Within the context of the RESPPECTUS principles and the structurally informed cognitive-behavioral case conceptualization, the present chapter focuses on the use of cognitive restructuring and behavioral interventions with Black Americans. A substantive discussion of cognitive restructuring interventions with Black Americans must address those factors which influence both the cognitive model and collaborative empiricism. The chapter begins by comparing an objective Black reality to a socially constructed Black reality and describing the implications for cognitive restructuring with Black Americans. Factors which may impact therapeutic rapport are considered from both the cognitive-behavioral therapist’s and Black clients’ perspectives. The cognitive model, cognitive restructuring, and behavioral interventions with Black American clients are discussed. The case of Rodgerick is used to further exemplify the use of cognitive-behavioral interventions in congruence with the RESPPECTUS principles.