This chapter focuses on clinical assessment of spirituality in mental health settings. It is intended primarily for mental health professionals with different clinical backgrounds, although we hope it can be useful to other clinicians in different settings where spirituality is associated with mental health problems. A flexible schema is proposed through use of spiritual screening and history, followed by a formulation phase to help in articulating relationships between the patient’s spirituality and mental health experiences. A few psychotherapeutic ideas are then discussed which may be beneficial to the process of spiritual assessment. In giving spiritual assessment such a focus, we aim to offer techniques which may be useful in developing spiritual enquiry with patients, while also helping the clinician reflect on his/her own experiences. We also aim to show how spiritual assessment, in turn, can be therapeutic for patients by promoting capacity for curiosity and reflection, developing connections, and considering alternative perspectives. We conclude with a clinical vignette.