Psychotherapists’ interest in Buddhist traditions, once described as a new popular trend, should today be considered an established feature of the mental health field in the United States. Recognizing their religio-cultural import, religious studies scholars increasingly attend to clinicians’ approaches to Buddhist teachings and practices. However, existing literature on this topic frequently overlooks therapists’ own reportage about their activities. As a consequence, the variety of approaches that clinicians have taken to Buddhist traditions are often lost in the sweep of totalizing interpretations. Scholars declare these phenomena to be cases of either secularization or religious transmission. Commentators who herald a “spread of the Dharma” do not sufficiently acknowledge those who believe they are successful in secularizing Buddhist practices for audiences unaware of their origins. Meanwhile, those who describe the “secularization of Buddhism” brush over therapists who advance a Buddhist qua religious path as superior source of psychological healing. Moreover, such analyses do not account for recent scholarship demonstrating that categories like “religion” and “secular” have been socially co-constructed by particular communities for particular purpose. I conduct textual analysis, personal interviews with formative published clinicians, and ethnographic observation at continuing education conferences where therapists receive training on aspects of these approaches. I show that psychotherapists are molded by their own understandings of what defines “religion” and “secular.” Therapists’ relative levels of investment in preserving psychotherapy’s qualification as a secular biomedical discipline produce a multiplicity of treatments of Buddhist traditions. I delineate six overlapping sets of approaches that therapists take to Buddhist teachings and practices. Clinicians have (1) therapized, (2) filtered, (3) translated, (4) personalized, (5) adopted, and (6) integrated those elements of Buddhist traditions they view as religious. My study offers a more accurate description of these phenomena. It also clarifies how the ongoing re-construction of categories like “religion” and “secular” function “on-the-ground.” I demonstrate that these concepts are not only abstract categories for scholarly classification but concrete determinants of behavior for contemporary communities.