Identifying consistent factors that influence engagement or completion of therapy across studies allows services and policy-makers in criminal justice, child protection, community support and mental health systems to make informed decisions about approaches to therapy referral and how to support families through challenges they have that could affect their capacity to engage with services. This paper presents findings from a review of the literature aimed at identifying factors that may influence either engagement with therapy or the completion of therapy following a disclosure of child sexual abuse to authorities. The lack of Australian studies highlights the need for local research on factors influencing therapy use to help inform the design of referral systems and interventions to improve the use of available therapy services.

Key findings:

• Few factors consistently influenced engagement and completion - particularly for clinical studies reporting completion rates.
• Higher rates of engagement and completion appear to be associated with more severe abuse experiences - increased symptomatology (a set of symptoms) at intake seemed to increase completion rates among community samples.
• Family-level factors (e.g. parental attitudes about therapy) seemed to most consistently affect engagement rates.
• Parental involvement in therapy was one of the most consistent determinants of therapy completion, highlighting the importance of therapy models including a clear role for caregivers.
• Services and systems should monitor their own data on risk factors for disengagement and withdrawal to inform strategies to manage attrition.