Family-Inclusive and Relational Approaches to Trauma Recovery: Literature Review and Narrative Synthesis

Close interpersonal relationships represent both a key context for the genesis of complex trauma and a positive modifiable factor in recovery following trauma exposure. Furthermore, symptoms of individual trauma affect the family system and partners, supporting the need for systemic approaches in trauma recovery. This review sought to systematically identify and synthesise current approaches to involving the family or relational partners in trauma recovery, including an evaluation of their effectiveness on a range of individual and systemic outcomes. Eligible articles were published between January 2013 and October 2024, in English, and evaluated an intervention aimed at improving mental health or relational outcomes of trauma, where a family member or ally attended at least one session with the trauma-affected individual. Screening of an initial 3,169 articles identified a total of 41 eligible studies evaluating 32 different family-inclusive or relational approaches to trauma recovery. Data were narratively synthesised based on the characteristics of the study, population and intervention characteristics and the efficacy of each intervention on improving individual and systemic outcomes. Results suggest a generally positive impact of family-inclusion in trauma treatment paradigms, independent of intervention duration, theoretical underpinning, service setting or to the training or discipline of the provider. Practice recommendations are provided regarding different approaches based on the age and specific needs of the trauma-affected individual. Overall, the review supports family-inclusive and relational intervention frameworks that integrate well-established systemic practices in conceptualising the trauma experience as a shared experience and a shared recovery pathway.