This site is owned and operated by 

Practice Considerations For Domestic Violence Counselors

March 12, 2024


A sad looking man with hands on his head and serious looking lady both sitting on a couch across a therapist during an in person visit

As a counselor for individuals exposed to domestic violence, your day-to-day life is likely to be complex and emotionally demanding. Navigating the complexities of these situations and their subsequent mental health effects requires professional acuity and a profound sense of empathy and compassion. Here, we’ll explore the intersection of domestic abuse and mental health, with the objective of equipping you with the necessary tools to provide tailored, empathetic, and effective support.

Domestic violence is a global issue, with statistics revealing its profound impact on mental health. According to the World Health Organization, approximately 30% of women worldwide have been subjected to either physical or sexual intimate partner violence or non-partner sexual violence in their lifetime. Men also experience domestic violence, with at least 25% of all domestic violence cases being committed against male partners. 

Studies indicate that survivors of domestic abuse are at a higher risk for developing a variety of mental health conditions, including depression, anxiety, post-traumatic stress disorder, and substance use disorder. They are also more likely to experience more severe mental health symptoms such as disassociation, memory impairment, issues with identity, and the development of a negative self-concept. 

The prevalence of these conditions among survivors illustrates the need for counselors and support groups to provide empathetic, professional assistance that helps these individuals rebuild a healthy, balanced state of mind. Continue reading to learn how you can play an impactful role in the lives of survivors as a domestic violence counselor.

Considerations For Treating Clients Exposed To Domestic Violence

It can be crucial to understand that survivors of abuse often adopt coping mechanisms and patterns of behavior in an attempt to make a terrible situation better. Individuals who experience trauma and domestic violence may exhibit a range of mental health symptoms, reflecting the deep impact of these experiences on their psychological well-being. Some of the symptoms you might observe or be informed of by your clients can include: 

  • Persistent feelings of sadness or depression
  • Excessive anxiety and constant state of fear
  • Difficulty sleeping, including nightmares and insomnia
  • Loss of appetite, or excessive eating leading to abnormal weight changes
  • Feelings of guilt, worthlessness, and low self-esteem
  • Difficulty in concentrating or making decisions
  • Low self-esteem and protective behavior toward abusers
  • Withdrawal from social activities or isolation
  • Increased substance use as a coping mechanism

Many individuals also grapple with issues related to self-esteem and self-worth, which often leads to feelings of guilt, shame, and isolation. People who experience domestic violence may blame themselves and attempt to protect those who have abused them, which can lead to lower self-esteem and the potential development of unhealthy coping mechanisms and patterns of behavior/thinking. 

These symptoms not only add to the burden carried by survivors but may also complicate their journey toward recovery and healing. As such, it can be crucial that mental health providers strive to understand the unique nuances of each individual case and develop individualized treatment strategies that take into account the presence of these various symptoms and co-occurring disorders. Counselors can help by listening closely to the full context of clients’ experiences while validating their desire for safety and stability in the decisions they have made.

A sad mom and daughter comforting each other while seated on a couch

Some considerations for working with individuals who have experienced domestic violence include:

Take A Gentle, Empathetic Approach

As counselors, it can be imperative to approach cases of domestic abuse with caution and sensitivity. Rather than rush into goal setting or treatment too quickly, it may be worth focusing on uncovering the moving parts and potential triggers unique to a client prior to the development of a holistic treatment strategy. These are delicate scenarios in which the mental health of the individual may be affected by trauma and other issues that can be sensitive and triggering. 

The journey toward healing and recovery must be paced according to each client’s readiness and resilience. These individuals may be struggling with concerns like low self-esteem and might need extra support in understanding their unhelpful mental processes. As a domestic violence counselor, your role is to gently guide survivors through the healing process and empower them to regain control over their lives and relationships.

It may also be helpful to consider avoiding “What could you have done differently?” or similarly phrased questions. These types of questions may frame the situation as somehow being the fault of the client, which is already a common factor that many survivors may experience difficulties with. 

Counselors may need to consider the entire context of a client’s behavior to fully understand why they are engaging in certain patterns of behavior or thinking. The decisions that survivors of abuse make are often for reasons of safety, and this may make them appear maladaptive from outside the context of interactions with an abusive partner.

Acknowledge The Presence Of Trauma 

Recognizing the presence of trauma in individuals who have experienced domestic abuse can be paramount to effective counseling. Trauma, especially when related to domestic violence, can have deep-seated impacts on a person’s mental health, influencing their emotions, behaviors, and overall well-being. As counselors, understanding the pervasive nature of trauma can help in tailoring interventions to mitigate its effects and foster a healthy healing environment.

Equally important can be the identification and management of triggers associated with such traumatic experiences. Triggers can be anything— a phrase, a sound, a specific environment— that may remind the individual of the domestic abuse and violence they endured. These can potentially lead to flashbacks, panic attacks, or other distressing reactions. By acknowledging and working through these triggers, counselors may be more equipped to help individuals navigate their emotional landscape, build resilience, and progress toward re-learning how to engage in healthier relationships.

Understanding the risk of suicide in individuals who have experienced intimate partner violence (IPV) can also be a critical aspect of mental health counseling. According to the American Psychological Association (APA), these individuals face a significantly increased risk of suicidal thoughts and actions. Domestic abuse can take a toll on mental wellness, often resulting in depression, anxiety, PTSD, and feelings of hopelessness. 

This underscores the importance of mental health practitioners being well-equipped to recognize and respond to signs of suicidal ideation in their clients who have a history of intimate partner violence (IPV). Counselors who develop safety plans and create a compassionate and supportive therapeutic environment may observe more positive outcomes in therapy. Having open conversations about these difficult experiences and providing appropriate interventions can also ensure the safety of those at risk.

Consider Working Toward The Development Of Intimacy 

Domestic violence profoundly disrupts the foundation of trust and safety that underpins healthy relationships, often leading to detrimental impacts on intimacy. Experiences of IPV and domestic violence may cause survivors to consciously or subconsciously associate intimacy with fear, pain, and betrayal. 

It’s not uncommon for survivors to struggle with intimacy and trust in subsequent relationships due to trauma-related mental health symptoms. The therapist’s role involves aiding survivors in disentangling intimacy from abuse and empowering them to reclaim their capacity for love and connection.

A man wearing glasses sitting on a couch surrounded by his family while staring at the paper on his hand

Cognitive behavioral therapy (CBT) can play a vital role in helping individuals who have experienced domestic abuse rebuild their ability to foster intimacy and have fulfilling relationships. This therapeutic approach equips individuals with the necessary tools to identify and challenge negative thought patterns, enabling them to cultivate healthier self-perceptions and interpersonal relationships. CBT aids in boosting self-esteem and releasing the need to maintain control through mindfulness practices and self-reflection, which may help individuals see their experiences and patterns from a more objective perspective. It also helps individuals establish clear boundaries, which can be critical in preventing falling back into a pattern of abuse.

In addition to CBT, other treatments such as trauma-focused therapy may also promote healing after domestic abuse. Informing your treatment with strategies that allow individuals to process traumatic experiences and reframe their perspectives may help to improve their resilience and spur growth. Group therapy can be another powerful tool, providing a supportive environment where survivors can share experiences and strategies and benefit from a shared sense of community.

Address Co-Occurring Conditions

Approaching co-occurring conditions in survivors of domestic violence can be of paramount importance. Often, these individuals are grappling with not only the traumatic aftermath of abuse, but also with resulting mental health issues such as depression, anxiety, and post-traumatic stress disorder (PTSD). The intertwined nature of domestic abuse and mental health concerns necessitates a holistic approach from counselors. 

In one study, researchers explored the effectiveness of various common approaches to treatment for individuals exposed to domestic violence, whether in one instance or repeatedly. They found that therapists who used treatments that were adapted to the specific needs of each patient had the most successful treatment outcomes. This study demonstrates the importance of applying personalized treatment strategies to any client who has experienced domestic violence or IPV, taking into account any unique symptoms related to experiences of trauma as well as the presence of co-occurring conditions. 

Dual diagnosis treatment allows for the simultaneous management of co-existing conditions, offering a holistic approach that considers the complex interplay between mental health and domestic violence. This approach recognizes that each issue can perpetuate the others, creating a need to develop treatments that align with these unique complexities. 

Addressing The Needs Of Domestic Violence Survivors With Online Therapy

Addressing the complex needs of domestic violence survivors requires a multifaceted approach, and online therapy may enable treatment providers to reach more individuals in need while improving their ability to render effective treatment. Online therapy offers flexibility and accessibility that may help to improve access to therapy for those who have experienced or are experiencing IPV. With virtual platforms like BetterHelp, survivors can comfortably express their feelings, process their experiences, and explore different paths to healing. 

For many individuals who have experienced domestic violence, it may be difficult to open up about the situation and seek in-person therapy for fear of judgment or other personal reasons. Online therapy can provide a safe and compassionate environment that may motivate those who are hesitant about seeking help to decidedly reach out for the assistance they need.

The Efficacy Of Online Therapy For Survivors Of Domestic Violence

Because online therapy is a relatively new phenomenon, clients may be curious about its effectiveness in addressing their unique concerns. Research overwhelmingly shows that online and in-person therapy are equally effective and that both can be utilized in a range of situations, including those related to trauma. 

In one study examining an internet-based CBT intervention aimed at survivors of domestic violence, researchers found that participants experienced statistically significant reductions in PTSD, depression, and anxiety and improvements in quality of life. The comfortable setting of online therapy and the distance created between the provider and client may be crucial factors that contribute to these positive outcomes for individuals impacted by intimate partner violence.


It can be paramount for therapists to recognize that every individual experiencing domestic violence has a unique narrative and a distinct set of challenges intertwined with their mental health and relationships. As counselors, it becomes a responsibility to approach each case with an empathetic lens, focusing on the individual’s subjective experience and the potential traumas they carry. Addressing trauma and any co-occurring conditions necessitates a nuanced, patient-centric approach that respects the survivor’s journey and fosters a safe and supportive therapeutic environment. Some survivors may feel more comfortable opening up about their experiences in an online setting, which platforms like BetterHelp can offer.