In Appalachian Pentecostalism, the practice of casting out devils, often called spiritual deliverance, closely resembles exorcism but is distinct in approach and scope. Deliverance in this context involves prayer and spiritual intervention aimed at expelling evil spirits or demonic influences from individuals. Unlike the formalized Catholic exorcism rituals, which include specific prayers, incantations, use of holy water, and are performed by ordained priests under strict guidelines, Appalachian Pentecostal deliverance is more informal and holistic. It can address not only demon possession but other spiritual afflictions such as generational curses, witchcraft influences, and occult oppression.
Deliverance prayers may be performed by lay members, pastors, or spiritual leaders and typically include direct prayer, spiritual warfare, and an emphasis on healing the mind, body, and soul. This practice reflects the Appalachian tradition of self-reliance and close-knit community care, often taking place outside institutional formalities. It is part of a broader spiritual approach integrating faith, prayer, and healing, aiming to restore wholeness and reclaim individuals from harmful spiritual forces.
In summary, casting out devils in Appalachian Pentecostalism encompasses spiritual deliverance that is biblically rooted but practiced with local cultural adaptations, emphasizing prayer, community involvement, and healing, differing from the formal Catholic exorcism but sharing the goal of overcoming evil through spiritual power.
The thesis “These Signs Shall Follow: Endangered Pentecostal Practices in Appalachia” by Melanie Rae Harsha documents and analyzes a set of Pentecostal and Holiness practices—some common, others regionally endangered—particularly in Appalachian communities.
Here is a complete list of the practices discussed throughout the final draft:
Core Pentecostal “Five Signs” from Mark 16
Harsha’s thesis centers on these five practices (often called signs following):
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Casting out devils — exorcism or prayer to cast out evil spirits. 
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Speaking with new tongues — glossolalia, or speaking in unknown languages (central to receiving the Holy Ghost). 
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Taking up serpents — literal serpent handling (practiced by certain Appalachian Holiness churches). 
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Drinking deadly things — voluntary drinking of poison (most often strychnine). 
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Laying hands on the sick — faith healing and anointing with oil for recovery. 

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