In this systematic review, we synthesized the quantitative and qualitative research examining the role of evidence-based relationship variables (EBRVs) in the treatment of affectional and gender minority (AGM) individuals. A comprehensive search of PsycINFO, Web of Science, and PubMed from 2009 to 2019 yielded 14 unique studies (15 articles in total). Most studies examined the role of empathy and alliance. Positive regard, strong therapeutic alliances, genuineness, and empathy were all associated with improvements in treatment engagement and treatment outcome. There appeared to be no evidence that matching clients on sexual or gender identities improved outcomes. There were methodological concerns in the literature in regard to the use of hypothetical scenarios and variability in study design and measures. In sum, more research is needed to explore how EBRVs may be a necessary component of AGM affirmative care.
Clinical Impact StatementThe results of this systematic review indicate that the role of evidence-based relationship variables in working with affectional and gender minorities is an understudied, but clinically necessary, topic. The extant literature suggests that empathy, alliance, genuineness, and positive regard play an integral role in fostering a collaborative therapeutic environment.
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