In addition to psychotherapy for problems causing emotional distress, many individuals seek out growth-enhancing approaches such as spiritual direction, a practice that typically involves regular meetings between a director and an individual focused on the latter’s religious experience. In order to better understand the relationship between the two practices, and what leads individuals to seek direction or psychotherapy and how they experience these, we reviewed 40 peer-reviewed papers published between 1975 and 2015 that referred to both spiritual direction and psychotherapy. We also conducted a focus group of 7 individuals who had engaged in both psychotherapy and spiritual direction. The responses of focus group members generally confirmed the findings of the literature review, and in this report served to illustrate the following themes: similarities and differences between psychotherapy and direction, psychotherapist expertise, psychotherapy limitations, qualities of a good spiritual director, referrals, concurrent spiritual direction and psychotherapy, and spiritually integrated psychotherapy. Psychotherapy and spiritual direction both aim to help individuals flourish, but they differ in their primary goals, conceptions of problems addressed, and many of the resources utilized. Indications for psychotherapy most often include distress secondary to psychiatric conditions, while the primary indication for spiritual direction is growth in one’s relationship with God. (PsycINFO Database Record (c) 2018 APA, all rights reserved)