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Cultural Threads: An Afrocentric Paradigm for Integrating Social Justice Principles in the Practice of Family Therapy in Africa

PMCID: PMC12619664

PMID: 41240375

Abstract

ABSTRACT Family therapy has been slowly but steadily growing on the African continent. Considering Africa's rich yet complex economic, political, and sociocultural history, it is essential for family therapy practitioners to integrate social justice (SJ) principles into their research, training, and practice of family therapy. By doing so, we can help foster more inclusive, culturally responsive, and meaningful support for the historically underrepresented communities of African descent. More importantly, we recommend that addressing SJ issues in the practice of family therapy in Africa be rooted in Afrocentric frameworks of care and practice. Drawing on existing literature, we introduce the African‐Centered Wellness Model as a foundational framework for advancing socially just family therapy with African families. To demonstrate how the framework translates into clinical practice, two authors present case vignettes from their clinical work. A discussion of implications for integrating the principles of the model into research, training, and practice follows.

Full Text

The practice of systemic family therapy is rooted in the understanding that mental, emotional, and psychological well‐being cannot be separated from the relational, sociocultural, and political contexts in which individuals and families exist. Recent family therapy literature has underscored the critical importance of integrating social justice (SJ) principles into practice, arguing that overlapping identities (e.g., religion, social class, gender, sexual orientation, and others) can create varying experiences of marginalization and privilege (AAMFT 2023; Cutts 2013; Morrison et al. 2022). Within the family therapy field, it is broadly understood that taking an SJ perspective is essential for ensuring that available care and services meet and address the needs of clients, particularly those from culturally diverse backgrounds (Almeida and Tubbs 2020).
In Africa, where historical legacies and contemporary structures continue to shape family dynamics and mental health experiences, a socially just approach to family therapy is not only beneficial but also essential (Lombard and Twikirize 2014; Pillay 2020). Our main argument in this article is that engaging in ongoing discourse regarding SJ issues is vital for the growing profession of systemic family therapy across the continent. Without this lens, existing family therapy models risk ignoring and maybe misrepresenting the critical and nuanced sociopolitical and cultural forces that impact African families both on the continent and in the diaspora. Furthermore, unlike previous literature from Africa, which has addressed SJ largely within the fields of social work, school psychology, and clinical psychology (Ahmed and Pillay 2004; Pillay 2019), this article brings a much‐needed focus to family therapy, a field that is growing at a faster rate across Africa (Asiimwe et al. 2021).
A crucial component of this article is our proposed African‐Centered Wellness Model (ACWM) (Garrett‐Akinsanya 1998), which serves as the foundation for shaping our argument as well guiding the discussion set forth in the subsequent pages of this article. By proposing an Afrocentric framework rooted in resonant Afrocentric cultural values, spiritual traditions, and communal resilience, we aim to address the longstanding absence of African indigenous perspectives in mainstream family therapy practice (Nwoye 2015). We believe that failure to meaningfully integrate African‐centered paradigms into family therapy risks perpetuating cultural disconnection and clinical irrelevance. Furthermore, we integrate with our own clinical experiences and existing literature, to highlight how contemporary mental and relational health issues of most African individuals and families are shaped by SJ issues related to but not limited to, colonial legacies, war and organized violence, economic disparities, and gender‐based inequalities, and others. Thus, the purposes of this article are twofold: (1) to identify and discuss key SJ issues affecting families in Africa using existing literature and (2) to offer and discuss the utility of an actionable, Afrocentric model in therapeutic practice with families in both mainland Africa and African families in the diaspora.
As authors, we approach the discussion on SJ issues in Africa with an acknowledgment of the continent's immense cultural and linguistic diversity (54 countries, over 1000 ethnic groups) while also recognizing shared commonalities in values, beliefs, and practices across
African countries, particularly those in the sub‐Saharan region. Therefore, we caution against imposing external viewpoints or universalizing assumptions that may not align with African contexts, as the perspectives we share in this paper are informed by existing literature and anecdotal data from our own clinical work. The article sets forth by first acknowledging the historical undermining of local knowledge systems during colonialism and the continued challenge of integrating indigenous ways of knowing in contemporary family therapy practices. By centering African perspectives in family therapy discourse, we aim to challenge colonial legacies and promote culturally relevant and contextually appropriate mental health practices. Throughout the process of writing this article, we reflected on whether SJ issues in African societies mirror those in Western societies or have distinct historical and cultural roots shaped by the unique contexts of each region. We also wondered whether these issues were human rights concerns or shaped by a Western lens, which we acknowledge we have been exposed to, to larger extent. These curiosities coupled with our unique cultural intersectional lived and clinical experiences as family therapy scholars of African descent guided our exploration of the current literature that shaped this study.
SJ is such a multifaceted concept, often difficult to define comprehensively, yet most scholars agree on five core principles of SJ: access (equal availability of resources), equity (fair opportunities despite historical injustices), diversity (inclusive representation in positions of power), participation (community involvement in decision‐making), and human rights (protection of individual freedoms and dignity) (Cutts 2013). From a systems theory perspective, these principles reflect how individual, familial, and community challenges are deeply interconnected with and are influenced by larger societal structures (Gómez‐Carrillo and Kirmayer 2023).
Within the African context, mental health and relational issues cannot be separated from historical and systemic influences. For example, the history of colonialism, socioeconomic disparities, wars and organized violence, and the imposition of Western ideologies and religion have shaped current mental health problems across many African communities (Asiimwe et al. 2021). These systems of inequality, rooted in colonial and postcolonial histories, continue to influence the present‐day struggles, such as access to health care, education, and economic opportunities of many African families and communities both on the continent and in the diaspora. The psychological distress arising from these injustices manifests in family systems, where mental health issues, such as trauma, grief, and dysfunction, often reflect larger societal struggles.
In line with Winter and Hanley (2015), SJ in therapy should therefore not remain an abstract notion but be actively translated into practice. In this context, the framework we present, the ACWM, provides a culturally responsive approach for doing so, specifically by emphasizing the importance of cultural resonance in health and wellness. By centering African worldviews, traditions, and values, the model acknowledges the vital role these cultural elements play in shaping individual and collective mental and relational health. Thus, it is essential to situate this discussion within a broader systemic context to understand how deeply interwoven these issues are across the personal, familial, and societal levels.
Africa is one of the most culturally diverse continents on the planet, with over 1.4 billion people, represented by many ethnic groups and languages (World Bank 2024). This immense diversity shapes Africa's social, economic, and political systems, which in turn influence cultural traditions, values, and interpersonal relationships across its 54 countries. Broadly, Africa can be conceptualized in four large blocks which include, Anglophone Africa (referring to countries like Uganda, Kenya, South Africa, Nigeria, Ghana, Zimbabwe, Zambia, and others that were colonized by Britain), Francophone Africa (referring to countries colonized by France and Belgium, such as Ivory Coast, Rwanda, Burkina Faso, Togo, Senegal, and others), Portuguese Africa (e.g., Mozambique, Angola, and Madagascar), and Arab Africa (e.g., Algeria, Egypt, Tunisia, Morocco, Libya, Sudan, etc.). Other blocks of Africa include countries such as Eritrea, Somalia, and Ethiopia (that were not directly colonized by foreign powers) and Liberia, which was part of the American Colonization Society Project (Scruggs 2010).
Even within each African country, there is significant immense cultural, linguistic, and ethnic diversity. In Uganda, for example, the Baganda speak Luganda and maintain a centralized monarchy through the Buganda Kingdom, while the Basoga and Acholi speak different languages and follow distinct cultural traditions. Similarly, Kenya, with a population exceeding 50 million, has over 40 ethnic groups. The Kikuyu, part of the Bantu group, are predominantly farmers, while the Maasai, from the Nilotic group, are pastoralists. Kenya has made strides toward SJ through the 2010 Constitution, which laid the foundation for promoting human rights and equality (The Constitution of Kenya 2010). Despite this progress, challenges such as poverty, gender‐based violence, youth unemployment, and corruption persist. Institutions like the Kenya National Commission on Human Rights (Kenya National Commission on Human Rights 2021) and civil society groups are instrumental in advocating for marginalized communities. Nigeria is another example of African countries exemplifying deep ethnic diversity. For example, the Hausa people of northern Nigeria follow Islamic customs, the Yoruba in the southwest blend Christianity with traditional practices, while the Igbo in the southeast maintain unique cultural beliefs rooted in African spirituality. Green (2013) attributes Africa's diversity to historical influences like geography, colonialism, the slave trade, and urbanization, which reinforced ethnic divisions across the continent.
In the postcolonial era, issues such as urbanization and migration have redefined Africa's ethnic diversity. Despite colonial influences, many Africans have preserved their languages and traditions. Present‐day Africans are multilingual and tend to speak their native languages alongside colonial languages, like, English, Portuguese, or French (Asiimwe et al. 2021). Today, Africa remains a mosaic of cultures, even within single nations, while at the same time maintaining the Ubuntu (a shared sense of humanity, harmony, and interconnectedness; Nussbaum 2003). This analysis highlights the resilience and adaptability of African identities in preserving their rich heritage amid globalization and modernization. The examples presented demonstrate that even within a single African nation, the diversity of languages, traditions, and cultural practices can be profound. As observed above, cultural disparities impact SJ issues since historically, traditional norms have tended to create inequities in political participation, health care, and education. To promote diversity and equity, we must find a balance between protecting cultural heritage while at the same time furthering socioeconomic development and human rights.
Historically, Western scientific ideals which have dominated psychotherapy practice in most of Africa have been criticized for being elitist, Eurocentric, and disconnected from local realities (Leopeng 2019; Vorhölter 2024). Some scholars have argued that for family therapy to gain legitimacy with African people, it must integrate the cultural, spiritual, and sociopolitical narratives of African families and communities (Bakker and Snyders 1999). Today, Africa faces numerous SJ challenges, to mention a few such as poor health systems, gender inequality, and discrimination against sexual and gender minorities (SGMs), while also simultaneously possessing vast economic potential. With a population of approximately 1.4 billion and a median age of 19, the continent's youth are driving economic growth and transformation (UNDP 2020; World Bank 2021).
Indeed, Africa's immense cultural diversity and the increasing participation of African practitioners in the training, research, and practice of family therapy underscore the increased need for an Afrocentric perspective on SJ. Contemporary African family therapy scholars like Augustine Nwoye (2018) have highlighted the potential for family therapy to foster social change and resilience among Africans by emphasizing indigenous healing practices and integrating African worldviews into therapeutic models to address psychosocial challenges in ways that are both contextually relevant and empowering. This would enable practitioners to empower families toward change while challenging systemic injustices, at the same time. Failure to do so risks silencing African social values (e.g., communism and relational harmony) and lived experiences, thereby continuing to render indigenous knowledge invisible (Almeida et al. 2017). Moreover, it perpetuates colonial‐era assumptions of Western superiority and limits the growth of indigenous frameworks, which can lead to poorly prepared, socially unconscious therapists and ineffective practices (Zimmerman and Haddock 2013). Furthermore, without culturally resonant frameworks, clinical practice may alienate African communities and hinder cross‐cultural research and collaboration. To address these issues, we now introduce an ACWM as a framework through which we can advance the SJ agenda within family therapy in Africa.
The ACWM is a culturally grounded, systemic framework designed for working with individuals of African descent. Developed by Garrett‐Akinsanya (1998), this framework emphasizes the holistic integration of body, mind, and spirit within a communal and ecological context. Additionally, the model recognizes the influence of cultural heritage, ethnic identity, and spirituality on well‐being (Grills et al. 2018; Myers 1991; Nobles 1992). Rooted in Afrocentric psychology, the model's main aim is to promote psychotherapy practices that affirm and integrate the clients' traditions, beliefs, and values (Grills et al. 2018). Although this model has been widely applied across African communities on the continent and in those in the diaspora, its potential for addressing SJ issues in family therapy remains underexplored in published literature. Given Africa's complex multicultural landscape, which is shaped by historical as well as ongoing, sociocultural, and political influences, the model offers a culturally resonant framework for family therapists to address mental and relational health challenges through the lens of cultural wisdom and contextual understanding. This model is established on the Nguzo Saba (seven principles of ancient African wisdom) (Karenga 1988), and outlines eight interconnected dimensions of wellness, using Swahili terminology to integrate cultural values and enhance relevance for Africans globally (Figure 1).
The African‐centered wellness model (Garrett‐Akinsanya 1998).
Arguably, the most pressing SJ issue in African contexts is access to quality mental and relational health care. Systematic reviews by Essien and Asamoah (2020) and Aguwa et al. (2023) highlight several barriers to care, including stigma, inadequate infrastructure, and a shortage of trained professionals. Particularly in many rural areas of Africa, individuals often rely on established traditional structures of care, which often include, consultations with respected elders, traditional healers and local herbalists, religious figures, and others, before seeking the help of a mental health professional. While these structures of care have been relied upon for many years, they tend to delay care and can at times, compound the client's symptoms. Even among wealthier families, religious leaders are often the first line of consultation in cases of relational distress, which underscores the cultural salience of religion in Africa. We thus argue that family therapists (and truthfully all mental health professionals) across the continent, and those working with African populations globally, must advocate for policies that ensure culturally relevant, affordable, and accessible services. Drawing on Nwoye's (2018) concept of therapists as agents of social change, the ACWM provides a framework for therapists to support efforts toward equity in mental health care. Clinicians are encouraged to move beyond treating isolated symptoms and instead consider broader systemic influences, such as historical trauma, structural inequality, and cultural dislocation. Therapists must also engage in advocacy work to help shape mental health policies that bridge traditional healing and modern therapeutic care, such as family therapy, which is still a new kid on the block in many African settings (Asiimwe et al. 2021). This approach will ensure that no individual or family is left behind or untreated.
Furthermore, given the widespread impact of conflict, war, and colonial legacies in Africa, trauma‐informed care must also be culturally grounded. Armed conflict, political instability, and displacement have had devastating psychosocial impacts across the continent. Many families face unprocessed trauma, with limited access to trauma‐informed and relationally oriented care. While trauma‐focused interventions like Narrative Exposure Therapy and Eye Movement Desensitization and Reprocessing have been effective in some contexts (Koebach et al. 2021), they largely focus on treating individual symptoms, neglecting relational and communal healing. The ACWM emphasizes relational well‐being and the interconnectedness of individuals, families, ancestors, and spiritual systems. We encourage therapists to consider how trauma reverberates through family systems, not just individuals, and to include traditional beliefs and communal practices in their interventions. Culturally attuned trauma care emphasizes collective healing, spiritual wellness, and relational restoration can more effectively support families in postconflict or high‐adversity settings. As such, there is a need for equipping mental health providers in African settings with skills to offer relational trauma therapy that reflects the communal healing frameworks central to African contexts.
As cultural adaptation becomes a global priority in mental health practice, therapist training must be reoriented to include culturally responsive frameworks (Knudson‐Martin et al. 2019; Seponski et al. 2013). Given the African cultural diversity discussed earlier, the growing practice of family therapy among African communities must reflect the diverse cultural beliefs, family systems, and community values of the continent. This is especially critical given that historically, and even today, many current mental health interventions in Africa are based on predominantly individualistic Western models of psychotherapy, which tends to neglect African relational norms or community structures (Bakker and Snyders 1999; Asiimwe et al. 2021). Importantly, models emerging from historically underrepresented contexts, such as the proposed ACWM, can play a vital role in training culturally competent clinicians, especially those from Africa or those intending to work with African clients. This approach is useful for preparing therapists to deliver interventions that reflect the lived realities and cultural strengths of African families while at the same time addressing contemporary SJ challenges.
With much of the African population under 18 (United Nations 2022), youth mental health must be prioritized. Jörns‐Presentati et al. (2021) conducted a systematic review of 37 studies, in which they reported high prevalence rates of depression (26.9%), anxiety (29.8%), behavioral problems (40.8%), posttraumatic stress disorder (PTSD) (21.5%), and suicidal ideation (20.8%) among sub‐Saharan adolescents. These rates surpass those found in many high‐income regions, yet mental health infrastructure in most of Africa remains severely underdeveloped. The literature shows that untreated mental health problems among youth lead to academic challenges, substance abuse problems, and social withdrawal, which impact not only the individual but also the family unit as well (Jörns‐Presentati et al. 2021). Given the appalling statistics above, addressing the mental health challenges of African youth requires culturally adapted family therapy interventions that integrate African ideas and values. Thus, we encourage therapists to find ways to integrate principles from the proposed model to foster safe, culturally affirming environments for youth at risk of various mental health challenges. By leveraging African principles like respect for elders, communal connections, and interdependence, therapists can help families build protective relational networks that support the mental, emotional, and relational well‐being of the young people of Africa.
Child marriage is another issue with deep relational and developmental implications for families and communities in Africa. Research by Yaya et al. (2019) reported that child marriage affected 54% of girls across 34 sub‐Saharan African countries, with rates as high as 81.7% in countries like Niger. Early marriage is associated with increased fertility, terminated pregnancies, early childbirth, and diminished opportunities for economic advancement. It also undermines girls' educational and economic potential as well as exposes girls to power imbalances in intimate relationships and intimate partner violence. Family therapists working through the African‐Centered Wellness lens can engage families and communities to shift and gently challenge (like in the third case with the Ugandan family) norms and beliefs and prevent early marriages. Rather than only highlighting the harm, such as lost educational opportunities, relational distress, and low self‐esteem, therapists can frame prevention within cultural narratives of faith, protection, care, and collective responsibility. Through collaborating with parents and elders, practitioners can promote wellness and empowerment without dismissing local values. This approach has the potential to foster mutual learning, healing, and transformation for families and communities.
It is our belief that gender inequality and power imbalances in African societies require a culturally sensitive, non‐polarizing approach. In most of Africa, gender disparities manifest in unequal access to education, employment, and health care, while economic instability exacerbates relational stress, domestic violence, and child neglect (Karoui and Feki 2018). While we acknowledge that certain patriarchal norms can be harmful, they also function within cultural systems that provide structure and meaning for many families and communities. Rather than adopting an adversarial stance, we encourage therapists to apply cultural humility and practical wisdom, key principles in the ACWM, to open dialog and foster inclusivity. This “Both/And” perspective respects multiple truths and could avoid the potential harmful consequences of unintentional alienating one gender over the other. By positioning family therapists as facilitators of safe, reflective conversations, this approach could help families transform without fracturing.
Discrimination against SGMs remains a persistent violation of human rights across many African countries. For example, homosexuality is criminalized in 33 out of 55 African countries (Mugisha 2024), and this social stigma continues to marginalize LGBTQ+ individuals, further exacerbating mental and relational health challenges among individuals that belong to these communities. Studies show that SGMs face high rates of psychological distress, PTSD, and depression due to systemic discrimination and violence (Müller and Daskilewicz 2018; Pulerwitz et al. 2024). In Kenya, one study found that over half of 527 surveyed SGMs reported PTSD symptoms, and 26.1% experienced depression (Harper et al. 2021). These alarming statistics highlight that working with SGMs in Africa demands a balance of courage, cultural knowledge, and clinical ethics. Given the legal and societal discrimination SGMs face in many African countries, open advocacy may not always be feasible, and in worst cases could lead one to harsh legal consequences. However, (CFTs) couple and family therapys can create affirming therapeutic spaces that offer validation, safety, and support for SGM clients by intentionally applying the principles of the ACWM, especially the Kujichagulia (self‐determination) dimension, which emphasizes naming, defining, and advocating for one's community, while at the same time, actively resisting oppression. For example, therapists could gently challenge harmful societal narratives against SGM clients within the therapeutic process, promote community dialog, and affirm ideas of shared humanity (i.e., Ubuntu) and Umoja (Unity). The therapist's role as a culturally grounded bridge‐builder becomes essential in transforming stigma into empathy, even in highly conservative and discriminatory contexts.
As family therapy gains traction in Africa, CFT education and training in Africa must evolve and be rooted in the continent's cultural and sociopolitical realities. While the emergence of CFT graduate programs, especially in Kenya, signals progress, these programs must intentionally prepare therapists to address systemic inequalities through SJ‐oriented curricula. We agree with Zimmerman and Haddock (2013), that therapists must be equipped to challenge ingrained biases shaped by colonialism, patriarchy, and homophobia. Thus, programs must emphasize cultural competence, antioppressive frameworks, and Afrocentric paradigms such as the proposed ACWM to challenge the status quo. Curriculum redesign should prioritize African epistemologies, experiential learning in diverse settings, and critical engagement with global literature. As Wampler and Patterson (2020) note, systemic therapy provides tools for contextual thinking, but without culturally and contextually attuned training, therapists risk replicating oppressive structures. Relational and systemic approaches, when culturally grounded, are ideally suited to support African families navigating sociopolitical and historical adversity. Integrating Afrocentric paradigms, such as the ACWM, could further strengthen training, bridge generational divides, and foster resilience.
Research is equally vital in all these endeavors. As Pillay (2020) notes, advancing SJ requires building a culturally relevant evidence base. The ACWM offers a foundation for exploring culturally grounded, strength‐based interventions. However, no empirical evidence currently supports the model's usefulness in examining the mental and relational health and well‐being of African families and communities. To advance the science, African CFT researchers must investigate the model's practical and empirical applications, develop locally grounded approaches, and document traditional practices already addressing family mental health.

Sections

"[{\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0001\", \"jmft70091-bib-0007\", \"jmft70091-bib-0019\", \"jmft70091-bib-0004\"], \"section\": \"\", \"text\": \"The practice of systemic family therapy is rooted in the understanding that mental, emotional, and psychological well\\u2010being cannot be separated from the relational, sociocultural, and political contexts in which individuals and families exist. Recent family therapy literature has underscored the critical importance of integrating social justice (SJ) principles into practice, arguing that overlapping identities (e.g., religion, social class, gender, sexual orientation, and others) can create varying experiences of marginalization and privilege (AAMFT\\u00a02023; Cutts\\u00a02013; Morrison et al.\\u00a02022). Within the family therapy field, it is broadly understood that taking an SJ perspective is essential for ensuring that available care and services meet and address the needs of clients, particularly those from culturally diverse backgrounds (Almeida and Tubbs\\u00a02020).\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0017\", \"jmft70091-bib-0028\", \"jmft70091-bib-0051\", \"jmft70091-bib-0005\"], \"section\": \"\", \"text\": \"In Africa, where historical legacies and contemporary structures continue to shape family dynamics and mental health experiences, a socially just approach to family therapy is not only beneficial but also essential (Lombard and Twikirize\\u00a02014; Pillay\\u00a02020). Our main argument in this article is that engaging in ongoing discourse regarding SJ issues is vital for the growing profession of systemic family therapy across the continent. Without this lens, existing family therapy models risk ignoring and maybe misrepresenting the critical and nuanced sociopolitical and cultural forces that impact African families both on the continent and in the diaspora. Furthermore, unlike previous literature from Africa, which has addressed SJ largely within the fields of social work, school psychology, and clinical psychology (Ahmed and Pillay\\u00a02004; Pillay 2019), this article brings a much\\u2010needed focus to family therapy, a field that is growing at a faster rate across Africa (Asiimwe et al.\\u00a02021).\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0008\", \"jmft70091-bib-0026\"], \"section\": \"\", \"text\": \"A crucial component of this article is our proposed African\\u2010Centered Wellness Model (ACWM) (Garrett\\u2010Akinsanya\\u00a01998), which serves as the foundation for shaping our argument as well guiding the discussion set forth in the subsequent pages of this article. By proposing an Afrocentric framework rooted in resonant Afrocentric cultural values, spiritual traditions, and communal resilience, we aim to address the longstanding absence of African indigenous perspectives in mainstream family therapy practice (Nwoye\\u00a02015). We believe that failure to meaningfully integrate African\\u2010centered paradigms into family therapy risks perpetuating cultural disconnection and clinical irrelevance. Furthermore, we integrate with our own clinical experiences and existing literature, to highlight how contemporary mental and relational health issues of most African individuals and families are shaped by SJ issues related to but not limited to, colonial legacies, war and organized violence, economic disparities, and gender\\u2010based inequalities, and others. Thus, the purposes of this article are twofold: (1) to identify and discuss key SJ issues affecting families in Africa using existing literature and (2) to offer and discuss the utility of an actionable, Afrocentric model in therapeutic practice with families in both mainland Africa and African families in the diaspora.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-note-0001\"], \"section\": \"\", \"text\": \"As authors, we approach the discussion on SJ issues in Africa with an acknowledgment of the continent's immense cultural and linguistic diversity (54 countries, over 1000 ethnic groups) while also recognizing shared commonalities in values, beliefs, and practices across\\n African countries, particularly those in the sub\\u2010Saharan region. Therefore, we caution against imposing external viewpoints or universalizing assumptions that may not align with African contexts, as the perspectives we share in this paper are informed by existing literature and anecdotal data from our own clinical work. The article sets forth by first acknowledging the historical undermining of local knowledge systems during colonialism and the continued challenge of integrating indigenous ways of knowing in contemporary family therapy practices. By centering African perspectives in family therapy discourse, we aim to challenge colonial legacies and promote culturally relevant and contextually appropriate mental health practices. Throughout the process of writing this article, we reflected on whether SJ issues in African societies mirror those in Western societies or have distinct historical and cultural roots shaped by the unique contexts of each region. We also wondered whether these issues were human rights concerns or shaped by a Western lens, which we acknowledge we have been exposed to, to larger extent. These curiosities coupled with our unique cultural intersectional lived and clinical experiences as family therapy scholars of African descent guided our exploration of the current literature that shaped this study.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0007\", \"jmft70091-bib-0053\"], \"section\": \"Conceptualizing SJ in Africa: A Systems Theory Perspective\", \"text\": \"SJ is such a multifaceted concept, often difficult to define comprehensively, yet most scholars agree on five core principles of SJ: access (equal availability of resources), equity (fair opportunities despite historical injustices), diversity (inclusive representation in positions of power), participation (community involvement in decision\\u2010making), and human rights (protection of individual freedoms and dignity) (Cutts\\u00a02013). From a systems theory perspective, these principles reflect how individual, familial, and community challenges are deeply interconnected with and are influenced by larger societal structures (G\\u00f3mez\\u2010Carrillo and Kirmayer\\u00a02023).\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0005\"], \"section\": \"Conceptualizing SJ in Africa: A Systems Theory Perspective\", \"text\": \"Within the African context, mental health and relational issues cannot be separated from historical and systemic influences. For example, the history of colonialism, socioeconomic disparities, wars and organized violence, and the imposition of Western ideologies and religion have shaped current mental health problems across many African communities (Asiimwe et al.\\u00a02021). These systems of inequality, rooted in colonial and postcolonial histories, continue to influence the present\\u2010day struggles, such as access to health care, education, and economic opportunities of many African families and communities both on the continent and in the diaspora. The psychological distress arising from these injustices manifests in family systems, where mental health issues, such as trauma, grief, and dysfunction, often reflect larger societal struggles.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0036\"], \"section\": \"Conceptualizing SJ in Africa: A Systems Theory Perspective\", \"text\": \"In line with Winter and Hanley (2015), SJ in therapy should therefore not remain an abstract notion but be actively translated into practice. In this context, the framework we present, the ACWM, provides a culturally responsive approach for doing so, specifically by emphasizing the importance of cultural resonance in health and wellness. By centering African worldviews, traditions, and values, the model acknowledges the vital role these cultural elements play in shaping individual and collective mental and relational health. Thus, it is essential to situate this discussion within a broader systemic context to understand how deeply interwoven these issues are across the personal, familial, and societal levels.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0038\", \"jmft70091-bib-0030\"], \"section\": \"Contextualizing and Exploring African Diversity\", \"text\": \"Africa is one of the most culturally diverse continents on the planet, with over 1.4 billion people, represented by many ethnic groups and languages (World Bank\\u00a02024). This immense diversity shapes Africa's social, economic, and political systems, which in turn influence cultural traditions, values, and interpersonal relationships across its 54 countries. Broadly, Africa can be conceptualized in four large blocks which include, Anglophone Africa (referring to countries like Uganda, Kenya, South Africa, Nigeria, Ghana, Zimbabwe, Zambia, and others that were colonized by Britain), Francophone Africa (referring to countries colonized by France and Belgium, such as Ivory Coast, Rwanda, Burkina Faso, Togo, Senegal, and others), Portuguese Africa (e.g., Mozambique, Angola, and Madagascar), and Arab Africa (e.g., Algeria, Egypt, Tunisia, Morocco, Libya, Sudan, etc.). Other blocks of Africa include countries such as Eritrea, Somalia, and Ethiopia (that were not directly colonized by foreign powers) and Liberia, which was part of the American Colonization Society Project (Scruggs\\u00a02010).\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0056\", \"jmft70091-bib-0014\", \"jmft70091-bib-0009\"], \"section\": \"Contextualizing and Exploring African Diversity\", \"text\": \"Even within each African country, there is significant immense cultural, linguistic, and ethnic diversity. In Uganda, for example, the Baganda speak Luganda and maintain a centralized monarchy through the Buganda Kingdom, while the Basoga and Acholi speak different languages and follow distinct cultural traditions. Similarly, Kenya, with a population exceeding 50 million, has over 40 ethnic groups. The Kikuyu, part of the Bantu group, are predominantly farmers, while the Maasai, from the Nilotic group, are pastoralists. Kenya has made strides toward SJ through the 2010 Constitution, which laid the foundation for promoting human rights and equality (The Constitution of Kenya\\u00a02010). Despite this progress, challenges such as poverty, gender\\u2010based violence, youth unemployment, and corruption persist. Institutions like the Kenya National Commission on Human Rights (Kenya National Commission on Human Rights\\u00a02021) and civil society groups are instrumental in advocating for marginalized communities. Nigeria is another example of African countries exemplifying deep ethnic diversity. For example, the Hausa people of northern Nigeria follow Islamic customs, the Yoruba in the southwest blend Christianity with traditional practices, while the Igbo in the southeast maintain unique cultural beliefs rooted in African spirituality. Green (2013) attributes Africa's diversity to historical influences like geography, colonialism, the slave trade, and urbanization, which reinforced ethnic divisions across the continent.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0005\", \"jmft70091-bib-0025\"], \"section\": \"Contextualizing and Exploring African Diversity\", \"text\": \"In the postcolonial era, issues such as urbanization and migration have redefined Africa's ethnic diversity. Despite colonial influences, many Africans have preserved their languages and traditions. Present\\u2010day Africans are multilingual and tend to speak their native languages alongside colonial languages, like, English, Portuguese, or French (Asiimwe et al.\\u00a02021). Today, Africa remains a mosaic of cultures, even within single nations, while at the same time maintaining the Ubuntu (a shared sense of humanity, harmony, and interconnectedness; Nussbaum\\u00a02003). This analysis highlights the resilience and adaptability of African identities in preserving their rich heritage amid globalization and modernization. The examples presented demonstrate that even within a single African nation, the diversity of languages, traditions, and cultural practices can be profound. As observed above, cultural disparities impact SJ issues since historically, traditional norms have tended to create inequities in political participation, health care, and education. To promote diversity and equity, we must find a balance between protecting cultural heritage while at the same time furthering socioeconomic development and human rights.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0055\", \"jmft70091-bib-0057\", \"jmft70091-bib-0006\", \"jmft70091-bib-0032\", \"jmft70091-bib-0037\"], \"section\": \"The Rationale for Integrating Afrocentric Perspectives in Conceptualizing SJ as It Relates to Couple and Family Therapy in Africa\", \"text\": \"Historically, Western scientific ideals which have dominated psychotherapy practice in most of Africa have been criticized for being elitist, Eurocentric, and disconnected from local realities (Leopeng\\u00a02019; Vorh\\u00f6lter\\u00a02024). Some scholars have argued that for family therapy to gain legitimacy with African people, it must integrate the cultural, spiritual, and sociopolitical narratives of African families and communities (Bakker and Snyders\\u00a01999). Today, Africa faces numerous SJ challenges, to mention a few such as poor health systems, gender inequality, and discrimination against sexual and gender minorities (SGMs), while also simultaneously possessing vast economic potential. With a population of approximately 1.4 billion and a median age of 19, the continent's youth are driving economic growth and transformation (UNDP\\u00a02020; World Bank\\u00a02021).\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0027\", \"jmft70091-bib-0003\", \"jmft70091-bib-0041\"], \"section\": \"The Rationale for Integrating Afrocentric Perspectives in Conceptualizing SJ as It Relates to Couple and Family Therapy in Africa\", \"text\": \"Indeed, Africa's immense cultural diversity and the increasing participation of African practitioners in the training, research, and practice of family therapy underscore the increased need for an Afrocentric perspective on SJ. Contemporary African family therapy scholars like Augustine Nwoye (2018) have highlighted the potential for family therapy to foster social change and resilience among Africans by emphasizing indigenous healing practices and integrating African worldviews into therapeutic models to address psychosocial challenges in ways that are both contextually relevant and empowering. This would enable practitioners to empower families toward change while challenging systemic injustices, at the same time. Failure to do so risks silencing African social values (e.g., communism and relational harmony) and lived experiences, thereby continuing to render indigenous knowledge invisible (Almeida et al.\\u00a02017). Moreover, it perpetuates colonial\\u2010era assumptions of Western superiority and limits the growth of indigenous frameworks, which can lead to poorly prepared, socially unconscious therapists and ineffective practices (Zimmerman and Haddock\\u00a02013). Furthermore, without culturally resonant frameworks, clinical practice may alienate African communities and hinder cross\\u2010cultural research and collaboration. To address these issues, we now introduce an ACWM as a framework through which we can advance the SJ agenda within family therapy in Africa.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0008\", \"jmft70091-bib-0010\", \"jmft70091-bib-0022\", \"jmft70091-bib-0024\", \"jmft70091-bib-0010\", \"jmft70091-bib-0013\", \"jmft70091-fig-0001\"], \"section\": \"The African\\u2010Centered Wellness Model\", \"text\": \"The ACWM is a culturally grounded, systemic framework designed for working with individuals of African descent. Developed by Garrett\\u2010Akinsanya (1998), this framework emphasizes the holistic integration of body, mind, and spirit within a communal and ecological context. Additionally, the model recognizes the influence of cultural heritage, ethnic identity, and spirituality on well\\u2010being (Grills et al.\\u00a02018; Myers\\u00a01991; Nobles\\u00a01992). Rooted in Afrocentric psychology, the model's main aim is to promote psychotherapy practices that affirm and integrate the clients' traditions, beliefs, and values (Grills et al.\\u00a02018). Although this model has been widely applied across African communities on the continent and in those in the diaspora, its potential for addressing SJ issues in family therapy remains underexplored in published literature. Given Africa's complex multicultural landscape, which is shaped by historical as well as ongoing, sociocultural, and political influences, the model offers a culturally resonant framework for family therapists to address mental and relational health challenges through the lens of cultural wisdom and contextual understanding. This model is established on the Nguzo Saba (seven principles of ancient African wisdom) (Karenga\\u00a01988), and outlines eight interconnected dimensions of wellness, using Swahili terminology to integrate cultural values and enhance relevance for Africans globally (Figure\\u00a01).\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0008\"], \"section\": \"\", \"text\": \"The African\\u2010centered wellness model (Garrett\\u2010Akinsanya\\u00a01998).\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0052\", \"jmft70091-bib-0050\", \"jmft70091-bib-0027\", \"jmft70091-bib-0005\"], \"section\": \"Access to Trauma\\u2010Informed, Culturally Relevant Care\", \"text\": \"Arguably, the most pressing SJ issue in African contexts is access to quality mental and relational health care. Systematic reviews by Essien and Asamoah (2020) and Aguwa et al. (2023) highlight several barriers to care, including stigma, inadequate infrastructure, and a shortage of trained professionals. Particularly in many rural areas of Africa, individuals often rely on established traditional structures of care, which often include, consultations with respected elders, traditional healers and local herbalists, religious figures, and others, before seeking the help of a mental health professional. While these structures of care have been relied upon for many years, they tend to delay care and can at times, compound the client's symptoms. Even among wealthier families, religious leaders are often the first line of consultation in cases of relational distress, which underscores the cultural salience of religion in Africa. We thus argue that family therapists (and truthfully all mental health professionals) across the continent, and those working with African populations globally, must advocate for policies that ensure culturally relevant, affordable, and accessible services. Drawing on Nwoye's (2018) concept of therapists as agents of social change, the ACWM provides a framework for therapists to support efforts toward equity in mental health care. Clinicians are encouraged to move beyond treating isolated symptoms and instead consider broader systemic influences, such as historical trauma, structural inequality, and cultural dislocation. Therapists must also engage in advocacy work to help shape mental health policies that bridge traditional healing and modern therapeutic care, such as family therapy, which is still a new kid on the block in many African settings (Asiimwe et al.\\u00a02021). This approach will ensure that no individual or family is left behind or untreated.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0016\"], \"section\": \"Access to Trauma\\u2010Informed, Culturally Relevant Care\", \"text\": \"Furthermore, given the widespread impact of conflict, war, and colonial legacies in Africa, trauma\\u2010informed care must also be culturally grounded. Armed conflict, political instability, and displacement have had devastating psychosocial impacts across the continent. Many families face unprocessed trauma, with limited access to trauma\\u2010informed and relationally oriented care. While trauma\\u2010focused interventions like Narrative Exposure Therapy and Eye Movement Desensitization and Reprocessing have been effective in some contexts (Koebach et al.\\u00a02021), they largely focus on treating individual symptoms, neglecting relational and communal healing. The ACWM emphasizes relational well\\u2010being and the interconnectedness of individuals, families, ancestors, and spiritual systems. We encourage therapists to consider how trauma reverberates through family systems, not just individuals, and to include traditional beliefs and communal practices in their interventions. Culturally attuned trauma care emphasizes collective healing, spiritual wellness, and relational restoration can more effectively support families in postconflict or high\\u2010adversity settings. As such, there is a need for equipping mental health providers in African settings with skills to offer relational trauma therapy that reflects the communal healing frameworks central to African contexts.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0015\", \"jmft70091-bib-0031\", \"jmft70091-bib-0006\", \"jmft70091-bib-0005\"], \"section\": \"Therapist Training and Culturally Responsive Practice\", \"text\": \"As cultural adaptation becomes a global priority in mental health practice, therapist training must be reoriented to include culturally responsive frameworks (Knudson\\u2010Martin et al.\\u00a02019; Seponski et al.\\u00a02013). Given the African cultural diversity discussed earlier, the growing practice of family therapy among African communities must reflect the diverse cultural beliefs, family systems, and community values of the continent. This is especially critical given that historically, and even today, many current mental health interventions in Africa are based on predominantly individualistic Western models of psychotherapy, which tends to neglect African relational norms or community structures (Bakker and Snyders\\u00a01999; Asiimwe et al.\\u00a02021). Importantly, models emerging from historically underrepresented contexts, such as the proposed ACWM, can play a vital role in training culturally competent clinicians, especially those from Africa or those intending to work with African clients. This approach is useful for preparing therapists to deliver interventions that reflect the lived realities and cultural strengths of African families while at the same time addressing contemporary SJ challenges.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0033\", \"jmft70091-bib-0012\", \"jmft70091-bib-0012\"], \"section\": \"Family Focused Interventions for Youth Mental Health\", \"text\": \"With much of the African population under 18 (United Nations\\u00a02022), youth mental health must be prioritized. J\\u00f6rns\\u2010Presentati et al. (2021) conducted a systematic review of 37 studies, in which they reported high prevalence rates of depression (26.9%), anxiety (29.8%), behavioral problems (40.8%), posttraumatic stress disorder (PTSD) (21.5%), and suicidal ideation (20.8%) among sub\\u2010Saharan adolescents. These rates surpass those found in many high\\u2010income regions, yet mental health infrastructure in most of Africa remains severely underdeveloped. The literature shows that untreated mental health problems among youth lead to academic challenges, substance abuse problems, and social withdrawal, which impact not only the individual but also the family unit as well (J\\u00f6rns\\u2010Presentati et al.\\u00a02021). Given the appalling statistics above, addressing the mental health challenges of African youth requires culturally adapted family therapy interventions that integrate African ideas and values. Thus, we encourage therapists to find ways to integrate principles from the proposed model to foster safe, culturally affirming environments for youth at risk of various mental health challenges. By leveraging African principles like respect for elders, communal connections, and interdependence, therapists can help families build protective relational networks that support the mental, emotional, and relational well\\u2010being of the young people of Africa.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0039\"], \"section\": \"Preventing Child Marriage Through Systemic Engagement\", \"text\": \"Child marriage is another issue with deep relational and developmental implications for families and communities in Africa. Research by Yaya et al. (2019) reported that child marriage affected 54% of girls across 34 sub\\u2010Saharan African countries, with rates as high as 81.7% in countries like Niger. Early marriage is associated with increased fertility, terminated pregnancies, early childbirth, and diminished opportunities for economic advancement. It also undermines girls' educational and economic potential as well as exposes girls to power imbalances in intimate relationships and intimate partner violence. Family therapists working through the African\\u2010Centered Wellness lens can engage families and communities to shift and gently challenge (like in the third case with the Ugandan family) norms and beliefs and prevent early marriages. Rather than only highlighting the harm, such as lost educational opportunities, relational distress, and low self\\u2010esteem, therapists can frame prevention within cultural narratives of faith, protection, care, and collective responsibility. Through collaborating with parents and elders, practitioners can promote wellness and empowerment without dismissing local values. This approach has the potential to foster mutual learning, healing, and transformation for families and communities.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0054\"], \"section\": \"Cultural Wisdom for Navigating Issues of Gender Inequality\", \"text\": \"It is our belief that gender inequality and power imbalances in African societies require a culturally sensitive, non\\u2010polarizing approach. In most of Africa, gender disparities manifest in unequal access to education, employment, and health care, while economic instability exacerbates relational stress, domestic violence, and child neglect (Karoui and Feki\\u00a02018). While we acknowledge that certain patriarchal norms can be harmful, they also function within cultural systems that provide structure and meaning for many families and communities. Rather than adopting an adversarial stance, we encourage therapists to apply cultural humility and practical wisdom, key principles in the ACWM, to open dialog and foster inclusivity. This \\u201cBoth/And\\u201d perspective respects multiple truths and could avoid the potential harmful consequences of unintentional alienating one gender over the other. By positioning family therapists as facilitators of safe, reflective conversations, this approach could help families transform without fracturing.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0020\", \"jmft70091-bib-0021\", \"jmft70091-bib-0029\", \"jmft70091-bib-0011\"], \"section\": \"Addressing the Needs of SGMs\", \"text\": \"Discrimination against SGMs remains a persistent violation of human rights across many African countries. For example, homosexuality is criminalized in 33 out of 55 African countries (Mugisha\\u00a02024), and this social stigma continues to marginalize LGBTQ+ individuals, further exacerbating mental and relational health challenges among individuals that belong to these communities. Studies show that SGMs face high rates of psychological distress, PTSD, and depression due to systemic discrimination and violence (M\\u00fcller and Daskilewicz\\u00a02018; Pulerwitz et al.\\u00a02024). In Kenya, one study found that over half of 527 surveyed SGMs reported PTSD symptoms, and 26.1% experienced depression (Harper et al.\\u00a02021). These alarming statistics highlight that working with SGMs in Africa demands a balance of courage, cultural knowledge, and clinical ethics. Given the legal and societal discrimination SGMs face in many African countries, open advocacy may not always be feasible, and in worst cases could lead one to harsh legal consequences. However,\\u00a0(CFTs) couple and family therapys can create affirming therapeutic spaces that offer validation, safety, and support for SGM clients by intentionally applying the principles of the ACWM, especially the Kujichagulia (self\\u2010determination) dimension, which emphasizes naming, defining, and advocating for one's community, while at the same time, actively resisting oppression. For example, therapists could gently challenge harmful societal narratives against SGM clients within the therapeutic process, promote community dialog, and affirm ideas of shared humanity (i.e., Ubuntu) and Umoja (Unity). The therapist's role as a culturally grounded bridge\\u2010builder becomes essential in transforming stigma into empathy, even in highly conservative and discriminatory contexts.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0041\", \"jmft70091-bib-0035\"], \"section\": \"Training and Research Implications\", \"text\": \"As family therapy gains traction in Africa, CFT education and training in Africa must evolve and be rooted in the continent's cultural and sociopolitical realities. While the emergence of CFT graduate programs, especially in Kenya, signals progress, these programs must intentionally prepare therapists to address systemic inequalities through SJ\\u2010oriented curricula. We agree with Zimmerman and Haddock (2013), that therapists must be equipped to challenge ingrained biases shaped by colonialism, patriarchy, and homophobia. Thus, programs must emphasize cultural competence, antioppressive frameworks, and Afrocentric paradigms such as the proposed ACWM to challenge the status quo. Curriculum redesign should prioritize African epistemologies, experiential learning in diverse settings, and critical engagement with global literature. As Wampler and Patterson (2020) note, systemic therapy provides tools for contextual thinking, but without culturally and contextually attuned training, therapists risk replicating oppressive structures. Relational and systemic approaches, when culturally grounded, are ideally suited to support African families navigating sociopolitical and historical adversity. Integrating Afrocentric paradigms, such as the ACWM, could further strengthen training, bridge generational divides, and foster resilience.\"}, {\"pmc\": \"PMC12619664\", \"pmid\": \"41240375\", \"reference_ids\": [\"jmft70091-bib-0028\"], \"section\": \"Training and Research Implications\", \"text\": \"Research is equally vital in all these endeavors. As Pillay (2020) notes, advancing SJ requires building a culturally relevant evidence base. The ACWM offers a foundation for exploring culturally grounded, strength\\u2010based interventions. However, no empirical evidence currently supports the model's usefulness in examining the mental and relational health and well\\u2010being of African families and communities. To advance the science, African CFT researchers must investigate the model's practical and empirical applications, develop locally grounded approaches, and document traditional practices already addressing family mental health.\"}]"

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