Still Looking for Mechanisms: A Realist Review of Batterer Intervention Programs.

Complex interventions, including batterer intervention or treatment programs (BIPs), require that program strategies interact with contextual factors to trigger often unseen In accordance with published realist review standards, we defined the review questions and rational, defined outcomes and formulating initial theories, searched the literature, applied inclusion and exclusion criteria, and analyzed and synthesizing data. An initial search yielded 5,149 citations, and after a systematic process using realist principles, six articles with sufficient information were included. Few evaluations contain the detail necessary to discern clear generative explanations of program processes. Evidence suggested that under some contextual conditions, strategies that trigger a self-reflexive process in participants may lead to changes in attitudes about violence, which may lead to the development of empathy for their partner. Additionally, programs that help participants differentiate between shame and guilt appear to increase both acceptance of responsibility and empathy. This realist synthesis illustrates several gaps in the evaluative literature. Few evaluations captured sufficient detail to examine the influence of contextual factors. Likewise, most evaluations only describe