This chapter offers practical utility to help expand rehabilitation counselors’ (RCs) and other mental health professionals’ thinking about the various considerations that underlie a culturally competent social justice approach to rehabilitation counseling practice. Rehabilitation counseling has demonstrated its commitment to the importance of cultural competency in improving the quality and availability of counseling and rehabilitation services to clients from traditionally under represented racial/ethnic groups. The chapter describes the multicultural and social justice counseling competencies (MSJCC), with particular attention directed to the social justice framework and how it may be used to assist in working toward equity in the context of changing demographics in American society. It then explains how individual and group racial, sexual identity, cultural, and identity development may impact the counseling process. The counseling literature recognizes LGBTQ individuals as inclusive under the umbrella of multicultural populations, as well as intersecting with other groups because of multiple identities.