Using the Cultural Formulation Interview With Afro Latinx Immigrants in Counseling: A Practical Application

Kirsis Allennys Dipre, Diana Gallardo, Susan F. Branco, Ladylanis Grullon Cepeda

Afro Latinx immigrants are an underserved population in the United States and within counseling specifically. The counseling profession has been slow to address the unique needs of this population despite the increased visibility of this group in recent years. Consistent with the codes of ethics from the American Counseling Association and the National Board for Certified Counselors and the Multicultural and Social Justice Counseling Competencies (MSJCC), counselors must continue to expand their repertoire and use empirically supported tools to address these mandates and increase cultural responsiveness in clinical practice. Despite its alignment with the MSJCC, the counseling literature demonstrates that the Cultural Formulation Interview is an underutilized, empirically supported tool. The authors describe how counselors may use the Cultural Formulation Interview in their clinical practice with Afro Latinx immigrants while operating from a multicultural and social justice–oriented framework.

Keywords: Afro Latinx, immigrants, clinical practice, Cultural Formulation Interview, MSJCC

     According to data from the 2020 Census, there are about 62.1 million Hispanics in the United States (U.S. Census Bureau, 2021). Of those, about 6 million identify as Afro-Latinos, accounting for about 2% of all adults and about 12% of all Latinx adults in the country (Gonzales-Barrera, 2022). Considering the Afro Latinx population is increasingly gaining visibility in the United States, there is a growing need for counselors to become well-versed in working with this population. Afro Latinxs have been found to be impacted by multiple systems of oppression because of their intersecting identities (Araujo-Dawson & Quiros, 2014; Hatzenbuehler et al., 2017; Lipscomb & Stevenson, 2022), which can have a detrimental impact on their sense of identity, mental health, and overall functioning as they cope with multiple demands not often acknowledged in the counseling literature (Adames et al., 2016; Newby & Dowling, 2007). The lack of recognition of the compounded impact of being a Black Latinx person in a racialized country, where Black and Latinx communities continue to be perceived as homogeneous groups and subjected to racism and xenophobia, contributes to these difficulties. When immigration status is considered in addition to these highly stigmatized identities, well-being can be drastically impacted as Afro Latinx immigrants are left to negotiate group membership and boundaries within communities that often reject them based on their intersectional identities (Newby & Dowling, 2007).

Current paradigms of intervention for working with multiply marginalized populations within the Latinx pan-ethnic label remain unidimensional, limiting both counselors’ understanding of clients and their ability to help clients understand their unique experiences and how these impact their well-being (Adames et al., 2016; López et al., 2018). When working with this population, it is imperative for counselors to pay close attention to the intersection of identities, oppression, and mental health; embrace a socioecological perspective; and work to balance individual counseling with social justice, as envisioned by the Multicultural and Social Justice Counseling Competencies (MSJCC; Ratts et al., 2016). We assert that the evidence-based Cultural Formulation Interview (CFI) is an underutilized intervention tool to support counseling practitioners’ and trainees’ MSJCC responsiveness when working with Afro Latinx immigrants in the United States. In this manuscript, we describe the CFI; highlight its alignment with the MSJCC; and demonstrate how the CFI may be used with Afro Latinx populations, an underserved and minoritized group.

Counseling Latinx Populations
     In the United States, counseling practice with Latinx populations has primarily emphasized the role of cultural values (Ayón et al., 2020; Mancini & Farina, 2021). Cultural values are the customs, beliefs, and guiding principles held in common by a cultural group that often help shape worldview and the perceptions of individuals of that culture (Ratts et al., 2016; Sue et al., 2022). Culture plays an important role in the presentation of illness and the experience of mental disturbance (Jones-Smith, 2018). Therefore, it is imperative for counselors to attend to cultural elements throughout the counseling process. This emphasis on the role of cultural values has made significant contributions to the Latinx mental health literature by providing a foundation for counselors and counselors-in-training (CITs). But there continues to be a lack of emphasis placed on interventions that explicitly consider the role of within-group differences among this diverse ethnic population (Adames et al., 2018; Barragán et al., 2020). Scholars and practitioners have relied on cultural values and categorized the discrimination Latinx individuals and communities experience from ethnic-, language-, and immigration-related factors, while glossing over racial stressors (López et al., 2018).

In a racially charged environment, like that of the United States, culture is often used as a proxy for race across health settings, including mental health settings. Among this population, this has been done through a reliance on the socialization of Latinx people not to identify themselves racially, and instead, use country of origin or immigrant generation to reflect their experiences (López et al., 2018; Telzer & Vazquez Garcia, 2009). With this focus, racialized experiences of Latinx individuals are lost—including the impact of skin color and other phenotypical characteristics on Latinxs and their mental health. Skin color, for instance, is a critical component of identity within the Latinx community because of its historical roots in African, Indigenous, and European cultures (Araujo-Dawson, 2015). This history has contributed to a wide range of skin tones within the population, from very light skin with European features to very dark skin with Indigenous or African features (Telzer & Vazquez Garcia, 2009). A preference for Whiteness within the Latinx community manifests itself through various forms of oppressive systems, such as colorism and anti-Blackness, both of which are associated with within-group discrimination and adverse mental health outcomes among Latinx populations (Araujo-Dawson, 2015; Ortiz & Telles, 2012).

In addition to the within-group differences that are often overlooked in the Latinx mental health literature, Latinx populations are also impacted by immigration demands. Demands such as personal processes like acculturation and resultant acculturative stress may arise because of the pressures of the host country (Ayón et al., 2020; Driscoll & Torres, 2020). Structural barriers put in place by governments and society at large contribute to the stress experienced by Latinx immigrants. These stressors may have adverse impacts on immigrants’ health and mental health (Ayón et al., 2020). For example, researchers suggest that immigrants are already experiencing day-to-day feelings of hopelessness and intense fear of being surveilled by immigration officials. Anti-immigration policies further exploit these feelings, which might significantly impact immigrants’ long-term mental health (Rhodes et al., 2015; Stacciarini et al., 2015).

Afro Latinx Identity and Multiple Marginalization
     Black and darker-skinned Latinos/as may experience higher levels of psychosocial stressors, which can erode the individual’s health through psychological and physiological responses and health behaviors (Capielo Rosario et al., 2019; Cuevas et al., 2016). Greater perceived discrimination based on ethnoracial appearance has been consistently associated with higher stress levels, anxiety, and depression (Ayers et al., 2013; Mena et al., 2020; Ramos et al., 2003). Additionally, the literature demonstrates that Black and darker-skinned Latinos have worse mental and physical health outcomes than White and lighter-skinned Latinos, noticeably resembling the non-Latino Black differences from non-Latino White populations (Cuevas et al., 2016).

Although the Afro Latinx immigrant population is directly impacted by the multiple marginalized social positions that they occupy in the United States, few mental health efforts have been launched to attend to this population explicitly. In the past 20 years, no scholars have explicitly addressed the Afro Latinx immigrant population in the mental health literature, with most researchers addressing the intersection of several marginalized and privileged identities such as ethnic and binary gender identities (López et al., 2018; Ramos et al., 2003); undocumented legal status, immigrant status, and ethnic identity (Ornelas et al., 2020); and legal status, women, and ethnic identities (Ramos-Sánchez, 2020). Adames et al. (2018) drew attention to Afro Latinx queer immigrants through the lens of intersectionality, indicating a shift in the field as it pertains to addressing the mental health needs of the Latinx population. Because of the impact of occupying multiple marginalized positions in the United States, as is the case of Afro Latinx immigrants, more clinical practice recommendations, such as the utility of the CFI, are warranted.


The MSJCC is conceptualized as a map that includes four main components: (a) quadrants of counselor–client interaction; (b) developmental domains of multicultural and social justice competency; (c) aspirational competencies of attitudes and beliefs, knowledge, skills, and action within each domain; and (d) ecological layers of counselor advocacy. The latter component is aimed at highlighting the fluidity and intersectionality of identities—experiences of marginalization that counselors must be aware of (Singh, Appling, & Trepal, 2020). Viewing the MSJCC within the context of the isms that exist within society, which lead to the marginalization of specific groups of people, is essential.

In their editorial review of developments in multicultural and social justice counseling, Lee and Moh (2020) noted that a critical step in realizing multicultural and social justice competence in the counseling profession is through the generation of andragogical practices that effectively promote their development. To do so, counselor educators must rely on empirically supported tools and theories for fostering the development of multicultural competency. With this aim, counselor educators have relied primarily on varying andragogical approaches (Hilert & Tirado, 2019; Killian & Floren, 2020), theories (Zeleke et al., 2018), and models (Cook et al., 2016), with some scholars directly integrating the MSJCC to work with specific populations (Carrola & Brown, 2018; Washington & Henfield, 2019). Zeleke and colleagues (2018) examined the usefulness of self-regulated learning strategies. Killian and Floren (2020) compared the effectiveness of different pedagogical approaches (i.e., didactic, experiential, and community service learning), while Hilert and Tirado (2019) examined contemplative pedagogy in teaching counseling trainees multicultural and social justice competencies. Similar to the examination of contemplative andragogy, Cook et al. (2016) used the professional development school model. These approaches significantly contributed to counselor education by generating knowledge that continues to move the counseling profession forward to centering multicultural responsivity.

Cultural Formulation Interview
     The CFI was first included in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013) to guide clinicians on how to conduct a cultural assessment in routine mental health settings (Aggarwal et al., 2015; DeSilva et al., 2018). Table 1 reflects the three versions of the CFI counselors may use with clients and their families. Each version of the CFI aligns with the four core elements of the MSJCC. A crucial prerequisite for conducting a cultural assessment, in tandem with use of the CFI, involves counselor receptiveness and capacity to engage in ongoing self-awareness (Ratts et al., 2016). The CFI helps counselors to culturally conceptualize the client’s presenting problem within systems of culture, oppression, and support. In so doing, the counselor may incorporate the client’s salient intersecting and marginalized identities into their clinical portrait while also maintaining attentiveness to their own personal and professional biases.

Table 1
The Cultural Formulation Interview

CFI Version Applicability Core Components
Core interview To use upon intake

with a client

16 semi-structured questions within 4 cultural domains:

1) Problem formulation
2) Perceptions of problem

3) Coping & help-seeking factors

4) Past coping & help-seeking factors

Informant interview To use with client’s

family members or significant others after initial intake (with

client permission)

17 semi-structured questions within 4 Cultural domains:

1) Problem formulation
2) Perceptions of problem

3) Coping & help-seeking factors

4) Past coping & help-seeking factors

Supplemental modules To explore subtopics of core domains in more detail 12 supplemental modules:

1) The explanatory model

2) Level of functioning

3) Social network

4) Psychosocial stressors

5) Spirituality, religion, and moral traditions

6) Cultural identity

7) Coping and help seeking

8) Clinician-parent relationship

9) School-age children and adolescents

10) Older adults

11) Immigrants and refugees

12) Caregivers


The CFI, a semi-structured instrument, includes instructions and open-ended questions for clinicians to use. Because of the increasing empirical support for how culture influences each aspect of mental health care (Barragán et al., 2020; Cariello et al., 2020; Driscoll & Torres, 2020), the CFI is ideally utilized during the initial evaluation of any client (DeSilva et al., 2018; Sue et al., 2022); however, the CFI can also be incorporated throughout the counseling process (Ramírez Stege & Yarris, 2017). Although the CFI is the most widely used cultural assessment tool throughout the world (DeSilva et al., 2018; Lindberg et al., 2021), there is a disconnect within counselor education wherein little emphasis exists on training counseling students to properly use this tool despite the profession’s mandate to use evidence-based instruments and interventions.

The CFI consists of three components: the core interview, the informant interview, and the supplemental modules (APA, 2013). The core interview totals 16 open-ended questions consisting of four domains: 1) cultural definition of the problem to include the client’s view of their presenting problem; 2) the client’s cultural perceptions of cause, context, and support to clarify what the client and their support group consider the origin of the problem to be and identify the connection between the problem and the client’s cultural identities; 3) cultural factors that affect past self-coping and help-seeking strategies; and 4) cultural factors that affect current help-seeking, including the client’s preferences for future care and concerns about the counselor–client relationship (APA, 2013; DeSilva et al., 2018). The counselor is encouraged to consider and assess how the client’s varying identities influence each domain. Simultaneously, counselors must collaborate with the client to identify the salience and intersection of their specific identities (Aggarwal et al., 2016; Ramírez Stege & Yarris, 2017).

The informant version of the interview consists of the four domains in the core CFI and gathers information related to the client and their presenting problem from the perspective of caregivers and other relevant stakeholders (Aggarwal et al., 2015; APA, 2013). The supplementary modules expand on specific subtopics stemming from the four domains in the core and informant components of the CFI. The modules are designed to help counselors conduct a more comprehensive cultural assessment while focusing on specific needs based on identities and resources (Aggarwal et al., 2015; DeSilva et al., 2018). These modules are 1) the explanatory model; 2) level of functioning; 3) social network; 4) psychosocial stressors; 5) spirituality, religion, and moral traditions; 6) cultural identity; 7) coping and help seeking; 8) clinician–parent relationship; 9) school-age children and adolescents; 10) older adults; 11) immigrants and refugees; and 12) caregivers (APA, 2013).

Aggarwal et al. (2016) noted the most common barrier to implementation of the CFI was the perceived lack of conceptual relevance between intervention and problem, while Jones-Smith (2018) highlighted the CFI’s lack of consideration of the embeddedness of the client in their traditional culture. In considering these limitations, researchers have indicated that information obtained from the CFI should be integrated with other clinical material to achieve the aims of the clinical assessment, including culturally valid diagnosis, social history, treatment planning, and patient engagement and satisfaction (DeSilva et al., 2018; Mills et al., 2017). Jarvis et al.’s (2020) review of CFI research reported that the CFI has been shown to clinically enhance the counselor–client relationship and increases counselor cultural sensitivity. They also noted that even mental health providers with limited CFI training demonstrated improved cultural responsivity with clients. Of relevance to Afro Latinx immigrant clients, Jarvis et al. (2020) found research supportive of the CFI’s success with Latinx-identifying clients. Nonetheless, Jarvis et al. indicated that the CFI may not be an ideal assessment for clients experiencing symptoms of psychosis, suicidal ideation, aggression, or cognitive impairment. Though research is mixed, the CFI provides an innovative way to help practicing counselors and CITs become more culturally responsive (Sue et al., 2022). Next, we consider how the CFI may be specifically applicable to clients who identify as Afro Latinx.

Application of the CFI

The CFI offers an empirically supported instrument for treatment planning and conducting a culturally appropriate assessment and has been shown to increase counselor cultural sensitivity (Jarvis et al., 2020). The following case study demonstrates how the CFI can be applied with a client who identifies as Afro Latinx. After the case study, we provide a description of the domains of the MSJCC, inherent within the CFI, as they relate to counselors working with Afro Latinx immigrants.

Case Study
     Martin is a 33-year-old, dark-skinned Afro Latinx immigrant from Mexico who is seeking counseling for the first time for what he describes as intense nervousness. Martin has noticed that he began experiencing muscle tension, excessive sweating, and increased agitation in the months following his relocation to the United States. Martin relocated about 14 months ago because of his job; he works as an engineer for a well-known firm in the city. Allison is the intern counselor assigned to Martin. Allison identifies as a queer White woman born in the United States. Allison first learned about the CFI during her assessment course. Her university and site supervisors both encouraged CITs to use the CFI as a supplement to the intake session to promote cultural responsivity. In their counseling intake session, Martin describes feeling incompetent at his job, as others often question his decisions. Martin reports that he never experienced the current symptoms before and is confused and scared. Martin responds with hesitancy, although he is willing to engage in the CFI questions.

Cultural Definition of the Problem
     After reviewing the confidentiality limitations and the risks and benefits of counseling, Allison explains that she will ask Martin questions from the CFI to better understand him and his situation. After Martin reports experiencing concerns about his job without offering more details, Allison asks, “Sometimes people have different ways of describing their problem to their family, friends, or others in the community. How would you describe your problem to them?” Martin thinks for a moment then shares, “I would tell them that I thought I finally made it—I have a good job, I am working full time, I earn enough to take care of myself and help my family. But now strange things are happening with me. I get sweaty out of nowhere for no reason. I feel sore in my body. I cannot seem to calm down. I never felt this way before.”

Cultural Perceptions of Cause, Context, and Support
     Following the CFI protocol, Allison asks a causation question: “What do you think is causing this problem for you?” Martin again pauses for a moment and responds, “I miss my friends and other things, but my family is here, so I do not understand why this is happening. Like I said, I was finally able to get the engineering position and it pays really well. I work with a lot of people who are really skilled engineers. So, I am not really sure what is going on.” Allison internally notes Martin’s comment about missing home and decides to return to the topic later. Allison elects to probe a bit more about the new position: “Say more about your new job. It sounds like it is something you worked hard to achieve.” Martin reports, “Like I said, I really like the new position and I try really hard to do my best. I show up early and stay late. I wear a suit and tie everyday even though other people don’t. I guess people are trying to help me because they ask me a lot of questions about what I am doing, if I understand things, and when I will be done.”

Allison states, “There seems to be a lot of attention on you and you’re not used to that,” before transitioning to a CFI question about supports: “Is there anything that makes the sudden sweatiness, body soreness, or trouble calming down better—such as support from family, friends, or others?” Martin quickly responds, “My brothers and sisters are here, and I live with my sister’s family for now. They are great to be around and help me understand how things work in the U.S. Also, I get to hang out with my nieces and nephews a lot after work, playing video games or going food shopping. I really like eating together with them as a family too. I don’t have the sudden sweating thing with them, and I feel tranquilo [calm] around my family.”

Allison continues to the CFI module about the role of cultural identity and explains, “Sometimes, aspects of people’s background or identity can make their problem better or worse. By background and identity, I’m referring to the communities you belong to, the languages you speak, country of origin, race, ethnicity, gender, sexual orientation, faith, religion, that kind of thing. For you, what are the most important aspects of your background or identity?”

Martin takes a moment to consider and responds, “I mean . . . being a Mexican man is really important to me but also, I have no choice about my skin color and people at my job know I’m an immigrant, which I think is why they treat me differently.” Allison notes this and adds, “I remember you just said you missed some of your friends and family who are still at ‘home.’ Tell me more about that too, please.” Martin smiles and his face lights up as he explains he recently immigrated from Mexico where his parents, other siblings, and other extended family members still reside. “Yes, like I was saying, I miss home because, back there, I wasn’t treated differently. We had a common language, so speaking Spanish felt more comfortable than it does now. Even though I speak English, I feel so much pressure to speak properly or act more like my coworkers. There were no hidden expectations—here I feel like, because I’m not from here, I look darker, and I speak Spanish, I have to fit a mold that I’m not sure exists.” Next, Allison responds, “I hear you saying there are cultural differences and an unspoken expectation about your cultural background that are impacting you and how you’re understanding the situation. Can you tell me more about what you’re referring to specifically?” Again, Martin takes a minute to think and responds, “I think the pressure I feel to fit into a box—because of my darker skin, because I’m Mexican, because I’m a Spanish-speaker—causes confusion for me since I’ve never experienced this and I think it causes confusion for my coworkers too, and then people respond to me in ways that make me question my reality. When I started this new job, my coworkers wouldn’t stop asking me why I spoke Spanish if I was Black, and I didn’t know how to respond. Like, I never really thought about being Black. In Mexico we don’t talk about race, and here it seems this is the only important part of a person. I don’t understand it, and I feel trapped because either I have no choice on how they perceive me, or they make assumptions simply based on my skin color.”

Cultural Factors Affecting Self-Coping and Past Help Seeking
     Allison summarizes Martin’s responses and moves to the CFI self-coping strategies: “What have you done on your own to help you manage those things that happen with your body?” Martin reports that when the feelings happen at work, he goes to the restroom to splash cold water on his face. He also might get a glass of water. Sometimes he goes outside to get fresh air. Once, according to Martin, when it was really bad, he called his sister. Later that day, his sister recommended he contact their primary care physician. The physician ruled out any medical origins to Martin’s symptoms and referred Martin to the counseling center where Allison interns.

Because Allison knows Martin never experienced these symptoms before and had already sought medical help, she continues with a modified CFI question on past help seeking: “Martin, you shared this is the first time you experienced this problem; however, I’m wondering if there were other kinds of help you have found to be useful when dealing with difficult situations?” Martin indicates he typically sought help from his siblings first, much like he does now, and secondarily sought guidance from his parents. In this instance, Martin did not want to worry his parents, so he has not informed them of what is happening. Martin also reports finding some comfort in prayer at mass.

Allison continues with a CFI question about barriers to help seeking: “It sounds like not wanting to worry your parents is getting in the way of accessing their support. Are there other things getting in the way of getting help right now?” Martin responds, “It may be hard for me to find a time to meet every week because I do not want my work to start getting messed up. Also, I do not want anyone to know I am coming here because they will think I am crazy.”

Cultural Factors Affecting Current Help Seeking
     Allison moves to the final section of the CFI and states, “You told me that calling your sister was helpful when the sudden sweatiness and uncalm feelings come up. Is there anything you can think of that I can provide you with to help in those moments?” Martin thinks a bit and replies, “I think directions on how to get it to stop would be really important because I do not want people at work to notice. As it is they ask me a lot of questions about what I am doing, and the out-of-nowhere sweating and discomfort makes that worse.”

After providing brief psychoeducation and explaining potential strategies to address his symptoms, Allison moves to the final CFI question, which attends to the counselor and client relationship. She states, “The counseling relationship is unique because the counselor and client can be very different at times. Like you and I are from different places and look different, too. And because of that, we may not necessarily understand each other immediately. Is this something that worries you?” Martin thinks about this and responds, “Well, you are not a man, and you are not from Mexico. So, I am not sure if you will understand. Also, English is something I am pretty good at, but I am still working on it. Do you speak Spanish in case I have to say things in Spanish?”

Counselor Self-Awareness
     The MSJCC (Ratts et al., 2016) and the CFI call for culturally responsive counselors to seek intrapersonal self-awareness and understanding regarding their own social statuses, identities, and worldview (Singh, Nassar, et al., 2020). It is particularly important for counselors working with Afro Latinx immigrants to explore and understand these constructs in relation to their role in the counseling profession, society at large, and in the counseling relationship. As an example, Allison can consider the extent to which her privileged and marginalized identities pertaining to race, ethnicity, and nationality position her in relation to Martin. More specifically, Allison needs to explore how her values and beliefs about these identities influence her views of Martin. Allison can utilize self-reflection to address questions like (a) What are my thoughts, beliefs, and feelings about immigrants who have different ethnic and racial identities than me? (b) What are my thoughts, beliefs, and feelings about immigrants who have similar ethnic and racial identities to mine? and (c) What are my thoughts, beliefs, and feelings about people who are immigrants, regardless of their other identities? These questions will support Allison in developing a greater sense of self-awareness and will encourage openness to understanding Martin’s experiences and worldviews. The CFI helped Allison gain a greater understanding of the systems of oppression that may be actively impacting Martin and his well-being while challenging her bias toward individualistic conceptualizations of clients.

Client Worldview
     Although client worldview is different for everyone regarding culture and lived experiences, being an Afro descendant and an immigrant in the United States comes with unique and ubiquitous challenges. Afro Latinx immigrants have been found to have lower socioeconomic status, lower income, and overall fewer resources than lighter-skinned immigrants entering the United States (Cuevas et al., 2016). In addition to having fewer economic and social resources available to them, the shared experience of migration as a Black person in the United States may predispose clients with these intersecting identities to experience mistrust toward health care workers and others working for government institutions in general (Mancini & Farina, 2021). As a result, they may be reluctant to seek help from licensed professionals or even engage in health-promoting behaviors. Although it is important for counselors working with this population to engage in cultural encounters that allow clients to define their own experiences of living in the United States as a Black Latinx person, it is also important for the counselor to understand that institutionalized beliefs about Black people and immigrants in the United States can represent significant challenges for the counseling process and clients’ growth. As such, the CFI supports the counselor in developing respect for the client’s worldview, understanding the ways in which this worldview aligns—or does not align—with their own worldview, and accepting the client as they are to engage in a nonjudgmental and growth-promoting working alliance.

In the case study, Allison used the CFI to examine key elements of the client’s worldview, particularly as it related to the cultural definition of the problem and perceptions of the causes and context. For example, the client’s concealment of his help-seeking behaviors from some family and friends may be a key point of entry for the counselor’s interventions. Through a closer examination of Martin’s concealment, Allison may gain a greater understanding of her client’s worldview while simultaneously challenging her own biases regarding her beliefs. At the intrapersonal and interpersonal intervention levels, Allison can seek additional awareness and knowledge about the migration experiences of Black Latinx populations through research, supervision, and consultation. At the institutional and community intervention levels, Allison could advocate to increase the awareness of her coworkers and the larger counseling field regarding this population, including specific needs and barriers to consider when working with Afro Latinx immigrants.

Counseling Relationship
     Counselors need to develop an appreciation of the unique aspects of the counseling relationship by building on the gained awareness and understanding of themselves and their clients in addition to considering the unique status of their clients and how they are impacted by membership in marginalized and privileged groups—which in turn impacts how the client relates to others and the counselor (Ratts et al., 2016; Singh, Appling, & Trepal, 2020). With this gained awareness of the client’s worldview and lived experiences, counselors must authentically engage with their Afro Latinx clients and demonstrate unconditional acceptance of the clients and what they bring into the counseling relationship. Because of the unique social statuses of counselor (who may experience a high degree of privilege) and client (who may experience a level of oppression based on the intersection of identities—race x ethnicity x immigration status), the client–counselor relationship requires significant attention from both parties involved. As the counselor is expected to have an awareness of the dynamics of power and privilege both within and outside the counseling environment, it is the counselor’s responsibility to initiate the discourse regarding these dynamics with the clients.

Allison is guided by the awareness of the levels of privilege and marginalization present in the counseling space as emphasized by the MSJCC and put into practice with the CFI. Allison moved beyond this level of awareness by assessing cultural factors affecting current help seeking. The use of the CFI assisted Allison in building the client–counselor relationship but also empowered Martin to collaborate in the direction of their treatment. It should be noted how the CFI instrument in and of itself encapsulates the concept of broaching in counseling, whereby a counselor discusses “those racial, ethnic, and cultural issues that are relevant to a client’s presenting concerns” (Day-Vines et al., 2021, p. 348).

Counseling Advocacy and Interventions
     In the scenario presented above, Martin’s responses illuminated areas in which his counselor could directly engage in advocacy at the individual, intrapersonal, interpersonal, institutional, community, public policy, and global/international ecological levels. At the individual and intrapersonal levels, Allison could continue to strengthen their awareness of possible treatment approaches for this specific client in addition to continuing to develop their self-awareness, particularly around social identities, privilege, and oppression. At the interpersonal level, Allison could make intentional use of the gained knowledge and increased awareness in the counseling process to foster client growth and improvement. At the institutional and community levels, Allison could look for local and national organizations to potentially connect the client to, thereby increasing their community support and network. Allison may also contact the same organizations and seek professional involvement with the goal of advocating with and for Afro Latinx immigrants in the United States. This advocacy may also take the form of presenting webinars and at professional conferences on this particular population.


     As the case study demonstrates, when working with Afro Latinx immigrants, there are multiple ways counselors can integrate the CFI into their counseling practice. Based on their social locations in the United States and considering the sociopolitical climate, Afro Latinx immigrants are likely to experience increased psychological distress (Araujo-Dawson, 2015; Ramos et al., 2003). We illustrated an integration of the CFI to counseling practice as a means to assist counselors and CITs in developing their multicultural responsiveness and further providing culturally sensitive and appropriate services to Afro Latinx immigrants. It must be emphasized that careful explanation of the purpose of the CFI, its confidentiality, and the client’s complete control over the information shared is necessary. Multiple recommendations for counselor educators, CITs, and practicing counselors exist.

Counselor Educators
     Counselor educators should actively strive toward preparing CITs to be effective and culturally sensitive when working with a wide range of populations. The CFI may be introduced in a variety of Council for Accreditation of Counseling and Related Educational Programs (CACREP; 2015) common core areas: counseling and helping relationships, assessment and testing, social and cultural diversity, and practicum and internship. Counselor educators can disseminate the CFI with small and large group skills practice via role plays and case conceptualization to expose CITs to the instrument. In addition, counselor educators may collaborate with site supervisors to incorporate the CFI in their standard intake practices. With this collaboration, CITs would receive additional support and training as they learn to use the CFI with clients to strengthen their culturally responsive assessment and counseling skills.

The case study featured a client who identified as an Afro Latinx immigrant. We encourage counselor educators to facilitate discussions regarding the challenges that Afro Latinx immigrants may face in their lives and highlight the CFI as a tool to develop case conceptualization through an intersectional lens. Through direct emphasis on Afro Latinx immigrant clients, counselor educators can assist their students in strengthening their development as culturally responsive counselors.

     CITs can apply the CFI to conceptualize their clients’ presenting problems through a comprehensive and in-depth foundation offered by the MSJCC framework. The CFI questions offer opportunities for CITs to reflect on their client’s privileged and/or marginalized statuses and their salient identities, as well as client strengths-based help-seeking strategies. In turn, CITs are challenged to reflect upon their own positionalities and biases. Through continued practice using the CFI both in classroom and clinical settings, CITs can develop and strengthen their counseling competencies in a more intentional and MSJCC-aligned manner. In the case study, Allison, a CIT, had the opportunity to consult with her site supervisor or use the intake session as a case presentation. Both opportunities would provide her with additional feedback on how to effectively use the CFI in her work with this client and other clients with marginalized identities.

Practicing Counselors
     Similar to CITs, practicing counselors may integrate the CFI in their assessment efforts either at intake or throughout the counseling process. Though culture remains an important point of emphasis in the counseling of Latinx individuals, counselors must also consider the stressors involved during the migration process, as the experiences of being an immigrant vary based on the type and cause of migration (Jones-Smith, 2018). Similarly, counselors should also explore with the client any preference concerning skin color in the client’s family, as this preference may affect the assessment, diagnosis, and treatment of the client (Paniagua, 2013). In the case presented above, the CFI provided key points of entry for the counselor to broach the client’s understanding of his presenting problem through his lived experiences of being a Black, Spanish-speaking immigrant in the racialized United States. In allowing for this type of information to be expressed by the client, through the use of the CFI, the counselor would be better prepared to attend to the client’s needs in a more effective and MSJCC-aligned manner.


According to the MSJCC, it is imperative that counselor educators continue to incorporate empirically supported interventions and tools, like the CFI, in their teaching of CITs (Ratts et al., 2016). Using these interventions helps counselors to increase their multicultural responsiveness both through gaining knowledge and awareness and by becoming advocates. As it stands, the counseling profession is in continued need of intentional training of students to adequately use this tool and increase cultural sensitivity. To expand counselors’ roles as advocates and to integrate multiculturalism and social justice counseling competency into practice, as articulated by the MSJCC, we must reach for additional theories and tools that help us conceptualize privilege, oppression, power, and advocacy within the counseling relationship (Singh, Appling, & Trepal, 2020).

The CFI provides a powerful tool for the enhancement of clinical training and practice in counseling and counselor education. Counselor educators who teach their students to use the CFI in their practice will be equipping them with an empirically supported tool for enhancing their work with multiculturally diverse clients, as exemplified by the case study highlighted in this article. In addition, the CFI offers a viable opportunity for enhanced clinical training that could be translated into culturally responsive clinical practice. Considering the usefulness of the CFI and the lack of attention this tool has received in counselor education, it is crucial to expand our repertoire and make use of all available avenues for increasing the quality of counseling training.


Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.



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Understanding Racial Trauma: Implications for Professional Counselors

Warren Wright, Jennifer Hatchett Stover, Kathleen Brown-Rice

Racial trauma has become a common topic of discussion in professional counseling. This concept is also known as race-based traumatic stress, and it addresses how racially motivated incidents impede  emotional and mental health for Black, Indigenous, and people of color (BIPOC). Research about this topic and strategies to reduce its impact are substantial in the field of psychology. However, little research about racial trauma has been published in the counseling literature. The intent of this paper is to provide an in-depth perspective of racial trauma and its impact on BIPOC to enhance professional counselors’ understanding. Strategies for professional counselors to integrate into their clinical practice are provided. In addition, implications for counselor supervisors and educators are also provided.

Keywords: racial trauma, BIPOC, counseling, professional counselors, clinical practice

     The impact of racism on the psychological, emotional, and physical well-being of those subjected to it is no secret. In fact, the Centers for Disease Control and Prevention (2021) has declared racism as a public health issue and threat to the health of minoritized individuals. Similarly, the Federal Bureau of Investigation (2019) reported that 5,155 people were targets of racially motivated hate crimes in 2018: 47.1% of the victims identified as Black/African American, 13% as Hispanic/Latino, 4.1% as American Indian/Alaskan Native, and 3.4% as Asian. Daily experiences of racism for Black, Indigenous, and people of color (BIPOC) can lead to an increase in health complications and mental health disparities (French et al., 2020; Williams et al., 2019). Hemmings and Evans (2018) noted that because of racism, BIPOC communities have limited access to resources, which impacts their quality of education and health care. Thus, racially marginalized communities are susceptible to chronic illnesses and mental health concerns such as diabetes, heart disease, depression, and suicide (Hemmings & Evans, 2018). Furthermore, researchers have found that exposure to racism and discrimination increases levels of stress in the body and can lead to chronic illnesses such as high blood pressure, diabetes, and gastrointestinal issues for people of color (Bernier et al., 2021; Chavez-Dueñas et al., 2019; Smith et al., 2011; Wagner et al., 2015), therefore adversely impacting the livelihood and overall well-being of BIPOC communities.

Racism-related stressors can lead to race-based traumatic stress, also known as racial trauma (Carter, 2007; Comas-Díaz et al., 2019). Racial trauma and race-based traumatic stress occur when there is an experience of direct or indirect racism that leads to psychological and emotional injury for BIPOC. Examples include experiencing microaggressions in the workplace (Sue et al., 2019), witnessing an unarmed Black person being killed by law enforcement (Williams et al., 2018), and being physically attacked because others believe a person’s racialized group is the cause of a global pandemic (e.g., Asian American and Pacific Islanders [AAPIs]; Litam, 2020). There is a substantial amount of literature in the field of psychology related to racism, race-based traumatic stress, and racial trauma (Adames et al., 2023; Bryant-Davis & Ocampo, 2006; Carter, 2007; Comas-Díaz et al., 2019; French et al., 2020; Helms et al., 2010; Mosley et al., 2021). However, there is little to no research in the counseling profession related to racial trauma. Therefore, this article provides an overview of racial trauma and implications for the counseling profession.

Race-Based Traumatic Stress and Racial Trauma

     Racial trauma is the collective stress experienced by BIPOC directly or indirectly due to continuous racially motivated incidents of microaggressions, exclusion, discrimination, and sociopolitical events that create psychological and emotional harm (Anderson & Stevenson, 2019; Comas-Díaz et al., 2019). Race-based traumatic stress is one of the most common interchangeable terms for racial trauma and refers to the stress response and emotional injury that occur after experiencing a racist encounter (Carter, 2007; Williams et al., 2018). Carter (2007), along with other researchers (Chavez-Dueñas et al., 2019; Helms et al., 2010; Smith et al., 2007, 2016), examined the experiences of BIPOC and the accompanying psychological stress when they experience racism-related incidents. Constant exposure to racially motivated incidents can create and lead to an overwhelming emotional stress response for BIPOC. Bryant-Davis and Ocampo (2005), Hemmings and Evans (2018), and Litam (2020) discussed how racist incidents of physical assaults, verbal attacks, and threats to one’s safety impact a person’s sense of self and can cause a person to present with symptoms of trauma.

It is imperative to note that experiencing racism and presentation of trauma symptoms are not all life threatening. Therefore, racial trauma differs from the traditional diagnosable PTSD criteria as stated in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013). Although it is not explicitly stated in the DSM-5, racial trauma encompasses racism-related stressors associated with one’s membership in a racialized social group, historical trauma, and continuous exposure to racism-related violence. Consequently, conceptualizing and diagnosing a client that presents to counseling with trauma symptomology that does not fit the criteria for the PTSD diagnosis can be confusing for mental health professionals. Therefore, it is important for professional mental health counselors to be prepared to assess and treat clients who present to counseling with trauma symptomology related to racist incidents.

Impact of Racism and Racial Trauma

Racial trauma could impact a person’s sense of self, pride in culture, and identity (Brown-Rice, 2013; Skewes & Blume, 2019). Skewes and Blume (2019) found that assimilation, exploitation, and forced relocation led to the loss of spiritual and cultural practices for American Indian and Alaska Native (AI/AN) communities. Additionally, Brown-Rice (2013) stated that loss of cultural traditions and native practices creates a sense of confusion and hopelessness for Native American adults. Thus, racialized trauma can lead to a separation of cultural identity and practices. Similarly, Chavez-Dueñas and colleagues (2019) found that racial trauma has increased psychological distress for Latinx immigrant communities because of anti-immigration policies, opposition to assimilation into the American culture, and fear of deportation. Furthermore, racial trauma can lead to psychological concerns such as anxiety, depression, emotional dysregulation, and suicidal ideation (American Foundation for Suicide Prevention, 2020; Bryant-Davis & Ocampo, 2005; Comas-Díaz et al., 2019; French et al., 2020; Hemmings & Evans, 2018). Additionally, the American Foundation for Suicide Prevention (2020) found suicide rates for minoritized communities have increased. Moreover, racial discrimination has been positively correlated with suicidal ideation among African American young adults (American Foundation for Suicide Prevention, 2020).

Racism is consistently prevalent within American schools and continues to be an issue of concern experienced by BIPOC students (Kohli et al., 2017; Merlin, 2017). The experience of trauma coupled with racism and discriminatory practices in education has shown to impart racial disparities among BIPOC students in the areas of academic achievement, employment, and participation in the criminal justice system (Lebron et al., 2015). Black students are underrepresented in advanced courses, are less likely to be college ready, and spend less time in the classroom because of disciplinary practices (United Negro College Fund, 2020). According to a report on school discipline by the U.S. Department of Education Office for Civil Rights (2018), Black students only account for 18% of preschool enrollment, yet they make up 42% of total suspensions and 3 times more expulsions than their White peers. In addition, Black students are more than twice as likely to be referred to law enforcement and subject to arrest for school-based incidents when compared to their peers (United Negro College Fund, 2020). Furthermore, not only are Black students underrepresented in advanced courses, but they are overrepresented in special education programs and more likely to be identified with a disability (Harper, 2017). Therefore, it is imperative for professional mental health counselors to understand how racial trauma could impact the mental health and well-being of individuals at distinct phases of life span development (e.g., children, college students, etc.).

Currently, racial trauma has been exacerbated by the recent COVID-19 pandemic plaguing the United States and other parts of the world. Liu and Modir (2020) and Fortuna et al. (2020) highlighted the lived experiences within BIPOC communities regarding living in low-income neighborhoods, denial of access to care, and being disproportionately affected by the COVID-19 virus. Black Americans accounted for 34% of confirmed cases in the United States, followed by Latinos at 20%–25% of cases (Fortuna et al., 2020). This demonstrates that health disparities coupled with racism could impact the physical well-being of BIPOC. Racism-related stress impacts the emotional and physical health of BIPOC communities. This includes sense of self (Chavez-Dueñas et al., 2019), culture identity (Skewes & Blume, 2019), and overall wellness (Litam, 2020). Healing racial trauma requires professional mental health counselors working with BIPOC individuals to consider sociocultural factors such as systemic racism, oppression of marginalized communities, and cultural trauma.

Implications for Professional Counselors

The counseling profession highlights the importance of assessment competency as stated in the American Counseling Association (ACA) Code of Ethics (ACA, 2014; e.g., Standard E.5.c: Historical and Social Prejudices in the Diagnosis of Pathology) and the 2016 Council for Accreditation of Counseling and Related Educational Programs (CACREP, 2015) Standards (e.g., Assessment and Testing). In addition, the 2016 CACREP standards emphasized the importance of social and cultural diversity, highlighting strategies and techniques to identify and eliminate barriers of oppression and discrimination (CACREP, 2015). Because racial trauma is invasive and harmful for BIPOC individuals and communities, understanding its impact on psychological and emotional well-being is imperative for all mental health professionals in their respective roles. Thus, counselors must be prepared to provide culturally responsive care to BIPOC individuals who have experienced racism-related trauma.

Licensed Professional Mental Health Counselors
     Assessing for racial trauma is of utmost importance when conceptualizing and creating a treatment plan for BIPOC clients. It is imperative for counselors to become familiar with assessments and clinical interventions to inform their approach to treating racial trauma. Williams and colleagues (2018) proposed the UConn Racial/Ethnic Stress and Trauma Survey (UnRESTS) to assist mental health professionals in their case conceptualizations and treatment planning when racial trauma is present in BIPOC individuals. The UnRESTS is a clinician-administered semi-structured interview that is beneficial in case conceptualization to determine the multiple experiences of racism for the client. The interview comprises 6 sections: introduction of the interview, racial and ethnic identity development, experiences of direct overt racism, experiences of racism by loved ones, experiences of vicarious racism, and experiences of covert racism (Williams et al., 2018). Even though this survey is like the DSM-5 Cultural Formulations Interview (APA, 2013) and helps the counselor determine if the client’s symptomology fits criteria for PTSD, it should not be the only assessment tool used to determine a diagnosis of PTSD. Additionally, this interview tends to be lengthy in time; therefore, counselors should consider completing this interview within the first and second sessions. This assessment along with other clinical approaches could be beneficial to understanding the traumatic responses of clients impacted by racism.

Several BIPOC scholars have offered models, theories, and frameworks to heal racial trauma (Adames et al., 2023; Bryant-Davis & Ocampo, 2006; French et al., 2020; Mosley et al., 2021). Counselors must position themselves to consider approaches that go beyond Eurocentric theories and models when addressing and treating racial trauma. These include being critical of sociopolitical structures, awareness of one’s own racial identity, and comfort level when broaching the topic of racism and racial trauma (Adames et al., 2023; Thrower et al., 2020). For instance, Bryant-Davis and Ocampo (2006) provided a foundation for treating racial trauma in a safe environment. Their therapeutic approach included acknowledgment, grieving/mourning loss, analyzing internalized shame and racism, and centering coping and resistance strategies. Supporting clients to name oppressive systems, process their experiences of racist incidents, and deconstruct self-blame narratives because of racism fosters liberation and healing for BIPOC clients who have experienced racism-related stress and trauma (Adames et al., 2023). Thus, counselors must be empathetic and take initiative in helping BIPOC clients shift the focus on harm from self-blame to external oppressive factors. This promotes a strong sense of self and healthy living for BIPOC clients.

Similarly, models offered by Chavez-Dueñas et al. (2019), French et al. (2020), Mosley et al. (2021), and Adames et al. (2023) center the well-being and collective power of BIPOC communities. For example, critical consciousness, Black Psychology, Liberation Psychology, and trauma-informed care influenced these approaches to address racism-related stress and trauma. Subsequently, French and colleagues’ (2020) Radical Healing Framework centers justice and overall wellness for BIPOC communities. This is the intentional practice of going beyond just coping with racism to focus on healing wherein a client can thrive by connecting to community and engaging in resistance against racism-related stressors (French et al., 2020). Thus, helping clients to engage in activism and utilize microinterventions to disarm and address microaggressions can empower clients (Mosley et al., 2021; Sue et al., 2019). Microinterventions help equip clients with tools they can implement to assert boundaries and communicate disagreement with microaggressions (Litam, 2020; Sue et al., 2019). However, counselors must remember that safety is a priority when supporting clients in confronting perpetrators of racism-related trauma (Litam, 2020). Therefore, role-plays in counseling sessions could provide the space and time to strategize when it is and is not appropriate to confront perpetrators of microaggressions.

Utilizing these approaches with clients fosters validation and affirmation of their experiences. Failure to acknowledge and attend to the symptoms and experiences of racism-related stress and trauma can maintain psychological distress for BIPOC clients (Chavez-Dueñas et al., 2019). Furthermore, helping clients process the positive messages they received about their racial identity throughout their life can reinforce these approaches (Anderson & Stevenson, 2019). Thus, counselors should use a strength-based approach when supporting BIPOC clients in healing from racism-related stress and trauma. In addition, consultation with colleagues, supervisors, and counselor educators can provide support and a space to implement best practices to provide the most effective care for BIPOC individuals who have experienced racial trauma, rendering positive mental health outcomes.

Professional School Counselors
     Professional school counselors should demonstrate cultural competence and serve as essential stakeholders in identifying and supporting clients impacted by trauma (ACA, 2014; American School Counselor Association [ASCA], 2016; Parikh-Foxx et al., 2020). ASCA specifies these responsibilities and obligations in their ASCA Ethical Standards for School Counselors (ASCA, 2022). These principles serve as a framework in which professional values, norms, and behaviors are referenced. Further, school counselors can help to identify, respond to, and prevent incidents of racism and bias, as well as become resources to help promote systemic change and advocate for social justice within the educational setting (ASCA, 2020). However, ASCA (2021) recognizes the lack of racial literacy and the inherent gaps between racial equity and equality within education, petitioning for school counselors to continually pursue cultural competency and work toward mitigating the negative effects of racism and bias. Subsequently, ASCA guidelines encourage school counselors to examine their own biases and consult with community professionals to engage in immersive experiences and provide support to students and families who have experienced racial trauma or have been negatively impacted by racism (ASCA, 2021; Atkins & Oglesby, 2019; Levy & Adjapong, 2020).

As facilitators of change, school counselors can help to create environments that are safe and inclusive for both students and educators. One approach is to discuss issues of racial trauma using trauma-informed and restorative practices (National Child Traumatic Stress Network [NCTSN], 2018). Trauma-informed practices take on a phenomenological approach, seeking to identify, understand, and address the meaning behind student behaviors and experiences (Steane, 2019). Additionally, restorative practices not only provide an alternative to harsh disciplinary practices, but also create spaces for individuals to share their own perspectives without fear of judgement or ridicule, while being open to listening and validating the values, experiences, and perspectives of others (NCTSN, 2018; United Negro College Fund, 2020). Moreover, Anderson and Stevenson (2019) posited the concept of racial socialization, which is the intentional communication about the system of racism, racial identity, and experiences between parents and their children and others within the family system with similar racial and ethnic identities. Racial socialization aids in the development of a positive sense of self and cultural identity as mitigating forces to racial trauma. Further, the Racial Encounter Coping Appraisal and Socialization Theory (RECAST) helps families and youth prepare for, discuss, and respond to racially stressful experiences appropriately (Anderson & Stevenson, 2019). Thus, this can also prepare students to strategize how to respond to incidents of racism in the school environment.

It is evident that incidents of school-based racism are perpetuated by several factors and continue to negatively impact student performance and affect the health and well-being of BIPOC students (Kohli et al., 2017). The implementation of culturally responsive pedagogy can be used to mitigate this impact, increase academic success, and help students maintain cultural integrity (Ladson-Billings, 1995; Lebron et al., 2015). Counseling professionals can support this effort by engaging in training and professional development to understand racism and its impact on culturally diverse students and by facilitating necessary discussions that help to equip stakeholders with tools to adequately address discrimination, racism, and race-based trauma (NCTSN, 2018; Pietrantoni, 2017).

Counselor Supervisors
     The ACA Code of Ethics (2014; e.g., Section F: Supervision, Teaching, and Training) highlights the importance of counselor supervision for the development of counselors seeking licensure as independent mental health practitioners. Additionally, counselor supervision enhances a supervisee’s knowledge, skills, and ability to work with diverse clients (ACA, 2014). Therefore, counselor supervisors and their supervisees should be aware of racial trauma and the effects it could have on BIPOC clients. Pieterse (2018) posited guidelines and considerations for supervisors to follow when attending to racial trauma concerns in clinical supervision. Specifically, supervisors must be reflective of their own racial identity, understand how to assess for racial trauma, and implement effective clinical interventions for their supervisees’ clients impacted by racial trauma (Pieterse, 2018).

Additionally, understanding the concept of racial trauma in the larger context of historical trauma for BIPOC communities creates a learning environment for supervisees to deepen their knowledge of racial trauma (Comas-Díaz, 2000; French et al., 2020; Pieterse, 2018). For example, educating supervisees on historical depictions of racism-related stress and trauma for BIPOC communities, such as internment camps, chattel slavery, and colonization, provides the historical context of psychological wounds impacting BIPOC communities in present day by way of intergenerational trauma (Comas-Díaz et al., 2019; Nagata et al., 2019). Furthermore, clinical supervisors can role-play in supervision meetings with their supervisees to model helping clients process racist-related incidents, assessing for psychological distress, and empowering clients to practice effective coping and resistant strategies (Pieterse, 2018), thus ensuring supervisors’ awareness of multiculturalism and diversity in the supervisory relationship (ACA, 2014; e.g., Section F.2.b.: Multicultural Issues/Diversity in Supervision). It is critical for counselor supervisors to obtain the knowledge, skills, and abilities to best prepare counselor supervisees in addressing and treating racial trauma concerns.

Counselor Educators
     Moh and Sperandio (2022) urged the counseling profession to integrate trauma-informed curricula to best prepare counselors-in-training (CITs) to respond effectively to trauma concerns caused by systemic racism in the United States. However, there is hesitancy for counselor educators to teach CITs about racial trauma (VanAusdale & Swank, 2020). Specifically, counselor educators have reported a lack of knowledge and limited ability to teach CITs about racial trauma (VanAusdale & Swank, 2020), futher highlighting the need for trauma-informed curricula to be adopted in the counselor profession to best prepare counselors and educators to address the needs of those impacted by racial trauma. In addition, counselor educators’ lack of knowledge in trauma-informed care and racial trauma does not help prepare future CITs to address this concern once they have graduated from their respective counselor education programs, consequently leading to racial trauma concerns going unaddressed and deepening the wounds of racial trauma for BIPOC (Bryant-Davis & Ocampo, 2005; Comas-Díaz, 2000; Helms, et al., 2010).

However, counselor educators can find creative ways to implement racial trauma education into the classroom. For example, counselor educators can include required readings from BIPOC scholars in their classes that contribute to the racial trauma literature (e.g., Anderson & Stevenson, 2019; French et al., 2020; Mosley et al., 2021). Additionally, counselor educators can demonstrate how to implement the UnRESTS (Williams et al., 2018) for CITs in practicum and internship courses who are practicing conducting clinical interviews. Furthermore, counselor educators can introduce CITs to theories that go beyond the Eurocentric tradition. For example, the first author of this article, Warren Wright, was introduced to queer theory, critical theory, and critical race theory in his master’s-level multicultural counseling (formerly cross-cultural counseling) course. As a student, Wright was assigned to write a social justice and advocacy paper, in which he utilized critical race theory to discuss how adolescents’ responses to experiencing racism in K–12 education could present as behavioral and emotional dysregulation. To mitigate this concern, Wright created an after-school program that utilized dance movement therapy (i.e., stepping) to help Black adolescent males with emotional regulation, personal development, and academic excellence. This approach is an example of a trauma-informed and responsive practice that could reduce harsh disciplinary referrals and increase Black students’ socioemotional development (Stover et al., 2022). If counselor educators feel inadequate to teach trauma counseling or trauma-informed practices, they should seek additional training and consultation to increase their awareness, knowledge, and skills about trauma-informed curricula and approaches (Moh & Sperandio, 2022).


The aim of this article is to provide an understanding of racial trauma and its impact on the psychological and emotional well-being of BIPOC communities and provide recommendations for the counseling profession. Intentional practices, strategies, and approaches are needed to help reduce the impact of racial trauma experienced by BIPOC individuals and communities. Therefore, it is imperative for CITs, licensed professional mental health counselors, school counselors, counselor educators, and supervisors to be well-equipped to address racial trauma concerns. Failure of the counseling profession to address racial trauma concerns deepens the psychological and emotional injuries of racial trauma. Therefore, curricula for CITs should be adapted to best prepare the next generation of counselors to aid with and mitigate the lasting impacts of racially motivated trauma inflicted on BIPOC individuals and communities.


Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.



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Warren Wright, MEd, NCC, LPC, CCTP, is a doctoral student at Sam Houston State University. Jennifer Hatchett Stover, MA, NCC, LPC, CCTP, CSC, is a doctoral student at Sam Houston State University. Kathleen Brown-Rice, PhD, NCC, ACS, LPC, LCMHC, LCAS, is a professor at Sam Houston State University. Correspondence may be addressed to Warren Wright 1932 Bobby K. Marks Drive, Huntsville, TX 77340,