Over the past 10 years, major changes have occurred in spiritually sensitive clinical practice. During this time there has been increasing “evidence that the mental health professions are warming up to a more routine and explicit focus on spiritual issues” (Hathaway & Ripley, 2009, p. 44). Reflective of this change is a noticeable shift from an awareness of the need to incorporate spirituality in the treatment process, to the need to competently integrate spirituality in everyday practice. Ethical codes for the various mental health professions increasingly require that professionals be sensitive to a client’s religious and spiritual concerns. However, it is not always clear how therapists and other providers are expected to demonstrate such sensitivity. Does it mean that a spiritual history is to be performed? Should religious and spiritual concerns be identified, and these concerns be addressed by the provider? Or, are psychotherapists expected to provide spiritually oriented psychotherapy? This article considers these questions and offer a framework for answering them. It begins by distinguishing 2 types of spiritual care: basic and specialized spiritual care, and reflects on the professional responsibilities associated with each type. Then, it describes efforts to specify clinical competencies and finally identifies some implications of these efforts.