Representation of Diverse Populations in Couple and Family Therapy Intervention Studies: A Systematic Review of Race/Ethnicity, Sexual Orientation, Age, and Income in the United States from 2014 to 2019

Abstract

Disparities in mental health care among marginalized populations have been welldocumented. Without research designed to study interventions for diverse populations, disparities in the quality of services will persist. A systematic review of articles evaluating couple and family therapy (CFT) interventions was conducted to evaluate the representation of diverse populations. More specifically, researchers sought to examine race/ethnicity, sexual orientation, income level, and age of sample participants. One hundred ninety-six studies evaluating CFT interventions in the United States in ten journals were included in the analysis. Findings indicate that family therapy research is more representative of racial minority and low-income participants compared with studies of couple interventions. Couple therapy research is often still conducted with predominately white, middle-to high-income samples. Following whites, African Americans and Hispanic/Latinos were the most common racial/ethnic groups included in both couple therapy research and family therapy research. Participants in same-sex relationships were absent from family intervention research and under-researched in couple intervention studies. Only one couple therapy study recruited a sample in which the average age was late adulthood. These findings are cause for concern given the widening mental health disparities in the United States.

Reducing mental health disparities among racially and ethnically diverse populations: A review of couple and family intervention research methods (2010–2019)

“…Specific to representation, Sprenkle's (2012) review of CFT efficacy and effectiveness research from 2001 to 2011 revealed that inclusion of non-European American participants was most prevalent in the adolescent drug abuse literature, followed by the literature on conduct disorder, family psychoeducation for major mental illness, relationship education, and child/adolescent disorders. Tseng et al (2021) review of CFT interventions in 10 journals revealed nuances surrounding greater representation of racial and ethnic diversity in family therapy research compared to couple therapy research. In both areas, African American and Latinx groups were more frequently represented in studies than other racial and ethnic groups (Tseng et al, 2021).…”

“…Tseng et al (2021) review of CFT interventions in 10 journals revealed nuances surrounding greater representation of racial and ethnic diversity in family therapy research compared to couple therapy research. In both areas, African American and Latinx groups were more frequently represented in studies than other racial and ethnic groups (Tseng et al, 2021). Alongside evident progress, significant work remains to increase representation and improve upon critically conscious engagement and intervention strategies with racially and ethnically diverse couples and families.…”

Bringing behavioral observation of couples into the 21st century.

“…Both the sample and the human observational coders can be biased. The sample can be biased because a swath of the population (e.g., those from non-White racial/ethnic groups, sexual and gender minority couples, low-income couples, rural couples, and individuals in late adulthood) are generally underrepresented in couple research (e.g., Hartwell et al, 2017; Karney et al, 2004; Tseng et al, 2021; Williamson et al, 2022). With few minority couples in the training data, the algorithm may not have a sufficient sample of behavior in those couples, leading to less accurate behavior classifications for minority couples.…”

Couple therapy in the 2020s: Current status and emerging developments

“…The historical trend to focus on white middle class couples is reflected in studies of clients in couple therapy research(Tseng et al, 2021).…”