Relational-Cultural Theory and Social Work Interventions with Adolescent Girls: An Integrative Review

Background and Purpose:

Relational Cultural Theory (RCT) offers a feminist, relationally-centered approach to social work practice, with particular attention to the unique developmental experiences of girls, women, and individuals from diverse and traditionally underrepresented groups. Empathic relational connection—a central component of RCT—has been identified as a core protective factor in the well-being of adolescent girls exposed to trauma, and there is a need to synthesize research on interventions that promote relational health and empowerment in this population. This integrative literature review addresses the following research questions: 1) Across practice settings, how have the theoretical tenets of RCT been translated into direct practice interventions with adolescent girls? 2) To what extent have the experiences of adolescent girls from diverse and under-represented groups been represented in RCT intervention research?

Methods:

Five bibliographic databases were systematically searched for peer-reviewed articles through October 2023. Inclusion criteria for screening included the following: 1) peer-reviewed published articles with full-text accessible, 2) English language, 3) RCT used as guiding theoretical framework, 4) target population is girls spanning any phase of adolescence (ages 11 - 21 years), 5) implementation of an RCT-based intervention, and 6) attention to some developmental outcome(s) salient to girls’ well-being, such as self-esteem, prosocial skills, health risk behaviors, relationship skills, or mental health. Both authors independently screened and coded all articles, with a third doctoral-level researcher reconciling discrepancies. Data were analyzed using steps from the constant comparison method for integrative review analysis: data reduction, display, and comparison.

Results:

Systematic searching yielded 716 initial citations; 65 citations met criteria for full-text review, and 12 studies met inclusion criteria. Seven RCT-based interventions were implemented across studies, the majority of which were small-group interventions. Study samples included girls with a history of violence exposure, clinically significant emotional-behavioral difficulties, foster care experiences, and/or placement in juvenile detention. Analysis revealed four core RCT concepts that were linked with intervention components across all twelve studies: mutual empathy, authenticity, empowerment, and the overall strengthening of relational connections. Interventions and implementation strategies are discussed in detail. Over half of the included studies reported samples that were over 50% individuals from diverse and/or underrepresented racial/ethnic groups. Diversity on metrics of sexual or gender minority status, religious background, disability, or minoritized identities other than race/ethnicity were not addressed in any studies.

Conclusions and Implications:

Findings deepen our understanding of RCT as a gender-responsive and relationally-centered approach to therapeutic work with adolescent girls. Practitioners seeking to translate the principles of RCT into direct practice intervention may use this review as an inventory of core principles and associated intervention strategies, as well as a catalog of RCT interventions that have been piloted with this developmentally specific population. Findings also revealed several limitations in this body of RCT intervention research, including the need for enhanced methodological rigor and measurement of intervention effects and participant outcomes, expansion of research with diverse focal populations, and incorporation of modern research on interpersonal neurobiology, bias, and oppression.