This special guest article was written for the Henry Smith Foundation by Alice Piller-Roner, Chief Executive of Woman’s Trust.
“I feared it ending and being left by myself.”
That was one of the simplest comments made during a recent Woman’s Trust survivor consultation. It also captures one of the central challenges in supporting women to recover from domestic abuse: recovery rarely fits neatly into a predetermined number of sessions, a commissioning cycle or a one-year grant.
Domestic abuse can affect almost every part of a survivor’s life: her mental and physical health, relationships, confidence, sense of safety and ability to trust her own judgement. Yet the support available after abuse is often fragmented, time-limited and focused on immediate symptoms rather than the experiences that caused them, and the fact that those behaviours were part of a coping strategy that allowed survivors to -well- survive.
Our recent consultation brought together women who had completed specialist counselling with the Woman’s Trust. Their experiences were different, but several themes were remarkably consistent: time matters; continuity matters; specialist knowledge matters; and being able to access the right support at different stages of recovery matters.
Longer-term support is about continuity, not dependency
Participants repeatedly contrasted specialist counselling with shorter interventions they had experienced elsewhere. Several described reaching the end of a short course of therapy just as they were beginning to understand what had happened to them.
One survivor reflected:
“If you’d measured my recovery after those six NHS sessions, you wouldn’t have captured what recovery eventually became for me.”
This does not mean counselling should continue indefinitely. It means we need to move away from assuming that recovery should happen within an arbitrary timetable.
What women described as valuable was continuity: regular sessions, time to establish trust, remaining with the same counsellor where possible, or with counsellors following the same organisational guidelines, and knowing that support did not simply disappear when one intervention ended.
At Woman’s Trust, counselling sits alongside workshops and peer support. Participants described this layered approach as particularly important. Peer groups often became the bridge after individual counselling ended, while knowing they could return to the organisation later for group projects and informal engagements offered reassurance even when they were no longer receiving formal support.
That distinction matters for funders and commissioners. Longer-term support should not mean an unlimited number of counselling sessions. It can mean a well-designed continuum: specialist counselling when it is needed, opportunities to step down into peer or group support, and a clear route back when circumstances change.
Domestic abuse requires specialist therapeutic knowledge
The second message from survivors was equally clear: domestic abuse counselling is not simply generic counselling delivered to somebody who happens to have experienced abuse.
Participants described mainstream mental health services as often recognising anxiety, depression or distress without necessarily understanding why those symptoms existed. Some felt reduced to a score or diagnosis. Others described having to repeatedly tell their traumatic story to new professionals and encountering systems that did not recognise coercive control and the complex dynamics between victim and perpetrator.
Individual professionals within those systems were often experienced positively. The issue raised by survivors was not primarily about individual competence or compassion; it was about whether the service model itself understood domestic abuse.
Specialist, trauma-informed practice changes the therapeutic conversation.
A practitioner who understands coercive control can recognise why a survivor may doubt her own judgement, struggle to establish boundaries or remain affected long after a relationship has ended. They understand that behaviours which appear irrational outside the context of abuse may have developed as effective ways of surviving it.
One participant described a professional contact who began crossing boundaries after learning that her husband was no longer living with her. She felt uncomfortable but did not initially recognise the extent of the problem. It was during specialist group therapy that the behaviour was identified as inappropriate and action was taken.
Her reflection was striking: after having boundaries crossed repeatedly through abuse, she did not always recognise when another boundary had been crossed. Specialist support helped her understand the principle and apply it to what was happening in her own life.
That is difficult to capture through session numbers alone. It is the value of specialist clinical judgement.
Funding quality means funding more than counselling hours
If we want more survivors to access this kind of support, we also need to be realistic about what makes a specialist service safe and sustainable.
Counselling hours are only one part of the infrastructure required.
High-quality provision requires clinical leadership, regular supervision, safeguarding and risk-management systems, appropriate caseloads, workforce development and mechanisms through which survivors can influence how services develop. It also requires organisations to collect useful evidence without turning counselling into an exercise in hitting numerical targets.
Short-term, tightly restricted grants can make all of this harder. Organisations may recruit a counsellor for a temporary project while lacking the funding needed to retain staff, strengthen supervision, invest in data systems or build longer-term relationships with survivors and partner agencies.
Longer-term flexible funding creates different possibilities. It allows organisations to plan their workforce, invest in quality, learn from what is working and respond when survivors’ needs change.
It can also help build provision in places where specialist counselling is currently limited through controlled piloting of projects: expansion needs to be carefully executed and monitored.
When we asked survivors why they would trust an organisation’s therapeutic approach, they told us they wanted to see genuine specialist training and supervision, sufficient resourcing, survivor involvement, confidentiality and an understanding of the dynamics of domestic abuse. Several were particularly concerned that expansion should not create another “postcode lottery”, where the name of the service is the same but the quality depends on where a woman happens to live.
How to measure the right things
There is a final challenge for funders and commissioners: deciding what success looks like.
Symptom measures matter. Reduced anxiety, depression, trauma-related distress, suicidal thoughts and self-harm are incredibly important outcomes.
Survivors however tell us that recovery also looks like greater confidence, stronger relationships, returning to employment or training, being able to recognise unhealthy behaviours, participating in community life and feeling able to make independent decisions about the future.
And sometimes an important outcome is simply knowing that specialist support remains available if it is needed.
One woman put this particularly powerfully:
“Somebody continuing to need specialist support doesn’t mean the service isn’t working. With long-term abuse, recovery itself can be long-term.”
The ambition of specialist counselling should ultimately be independence, not dependence. But sustained support can be precisely what makes that independence possible.
After thirty years of providing specialist therapeutic support to women affected by domestic abuse, Woman’s Trust has seen how much can change when survivors are given the time, expertise and safety they need to recover.
The challenge now is not simply to fund more counselling sessions.
It is to build a system in which specialist domestic abuse counselling is recognised as an essential part of recovery; in which organisations have the stability to provide it well; and in which women are given enough time to rebuild lives that abuse may have taken years to dismantle.
Alice Piller-Roner, Chief Executive, Woman’s Trust
If your organisation delivers this kind of support, or you know one that does, visit our fund page to find out more, check your eligibility, and register for our launch webinar on 15 September at 11:00am.
If you miss the live event, you can watch the recording which will be added to the Fund webpage up to 5 working days after the event.