Increasing familial engagement in family violence services: a systematically conducted realist review of barriers and facilitators

PurposePhysical, emotional, and sexual violence and abuse occurring between close or extended family members are forms of family violence (FV). The negative impacts of FV are diverse, numerous, and pervasive for all individuals involved. To effectively support individuals experiencing FV, services designed to reduce and prevent FV and its associated harms must maintain participant engagement. Therefore, the purpose of this realist review was to synthesize literature on barriers and facilitators to individuals’ engagement in FV services so that relevant strategies can be implemented to improve service effectiveness.MethodsThis realist review was conducted systematically and searched five databases up to August 2024, screening 1, 334 evidence sources. Findings were examined in relation to families and parents, including mothers, fathers, and children, and were supplemented by relevant service provider perspectives.ResultsMost findings from the 24 included studies focused on facilitators of engagement. Priming and introductory sessions, provider-family rapport, group formats, empathy, trustworthiness, and family-centred approaches that consider familial needs and goals were identified as important facilitators of engagement in FV services. Prominent barriers included socioeconomic challenges, competing demands, childcare responsibilities, inadequate provider-client rapport, limited accessibility, intense initial meetings, and long service duration.ConclusionsRooted in family-centred approaches and interagency collaboration, recommended strategies to improve family engagement in FV services focus on opportunities during service: 1) intake; 2) initiation; and 3) delivery. These strategies are described in relation to context (e.g., socioeconomic factors) and potential mechanisms (e.g., perceived cultural safety), and could be further evaluated using implementation science methods to optimize family engagement in FV services.