The epidemic of HIV/AIDS has resulted in an increasing population of individuals in need of counseling services: persons living with AIDS, as well as family, friends, and caregivers. The relationship between HIV/AIDS clients' counseling and spiritual issues is demonstrated by a review of salient literature. Three broad themes are used: terminal illness issues such as post‐death existence and existential meaning of life, religious disenfranchisement from society or families of origin, and multicultural spiritual and religious issues. Practical recommendations for counselors and research implications are included.

Forty-three individuals receiving psychotherapy for childhood sexual abuse and 34 clients who sought psychotherapy for other reasons were compared on several aspects of spiritual functioning. The 2 groups did not differ significantly in spiritual well-being. However, both groups scored lower than samples of medical outpatients and hospice workers. Most reported initiating and discussing spiritual issues during therapy, were satisfied and comfortable with these discussions, and rated spirituality as important to problem resolution. They also listed several obstacles to spiritual development. Possible research and practice implications are discussed.