The purpose of this mixed methods dissertation study is to determine an operational definition for a new construct: a spiritually competent orientation (SCO). The SCO construct has emerged in recent literature but has only been defined theoretically. An exploration of the literature from which it emerged implies the possibility of improving the way clinicians approach religion and spirituality (R/S) in mental health services. A broader review of relevant R/S literature revealed possibilities for understanding and beginning to define SCO, but there was not a consensus among scholars about the components of SCO. A mixed methods modified e-Delphi (or online Delphi) panel of 13 experts in R/S integration responded to questions designed to gather input and seek consensus about the possible components of SCO. Six domains, 16 themes, and 101 items of SCO stemmed from the first round of questions to the panel. The panelists reached consensus for 77 items in the second-round survey by rating their level of agreement that each item was part of SCO. The six domains include the following: (1) Ethical; (2) Humility; (3) Comfort; (4) Opportunities; (5) Growth; and (6) Constructivism. Discussion of findings includes implications, strengths, and limitations of the study, as well as possible future directions for studying SCO. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]