time) to having to “face life”?   When you read of illnesses, does it often seem as if you share all the same symptoms resulting in your worrying a lot about it?

13) Are you on medication? If so, what are the effects?

Do you take any illicit drugs? (We will not ask you to “turn yourself in” for personal, illegal drug usage; however, drug selling is another matter entirely.)

14) Do you listen to secular music?  What kind?

Does the “Christian“ music you listen to “minister” more to your body and soul than to your spirit?  Do you idolize “Christian stars”?   Do the words speak of “ me, me, me” or do they give glory to the grace of God in your life?  Is there anything in your reading viewing material that you believe may be causing a breach in your spiritual armor?  Are you addicted to video games and/or do you waste way too much time playing them? What is the content of the video games you play?  List the nature of the games you have in your home. 

15) Do you have any (other) addictions?

E.g.: Nicotine, alcohol, junk food, gambling, buying, soap operas (or any secular program you MUST always see), inordinate amounts of sleep, etc.?

 16) Do you seem to be frequently involved in damaging relationships?  Is it hard for you to cut off a negative relationship?  Are you so loyal that you partake in the sins of another without even thinking of disassociating yourself with that person? Do you have a need to be in control of others?  Or, can others easily control you?

Do you avoid close relationships due to so much hurt from past relationships?

 17) Do you have a criminal record? Were you guilty? Of what? Have you spent time in jail or prison? If you had gotten caught for something in the past, would you have gone to jail for that thing you did?


18) Do you have a history of mental illness? Have you spent time in intensive therapy or in a facility for mental illness?  What was the diagnosis?   Do you get into frequent relationship issues because you often perceive others’ words and expressions as being hurtful?  Are you paranoid?    Do you have an exaggerated view of yourself that you protect at all times?     Do you find yourself “covering up” all negative issues in yourself and in your home in order to maintain a “front”? Do you feel tiny underneath the “armor” of lies you have constructed to make sure others see you and/or your family in a positive light?    Do you habitually lie rather than face truth?   Most important:  Do you bring TRUTH in your life to LIGHT or would you rather believe and live lies?   Do you deliberately allow yourself to live in a fantasy world OR has someone told you that you are totally out of touch with reality?   Are you deeply bothered when you have obviously hurt someone else?   Do you experience other mental and/or serious emotional issues?

 19) Do you have any eating disorders, e.g., sometimes refusing to eat or eating too much and vomiting it out?

 Are you a glutton?  Does your weight keep you in such poor health that it is hard to perform the things for which you are responsible?   Are your eating habits so poor in quality that some of whatever problems you have could possibly be a direct result of too much junk food and too little nourishment?

 20) What is your average time per night that you sleep?  Are you frequently troubled with sleeplessness?  Do you sleep too much and too often?

 21) How much time do you spend a week (on the average) watching TV? What programs do you habitually watch? Is there any program you are bound to?

 22) Are you having credit card spending habit trouble? Are you frequently troubled with overdue notices?

      Do you get "drunk" with spending? Do you ever find yourself trying to buy relationships with others? Do you often find yourself used by others taking advantage of your money or possessions but you don’t dare say, “No”?

23) Think over the people you spend time with socially (including on the Internet). Are they Christians? Is anyone not a Christian? Does anyone drag you down spiritually?

Think of the conversational content with your various friends: Is there anyone who is obviously an influence upon you to be critical, negative, carnal, etc?

What kind of people are you attracted to and who seems drawn to you? What does that say to you about who you are?   Are their sites and/or blogs that you are drawn to on the Internet that are not edifying to your spiritual life?

Do you just have to “keep up with” all the latest “star” related gossip? Do these people seem as if they are “real” in your own personal “world”?

Are you involved in any relationship in any way, anywhere that you know is not what the Lord wants for you?


 "Whatever you eat or drink or whatever you do, do it all for the glory of God." 1 Corinthians 10:31     

 24) Is there a sin you have committed or are committing that you cannot seem to repent of?

 25) Do you suffer from a feeling of rejection frequently?

 26) What religions or denominations have you actively participated in?  Whose religious literature do you now get and read regularly? What religious TV, radio programs, and/or Internet materials do you listen to or read regularly?  What church or churches do you frequently visit (other than your local church)?  What parachurch organizations are you either a member of or do you attend regularly?  Name several Christian books you have read within the last few months? What minister(s)’ recorded messages to you regular listen to?     Do you have a deep, loving loyalty to be faithful to attend and to “build up” your local church? Or, do you find yourself being overly critical of your local church and/or are happy to miss services for whatever excuse you can find without challenging that “excuse” as to it’s validity?    What ministry are you personally conducting regularly above and beyond your local church involvement or what ministry are you actively working with apart from your local church?

 27) Would you say that your parents loved you and wanted to do the very best they would to provide for your physical and emotional needs? Were they Christians?     -Were you basically normal as a child or did you manifest special needs or problems beyond the ordinary?  

Are there any negative messages in your head from your parents? E.g.: "You will never amount to anything";"You had better do your best to look good because you are stupid"; "you will end up in jail," etc.  Or, were their expectations SO high for you    that you “dropped out” of trying to “live up” to their expectations rather than be saddled with their dreams for your life?

 28) List and explain concerning any other areas you feel are pertinent in considering your being completely healed which were not covered above.