Prevalence in the UK

Domestic violence and abuse affects people across all demographics in the UK. According to the Office for National Statistics, an estimated 2.1 million adults aged 16 to 74 experienced domestic abuse in England and Wales in the year ending March 2023 – approximately 1.4 million women and 751,000 men. These figures are widely considered to be underestimates, as a significant proportion of incidents go unreported due to fear, shame, financial dependency, or concern for children.

SafeLives, a UK charity dedicated to ending domestic abuse, estimates that on average a victim experiences 50 incidents of abuse before contacting police. Many will seek support from a GP, a mental health professional, or a counsellor long before they approach statutory services – making the therapeutic space a critical early point of contact.

Psychological Impact on Survivors

The psychological consequences of domestic violence are wide-ranging and often long-lasting. Survivors frequently present with post-traumatic stress disorder (PTSD), depression, anxiety, and complex trauma responses. Complex PTSD (C-PTSD) – which arises from repeated or prolonged trauma rather than a single incident – is particularly common among those who have experienced sustained domestic abuse. Symptoms can include emotional dysregulation, persistent shame and self-blame, difficulties in trusting others, and a distorted sense of self.

Shame is one of the most significant barriers survivors face. Many have been told by an abusive partner that they are worthless, that no one will believe them, or that they are responsible for the abuse. These messages can become internalised, making it hard for clients to recognise their experience as abuse at all. Counsellors should be alert to the way shame presents – often as minimisation, self-deprecation, or reluctance to name what has happened.

Coercive control, which was criminalised in England and Wales under the Serious Crime Act 2015, can be harder for clients to identify than physical violence. It operates through patterns of isolation, monitoring, financial restriction, and psychological manipulation that erode a person’s autonomy gradually over time. Survivors often do not recognise these controlling behaviours as abusive until much later.

Trauma-Informed Practice with Survivors

Working with domestic violence survivors requires a trauma-informed approach – one that prioritises physical and emotional safety, recognises the impact of trauma on the nervous system and behaviour, and avoids re-traumatisation. The core principles of trauma-informed care include safety, trustworthiness, collaboration, empowerment, and sensitivity to cultural and gender issues.

In practical terms, this means:

• Creating a consistent, predictable therapeutic environment where the client can begin to feel safe
• Avoiding approaches that require the client to repeatedly narrate traumatic events before they are ready
• Recognising that dissociation, numbing, or apparent detachment may be trauma responses rather than lack of engagement
• Working at the client’s pace and prioritising their sense of agency and choice throughout
• Being aware of how the counsellor’s own reactions to disclosures of violence may affect the therapeutic relationship

Person-centred approaches that foreground unconditional positive regard are particularly valuable with survivors who have experienced sustained criticism and control. Trauma-focused CBT and EMDR are also used by practitioners working in this field, though these are typically offered within specialist domestic abuse services rather than general counselling settings.

Safeguarding Duties

Counsellors have a duty to act when there is risk to life or risk to children. The BACP Ethical Framework for the Counselling Professions makes clear that confidentiality is not absolute and that protecting clients and others from serious harm can, in some circumstances, override the obligation to keep information private.

Key safeguarding considerations in domestic abuse cases include:

• Whether children are living in the household and witnessing or experiencing abuse
• Whether the client is at immediate risk of serious harm or homicide
• Whether the client has capacity to make decisions about their own safety

The SafeLives DASH (Domestic Abuse, Stalking and Honour-Based Violence) risk identification tool is used by many practitioners and agencies to assess the level of risk a victim faces. High-risk cases may be referred to a Multi-Agency Risk Assessment Conference (MARAC), where police, social care, health, and other professionals share information to manage risk. Counsellors should be aware of MARAC processes and know how to make a referral if needed.

When a client discloses domestic violence, the counsellor’s first response should be to listen without judgement, acknowledge what the client has shared, and explore what support they want. Jumping immediately to advice or referrals can feel controlling to someone whose autonomy has been stripped away. The client must remain in control of decisions about their own safety wherever possible.

Challenges Counsellors Face

Working with domestic violence survivors can be emotionally demanding. Vicarious trauma – where the therapist absorbs the distress of the client’s experiences – is a recognised occupational risk for practitioners in this field. Regular supervision is essential, not only to maintain ethical practice but to protect the counsellor’s own wellbeing.

Counsellors may also find it difficult when a client chooses to remain in or return to an abusive relationship. This is a common pattern and does not indicate failure on either side. Leaving an abusive relationship is a complex process that often involves multiple attempts. Research by Women’s Aid suggests that on average it takes a survivor seven attempts to leave permanently. The counsellor’s role is to remain supportive, non-judgemental, and focused on safety planning – not to pressure the client into a course of action they are not ready for.

Another challenge is the risk of collusion – where the counsellor’s desire to support the client inadvertently normalises abusive behaviour or fails to name it clearly. Maintaining an informed understanding of what constitutes domestic abuse helps counsellors hold an appropriate therapeutic perspective.

Referral Pathways and Specialist Services

Counsellors working in general practice settings are not expected to be specialist domestic abuse practitioners, but they should know where to signpost clients who need more targeted support. Key services include:

• National Domestic Abuse Helpline (run by Refuge): 0808 2000 247, available 24 hours a day
• Women’s Aid: provides a network of local refuge and outreach services across the UK
• Men’s Advice Line: 0808 801 0327, for male victims of domestic abuse
• SafeLives: resources for practitioners and a directory of local Independent Domestic Violence Adviser (IDVA) services
• MARAC: for high-risk cases requiring multi-agency coordination

Where counsellors work within organisations that have their own safeguarding policies, they must follow those procedures. In private practice, it is good practice to have a clear safeguarding protocol in place before taking on clients in this area.