This paper provides a meta-theoretical context for a spiritually oriented psychotherapy, namely Constructivism. It also presents some empirical and theoretical support for this Constructivist position which is consistent with cognitive psychology and concepts from both Western and Eastern traditions. It summarizes the work of Mahoney on Constructivism and integrates it with Personal Construct Psychology. It then provides the perceptual, theoretical, and empirical underpinnings for an integrative, holistically oriented clinical model that focuses on how clients construct their realities. The paper concludes with a discussion of the levels of therapeutic work that clients contract for, placing them in charge of their lives. The goal, for clients who chose the deepest path, is the philosophical understanding that they create the relative realities to which they respond, causing both their suffering and potential liberation. The ultimate choice is theirs, and not the therapist's.