This chapter provides an overview of traditional Native American spiritualities and life ways as systems of faith, then discusses the role and influence of Christianity, and, finally, offers implications for pastoral counseling with Native people from a culturally based perspective. In terms of faith and belief, Christianity has had the greatest influence on Native Americans. Essentially, cultural competence is critical in pastoral counseling with ethnic and spiritually marginalized groups such as Native Americans due to historical struggles, mistreatment, and a resulting potential for mistrust. Pastoral counselors must avoid making assumptions about the cultural identity of Native American clients without gathering information about both the individual’s internal and external experiences. Both verbal and nonverbal cues offer pastoral counselors a sense of a Native American client’s level of acculturation. Pastoral counselors might get involved with working on large social issues that will then indirectly affect the experience of Native American clients.