Training and Education in Professional Psychology

© 2024 American Psychological Association 2025, Vol. 19, No. 1, 37–50

ISSN: 1931-3918 https://doi.org/10.1037/tep0000497

The Cross-Racial Training Approach: A Practical Training Framework

Charmeka Newton1, Janeé M. Steele2, Nesreen Jaber1, and Alexander Pace3
1
Department of Counseling Psychology and Community Services, University of North Dakota
2
School of Counseling, Walden University
3
Grand Forks, North Dakota, United States

In an effort to move beyond applied psychology’s culturally encapsulated Eurocentric worldview, several
guidelines on how to responsively work across cultures have recently been set forth by the profession (e.g.,
American Psychological Association, 2017; Ridley et al., 2021; Sue et al., 2022). However, many of these
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

guidelines focus on the acquisition of knowledge and not skills. Thus, this article proposes a coherent
This document is copyrighted by the American Psychological Association or one of its allied publishers.

framework through which cross-racial psychotherapy skills can be developed among graduate-level
students. More specifically, we look at the impact of salient topics such as racialized trauma and race
and culture in therapy as well as challenges and considerations in cross-cultural training and propose the
cross-racial training approach, a five-level training model consisting of trainee awareness, therapeutic
safety, broaching, insight work, and healing work that is designed for White and Black, Indigenous, and
people of color trainees. We present two clinical vignettes to demonstrate the model. The article concludes
with a discussion of the model’s potential strengths, shortcomings, and implications.

Public Significance Statement

This article emphasizes the importance of a skill-focused approach in cross-cultural psychotherapy
training, advancing beyond traditional knowledge-based guidelines. The authors introduce the cross-
racial training approach, a five-level model aimed at providing White and Black, Indigenous, and people
of color graduate students with practical skills to effectively address racialized trauma and cultural
dynamics in therapy. We believe this article will significantly contribute to the field and support trainees
in delivering culturally responsive care to diverse populations.

Keywords: cultural competency, training for graduate students, multicultural education

“The master’s tools will never dismantle the master’s house. They Eurocentric worldview as Lorde purposes, we must have training
may allow us temporarily to beat him at his own game, but they will mechanisms that promote culturally responsive practices (Adames et
never enable us to bring about genuine change” (Lorde, 1984, p. 25). al., 2023; American Psychological Association [APA], 2021).
Forty years later, psychology is still “in progress” in meeting Lorde’s Culturally responsive treatment recognizes the importance of cultural
challenge. To deconstruct psychology’s culturally encapsulated and racial identity in the therapeutic process (Ancis, 2004). This

This article was published Online First October 10, 2024. student at the University of North Dakota. She has a master’s in clinical child
Charmeka Newton https://orcid.org/0000-0003-0332-0651 psychology and a Bachelor of Arts in philosophy. Her research interests center
Janeé M. Steele https://orcid.org/0000-0003-1239-5786 around culturally appropriate care for racially and ethnically marginalized
Nesreen Jaber https://orcid.org/0009-0001-4451-042X clients, intersectionality, and social justice. Nesreen is a Lebanese American
CHARMEKA NEWTON, PhD, is a Clinical Assistant Professor in the College of cisgender woman who strives to incorporate advocacy into all components of
Education and Human Development at the University of North Dakota’s her academic and clinical work.
Counseling Psychology and Community Services Department. She received ALEXANDER PACE’s research interests include issues around race and
her doctorate from Western Michigan University and is a licensed clinical training, the use of art-based intervention as a form of healing from
psychologist. Her areas of expertise and research interests include multicultural trauma, and sports performance psychology. He is an intern at Legacy Mental
counseling, antiracism teaching, positive racial identity development, and Health Services, PLLC.
research methods. She currently serves as a clinical supervisor for graduate- Charmeka Newton played a lead role in conceptualization, visualization,
level practitioners and students. writing–original draft, and writing–review and editing. Janeé M. Steele played
JANEÉ M. STEELE, PhD, is part of the core faculty in the School of a supporting role in conceptualization and writing–review and editing.
Counseling at Walden University. She received her doctorate from Western Nesreen Jaber played a supporting role in writing–review and editing.
Michigan University and is a licensed professional counselor. Steele is also Alexander Pace played a supporting role in writing–review and editing.
the owner of Kalamazoo Cognitive and Behavioral Therapy, PLLC, where CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to
she provides therapy, supervision, and training in CBT. Her research and Charmeka Newton, Department of Counseling Psychology and
professional interests include counselor training, social justice advocacy, and Community Services, University of North Dakota, Education Building
culturally responsive treatments in therapy. Room 200, 231 Centennial Drive Stop 7189, Grand Fork, ND 58202-7189,
NESREEN JABER, MS (she/her/hers), is a counseling psychology doctoral United States. Email: [email protected]

37
 38 NEWTON, STEELE, JABER, AND PACE

involves understanding and respecting the client’s racial and cultural understand how culture influences the worldviews of both the
background, values, and beliefs and incorporating them into the psychotherapist and the client, as well as dynamics within the
therapy sessions. Clinically, the significance of this is that when psychotherapy relationship), (b) cultural comfort (i.e., the level of
psychologists attempt to understand and respect the racial identity of comfort one has while discussing issues related to diversity,
clients, clients are more likely to feel validated and understood, client power, and oppression during therapy), and (c) cultural opportunities
mistrust of providers is mitigated, cultural ruptures are minimized, (i.e., the extent to which psychotherapists take or create opportunities
and premature termination of services is lessened (Anderson et al., to explore topics related to culture with clients). Accordingly,
2019; Brooks & Hopkins, 2017). Essentially, culturally responsive this framework has been reflected within the clinical supervision
therapy leads to better treatment outcomes and greater healing. Thus, literature as a model focused heavily on the interpersonal and
this article proposes a coherent framework through which cross- relational processes between trainee and supervisor (Davis et al.,
racial, structurally competent psychotherapy skills can be developed 2018; Owen et al., 2011).
among graduate-level students. The importance of cultural compe- Despite recent advances, the vast majority of the literature
tence in psychotherapy cannot be overstated because as trainees examines cultural responsiveness and training through the lens of
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

interact directly with clients, they encounter specific barriers related the knowledge, didactic activities, and awareness that individuals
This document is copyrighted by the American Psychological Association or one of its allied publishers.

to diverse backgrounds. Some of these barriers include addressing acquire, with less emphasis placed on clinical skill acquisition
personal bias, practicing cultural humility, and intentionally training (Chu et al., 2022). In essence, while the immense work of
broaching race during therapy (Day-Vines et al., 2007; Holyoak et recent and seminal scholarship has allowed us to operationalize terms
al., 2020; Pearce, 1994). Hence, ongoing professional development and further understand multicultural competency, the translation of
and training are essential to provide culturally responsive care in cross-cultural competency into actionable clinical training activities
cross-racial psychotherapy. Cross-racial psychotherapy relation- is lacking.
ships refer to dyads wherein the psychotherapist and the client are of There are inherent challenges in increasing practical training of
different racial backgrounds. skills. For example, Toporek and Sloan (2016) identified expertise
As population trends in the United States are becoming more as one obstacle for implementing skills. Thus, training programs
racially diverse and as graduate students also become more racially may focus on knowledge rather than the implementation of skills,
and ethnically diverse (APA, 2021/2022; Craig et al., 2018), it is given the paucity of guidance on skill development. As such, there
likely that most graduate students in training will engage in cross- appears to be a need for training approaches that can help in the
racial psychotherapy relationships at some point in their careers. acquisition of culturally responsive skills for graduate-level students.
Psychology graduate students in training should be taught how In response to this need, we, the authors, present the cross-racial
to recognize the ways in which the worldviews and life experiences training approach (CRTA), in which we describe how to help trainees
of Black, Indigenous, and People of Color (BIPOC) clients may be in the helping professions cultivate the skills necessary for strong
different from members of the dominant culture (Stoute, 2020). The cross-cultural psychotherapy relationships. While the journey
bedrock of improving clinical services to BIPOC populations and trainees will need to embark on may look different at various points
promoting the healing of these populations is rooted in trainees due to their unique lived experiences as racialized beings, the CRTA
being able to utilize culturally responsive skills (Sue et al., 2022). model is for all trainees, BIPOC and White. Furthermore, while the
Trainees must not only be able to acknowledge their worldviews levels of the model may be approached sequentially during training
and how they may differ from clients, but they must also be prepared and are described as such in the present article, in practice, skills
to engage in discussions of identity and structural oppression, described at each level of the CRTA permeate the entirety of the
to address microaggressions in the clients’ lives and in therapy, and therapeutic process and may be emphasized across the various levels
to facilitate rupture repair when they inevitably commit a micro- of training as trainees develop mastery of the aspects of therapy
aggression that could impact the therapeutic relationship (Grzanka highlighted in the model.
et al., 2019; Hook et al., 2017; Moradi & Grzanka, 2017). The remainder of the article begins with a review of the literature
Historically, the tripartite model of multicultural psychotherapy exploring the general significance of race during therapy within
proposed by Sue et al. (1982, 1992) has undergirded the profession the U.S. context. More specifically, we look at the impact of salient
with invaluable context regarding the translation of awareness, topics, such as racialized trauma, race and culture in therapy,
knowledge, and skills into multicultural competency. Over the past intersectionality and racial identity development, and challenges in
decade, many training guidelines, constructs, and theories have cross-cultural training. The CRTA is then set forth, followed by two
expounded upon the tripartite model of multicultural psychotherapy clinical training vignettes. The article concludes with a discussion of
competencies proposed by Sue et al. (1982, 1992) and Ratts et al. the implications for ongoing training and supervision.
(2016) to inform the training of graduate students in culturally
responsive ways. Some of these guidelines include the guidelines
Racialized Trauma
put forth by the Task Force on Race and Ethnicity Guidelines
Psychology (APA, 2017), as well as the recent multicultural Why emphasize race? In recent years, greater attention has been
orientation framework (Hook et al., 2017). placed on the negative impacts of racism and discrimination on
The multicultural orientation framework (Hook et al., 2017) in mental, physical, spiritual, and emotional health (Wilcox, 2023). For
particular was developed to be more consistent with the process- many BIPOC clients, life in the United States is marked by racism,
oriented language typical of psychotherapy and to increase the discrimination, and prejudice, which can lead to racialized trauma
empirical basis from which cultural competence is conceptualized (Carter, 2007; Comas-Díaz & Torres-Rivera, 2020; Crosby et al.,
during the psychotherapy process. It consists of three primary 2022). Racialized trauma refers to mental and emotional injury
constructs: (a) cultural humility (i.e., a way of being that seeks to characterized by repeated exposure to discrimination, humiliation,
 CROSS-RACIAL TRAINING APPROACH 39

harassment, racially motivated violence or aggression, real and research suggests that positive racial identity may serve as a protective
perceived threats due to racial identity, and witnessing racism-related factor against internalized racism and other challenges to healthy self-
harm to other BIPOC individuals (Carter et al., 2019; Comas-Díaz et esteem (Pieterse et al., 2012).
al., 2019; Crosby et al., 2022). Race may also influence the psychotherapy process in terms
Research suggests that racialized trauma can result in symptoms of its impact on the quality of the therapeutic relationship. White
similar to those in other trauma disorders, including depression, heterosexual male privilege significantly shapes the landscape of
anxiety, intrusive thoughts, avoidance, paranoia, somatic complaints institutional environments (Iverson, 2007; Liu, 2017). It plays a
(e.g., headaches and digestive issues), and hyperarousal (Carlson pivotal role in shaping educational and clinical practices within
et al., 2018; Comas-Díaz et al., 2019). Racialized stress and trauma universities, as well as influencing the socialization process of
have also been associated with a number of physical health symptoms, trainees (Grzanka et al., 2019). Poor awareness of this structural
such as cardiovascular disease and diabetes, as well as various social lens in therapy can ultimately result in cultural ruptures (Helms,
determinants of mental health including intergenerational poverty, 2017). Effective treatment is limited by the cultural competencies
disparate incarceration rates and sentencing, and the lack of belonging of the graduate-level student in training, which is extremely
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

in settings such as schools and workplaces (Crosby et al., 2022; relevant given that the therapeutic alliance remains one of the
This document is copyrighted by the American Psychological Association or one of its allied publishers.

Cuevas et al., 2020; Johnson-Lawrence et al., 2013). Such experiences most significant contributors to positive treatment outcomes
may lead to shame, guilt, and internalized blame among BIPOC (Kinouani, 2020; Wilcox, 2023). Cultural insensitivity and failure
individuals who experience racialized trauma (Carlson et al., 2018; to acknowledge race are well-documented reasons that BIPOC
Comas-Díaz et al., 2019). Culturally responsive care for BIPOC clients prematurely terminate or do not enter therapy (e.g., Cooper
clients, therefore, requires intentional exploration of precipitants to & Conklin, 2015). A rupture, or an event that breaches the trust
these symptoms, which may include covert and overt acts of in the therapeutic relationship, and the inability to mend ruptures
racism such as being a survivor of a hate crime; experiencing impact treatment success (Hook et al., 2017; Marmarosh, 2021).
microaggressions; being the target of racist comments, racial In sum, the potential effects of race on the psychotherapy
discrimination, and racial profiling; and witnessing race-based relationship, as well as the impact of race on BIPOC clients’
events (Hemmings & Evans, 2018). worldviews and presenting concerns, as described above, under-
Without the adequate exploration of discrimination and other score the significance of race and culture within therapy. Therefore,
race-based events on racial–ethnic minority clients’ presenting trainees must be equipped with the skills to examine the influences
concerns, psychologists may overlook factors that would otherwise of race, culture, and racism in psychotherapy relationships.
have a significant impact on case conceptualization and treatment First coined by legal scholar and critical race theorist
planning (Day-Vines et al., 2020; Sue et al., 2022). Therapeutic Kimberlé Crenshaw in 1989, intersectionality, by definition, serves
spaces are essential for BIPOC clients, who are often silenced as a basis that can help us understand how systems of domination
by anti-BIPOC racism in common life settings, to openly share create distinct experiences of privilege and oppression that influence
and process their experiences of racism without the threat of people’s lives differentially based on their sociopolitical identities
reenactments of racism by the psychotherapist (Kinouani, 2020). (Crenshaw, 1989; Shin et al., 2017). For example, a Black American
Hence, there is a need for a model that will guide trainees on how to man who identifies as gay and is impoverished may experience
create these safe spaces for examining clients’ racialized experiences unique structural and systemic oppressions rooted in racism,
and their culturally shaped worldviews. classism, and heterosexism. Similarly, trainees’ multiple identities
are inevitably shaped by systems of domination that impact their
insights into themselves, their ability to create therapeutic safety, the
Race and Culture in Therapy
way in which they broach, and how they engage in insight and healing
Beyond the harmful mental health effects of racism and work. As such, trainees must undergo training that helps them
discrimination, race often has a broader cultural significance to the understand their own intersectional identities, as well as how their
worldviews and lived experiences of BIPOC clients. According to clients’ multiple identities and experiences of oppression might
Kohl (2006), a “worldview constitutes our psychological orientation impact their presenting concerns and the treatment processes.
in life and determines how we think, behave, make decisions, and Racial identity development is a process that describes how
define events. It includes one’s group and individual identities, individuals come to understand their racial identity and how it
beliefs, values, and language that construct a reality for perceiving life shapes their experiences in the world (Constantine et al., 1998).
events” (p. 176). BIPOC clients with collectivist worldviews, for There are several frameworks that have been developed to describe
example, may emphasize interdependence and family kinship ties, stages of racial and ethnic identity development across diverse
family values, and deference to authority over individual goals populations (e.g., Cross, 1971; Helms, 2014). Trainee and client
(Hunter, 2008). Moreover, there is cultural variation in the conceptual racial identity development can have a significant impact on the
self (i.e., independent and interdependent self-construal) that informs treatment process (Sadusky et al., 2023). As such, attitudes toward
one’s view of self, the qualities that make the self, and emphases on cross-racial dialogue among individuals at higher and lower levels
individual, communal, or relational ways of being (Kanagawa et al., of racial identity development may vary, requiring differential
2001). In the psychotherapy context, this is significant as most didactic and experiential supervisory support.
psychological theories focus on notions of the bounded individual and
emphasize personal achievement. Furthermore, besides helping
Challenges in Cross-Cultural Training
graduate-level students in training develop a greater understanding
of the client’s cultural worldview, exploration of a BIPOC client’s Training programs often state an emphasis on understanding
racial identity during therapy can be an intervention in itself, as the needs of diverse client populations and outline the students’
 40 NEWTON, STEELE, JABER, AND PACE

responsibilities toward this end (Geerlings et al., 2018; Haldeman & The CRTA
Rasbury, 2014). However, there is not a clear consensus across
programs regarding how to implement multicultural training and As previously stated, the CRTA presented in this article
represents a process framework for use with graduate trainees in
facilitate vulnerable and authentic dialogue wherein students are
the helping professions to foster ethical and culturally appropriate
encouraged to challenge their personal biases for the sake of serving
clinical services. This approach consists of five training levels:
clients who may hold vastly different worldviews than themselves
(a) trainee awareness, (b) therapeutic safety, (c) broaching, (d)
(Geerlings et al., 2018). Some researchers have suggested that
insight work, and (e) healing work. These levels work as a process
multicultural and diversity curricula ought to contain opportunities
through which graduate trainees can facilitate the essential clinical
for students to write about and share their deeply held beliefs,
components of safety and openness, contributing to the environment
followed by discussions of how those beliefs may influence their
necessary for clients to realize, disclose, and heal from racialized
clients’ work via conceptualizations, treatment plans, and diagnoses
trauma and talk about issues connected to their race.
(Haldeman & Rasbury, 2014). Another suggestion is for trainees to
Table 1 summarizes awareness-building questions, skills, activities,
be taught explicitly that their own beliefs are not to be enforced onto
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

and processes that characterize each level of the CRTA. While beyond
clients nor should they strive to change the client’s beliefs; instead,
This document is copyrighted by the American Psychological Association or one of its allied publishers.

the scope of the current article, the pedagogical principles under-

they should focus their efforts on advocacy work that enhances the girding the model are derived from constructivist and liberatory
ethical and competent treatment of marginalized peoples (Cohen et philosophies recommended throughout the multicultural counseling
al., 2012). literature for challenging cultural centrism and developing cultural
Beyond challenges facilitating the introspection necessary to competence in graduate-level trainees (see Comas-Díaz & Torres-
develop a culturally sensitive orientation to psychotherapy, Rivera, 2020; Marbley et al., 2011; Steele, 2008). As such, the
psychology training, and practice are deeply rooted in Western awareness-building questions are designed to prime trainees to
models developed for European and North American populations, explore, deconstruct, or coconstruct their understanding of the
which further limits their cultural applicability (Geerlings et al., significance of race in the therapeutic process, while the skills
2018). Thus, there is a need to address how these models may fall illustrate how this understanding may be translated into compe-
short of meeting the needs of BIPOC clients. Graduate students and tency. The activities and processes illustrate how the skills can be
faculty often struggle to apply these models of training and practice practiced and evaluated. The paragraphs below discuss elements of
with clients from different cultural groups, and though students the table in further depth.
have expressed a willingness to work cross-culturally, they struggle
to do so from the lack of experience, knowledge, didactic training,
and confidence in their own cultural competence (Geerlings et al., Level 1: Trainee Awareness
2018). Moreover, given the inherent power dynamic that is
The foundational level of the CRTA is trainee awareness. This
embedded in the clinical supervision relationship, the clinical
level entails increasing awareness of the trainee’s view of self and
supervisor’s social positioning, competency in culturally respon-
their limitations, as well as ways in which Eurocentric and patriarchal
sive training, and the value they place on this can impact the degree
values may be reflected in the trainee’s worldview and the
to which culturally responsive skills are taught (Arczynski &
psychotherapy process. Similar to Sue et al.’s (2022) framework,
Morrow, 2017). The latter can also create additional conflict for the trainee awareness is based on the realization that it is important to
trainee as they decide whether to bring up culturally responsive know oneself as a racial being to work effectively across cultures and
skill issues in supervision or not. The present model assumes that be aware of how one’s identity socialization and lived experiences
the supervisor is racially conscious and at an advanced or can shape the therapeutic space. Moreover, another aspect of this
progressive stage of racial identity development (Jernigan et al., level entails increasing appreciation for differences between the
2010). However, it is important to note that if a supervisor is not in worldviews of the psychotherapist and the client (Davis et al., 2018).
an advanced stage of racial identity, they might struggle with the Accordingly, at the awareness stage of the process model, the
use of the model, as they would not have the racial consciousness graduate-level trainee is guided to think of the cultural and racialized
needed to train others. self in relation to others. As shown in Table 1, faculty and supervisors
An additional challenge in cross-cultural training is that graduate facilitate the exploration of awareness-building questions for trainees
training programs must focus not only on increasing the well-being such as the following: “How does my racial identity impact the
of clients but also on the comfort, belonging, and success of therapeutic alliance?” “In what way do I exert privilege and how
BIPOC trainees. Graduate students from marginalized groups often might this impact the client?” “What are my biases toward people of
experience stressors related to being different from their faculty and different racial backgrounds?” “How do I work on these biases?”
the majority of other students, which impacts their success and Skills such as critical reflexivity, conceptualizing the influence of the
feelings of exclusion (Koch et al., 2022). Training graduate students trainees’ identities, worldviews, and experiences with privilege and
involves modeling positive experiences, inclusion, mentorship, and oppression, can be used at this level.
affirming practices that foster belonging and success (Koch et al., This facilitation is aided through constructivist and liberatory
2022). Training should raise awareness of multicultural and diverse pedagogical strategies such as cultural decentering and interpersonal
interactions to increase the understanding and implementation of dialogue using tools that may include journaling, self-assessment,
culturally competent behaviors toward trainees and, in turn, toward and classroom discussions (Marbley et al., 2011; Steele, 2008). It is
clients (Koch et al., 2022). Training program faculty and supervisors especially important for BIPOC trainees at this stage to reflect on
have the responsibility of modeling to their own trainees’ ways in how their own oppression may impact the psychotherapy dyad.
which to engage in inclusive and affirming dialogue. Faculty and supervisors ought to initiate feedback from trainees to
 This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Table 1
The Cross-Racial Training Approach

Level Awareness-building question Skill Activity and process

Trainee awareness: Trainees learn to maintain • “How does my racial identity impact the • Self-reflection • Journaling
an accurate view of their cultural worldview therapeutic alliance?” • Self-awareness • Classroom discussions
and constantly assess how identity and • “In what way do I exert privilege and how • Critical consciousness • Reflection papers
positionality may influence the might this impact the client?” • Cultural decentering • Informal self-assessments and privilege
psychotherapy process. • “What are my biases toward people of • Valuing multiple realities inventories
different racial backgrounds?” • Formal assessments such as the Implicit
• “How do I work on these biases?” Association Test
• Discourse analysis examining cultural
themes and hidden values within both U.S.
social contexts and the counseling
curriculum
Therapeutic safety: Trainees learn to • “How at ease, calm, and secure do I feel in • Multicultural orientation (i.e., cultural • Role plays practicing the basic and advanced
intentionally create environments that discussing cultural and racial identity issues?” humility, comfort, opportunities) counseling skills emphasized at this level
promote safety through the integration of • “What opportunities outside of the thera- • Validation using counseling scenarios related to race and
cultural humility with basic and advanced peutic alliance can I take advantage of to gain • Compassion racism
counseling techniques. comfort?” • Empathy • Exposure/immersion activities
• “To what extent do I seek opportunities to • Affirmation of client meanings • Assessment of trainee ability to facilitate
understand different racial or cultural beliefs, • Use of client language therapeutic safety using the basic and
values, and racial identity?” • Minimal encouragers advanced counseling skills emphasized at this
• “How do I display humility with my clients?” • Accurate communication through para- level when discussing race and racism during
phrases, summarizations, and reflections field experience
• Therapist self-disclosure
• Verbalization of client strengths
Broaching: Trainees learn to make deliberate • “How do I help clients share about their own • Rapport building • Role plays practicing broaching
efforts to explore the racial, ethnic, and cultural identities?” • Verbalization of cultural differences and • Examination and restructuring of cognitions
cultural identities of the client and the • “What methods or interventions do I use to power differentials within the counseling leading to fear or other difficult emotions
influence of these identities on the client’s invite clients to explore how race and culture relationship surrounding broaching using activities such
presenting concerns. influence their presenting concerns • Acknowledging limitations in understanding as journaling, reflection papers, thought
CROSS-RACIAL TRAINING APPROACH

specifically?” due to one’s cultural worldview records, advantage/disadvantage analysis,

• “How would I inform my clients of the intent • Intentional exploration of social identity and and/or behavioral experiments
to explore culture throughout therapy?” oppression in the client’s life and presenting • Assessment of trainee ability to broach issues
problems of race during field experience
• Identifying opportunities for social action
Insight work: Trainees learn to use culturally • “In what ways might race and racism • Obtaining and organizing information about • Case conceptualization write-ups using fic-
derived or adapted theories of influence a client’s presenting concerns?” the client to identify the precipitants to their tional cases developed by students or faculty
psychotherapy to help clients make • “How might the client’s racial worldview concerns within the context of racism and or taken from popular media
connections between their presenting influence their view of mental health and discrimination • Assessment of trainee ability to integrate race
problems and experiences with race. wellness?” • Utilizing client data to formulate hypotheses into case conceptualization and treatment
regarding the etiology and maintenance of planning during field experience
client problems within the context of racism
and discrimination
• Identifying culturally derived strengths and
sources of coping that mitigate the severity of
client problems
(table continues)
41
 42 NEWTON, STEELE, JABER, AND PACE

psychoeducation and demonstration of cul-

• Assessment of trainee ability to implement

assess their experiences of support, inclusion, and belonging to

culturally responsive, theory-specific inter-

• Role plays that emphasize the use of counter the impacts of oppression and racism. Acknowledgment of
turally responsive, theory-specific biases, both explicit and implicit, is additionally crucial at this level
for both White and BIPOC trainees, as these biases act as templates

ventions during field experience

Activity and process

• Giving and receiving feedback that unconsciously influence psychotherapists’ responses even
when they rate themselves as multiculturally competent (Abreu,
1999; Boysen & Vogel, 2008; Castillo et al., 2007).
Also at this stage, graduate trainees should work on racial identity
development (Singh, 2019). White graduate students in training
interventions

should be taught to acknowledge their Whiteness and White

privilege during the intake session with all clients, particularly with
BIPOC clients, and prompted to process these identities and
positions with their training faculty members and clinical super-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

visors. White trainees must be aware of how their intersecting

This document is copyrighted by the American Psychological Association or one of its allied publishers.

identities also work in tandem with their Whiteness. Additionally,

focusing the activities listed in Table 1 in ways that raise critical
healing approaches and community healers
• Community and sociopolitical engagement
Use of alternative/non-Western/Indigenous

consciousness (e.g., reflecting and acting upon sociopolitical

environment), name White power institutions and racial capitalism,
and develop awareness of White supremacist norms can help the
trainee to be conscious of differences in worldviews that can
Psychological empowerment

influence their interpretation of BIPOC clients and refrain from

Skill

Strength and resistance

enacting microaggressions (Wilcox, 2023). For BIPOC graduate-

Critical consciousness

Cultural authenticity

level students, the focus should reflect upon additional awareness-

Embodied healing

building questions such as the following: “What forms of oppression

Self-knowledge

have I experienced (e.g., colorism, racism, or classism)?” “How

Radical hope

does oppression impact the work I do with clients (both of dominant

and marginalized identities)?” “How do I heal from the racism I have
experienced?” “What kind of support do I need as a BIPOC graduate
student of color?” At this level, training programs can focus on
•
•
•
•
•
•
•
•

didactic activities to promote racial healing, such as utilizing The

Racial Healing Handbook (Singh, 2019), microaggression work-
• “What interventions promote healing from

• “How can I help clients address systemic

shops, and social identity awareness activities. Examples of specific

• “What are the psychological effects of

learning strategies that supervisors might consider include roleplay

oppression affecting their presenting
Awareness-building question

and other structured exercises, such as those that are included in the
book Experiential Activities for Teaching Multicultural Competence
in Counseling (Pope et al., 2011).
Learning about microinterventions and the application of these
the effects of racism?”

interventions is key at this stage for White and BIPOC trainees (Sue
et al., 2019). Microinterventions are intentional or unintentional
words or deeds that validate the experiences of individuals targeted
concerns?”

by racism, affirm their racial identity, or provide support and

racism?”

encouragement (Sue et al., 2019). The training of these students

should further commit to acknowledging and addressing micro-
aggressions or other cultural ruptures in their professional relation-
ships (Hook et al., 2017). Early-level student training would benefit
Healing work: Trainees learn how to facilitate

from a focus on dyadic activities, experiences, course assignments,

opportunities, and dialogues that build the students’ introspection on
their own lived experiences, biases, and privileges and how those
recovery from presenting problems

impact the psychotherapy dyad.

influenced by race and racism.

Level 2: Therapeutic Safety

Level
Table 1 (continued)

At the therapeutic safety level, the trainee is learning skills to be

intentional about creating an environment that is safe for BIPOC
clients. A safe environment is one wherein BIPOC and marginalized
folks can discuss, share, relate, and process their experiences
without the threat of silencing or the reenactments of historical and
contemporary atrocities (Kinouani, 2020). Questions to consider at
this level include the following: “How at ease, calm, and secure do I
 CROSS-RACIAL TRAINING APPROACH 43

feel in discussing cultural and racial identity issues?” “What comfortable addressing topics of race in the psychotherapy dyad.
opportunities outside of the therapeutic alliance can I take advantage As a caveat, it is important to note that Wilcox (2023) would argue
of to gain cultural comfort?” “To what extent do I seek opportunities that “oppression is not culture”; thus, it could be a misnomer to call
to understand different racial or cultural beliefs, values, and racial skills like broaching “culturally responsive” when talking about
identity?” “How do I display humility with my clients?” (Davis the impact of structural oppression. However, within this model,
et al., 2018; Hook et al., 2017). broaching is used to explore the influences of the client’s concerns
As shown in Table 1, at this level, graduate trainees are working in the client’s broader life and in the therapeutic relationship.
on developing and demonstrating cultural humility by projecting While there are marginalized aspects of identity, identity also
a disposition that is other-oriented and deferential to the client’s provides belonging, strength, and a source of coping. Moreover,
cultural values and norms, using skills known to communicate this oppression often influences the cultural experiences of BIPOC
disposition such as validation, compassion, and empathy (Day- populations. Together, these reasons are why we frame the discussion
Vines et al., 2020; Hook et al., 2017; Steele, 2024). Of equal of these topics as culturally responsive.
importance, trainees are learning to facilitate the ongoing process of Trainees must also look at how they will broach the intersecting
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

acknowledging areas and committing to work on growth areas, with identities of the client so that they may understand the client
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a goal of increasing comfort and taking the initiative to explore holistically. Moreover, teaching broaching skills training programs
aspects of the client’s racial identity (Davis et al., 2018). White can engage with the teaching and practice methods of Day-Vines
and BIPOC trainees must evaluate how they will create safe et al. (2007, 2020) by embedding broaching into theories and
environments that honor and appreciate the intersectional identities techniques courses and diagnostic skills labs for student practice.
of their clients. Consistent with the constructivist principle of observing, naming,
Therapeutic safety can also be taught by helping trainees interpreting, and giving meaning to the world around them, trainees
understand the various communication styles and patterns of various are also encouraged to examine cognitions. For example, trainees
racial and cultural groups (Orbe & Harris, 2013). For example, can be encouraged to examine difficult thoughts that lead to fear and
within some racial groups, interrupting or interjecting is not seen as other difficult emotions related to broaching racial content (e.g., “I
disrespectful but as a normal pattern of communication. Realizing might say the wrong thing,” “I should only bring up race if the client
one’s own communication style and other’s communication is does,” “The client might get mad at me and that would be awful,” or
important in being able to best relate with clients (Sue et al., 2022). “Race doesn’t matter”) using activities such as journaling, reflection
Incorporating human communication theory and skills into training papers, thought records, advantage/disadvantage analysis, and/or
may aid trainees in developing intercultural interpersonal skills— behavioral experiments (Steele, 2008).
such skills may be attained through multidisciplinary communica-
tion seminars.
Graduate training at this level should also focus on helping Level 4: Insight Work
students learn skills of empathy, positive regard, and cultural
humility. For example, trainees can cultivate service-learning The fourth level, insight work, focuses on helping the trainee to be
opportunities that allow students respectful and invited exposure introspective and to understand the role that race and racism may
to different cultures and communities so that students can learn have in the client’s presenting problems. Accordingly, awareness-
and increase their comfort and critical consciousness across building questions at this level include the following: “In what ways
cultures, which may increase the likelihood of them having the might race and racism influence a client’s presenting concerns?”
therapeutic skills to create safety within the therapeutic setting “How might the client’s racial worldview influence their view of
(Campbell & Oswald, 2018) mental health and wellness?” (see Table 1). To this end, trainees
might be challenged to explore the nuances of race, for example,
in terms of the effects of internalized racism. Skills that might be
Level 3: Broaching taught at this level would be connected to case conceptualization,
Once the trainee has learned about establishing therapeutic case organizational skills, assessment of the type of oppression
safety, they are then in a better position to seize opportunities to experienced, and empathic active listening.
address issues of race and racism by developing broaching skills. To guide this exploration, training faculty and supervisors
Awareness-building questions to be considered at the broaching may use culturally adapted theories of psychotherapy such as
level of CRTA should help students address the following: “How cognitive behavioral therapy to facilitate insight into the ways in
do I help clients share about their own cultural identities?” “What which various race-related phenomena may contribute to negative
methods or interventions do I use to invite clients to explore how cognitions and emotional and psychological distress (e.g., Steele
race and culture influences their presenting concerns specifically?” & Newton, 2022). In line with the research on healing the invisible
“How would I inform my clients of the intent to explore culture wounds of racism, training at this stage may also more broadly
throughout therapy?” entail teaching students how to examine messages of internalized
Day-Vines et al.’s (2007, 2020) model of broaching skills entails self-devaluation, internalized voicelessness, and the assaulted
deliberate and intentional efforts to discuss the racial, ethnic, and sense of self (Hardy, 2013). These aims may be accomplished
cultural identities of the client, as well as to actively evaluate the using activities such as case conceptualization write-ups with
impact of these identities on the client’s presenting concerns within fictional cases developed by students or faculty or taken from
intracounseling, intraindividual, intra-racial/ethnic and cultural popular media, as well as assessment of trainees’ abilities to
domains, and interracial/ethnic and cultural domains (see Table 1). integrate race into case conceptualization and treatment planning
Furthermore, as Sue et al. (2022) explicated, it is essential to be during field experiences.
 44 NEWTON, STEELE, JABER, AND PACE

Insight-level training also involves teaching trainees how to development of a self-care plan, as engaging in this work can produce
examine and account for various forms of discrimination and vicarious racialized trauma for BIPOC trainees in supporting their
oppression that impact their clients’ well-being. As Singh et al. BIPOC clients. Similarly, White trainees might become distressed
(2020) suggested, this may include the incorporation of social over feelings of responsibility and shame for not having done more to
justice theories that help conceptualize privilege and oppression disrupt oppressive and White supremacist systems previously.
and teaching students how to uncover any vicarious, historical, Illustrations of the model using two case examples are provided in the
or transgenerational trauma—what some have termed “soul section below.
wounds”—resulting from experiences of colonization, genocide,
slavery, dislocation, ethnic cleansing, or similar events (Duran, Case Illustrations
2006; Geter, 2018). Liberation psychology is one example of a
theory that may be introduced at this level to expand trainee The Case of Sean
awareness of the uses of therapy for liberation and social justice Sean is a 23-year-old Black cisgender man in his first year of
work (Comas-Díaz & Torres-Rivera, 2020). Liberatory pedagogy graduate studies in psychology. He is originally from Detroit,
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

following the stages identified by Steele (2008) may be used as a Michigan, and grew up in a lower socioeconomic status single-
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pedagogical approach to teach trainees to conceptualize the role of parent home with his mother. In his first semester in the program,
privilege and oppression in the profession of psychology and in the he has struggled to find a sense of belonging due to being one of the
mental health concerns of their clients. few Black American men in his program. He was also racially
profiled by a White campus safety officer shortly after his arrival
Level 5: Healing Work at the university. This incident has caused him to reflect on other
experiences of racism he has had. Sean finds himself holding anger
The final level of the CRTA is healing work, during which and resentment toward White Americans because he feels isolated
students learn about how to facilitate recovery from presenting and mistreated by them. Despite these experiences, Sean is
problems influenced by race and racism. As shown in Table 1, motivated and eager to obtain his degree.
awareness-building questions at the healing work level may include
the following: “What are the psychological effects of racism?”
“What interventions promote healing from the effects of racism?”
The Case of Jennifer
“How can I help clients address systemic oppression affecting Jennifer is a 25-year-old White bisexual woman in her first year
their presenting concerns?” These questions prime trainees to be of psychology graduate school. She is originally from a suburb
conscious of symptoms that develop as a result of experiences with of Denver, Colorado. Jennifer grew up in a two-parent household
racism and to target interventions that have been found to be and describes her life as rather “privileged,” explaining that “she
effective in the treatment of racialized trauma. For example, research never really wanted for much.” She also acknowledges that while
shows that racialized trauma is similar to other forms of trauma in growing up, she was not exposed to many diverse racial or ethnic
that it produces symptoms of intrusion, arousal, and avoidance cultures. It was not until she left for college that she disclosed her
(Carter, 2007). Accordingly, at this level graduate trainees will sexual orientation to her parents. Since sharing her sexual identity,
focus on learning skills to enact changes and experience growth in she has found that neither of her parents are accepting, and it is a
areas known to promote healing from racialized trauma, such as topic they “tend to avoid.” Furthermore, as Jennifer has entered
positive racial socialization and identity, self-compassion, self- adulthood, she has been more reflective of her Whiteness and finds
acceptance, psychological empowerment, and community and herself holding what she labels as “a liberal and open mindset.”
sociopolitical engagement (Brown, 2008; Sue et al., 2019). During She wants to engage with people of different racial groups but is
the healing work level, training should focus on developing client sometimes afraid to engage, as her upbringing lacked exposure to
interventions that help the trainee in the psychotherapy process. racial diversity.
For example, the incorporation of French et al.’s (2019) framework
of radical healing and the teaching of the skills connected with
Trainee Awareness
how to help clients develop critical consciousness, radical hope,
strength and resistance, cultural authenticity, and self-knowledge are In the cases of Sean and Jennifer, both students would benefit
imperative at this level. Learning more about alternative/non- from understanding how their racial identity may impact cross-racial
Western/Indigenous healing approaches, community healers, and psychotherapy dyads. Exploration of racial identity could be done
resources to work toward social change are other important tasks to through coursework that focuses on theories of racial identity and
be completed at this level. lifespan development. This would include coursework that could
Faculty working with students at the healing work level of the help the trainees evaluate and gain an understanding of themselves
CRTA may focus on providing skills training and field experience as racial beings who work across cultures.
opportunities to teach approaches found to be effective in the More specifically, Jennifer would benefit from activities that
treatment of trauma and to facilitate the goals of French et al.’s define Whiteness but provide strategies that deconstruct Whiteness
(2019) framework of radical healing, such as psychoeducation should be at the core of training (Helms, 2017). For example,
and embodied healing (Menakem, 2017; Steele, 2024). Further, Jennifer may be encouraged to look at ways in which she can
continued emphasis on the development and implementation of relinquish her White privilege and what this really means as she
social action plans to address various forms of oppression that gains comfortability with engaging in and facilitating racial and
impact client well-being should also be maintained at this level. cultural discussions. For example, Jennifer could be supported in
Last, at this level it is important for the trainee to work toward the examining the dynamics between holding privileged identities
 CROSS-RACIAL TRAINING APPROACH 45

(i.e., White) and marginalized identities (i.e., bisexual) using consider how he will navigate these biases and difficulties in the
activities such as cultural decentering (i.e., explicit articulation, psychotherapy room, particularly how can he maintain cultural
group sharing, and written reflection on one’s cultural beliefs and humility and cultural comfort with his clients while protecting his
worldviews; McAuliffe & Milliken, 2009) and discourse analysis own mental well-being. Psychoeducation around Sue et al.’s
(i.e., examining themes in various cultural and political realities; (2019) microintervention would be of importance for Sean at
Steele, 2008). this level to provide him with tangible strategies to address
Sean may benefit from looking at Cross’s (1971) Nigrescence microaggressions he may be a target of during sessions. For
model to aid his awareness. For example, he could locate himself Jennifer, it would be important for her to look at how her
within the theory to gain insight into how he is currently navigating Whiteness may break down the safety for some clients of color as
the world and how his experiences of racism and subsequent they may have experienced race-based hurt from White Americans
resentment toward White Americans may impact his client work. He that transfers into the psychotherapy dyad. At this level, Jennifer’s
may also benefit from taking self-assessments associated with Black training could focus on how to mitigate and handle when a cultural
racial identity and completing reflection papers on his formative rupture occurs.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

experiences and the insights he develops. The training of Sean and Jennifer in the aforementioned areas can
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At the trainee awareness level, it would also be vitally important occur through coursework. It might also be important for faculty to
to provide opportunities and coursework that would allow Sean and address critical concerns with these students one-on-one to promote
Jennifer to evaluate the biases they may bring to the psychotherapy in-depth dialogue and understanding. Mentorship at this level may
dyad while also teaching them to manage defensive reactions be important especially for Sean, as research has indicated that
that occur during this exploration. Some helpful exercises include informal mentoring for ethnic minority students has been found to
mindfulness-based activities such as meditative audios that can help be successful at creating an inclusive climate for mentees (Jones
trainees focus on their sensations and thoughts in a nonjudgmental et al., 2018).
way (Lueke & Gibson, 2015). Journaling as a part of course
assignments can also be helpful as trainees can write about shame,
guilt, embarrassment, or anxiety they may have and process Broaching
tangible steps to conquer bias. Completing an assessment such as the
Implicit Association Test would be another critical element of At the broaching level, Sean and Jennifer could develop
examining bias. script narratives that will inform their clients in the early stages
Finally, Sean and Jennifer would benefit from cross-cultural of therapy of their intentions to look at issues of race, ethnicity,
exchanges embedded in their early training activities to foster and culture in sessions. To increase comfort, Sean and Jennifer
exposure, expansion of their comfort zones, and self-awareness of could practice broaching with each other by exploring their lived
issues of privilege, bias, and racism. This may involve a service- racial/cultural experiences together. For this practice it may be
learning project and integration of antiracism scholars in the necessary for faculty to ensure the students have built relational
course curriculum. This not only could increase trainees’ exposure foundations to genuinely explore these identity-based questions.
to different cultures, but it may also help trainees of color feel For example, Jennifer may want to pose questions to Sean
empowered and validated to see themselves reflected in the examining how his lived experiences as a Black man have
scholarship. influenced his worldview and work as a psychotherapist. Similarly,
Sean may want to help Jennifer ponder how her identity and
worldview as an economically privileged White woman has shaped
Therapeutic Safety
her as a therapist.
At this level, both Sean and Jennifer would need to examine how Furthermore, to strengthen skills in broaching, it is imperative to
they can create safe cross-cultural therapy environments via cultural examine how social identities work in tandem. For example,
humility and cultural comfort (Hook et al., 2017). Accordingly, Jennifer may want to explore how her experiences of marginaliza-
training should focus on helping Sean and Jennifer think critically tion as a bisexual woman while holding privilege as a White
about how their therapeutic environment (e.g., clinic, room) American impact her understanding of her clients’ lived experi-
can send culturally safe messages. Discussions around avoiding ences. As a result of this exploration, Jennifer could go on to develop
culturally biased language on intake forms and incorporating an initial broaching statement that sounds something like this:
inclusive language in the therapy room would be taught at this
As a White woman, I hold privilege and have not experienced the
level of training. Furthermore, faculty and supervisors explicitly
racism you may have experienced as person of color. While I may have
teach basic and advanced counseling skills, such as validation,
experienced discrimination as someone who identifies as a bisexual
compassion, and empathy to affirm clients and communicate an woman, I will never know your experience as a person color, but I want
accurate understanding of their experiences. They also emphasize to support you and want to explore how these experiences impact you.
the integration of culture into case conceptualization and treatment
planning. Evaluating how to coconstruct conceptualizations during Thus, at this level, practicing broaching statements reflecting
treatment planning is a critical task in Sean and Jennifer’s training intracounseling, intraindividual, intra-racial/ethnic and cultural,
program at this level. and interracial/ethnic and cultural domains (Day-Vines et al., 2020)
Sean, as a Black man, may need to process how anti-Black racism will be important for both Sean and Jennifer so they can get
may trigger client bias and stereotypes. Additionally, Sean comfortable with having these conversations. Coursework that
may experience difficulty in cultivating empathy for White clients prepares students in microskills are appropriate for this part of the
who may activate racial trauma responses in him. Sean will need to model as well.
 46 NEWTON, STEELE, JABER, AND PACE

Insight Work The application of French et al.’s (2019) model on radical healing
would be an appropriate exercise at this level for both trainees.
At the insight work level, trainees are challenged to explore the
For example, to help BIPOC clients develop critical consciousness
nuances of how race influences the presenting concerns of their
as suggested in the framework, Sean and Jennifer could practice
clients, such as the effects of internalized racism or stereotype threat
providing psychoeducation on relevant topics and asking questions
on well-being. Sean and Jennifer could be taught culturally adapted
that promote reflection, efficacy, and a commitment to action. Other
theories of psychotherapy such as cognitive behavioral therapy to
elements of the framework such as radical hope and strength and
facilitate insight into the ways in which various race-related
resilience might be facilitated by teaching interventions such as
phenomena may contribute to negative cognitions, emotional, and
photovoice to assist clients with further observing, interpreting, and
psychological distress (e.g., Steele & Newton, 2022). During insight
envisioning their current and future realities. Through the use of
work, Sean and Jennifer could also both be encouraged to explore
photovoice, trainees could encourage clients to take photographs
theories that shed light on the lived experience of clients of color
and use narratives to translate their lived experiences into actionable
(e.g., Black feminist theory, Collins, 2009, or optimal conceptual
knowledge to promote change (Wang & Burris, 1997).
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theory, Myers, 1999), and then examine what theories they best
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connect with.
During insight work Sean and Jennifer would also be encouraged Strengths and Implications for Supervision and Graduate
to think critically about how racial identity development may impact Students in Training
the clients they will serve intra- and interpersonally. For example,
There are several strengths of the CRTA. First, it provides training
research suggests that BIPOC individuals at higher levels of racial
programs with a framework to facilitate trainees’ skill development
identity development have greater racial pride and coping in response
in cross-racial therapeutic contexts. Second, the CRTA provides
to racism (Brondolo et al., 2009). Conversely, individuals at lower
tangible levels that can be implemented by the training program
levels of racial identity development may find less salience in race
and offers suggestions for curricular materials and exercises. Third,
and may have a less favorable response to the exploration of race
the CRTA moves us beyond knowledge of cultural and racial
during therapy (Sue et al., 2022). Accordingly, thinking critically
dynamics in therapy into transformative and dynamic teaching of
about and understanding how to facilitate insight regarding racial
implementable skills.
identity development may assist Sean and Jennifer to more
While the levels of the model are described sequentially to
effectively conceptualize and meet the needs of BIPOC clients.
facilitate conceptual understanding of the process through which
Finally, another area of insight work could include an
effective cross-racial therapy may occur, the training involved at
examination of other relevant cultural considerations for BIPOC-
each level may take place simultaneously or individually. Moreover,
identifying groups. For example, Sean and Jennifer could be
the depth at which the levels are understood and implemented will
encouraged to explore how religious and spiritual networks can be
grow over intentional time, trainees’ clinical experience, and as
engaged in client care. Moreover, building insight into how various
clinicians and training programs are more practiced in facilitating
racial groups conceptualize mental distress and mental health
authentic learning spaces. As such, the various levels illustrated
treatment is important for trainee development. For instance, within
through the description of the CRTA suggest specific attitudes and
the Black community, there is often a stigma about seeking mental
behaviors necessary for effective clinical work. Knowledge of these
health treatment as this might be conceived as not having spiritual
attitudes and behaviors can assist trainees with assessing their
faith in their higher power (Walker, 2020). Gaining insight and
cultural responsiveness and ability to work toward healing BIPOC
helping clients gain insight into this stigma and how to work with the
clients’ racialized trauma. In terms of attitudes, the CRTA promotes
stigma is an important skill for Sean and Jennifer to have to make
awareness of privilege and power differentials that exist between
therapy meaningful and increase client retention in the treatment.
psychotherapists in training and their clients, as the foundation of
the model is rooted in an acknowledgment of the impact of the
Healing Work trainees’ cultural values and norms on the therapeutic process.
Accordingly, the approach suggests continued assessment of the
The last level of healing work may come later in Sean and trainees’ worldviews and biases.
Jennifer’s training as it involves the development of more advanced Beyond trainee disposition, the CRTA implies that being a lifelong
skills. During healing work, the trainees will learn about culturally learner must be embraced by faculty and clinical supervisors. Faculty
adapted techniques that might facilitate healing for diverse racial must be willing to continually further their own learning on issues
populations based on the insights gained at the previous level. The connected to race and cross-cultural work and move beyond their
utilization of workbooks such as those written by Singh (2019) and comfort zones to effectively train and use the model. It is essential for
Steele and Newton (2023) can be valuable during this stage to help supervisors to initiate discussions of multiculturalism within the
Sean and Jennifer develop a toolkit of culturally adapted strategies context of systems of oppression, power, and privilege (Peters &
that promote healing. Rivas, 2018). Thus, both faculty and supervisors ought to be
Given the role of empowerment and advocacy in healing among competent in these levels to facilitate and assess these competencies
BIPOC populations, didactic and experiential activities that can in trainees.
enrich Sean and Jennifer’s understanding of advocacy/activism can
also be important self-advocacy and activism skills that can be
Limitations and Future Directions
translated into therapy sessions. Sean and Jennifer may be asked to
think about how they can create social change and how they might One limitation of the CRTA is the lack of unified measurement for
be able to empower their clients to create such change. faculty to rate successful and effective application of the learning
 CROSS-RACIAL TRAINING APPROACH 47

activities. A suggestion might be using a Likert-type scale that Adames, H. Y., Chaves-Dueñas, N. Y., Lewis, J. A., Neville, H. A., French,
denotes a level of “meeting expectation” on each of the five levels B. H., Chen, G. A., & Mosley, D. V. (2023). Radical healing in
before the trainee moves forward. Assessment of these skills could psychotherapy: Addressing the wounds of racism-related stress and trauma.
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assessed through research that looks at the qualitative experience of phics-data (Original work published 2021)
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research concerning culturally responsive psychotherapy and the
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