Modern psychology and psychiatry are based in the worldview of naturalism, which is why they view humans reductionistically, focusing exclusively on their biological and psychosocial features. Historic Christianity, by contrast, has tended to view humans more holistically, as highly complex, necessarily mysterious creatures, that have biological and psychosocial features, as well as ethical and spiritual features, that cannot be entirely reduced to biopsychosocial processes. Consequently, case conceptualization for Christian therapists involves a more comprehensive assessment that includes ethical and spiritual considerations. A sample case conceptualization will be presented, illustrating this four-dimensional framework.