Diversity and Inclusion in Clinical Trials Are Preconditions for Equity

A systematic review of randomized clinical trials (RCTs) in the United States of standard dialectical behavior therapy (DBT that included all four components of individual therapy, skills group, phone coaching, consultation team) found that most of the published studies reported race (94.4%) and ethnicity (72.2%), but few reported sexual orientation (11.1%) or gender identity (5.6%) (Harned et al., in press). Harned and colleagues (in press) were able to obtain additional data by request to the authors. Although more identity data had been collected than was reported in the published studies, diverse methods were used which precluded some comparisons. They also found that the proportions of participants’ race and ethnicity were comparable to their representation in the U.S. population, albeit some in very small absolute numbers (e.g., four American Indian/Alaska Native participants). However, none of the RCTs examined differences in treatment efficacy by identities, either singly or in combination. It is reasonable to imagine that disparities in the prevalence of a condition such as BPD— such as the overrepresentation of sexual orientation minorities with BPD compared to the population—may extend to disparities in treatment outcomes © 2022. American Psychological Association