The salience of religion in society and health care has received increased attention. Recent developments in psychiatry reflect a broader view of religion that includes an appreciation of its adaptive and maladaptive dimensions. An examination of religious countertransferential and transferential reactions provides a framework for examining religious themes. Case examples illustrate the following critical factors that increase therapists' skill in working with religious themes: 1) monitoring the therapist's own attitude toward religious content, 2) attending to religious content, 3) seeking consultation, and 4) using religious content in interpretations.