Psychological therapies are another focus for entanglement with spirituality. Prayer has caused concern in the literature, particularly in respect of boundary issues arising when clinicians pray with patients, but the nature of prayer is explored here rather as a way of giving attention to things that are most desired. Scientific evidence suggests that prayer is a form of positive religious coping for patients. Mindfulness, with its roots in Buddhism, is widely applied as a secular spiritual intervention that is helpful in a range of mental health conditions. Silence has long been recognised as a significant and meaningful phenomenon within psychotherapy, but also has its place in contemplative spiritual practices. A theme running through these three practices is that of careful attentiveness, in which spiritual and psychological concerns become entangled. Good clinical practice requires careful attention-giving, so there is a sense in which treatment planning in psychiatry can be considered a kind of prayer, understood as careful attentiveness to what is most desired by patients. Examples are drawn from Christian, Islamic and Buddhist spirituality and practice.