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The therapeutic alliance and helping relationship are fundamental to counseling and the use of theories to direct work with clients. Basic ways of being in session connect to skills of helping, which allow the counselor or therapist to be attuned and open to the client’s lived experience. Counselors and therapists respond to the cues of the client and provide warmth and empathy, while helping to unpack meaning and create opportunity for emotive experiencing by asking open-ended questions and then clarifying, reflecting, and summarizing what has been shared. Core helping skills are directly connected to being culturally responsive through counselor trainings in cultural competency, cultural humility, and cultural responsiveness. Counselors and therapists are also responsive, both therapeutically and theoretically, by carrying a deep appreciation for the cultural diversity of each client. The use of theories may need to be appropriately integrated to meet the needs of clients. In addition, multicultural and social justice orientations must be integrated with any use of theory. It is our hope that, with this book, readers will continue to examine the therapeutic relationship and how cultural diversity affects each of the theories they will learn in the various chapters.