Despite a proliferation of spiritually oriented psychotherapies during the past 2 decades in the mental health professions, outcome research is lacking. In this present article, 6 published outcome reviews that shed light on the efficacy of these psychotherapies are discussed. Although there is general support for the efficacy of spiritually oriented treatment approaches, the data base is relatively small and has methodological limitations. Spiritually oriented cognitive approaches for religious clients with depression and anxiety meet evidence-based standards of efficacy. Several other spiritually oriented approaches are probably efficacious but need additional investigation. Methodological recommendations for improving the quality of future studies in this domain are made. Philosophically and methodologically pluralistic research strategies that do not reduce spiritual phenomena into a naturalistic and materialistic framework are recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)