Using a longitudinal mixed-methods research design, the present study examined the development of multicultural competence and skills among 14 doctoral-level clinical trainees across three cohort groups, through providing counseling and therapy to refugees within a multicultural psychotherapy practicum. The results show that trainees reported significant increases in all domains of the measures of multicultural counseling competencies and self-efficacy as they worked with refugee clients between pre- and post-practicum, with medium to large effect sizes. The results of the Multi-Level Model analysis of trainees' coded, post-session qualitative journals further revealed that the trainees' growth curve for developing multicultural counseling and therapy skills was characterized by a non-linear pattern. Finally, trainees' qualitative journal narratives additionally highlighted profound and nuanced cognitive, affective, behavioral, and interpersonal learning impacts and gains through this refugee-servicing practicum. Implications and recommendations for future multicultural counseling training and research are considered.