In the second chapter, structures are used to describe how laws, policies, and their institutional implementation impact the lives of Black Americans and how this impact influences the cognitive-behavioral therapy (CBT) process. However, the most suitable definition of structural racism includes the different methods by which larger social systems collectively create and sustain racially biased legislation, belief systems, and behaviors that detrimentally impact marginalized racial groups. Structural and systemic racism are used interchangeably; however, it is acknowledged that differences between these terms have been articulated. Bronfenbrenner’s ecological systems theory was used to explain how Black individuals who receive CBT interact with several larger social networks, including but not limited to their families and communities. The chapter concludes with descriptions of how CBT can be used to address the psychosocial sequalae that catalyze or exacerbate Black American mental illness.