Background: The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together. Objective: As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families. Methods: A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented. Results: Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver–care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself. Conclusions: In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.

The impact of family violence (FV) on children is a significant global public policy issue. Earliest identification of FV among children is critical for preventing escalating sequelae. While practitioners routinely ask adults about FV, there are relatively few measures that enable children to reliably self-report on their own safety. This review sought to systematically identify and appraise all available child self-report measures for screening and assessment of FV in both clinical and research settings. Database searching was conducted in January 2022. Articles were eligible for review if they included a validated child (5–18 years) self-report measure of FV (including victimization, perpetration, and/or exposure to inter-parental violence). Screening of an initial 4,714 records identified a total of 85 articles, representing 32 unique validated instruments. Results provide an up-to-date catalog of child self-report measures of FV, intended to benefit practitioners, services and researchers in selecting appropriate tools, and in understanding their suitability and limitations for different cohorts and practice goals. While just under half of the measures captured both exposure to inter-parental violence and direct victimization, none captured all three domains of exposure, victimization and perpetration together. Instruments with provision for input from multiple respondents (e.g., both child and parent report) and with assessment of contextual risk factors were few. Findings point to the need for developmentally appropriate, whole-of-family screening and assessment frameworks to support children in the early identification of family safety concerns.

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.

Policy calls for family‐inclusive, single‐session approaches to mental health challenges are growing. In response, an online, single‐session family therapy approach, Walk‐In Together (WIT), was successfully piloted in a small team format in a specialist setting. For wider implementation, including in mental health services, use of a team for WIT sessions was a clear resource barrier. This small qualitative study examined the viability of a co‐therapy approach to WIT sessions. For a 4‐month period, families were allocated to one of two WIT program formats. Ten completed the two‐therapist format, and six the team format. Sixteen family members participated in semi‐structured individual interviews, exploring their experiences of the WIT service. Four therapists participated in a focus group about working in the differently sized co‐therapy models. Descriptive qualitative analyses consider similarity and difference in the experiences of these two ways of working. For family members, strong similarity of session experience, essential change elements and nature of impact was evident between the two formats. In contrast, therapists showed some preference for the team format, particularly with complex presentations and training contexts, yet fully endorsed a two‐therapist format in resource limited contexts. From family and therapist perspectives, essential change was equally achieved in the team and co‐therapy formats. The benefit of a WIT session for family members appears to lie more with timely response, transparent engagement and well‐contained process and less with the number of therapists providing these functions. We describe ways in which the current study may inform research and support implementation.

Background: Early relational health is critical for childhood development, and disruptions in infant-caregiver trust can heighten risk. MERTIL for Parents is a brief, universal, online program designed to build parental understanding of relational trust and its role in infant development. This pilot study is the first evaluation of the program. Objectives: To evaluate the acceptability and short-term outcomes of MERTIL for Parents. Methods: Seventy-three parents (n = 69 mothers) of children aged 0–5 years, referred by practitioners, completed the program and online questionnaires at baseline (N = 73), post-intervention (n = 50), and three-month follow-up (n = 25). Results: The program demonstrated high acceptability: 98% of parents who engaged with the program found the content useful, 92% felt the length was appropriate, and all would recommend it to others. Program completion and satisfaction did not vary by sociodemographic or psychosocial characteristics. At three-month follow-up, parents reported significant improvements in their enjoyment of the parent–child relationship (p < 0.001), attunement to their child (p < 0.001), parenting confidence/competence (p = 0.004 and p = 0.003), help-seeking amenability (p < 0.001), and a reduction in irritability toward the child (p < 0.001), with medium to large effect sizes. No significant changes were observed for items assessing reflective functioning or perceived rejection. Conclusions: MERTIL for Parents shows strong acceptability and promising preliminary outcomes as a scalable, attachment and trauma-informed intervention supporting early relational health. Future research should examine long-term impacts and evaluate broader implementation across diverse families and service contexts.

Family roles in trauma recovery are increasingly recognised, yet systemic approaches remain underdeveloped because of limited models and engagement barriers. Single Session Thinking (SST) offers potential for trauma-related family work. This study identified how specialist family therapists were applying the SST approach when working with families affected by a traumatic event/s, and suggests corresponding adaptations to the existing SST session map. Sixteen specialist family therapists experienced in SST and trauma treatment completed a three-round Delphi study, producing practice guidelines and an adapted SST session map tailored to these families. Consensus was established on the foundation of family trauma treatment utilising an SST approach. Practice guidelines and adaptations to the SST session map emphasised containment, collaboration, and trauma-sensitive systemic practice. The adapted SST framework supports attuned, collaborative family engagement in high-demand, brief-intervention settings. Future research should incorporate family perspectives to further validate and refine the model alongside other trauma recovery approaches.