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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.

In this chapter, the author critically examines the deeply entrenched practices and theories within counselor education, revealing their roots in historically dominant, Eurocentric, and often racially oppressive assumptions. This study brings to light the pervasive impact of these traditional approaches, illuminating their role in perpetuating racial oppression and disparities in mental health care. The author presents a compelling argument for adopting Critical Race Theory (CRT) as an effective pedagogical and clinical practice framework in the counseling profession, a step toward its much-needed liberation. CRT's tenets are examined as a robust alternative, promoting socially just outcomes in counseling and psychotherapy. The article highlights CRT's capacity to address the well-established relationship between racism, white supremacy, and minority mental health. It proposes a groundbreaking model for praxis, predicated on CRT, which holds potential not only to challenge and disrupt oppressive structures but also to pave the way for the liberation of both the oppressed and the oppressor. This seminal work prompts a re-envisioning of counselor education, asserting a call for a transformative shift toward a liberation-based, social justice pedagogy.

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.

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.

Organisations and systems of care working within both specific and non-specific trauma-informed approaches must adapt a multicultural lens, in design, delivery and evaluation of services and interventions. Cultural and social factors can directly influence the exposure of individuals to traumatic events (Roberts, Austin, Corliss, Vandermorris, & Koenen, 2010). At the same time, social and cultural identities influence the development and experience of trauma and symptoms, including treatment outcomes (Marsella, 2010; Wilson, 2007). In this chapter, Ravind Jeawon and I provide some of the essential factors that trauma-responsive systems may wish to consider. The first part of this chapter deals with the idea of multicultural identities and practices and highlights some of the outcomes associated with accessing behavioural healthcare. The impact of intersectionality and microaggression on those from diverse backgrounds is also considered. Finally, a guiding framework is provided that examines what needs to be implemented across organisations in order to provide the system with a multicultural lens in which to view and deliver appropriate services. Crucially, multicultural responsiveness will not come from tick box training regimes, it is something that needs to be kept on the agenda and is a lifelong trajectory.

The severe underrepresentation of African American males in counseling and psychology is significant, especially in light of these fields’ mandates as health professions. In this chapter, I will use a within-race intersectionality paradigm (gender, class, skin color) to inform my analysis of factors that affect the presence of African Americans males on counseling and psychology faculties. I will briefly elucidate factors that, early on, effectively “weed out” African American males from the pool of aspirants for higher education, and thence, from counseling and psychology programs and faculties. I will apply cooperative inquiry – a radical peer-to-peer research method regarded as a well-developed action research approach – to explore Black males’ experience along a range of narratives.

In this chapter, Ravind Jeawon and I discuss the ideas around being responsive to diversity in an evidence based manner. Although this chapter belongs within the evidence based responsiveness section discussed in the previous chapter, we both considered it essential to provide a whole chapter on its theory and application, as it is an integral area often overlooked in clinical training and provided a curtesy overview during ongoing professional development and clinical supervision. The multicultural literature uses different terminology to refer to the practice of responsiveness, we discuss these ideas and the evidence base for them, while introducing the reader to other processes and theories which will help developing practitioners make sense of what can be a vastly complex area of clinical work. Several adapted, real life case examples are drawn from Ravind’s clinical experience to encourage reflection and provide insight into these processes.