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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.

Deliberate practice (DP) is an innovative training method for improving psychotherapy skills acquisition and expertise in the twenty-first century. I introduce the reader to the principles and processes of DP and the rationale for its use. The concept of DP is not new, indeed it is used to support the improvement of performance in diverse areas, from sport to music. However, its application to psychotherapy is still in its infancy. Firstly, I provide the rationale for including DP as a method of therapist training based on research that illustrates that many of the current criteria that we use to identify expertise have little to no added impact on client outcomes. Additionally, some of the limitations of current traditional training regimes are outlined, along with the emerging evidence base for DP as a training method that can help improve the acquisition of therapeutic skills and expertise.

In the previous chapter, the reader will have become familiar with the idea of screening for traumatic experiences within organisations as a way to identify those who may benefit most from interventions and support. In this chapter, I present an overview of the trauma therapy literature in the first instance and then explore some of the debates regarding specific trauma-informed treatments versus general therapeutic approaches. The multicultural competency literature is discussed, and the multicultural orientation approach of cultural humility, cultural opportunity and cultural comfort is highlighted in a practice context. This chapter concludes with a case study vignette that brings it all together with a clinical example of what trauma-informed therapy through a multicultural lens might look like. As such I operationalise choice, collaboration , trust and transparency, and cultural principles from the trauma-informed care literature. Although applied here to specific trauma-informed organisations, some of the methods and processes that I unpack can be used in non-specific organisations where social/case managers are employed and wish to operationalise choice and collaboration in a structured way.

This chapter highlights the perspectives, examples, and applications on the current trend in teaching and learning counseling ethics education in a more effective way. The trend utilizes inquiry-based learning concept and educational activities to foster counselor education training programs fast-forward in meeting the social demands and global challenges. The discussion is based on the theme emerged from an interpretive case study research conducted by the authors, in addition to the insightful literature authored by the profound educators and counseling researchers, globally. Teaching and learning counseling ethics education is an integrative effort and is more than just content acquisition from textbooks. In addition, the inquiry-based teaching and learning approach can be a tool in finding solutions for authentic problems through in-depth investigations while learning counseling ethics education. This chapter hopefully will improve counselor educators’ ability, strengthen counselor education training programs’ capability, and expand counseling students ethical competency; for creating innovations and adaptations in teaching and learning counseling ethics education, utilizing inquiry-based learning toward enhanced professional ethical practice in counseling realm.

Supervision is considered the signature pedagogy and after direct client practice it is rated as the number one learning and development method by practitioners. However, as we set out in this chapter, the relationship between supervision and client outcomes is not a strong one. Drawing on the use of routine outcome data, we demonstrate how clinical supervision can be improved when both practitioner and supervisor demonstrate an attitude of humility and a willingness to learn from the data they collect. Using these data to enhance supervision by improving client outcomes and to inform deliberate practice (DP) is the hall mark of the effective twenty-first century practitioner and supervisor.

Many psychological, cultural, and social barriers exist that impact Black male participation in the workforce. In this chapter, authors discuss the impact that mentorship, racism, society, culture, economics, and other pertinent factors have on the career development of Black men. This chapter examines programs and strategies that effectively address the career development needs of Black men. A review of counseling interventions and their applicability to career counseling with Black men are presented. Emerging trends in career development for Black men are also discussed. In addition, provided in this chapter are personal narratives given by the authors who contextualize their career development experiences through culturally-specific career development theoretical frameworks. Lastly, implications for research, counseling, counselor education, and policy, as well as recommendations for professional development are offered.

In the last chapter, I introduced the reader to the concept of empirically supported treatments and some of the research methods of providing evidence for the effectiveness of these interventions. Unfortunately, the field seems to place much importance on the techniques and methods used by the practitioner, when the reality is that there are a vast amount of components and variables that contribute to change in effective psychotherapy. In this chapter, I move beyond the idea of the treatment method and explore the idea of evidence based practice (EBP) in its entirety. The reader will be provided with a description of EBP as a tripartite model. While it is beyond the current chapter to delve in depth into each aspect of EBP, the chapter does act as an excellent introduction providing the practitioner with key learnings to build on.

Drawing on the slavery history of the United States, the theoretical framework of the post-traumatic slave syndrome is used to understand the influences and challenges of contemporary assessment and counseling issues of African American offenders.

Through a qualitative review of the literature, supporting evidence is given from an investigation of slavery’s historical laws, practices, experiences, and beliefs’ and its influences on contemporary assessment and counseling issues concerning African American offenders and the challenges met by counselors.

The laws, the practices, the experiences, and the beliefs during slavery have had a profound influence on contemporary issues of assessment and counseling African American offenders. The transgenerational adaptations associated with previous traumas during and after slavery influenced counselors’ ability to effectively assess and counsel African American offenders. Moreover, transgenerational adaptations are equally present among white counselors, which have contributed to challenges with assessments and counseling of African American offenders.

Understanding history that is theoretically framed out of the post-traumatic slave syndrome builds knowledge in understanding present challenges and barriers to effective counseling of African American offenders in three ways: (1) it makes the connection between slavery and contemporary issues concerning assessment and counseling of African American offenders; (2) it explains how race might complicate counseling and assessment process; and (3) it sheds light on significant counseling concepts related to rehabilitation or sanctions of African American offenders.

The last chapter examined evidence based relationships from the perspective of emotional expression and the inner experience of the practitioner in relation to the client. In this chapter, I am introducing the first of a number of variables situated in evidence based relationships. Empathy, congruence, unconditional positive regard, and the real relationship will be discussed. I have chosen to categorise these four variables together due to their significant overlap and interaction with each other in terms of practice and research. This chapter does not attempt to provide an exhaustive description of each factor. Rather, I provide a very brief overview of the variable, provide an analysis of the research behind each, and highlight Top Tips that can guide the practitioner in their development.