There is substantial evidence for dimensions of Religious/Spiritual Well-being (RSWB) being positively related with varying indicators of mental health, including subjective well-being and particular facets of personality structure. It has also been suggested that dimensions of RSWB might play an important role in the development, course and recovery of mental illness. Despite such claims, there have been numerous recordings of delusions and hallucinations adopting a religious nature. Moreover, certain god images turned out to be associated with anxious/depressive symptoms in psychiatric patients. However, contrary to these results religion and spirituality were found to have a protective function against addictive behaviours and suicide attempts. Patients with a severe mental disorder might use a variety of religiously/spiritually based strategies to cope with their disease effectively. However, relevant empirical evidence is still sparse and more research is needed in order to delineate the role of religious/ spiritual issues, as religion and spirituality may be part of the disease as well as part of the cure. Based on our own results concerning dimensions of RSWB in relation to personality factors and mental health, which were obtained from different samples of psychiatric inpatients as well as non clinical groups, possibilities and boundaries of a spiritually oriented psychotherapeutic approach will be discussed. This regards to the question, how to adequately address (specific?) religious/spiritual needs among general psychiatric and addiction patients in treatment.