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Research suggests that African-Caribbeans are less likely than their white British counterparts to ask for mental health support (Cooper et al., 2013). This is despite research identifying that minority groups as a whole, when compared to the white majority, report higher levels of psychological distress and a marked lack of social support (Erens, Primatesta, & Prior, 2001). Those who do request support are less likely to receive antidepressants (British Fourth National Survey of Ethnic Minorities, 1994; Cooper et al., 2010) even when controlling for mental health symptom severity, with African-Caribbeans less likely to make use of medication for depression even when prescribed (Bhui, Christie, & Bhugra, 1995; Cooper et al., 2013). Studies reporting on reasons for black people being less likely to attend for mental health consultation with their GP suggest a variety of explanations why this may be, focussing both on the suspicion of what services may offer (Karlsen, Mazroo, McKenzie, Bhui, & Weich, 2005) and the concern of black clients that they may experience a racialised service with stigma (Marwaha & Livingstone, 2002). Different understandings and models of mental illness may also exist (Marwaha & Livingstone, 2002). Different perspectives and models of mental health may deter black people from making use of antidepressants even when prescribed. Despite a random control trial showing that African-Caribbean people significantly benefit from targeted therapy services (Afuwape et al., 2010), the government, despite a report by the Department of Health in 2003 admitting there was no national strategy or policy specifically targeting mental health of black people or their care and treatment has not yet built on evidence-based success. One important aspect recognised by the Department of Health (2003), was that of the need to develop a mental health workforce capable of providing efficacious mental health services to a multicultural population. Although there were good strategic objectives little appeared to exist in how to meet this important objective, particularly in the context of research showing that such service provision could show real benefit. The Department of Health Guidelines (2003) focussed on the need to change what it termed as ‘conventional practice’, but was not specific in what this might be, or even how this could improve services to ethnic minorities. There was discussion of cultural competencies without defining what these were or referencing publications where these would be identified. There was a rather vague suggestion that recent work had begun to occur, but no indication that this had been evaluated and shown to have value (Royal College of Psychiatrists, 2001). Neither British Association for Counselling and Psychotherapy nor British Psychological Society makes mention of the need for cultural competencies in organisational service delivery to ethnic minority clients. This chapter will describe, explore and debate the need for individual and organisational cultural competencies in delivering counselling and psychotherapy services to African-Caribbean people to improve service delivery and efficacious outcomes.

The purpose of this paper is to examine how multicultural counseling students expressed their understandings about themselves and others in relation to diversity. The authors wanted to know how cognitive development, affective development, and sense of self-evolved during a multicultural counseling class to examine all aspects of growth.

Themes from a phenomenological qualitative analysis of journals from a multicultural counseling class suggest that students struggle with cognitive challenges (dealing with ambiguity, internalizing multicultural concepts, and self- and other-acceptance) and affective challenges (anger, guilt, and fear) in attaining multicultural growth.

This expanded view of multicultural growth that includes affective challenges can fill a prior gap in understanding how multicultural learning occurs.

Implications are explored for counselor educators and supervisors.

Recent use of journals to provide empirical insights into student growth include a study by Cohen et al. (2015), who used qualitative analyses of journal contents to examine growth in student attitudes toward geriatric clients, death, and dying. Knowing that student journals can provide insights into changing multicultural attitudes, and that qualitative methodology can provide tools for analysis, the authors decided that it might be possible to better understand multicultural growth by studying the journals written in a multicultural counseling class.

The recognition of the importance of addressing cultural issues in psychotherapy and counseling has been increasing. The present paper seeks to contribute to the specification of multicultural competencies in the fields of counseling and clinical psychology, based on clients’ perspectives. In particular, its objectives were to explore the experiences of individuals of ethnic minority groups regarding their access to the Portuguese healthcare system and to identify the multicultural competencies of the clinicians (as perceived by the clients) which would be required to improve culturally sensitive treatments.

The sample included 40 adults from different ethnic minority groups in Portugal – a total of 30 women and ten men – with a mean age of 34. Participants took part in one of eight focus groups, which were conducted using a semi‐structured interview plan.

Content analysis revealed that, generally, participants had experienced discrimination in the healthcare system, and that mental healthcare was perceived as mixed (both positive and negative). Furthermore, participants identified specific aspects of multicultural awareness, knowledge, and skills required of clinicians to provide culturally sensitive treatments, providing support for the tridimensional model of multicultural competencies.

Implications are discussed for ethical guidelines and clinical training of counselors, clinical psychologists, and other social and health professionals in Europe.

Sets out to report on an exploratory study in which perspectives on cross‐cultural counselling in mental health care in Auckland, New Zealand, are to be examined.

The study utilised a single questionnaire which sought mental health professionals' perceptions on issues and concepts of cross‐cultural counselling. The questionnaire was administered in the nine public psychiatric units in Auckland.

Apart from the health units providing bicultural (European and Maori) counselling services, there was little cross‐cultural counselling available to an increasingly multicultural community.

With regard to the need for cross‐cultural counselling, rather than address the issue of population change this study examines the effect that lack of diversity would have on the gains that would otherwise be made in the health‐care system of Auckland, New Zealand.

This chapter analyzes the impact of intercultural academic experiences on students in the areas of intercultural sensitivity and multicultural awareness, knowledge, and skills.

Cottey College’s mission statement includes a clause about educating students to be useful members of a global society (Mission, n.d., para. 1). Toward achieving the mission, each of Cottey College’s second year students is offered an international experience over spring break that is largely paid for by endowed funds. For spring break 2015, the author of this chapter and a colleague offered a trip to Thailand. To participate, students were required to take part in a Step into the World!: Thailand course that was intended to prepare them to successfully navigate, and later reflect upon, their experience abroad. The trip portion of the course spanned 10 days. To measure what impacts the course may have had, students were asked to complete a pre-course and post-course survey, the Intercultural Sensitivity Scale (Fritz, Möllenberg, & Chen, 2002), and to complete journal entries and a personal impact statement by which their multicultural awareness, knowledge, and skills were assessed.

Analysis of the results suggests the Step into the World!: Thailand course had a positive impact on the majority of students’ intercultural sensitivity and multicultural awareness, knowledge, and skills.

The findings support the importance of intentionally combining inside and outside of the classroom experiences to enhance student outcomes.

Injuries resulting from racism are largely hidden by silence. Community services to provide healing from racism are missing in at least one Canadian city. The purpose of this paper is to identify the injuries suffered by immigrants who experienced racism and discuss the development of culturally appropriate programs and tools to address injuries from racism.

Participants representing visible minorities service providers from non-profit, public-funded organizations in a major Canadian city took part in two focus groups. Data from focus groups were thematically analyzed.

Racism produces traumatic and persistent psychological, social and intergenerational injuries. An ostensible gap exists in services, professional education and skills to address the psycho-social effects of this complex problem. The complicity of silence in both dominant and subordinated groups contributes to its perpetuation. A dearth of screening and assessment instruments is a barrier in identifying individuals whose mental health and addiction problems may have underlying racism-related etiology. Creation of community healing circles is recommended as a preferred method over individual “treatment” to expose and deconstruct racism, strengthen ethnic identity and intergenerational healing.

These qualitative findings were generated based on the perspectives of a small purposive sample (n=8) of immigrant service providers and immigrants from one Canadian city. Many of these findings are consistent with the existing literature on internalized racism and racism injuries. Generalizability to the wider population of the province and of Canada requires further research.

Practitioners in health and social care as well as educators need to understand the injuries and internalized effects of racism to provide appropriate services and leadership. Development of anti-racism professional knowledge and skills, healing circles, and assessment instruments will contribute to deconstructing racism and mitigating its injuries.

Community-driven studies exploring racism and the lack of services to address the issue are scarce. This study pulls together the experience of service providers and their insights on ways to break the detrimental silence surrounding racism.

In 2017, racial minorities made up 18.6% of the population in Appalachia compared to 39.3% of the United States population. Of this 18.6%, Black/African Americans represent the largest minority group, at 9.7% (Pollard & Jacobs, 2019). This chapter focuses on the positionality and experiences of Black women educators teaching critical perspectives at the intersection of race, gender, and class in rural Appalachia. Using Black feminist thought (Collins, 1986, 2000), a coautoethnography is used to highlight the authors' teaching experiences as Black women educators from non-Appalachian areas. Themes and recommendations identified across the authors' experiences are presented.

Higher education and student affairs professionals have a very important, active role in the lives of their students. The issues college students face are complex and higher education professionals must be properly trained to be able to address them (Franklin-Craft, 2010). Projections that by 2030 most college students in the United States will be non-White increase the responsibility of those working in higher education to truly understand the developmental issues of a diverse student body (Karkouti, 2015; Rankin & Reason, 2005; Torres, Howard-Hamilton, & Cooper, 2003).

This chapter highlights findings of a study that examined the multicultural competence of graduate students in a higher education program. Employing a snowball sampling method, completed surveys were received from 28 master and doctoral students out of 45 surveys distributed (response rate = 62%). Responses on the Multicultural Competence in Student Affairs – Preliminary 2 Scale (MCSA-P2) were also examined by race, gender, and other pertinent variables. The findings from this research indicate the need for infusing diversity into the curriculum and requiring diversity courses to increase the cultural competence of graduate students in higher education programs. The findings also support the need and call for additional research and analyses to be conducted on multicultural competence of higher education/student affairs professionals. Implications for graduate programs in higher education and reflexivity of the researcher conclude the chapter.