Family-centered approaches and rapport improve engagement in family violence services despite significant socioeconomic barriersWhat helps families get help with family violence services

Frontiers in Medicine Published July 9, 2026 DOI ↗ Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain

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Key Takeaway

Note that rapport, empathy, and family-centered models can mitigate barriers like childcare and socioeconomic stress.

This systematic realist review synthesized 24 studies to identify the factors influencing engagement in family violence services for individuals including mothers, fathers, and children. The scope of the review focused on identifying specific facilitators and barriers that impact how families interact with and remain in support programs.

Key findings indicate that several elements facilitate engagement: priming and introductory sessions, established provider-family rapport, group formats, empathy, trustworthiness, and family-centered approaches that prioritize familial goals. Conversely, significant barriers were identified, including socioeconomic challenges, competing demands, childcare responsibilities, inadequate provider-client rapport, limited accessibility, intense initial meetings, and long service durations.

To improve engagement, the authors suggest focusing on three key stages: intake, initiation, and delivery. These should be rooted in family-centered approaches and interagency collaboration. While the review identifies these associations, it is important to note that as a realist review, it synthesizes existing literature rather than providing primary clinical trial data or direct evidence of causality.

When a family is dealing with violence, getting help can feel overwhelming. A new review of 24 studies looked at what helps or hurts families when they try to use family violence services.

The review found that certain things make it easier for families to engage. These include having a warm, trusting relationship with the provider, using group formats, and taking a family-centred approach that considers everyone's needs. Also, priming sessions that prepare families for what to expect can help.

On the other hand, many barriers get in the way. Families often face socioeconomic challenges, competing demands like work or childcare, and limited access to services. Sometimes the first meeting is too intense, or the service lasts too long. A poor relationship with the provider can also push families away.

This review is a synthesis of existing studies, not a new clinical trial. So it points to patterns, not proof of cause and effect. Still, it offers practical ideas for how services can better support families at every step: from intake to delivery.

What this means for you:

Trust, empathy, and practical support are key to helping families engage with violence services.

Common questions

What are the main barriers to families using violence services?

The review found barriers like socioeconomic challenges, competing demands, childcare responsibilities, poor rapport with providers, limited accessibility, intense initial meetings, and long service duration.

What helps families engage with family violence services?

Facilitators include priming sessions, good provider-family rapport, group formats, empathy, trustworthiness, and family-centred approaches that consider everyone's needs and goals.

Is this review based on new research?

No, it is a realist review that synthesizes findings from 24 existing studies. It does not provide new clinical trial data, so it shows patterns rather than direct cause and effect.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedJul 2026

View Original Abstract ↓

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.

Family-centered approaches and rapport improve engagement in family violence services despite significant socioeconomic barriersWhat helps families get help with family violence services

Common questions

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Family-centered approaches and rapport improve engagement in family violence services despite significant socioeconomic barriersWhat helps families get help with family violence services

Common questions

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