This article explores the relevance of adolescents’ spiritual, religious, atheist, and agnostic identity development in the therapy process and the potential difficulties that psychologists face in effectively working with adolescents around spiritual/religious issues. Psychologists’ limited personal and professional opportunities for increasing their self-awareness around their spirituality and religion may impact their ability to adequately address issues related to the spiritual/religious identity development of their adolescent clients. Psychologists’ limited knowledge, awareness, and skills in reference to the process of adolescents’ spiritual/religious/nonreligious identity may result in their neglect of spiritual/religious issues in psychotherapy. In such cases, adolescent clients may feel unsure if therapy is a safe place to discuss spiritual, religious, atheist, agnostic questions or issues that arise for them. The article concludes with practical suggestions that are framed around six critical concerns that are relevant for adolescents: (a) the relationship between spirituality/religion and health and coping, (b) negotiating multiple social identities, (c) religious cults, (d) religious conversion experiences, (e) anti-religious sentiment or religious discrimination, and (f) ethical considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)