By Psychotherapist Laura McCarthy, UKCP Accredited, BACP Registered. Ethics, Practice and Safeguarding Board Member at Woman’s Trust

Domestic abuse remains both a significant safeguarding issue and a major mental health challenge in the UK. The Government’s recently published Violence Against Women and Girls strategy emphasises prevention in schools, including teaching consent, challenging misogyny, and identifying harmful online behaviour. These measures are intended to stop abuse before it begins, but prevention alone cannot address the needs of the millions of women already living with the psychological consequences of abuse.

For the counselling and psychotherapy profession, this gap between prevention and recovery has direct clinical consequences. Survivors of domestic abuse are presenting in therapy rooms every day with complex trauma, yet the systems and training structures intended to support them have not kept pace with the scale of harm.

As International Women’s Day approaches, the gap between prevention focused policy and the reality of recovery is clear. Women living with trauma from domestic abuse require urgent, specialist mental health support to rebuild stability, manage ongoing psychological distress, and prevent further economic and social marginalisation. These needs remain under-addressed in current policy and service provision.

Domestic abuse is a national public health emergency, yet more women than ever are seeking help and being failed. Research by Woman’s Trust, which provides specialist mental health support for survivors, shows that half of all women who ask for trauma-informed mental health support after domestic abuse are turned away due to a lack of funding.

Domestic abuse is one of the most significant drivers of complex psychological trauma in women. Survivors often live in precarious situations, sofa surfing, returning to unsafe family homes, or remaining with abusive partners because trauma symptoms, disrupted employment, and financial hardship make leaving difficult.

Research estimates that over one million UK women are trapped with dangerous partners due to economic abuse, with 36 per cent experiencing mental health problems such as depression or suicidal thoughts, and 11 per cent becoming homeless as a result.

The interplay between trauma, poverty and mental health is profound. Hypervigilance, dissociation, insomnia and panic attacks undermine survivors’ ability to work, manage finances or navigate housing systems. Without specialist psychological support, women face escalating marginalisation and worsening mental health.

Nearly one in four women in the UK will experience domestic abuse in their lifetime, yet there is still no nationwide pathway providing specialist trauma-informed mental health care. Despite this prevalence, most core counselling and psychotherapy trainings do not require mandatory education in domestic abuse, coercive control or post-separation trauma. Many therapists qualify without being taught how to recognise ongoing abuse, assess risk, or work safely with the psychological impact of coercive control and economic abuse.

This creates a serious mismatch between the complexity of clients’ needs and the preparedness of the profession tasked with supporting them. Trauma-informed therapy in the context of domestic abuse is not an optional specialism. It is a core competency issue. Without this understanding, therapists may unintentionally minimise harm, misinterpret trauma responses, or place responsibility back onto survivors.

The VAWG strategy’s focus on prevention is important, but it must be paired with urgent investment in specialist mental health services. Education alone cannot reverse the psychological, emotional and economic damage already caused.

As demand continues to rise, specialist domestic abuse services are overwhelmed, while mainstream mental health services are often ill equipped to respond. Survivors are either turned away or placed on long waiting lists for generic therapy that may not meet their needs. This leaves many practitioners holding highly complex trauma without adequate training, supervision or systemic support.

For counselling and psychotherapy professionals, International Women’s Day is a timely reminder that ethical responsibility requires services and training standards that address both prevention and recovery.

As a profession, we cannot continue to treat domestic abuse as peripheral to mental health. If counselling and psychotherapy are to meet their ethical obligations, domestic abuse must be embedded within core training, supervision, commissioning and clinical standards.

Survivors should not have to survive alone, and we should do all we can to prevent possible self-harm and risk of suicide.

Domestic abuse affects an estimated 1 in 4 women in England and Wales, with 2.3 million adults experiencing domestic abuse in the last year alone (Office for National Statistics, Crime Survey for England and Wales, 2024).

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