Mental health professionals are often reluctant to label the religious and spiritual lives of their clients as “unhealthy” or “harmful.” Indeed, professional codes of conduct require that clinicians respect the religious and spiritual values of their clients and at the same time provide clients with ethical and efficacious mental health care. Accordingly, clinicians must consider a framework for assessing and addressing religion and spirituality that acknowledges and protects the worldviews of their clients without disrespecting expressions of religiousness and spirituality. This framework must also accurately label maladaptive thoughts and behaviors so that effective intervention may be implemented. Such a framework must be consistent with a scientific understanding of human behavior, while also respecting the moral values provided by religious and spiritual traditions. This article describes two useful strategies to assist clinicians in assessing and addressing unhealthy and potentially harmful expressions of religiousness and spirituality in psychotherapy. The authors also provide examples and case illustrations of common ethical concerns, as well as techniques for working through these concerns, to maximize clinician competency and client welfare.