Towards Culturally Responsive Practices: A Scoping Review of Systemic Family Therapy Interventions in Africa

Background Systemic Family therapy is slowly gaining momentum across Africa, with a growing number of family therapy interventions being implemented to address mental, emotional, and relational health challenges. However, most widely used family therapy approaches were developed in the Global North, and to date, we know little about the extent to which these interventions are culturally adapted and for which target outcomes in African contexts. This paper reviewed and synthesized existing literature on family therapy interventions in Africa to identify target outcomes and gaps in cultural adaptation, to inform future directions for family therapy research and practice on the continent. Methods Our review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. We identified 761 studies from scholarly sources, published between 2014–2025. Results Among the 14 empirical studies included, the interventions reflected diverse systemic family therapy models including Behavioral Family Therapy, Multiple Family Groups, Tuko Pamoja (family-strengthening intervention), Multi-Couple Therapy, African Family Counseling, Transgenerational Family Therapy, Adlerian Family Therapy, Structural Family Therapy, Emotionally Focused Therapy, and Rational Emotive Family Health Therapy. Cultural adaptations included integration of traditional storytelling, religious leadership involvement, and respect for hierarchical family norms. Across studies, we noticed an absence of clarity on systematic, theory-driven cultural adaptation processes. Conclusion Findings from this review advance the field by providing insights into the importance of conducting thorough cultural adaptations of family interventions before implementation in African settings as a foundation for advancing culturally relevant family therapy practices in African settings.