This game is in my opinion pretty good due to the music and boss design as well as attack patterns, though it suffers a major drawback-- the pinball system. It crushes newcomers, so you have to get used to it.
Highly Responsive to Prayers requires you to use a pinball (yin yang orb) to attack. You attack by shooting said pinball (your normal amulet bullets don't do ####, so you have to use the pinball)
Overall, for people looking for some weird challenge-- this is for you.
If you're a newcomer to the Touhou series, don't start with this one. I recommend Embodiment of Scarlet Devil instead.