This article presents some of the author's reflections and observations of the challenges and opportunities that arise when including matters of spirituality in the therapeutic process. Research indicates that many individuals want to incorporate their spiritual or religious ideas with therapy (Hull, Suarez, & Hartman, ), yet doing so can often raise discomfort in the client, therapist and the therapeutic process, and so frequently the topic is avoided. This article considers the presence and importance of spirituality for many clients in understanding the dilemmas they bring to the therapy room, and reflects on some of the personal and institutional challenges of integrating spirituality into the therapeutic process. It concludes with some thoughts about the modest contribution systemic therapy might make in this regard, including the usefulness of opening dialogue about a client's spiritual history with early enquiry (Payman, ) and considering the relational context of a person's spirituality using Bowen Family Systems Theory (Kerr & Bowen, ).