This document supports the APA’s goal of addressing structural racism in clinical practice by linking existing literature on the impact of race on patients’ lives with race as experienced in the clinical encounter. It provides psychiatrists with the necessary tools to speak with patients about race in a sensitive and professional manner using clinical vignettes. Incorporating these tools should increase understanding of how race and racism impact patients’ lives, decrease bias and enhance the therapeutic relationship. This document also encourages readers to seek to understand patients’ cultural and linguistic backgrounds as the beginning of any conversation about race, racism and discrimination. The authors believe this is the bedrock of culturally competent care, whether with a French speaking African immigrant, a Spanish speaking Latinx, or a Black teenager raised in the American South now living in the Northeast, as reflected in the included vignettes. The authors also acknowledge that racial groups are not homogeneous and that the focus on culture and language is intended to help psychiatrists focus on the unique aspects of an individual’s experiences in addition to talking about racial discrimination and bias.