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While spiritually oriented psychotherapy is gaining acceptance, clinicians are often uncertain what role to take in a given patient’s moral or spiritual life. Søren Kierkegaard’s 3 spheres of existence—the aesthetic, the ethical, and the religious—offer a framework for directing interventions toward more mindful, intentional, and passionately committed living, respectively. This report considers its clinical implications in the long-term treatment of a gay man who struggled with substance abuse, divided loyalties, and his faith. Kierkegaard’s model suggests a helpful organizing context for the use of spiritually oriented interventions.