Assessment and case conceptualization are also critical processes in spiritually oriented psychotherapy. This chapter describes a comprehensive and integrative assessment strategy that includes assessment of personality dynamics, family dynamics, cultural dynamics, and spiritual dynamics. An integrative assessment is an ongoing process that begins with an initial evaluation and continues through termination. As in conventional psychotherapy, case conceptualization is the link between assessment and treatment planning. The chapter also discusses and illustrates how spiritual factors and issues can be incorporated in developing an integrative case conceptualization. Today, the expectation is that therapists will not only be aware of and assess a client’s spiritual values and concerns, but will also incorporate them in the therapeutic process, specifically in the case conceptualization. In the past, this was not always an expectation. Accordingly, when therapists were not sufficiently aware of the client’s spiritual needs and issues, the result was often “a skewed and narrow case conceptualization of the presenting problem and may have led to inadequate treatment planning, as powerful sources of gains were largely overlooked” (Aten & Leach, 2009, p. 17).