Beginning in the mid-1990s, the construct of historical trauma was introduced into the clinical and health science literatures to contextualize, describe, and explain disproportionately high rates of psychological distress and health disparities among Indigenous populations. As a conceptual precursor to racial trauma, Indigenous historical trauma (IHT) is distinguished by its emphasis on ancestral adversity that is intergenerationally transmitted in ways that compromise descendent well-being. In this systematic review of the health impacts of IHT, 32 empirical articles were identified that statistically analyzed the relationship between a measure of IHT and a health outcome for Indigenous samples from the United States and Canada. These articles were categorized based on their specific method for operationalizing IHT, yielding 19 articles that were grouped as historical loss studies, 11 articles that were grouped as residential school ancestry studies, and three articles that were grouped as "other" studies. Articles in all three categories included diverse respondents, disparate designs, varied statistical techniques, and a range of health outcomes. Most reported statistically significant associations between higher indicators of IHT and adverse health outcomes. Analyses were so complex, and findings were so specific, that this groundbreaking literature has yet to cohere into a body of knowledge with clear implications for health policy or professional practice. At the conceptual level, it remains unclear whether IHT is best appreciated for its metaphorical or literal functions. Nevertheless, the enthusiasm surrounding IHT as an explanation for contemporary Indigenous health problems renders it imperative to refine the construct to enable more valid research.

The number of psychologists whose work crosses cultural boundaries is increasing. Without a critical awareness of their own cultural grounding, they risk imposing the assumptions, concepts, practices, and values of U.S.-centered psychology on societies where they do not fit, as a brief example from the 2004 Indian Ocean tsunami shows. Hermeneutic thinkers offer theoretical resources for gaining cultural awareness. Culture, in the hermeneutic view, is the constellation of meanings that constitutes a way of life. Such cultural meanings – especially in the form of folk psychologies and moral visions – inevitably shape every psychology, including U.S. psychology. The insights of hermeneutics, as well as its conceptual resources and research approaches, open the way for psychological knowledge and practice that are more culturally situated.

The American Indian historical trauma (HT) concept is an important precursor to racial trauma (RT) theory that reflects the distinct interests of sovereign Indigenous nations but shares much of the same promise and challenge. Here, that promise and challenge is explored by tracing HT’s theoretical development in terms of its anti-colonial ambitions and organizing ideas. Three predominant modes of engaging HT were distilled form the literature (HT as a clinical condition, life stressor, and critical discourse), each informing a research program pursuing a different anti-colonial ambition (healing trauma, promoting resilience, practicing survivance) organized by distinct ideas about colonization, wellness, and Indigeneity. Through critical reflection on these different ambitions and dialogue of their organizing ideas, conflict between research programs can be mitigated and a more productive anti-colonialism realized in psychology and related health fields. Key recommendations emphasized clarifying clinical concepts (e.g., clinical syndrome vs. idiom of distress), disentangling clinical narratives of individual pathology (e.g., trauma) from social narratives of population adversity (e.g., survivance stories), attending to features of settler-colonialism not easily captured by heath indices (e.g., structural violence), and encouraging alignment of anti-colonial efforts with constructive critiques establishing conceptual bridges to disciplines that can help to advance psychological understandings of colonization and Indigenous wellness (e.g., postcolonial studies). This conceptual framework was applied to the RT literature to elaborate similar recommendations for advancing RT theory and the interests of ethnic/racial minority populations through engagement with psychology and related health fields.

Multicultural professional psychologists routinely assert that psychotherapeutic interventions require culturally competent delivery for ethnoracial minority clients to protect the distinctive cultural orientations of these clients. Dominant disciplinary conceptualizations of cultural competence are "kind of person" models that emphasize specialized awareness, knowledge, and skills on the part of the practitioner. Even within psychology, this approach to cultural competence is controversial owing to professional misgivings concerning its culturally essentialist assumptions. Unfortunately, alternative "process-oriented" models of cultural competence emphasize such generic aspects of therapeutic interaction that they remain in danger of losing sight of culture altogether. Thus, for cultural competence to persist as a meaningful construct, an alternative approach that avoids both essentialism and generalism must be recovered. One means to capture this alternative is to shift focus away from culturally competent therapists toward culturally commensurate therapies. Indigenous communities in North America represent interesting sites for exploring this shift, owing to widespread political commitments to Aboriginal cultural reclamation in the context of postcoloniality. Two examples from indigenous communities illustrate a continuum of cultural commensurability that ranges from global psychotherapeutic approaches at one end to local healing traditions at the other. Location of culturally integrative efforts by indigenous communities along this continuum illustrates the possibility for local, agentic, and intentional deconstructions and reconstructions of mental health interventions in a culturally hybrid fashion.

Given the increasing proportion of ethnic minority individuals in the United States and psychology's historical reliance on theories derived from Euro American populations, it is important to monitor the status of cultural diversity research. We conducted a 10-year follow-up to Hall and Maramba's (2001) report of cross-cultural (CC) and ethnic minority (EM) publication trends. Comparing data from 1993-1999 and 2003-2009, we found that research on CC and EM issues continues to be underrepresented in the literature, particularly in top-tier journals. The American Psychological Association and Association for Psychological Science journals mirrored this discouraging trend, and the absence of top CC and EM authors on their editorial boards may point to a structural barrier to broader inclusion of cultural diversity research. We also found that fewer top CC and EM researchers are employed in psychology departments than one might hope, reflecting predominant attitudes within psychology of CC and EM research as peripheral to the larger field. Although clear that few gains have been made despite numerous awareness-raising efforts, the precise deficits were somewhat obscured, because the CC and EM terminology employed by Hall and Maramba (2001) did not fully capture the breadth of cultural diversity research currently underway in psychology. Thus, future attempts to assess the field would benefit from wider-reaching search terms. Additionally, we suggest that attention to reorganization within the evolving fields of cultural diversity research and to developing new categories of inquiry for research on cultural diversity that maintain focus on minority statuses in the United States may be productive routes forward for psychology as a discipline.