Systematic review finds no reliable evidence for Family Constellation Therapy effectiveness across clinical and non-clinical samples
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Key Takeaway
Consider that no reliable evidence supports Family Constellation Therapy effectiveness due to very low-certainty evidence and high risk of bias.
This systematic review and meta-analysis assessed the effectiveness of Family Constellation Therapy (FCT) across clinical and non-clinical samples. The scope included a synthesis of available literature to determine whether FCT provides reliable benefits for any specific condition. The study phase and setting were not reported in the source material.
Key findings indicate that no reliable evidence was found to support the use of FCT for any condition. The absolute numbers, effect sizes, and p-values were not reported. Consequently, all comparisons were rated as very low-certainty evidence. The authors noted that available data was insufficient to establish the effectiveness of the intervention.
Significant limitations were identified, including the fact that all trials included were judged to be at high risk of bias. Concerns regarding potential adverse effects were also identified, though serious adverse events, discontinuations, and tolerability were not reported. The sample size was not reported, and the primary outcome was not reported.
In terms of practice relevance, clinicians, policymakers, and consumers should reconsider adopting FCT while reliable evidence is not available. The certainty of the evidence is very low, and funding or conflicts of interest were not reported. This review underscores the current lack of robust data to inform clinical decision-making regarding this intervention.
View Original Abstract ↓
Introduction: Family Constellation Therapy (FCT) has been widely disseminated in clinical, public health, and judicial settings despite persistent concerns regarding its theoretical basis, safety, and the limited availability of rigorous randomised evidence supporting its clinical use. Objective: The aim of this systematic review is to assess the effects of FCT across all clinical conditions, explicitly considering both benefits and harms; and summarise the characteristics of studies and intervention settings used in randomised controlled trials of FCT. Methods: Following a prospectively registered protocol (CRD420251136190), we conducted a systematic search of seven databases (PubMed, EMBASE, APA PsycInfo, CENTRAL, BVS, Web of Science, and CINAHL) and grey literature (ICTRP and ProQuest database) without language or date restrictions to identify published and unpublished randomised controlled trials of FCT. Study selection, data extraction, risk of bias (RoB 2), and certainty of evidence (GRADE) were performed in duplicate. Statistical analyses followed a prospectively registered analysis plan with prespecified criteria for data pooling and for handling analytical limitations. Results: No reliable evidence was found to support the use of FCT for any condition across both clinical and non-clinical samples. All trials included were judged to be at high risk of bias and all comparisons were rated as very low-certainty evidence. Concerns regarding potential adverse effects were identified, and the available data was insufficient to establish the effectiveness of the intervention, precluding any clinical recommendation. Conclusion: Clinicians, policymakers, and consumers should reconsider adopting FCT while reliable evidence is not available.
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