We used Consensual Qualitative Research (CQR; Hill, 2012) to investigate the experiences of eleven religious/spiritual (R/S) Jewish therapists working with R/S Jewish clients in psychotherapy. R/S concerns involved struggles with Jewish identity, relationships, and the Jewish community. Therapists used R/S and non-R/S interventions to help with R/S concerns, although therapists explicitly discussed Jewish laws, beliefs, and practices more in successful than in unsuccessful cases. Therapists in both cases experienced R/S countertransference, but therapists in unsuccessful cases more often expressed uncertainty and regret regarding their clinical decisions. Therapists perceived that effective therapeutic interventions led to client improvement. Factors associated with success included therapists’ effective use of a shared R/S identity, ability to overcome tensions raised by R/S differences, and countertransference management; and clients’ openness, stability, and motivation. Implications include therapists developing an approach that is sensitive to R/S identity and researchers investigating therapeutic dyads with cultural and value-based similarities and differences.