Do identity-focused treatments improve mental health outcomes? A critical examination of assumptions and evidence in diversity-oriented psychotherapy research.

Controversy exists over the use of standard evidence-based mental health treatments for diverse populations. In particular, there is some skepticism regarding their efficacy, as well as concerns over their potential harms, for clients from non-majority groups and in those who experience identity-related stressors and discrimination. Because of the perceived inadequacy of standard treatments, identity-focused therapies (IFTs) have been developed for diverse populations, including cultural adaptations of existing therapies and treatments focused on identity-related stressors in sexual, gender, and racial minorities. We review the literature related to the necessity and benefits of IFTs. We conclude that standard evidence-based treatments appear to not be less effective in minority samples compared to those in majority groups. Further, despite claims to the contrary, there is little evidence to indicate that IFTs enhance therapy outcomes. We also discuss as yet unexamined potential harms of IFTs, and note a number of gaps in the literature. Overall, the findings of this review have implications for research, training, and psychotherapy in diverse populations.