1. The programme at a glance
Indication. An adult, of any sex and any orientation, who is experiencing or has experienced violence from an intimate partner or former intimate partner: physical, sexual, psychological or economic violence, or coercive control, that is, a set of means that deprive a person of their freedom, with or without blows (section 4). The person may still be living with the perpetrator, be in the process of leaving, or be separated.
Reference model. Support in two phases. The first, centred on the present, draws on specialist support for victims, evaluated in the research under the name of advocacy (section 14), and on empowerment programmes: assessing the danger, building a protection plan, giving the person back sources of support and control over their own decisions. The second, once the danger has ended, draws on the trauma-focused cognitive behavioural therapies that have been adapted for victims of intimate partner violence: guilt, shame, the memory, relationships.
Format. Fourteen individual sessions, in two phases: six sessions to get protected and regain a footing, eight to rebuild once the danger has passed. Sessions last 60 minutes, except sessions 10 and 11, devoted to the memory, which last 90 minutes. One session a week. As long as the danger lasts, the first phase is extended as regular follow-up, with no limit set in advance (section 31). Three booster sessions, at one, three and six months after the last session. This total is an assembly that has not been evaluated as such: the first phase takes up the order of magnitude of the present-centred programmes evaluated in shelters, from 12 to 16 sessions at most (D. M. Johnson et al., 2011, 2020), and the second that of Kubany's cognitive trauma therapy, eight to eleven sessions of an hour and a half (section 14).
Mechanism targeted. Coercive control works by shrinking the person's world: fewer ties, less money, less freedom of movement, less confidence in their own judgement, and more fear. The programme does the opposite, in this order: reduce the danger, give back resources and choices, then treat what the violence has left behind.
| Session |
Focus |
Session output |
| 1 |
Welcome the person and assess the danger |
Danger and suicide risk assessed, safe means of contact agreed |
| 2 |
The protection plan |
Plan written and stored somewhere safe, specialist service contacted |
| 3 |
Naming what is happening |
Forms of control recognised, dated record started |
| 4 |
Deciding at one's own pace |
Current decision written down, with what makes it safer |
| 5 |
Finding support again |
Three sources of support taken up again, a trusted person chosen |
| 6 |
Staying on one's feet, and choosing what comes next |
Plan for sleep and mood, move to the next phase decided |
| 7 |
Changing phase |
Measures repeated, targets for the second phase chosen |
| 8 |
Guilt |
Responsibility redistributed in writing |
| 9 |
Shame and trust in one's own judgement |
Belief about oneself re-rated |
| 10 |
The memory |
First full account, hot spots identified |
| 11 |
The memory, continued, and what is avoided |
Hot spots revisited, one safe situation taken up again |
| 12 |
The ex-partner and the children |
Contact rules written down |
| 13 |
Future relationships |
Markers for graded trust written down |
| 14 |
Review and what comes next |
Measures compared, written plan, boosters scheduled |
What the person takes away. Nine printable worksheets (section 38). Most of them never go home: a worksheet found by the perpetrator can put the person in danger, and each one says where it is to be kept.
What distinguishes this programme from the other manuals on this site. Three things. The person often still lives with the one who threatens them: safety is not a preliminary check, as in Post-traumatic stress disorder in adults: a therapist's manual, but the very object of the first phase. The decision to stay, to leave or to wait belongs to the person, and the treatment is never made conditional on leaving. Finally, everything that relates to the law refers to the law of the country where you practise and to your code of ethics.
2. Before you begin
The four preliminary decisions
Is the person in danger today? That is the question that governs everything (section 9). Immediate danger turns the session into getting the person to safety, with the resources and in accordance with the law of your country.
Is there a suicide risk? It is common in this population and is asked about explicitly (section 12).
Are there children in the home? Their exposure to the violence is in itself a harm, and it may call for a protective step (section 10).
Can the person be contacted safely? Even before the first session, agree on how to contact them, what message can be left, and what happens to appointment reminders. The Haute Autorité de santé (HAS), the French agency that publishes good practice guidelines, asks professionals to make sure that the patient can be reached without being put in danger (Haute Autorité de santé, 2019). Its guidelines are cited in this manual for their clinical content; whatever in them relates to French law is included only as an example.
What this programme does not treat
It does not treat the perpetrator of the violence. If the perpetrator is also your patient, you do not see the victim: the conflict of interest is untenable, and the victim could not speak freely. Refer them to a colleague.
It does not offer couple therapy as long as violence or control persists. Couple therapy is contraindicated in that case, as is mediation between partners: a person who is controlled does not speak freely in the other's presence, and pays on returning home for what they said. Couple therapy: a therapist's manual explains this in its section 9 and says what is done instead.
It does not replace specialist services, which provide information on rights, support people through the procedures and offer accommodation. The programme works with them, not in their place (section 14).
It does not on its own treat complex post-traumatic stress disorder (PTSD) that dominates the picture, that is, PTSD accompanied by lasting disturbances in the regulation of emotions, in self-image and in relationships (section 7). The second phase treats its components; if this picture becomes dominant, Complex post-traumatic stress disorder: a therapist's manual takes over.
It does not treat children. It protects them, it refers them on, and it helps the parent; children who are suffering have their own treatment (section 34).
How to use it
Read the whole manual before the first session, in particular sections 9, 10, 11 and 32: danger assessment, protection, confidentiality and written records, and the protection plan in detail. These are the four places where a mistake can have consequences that same day.
The programme has two points of entry. A person who is still experiencing violence, or who has just left, starts at session 1 and stays in the first phase for as long as the danger lasts. A person who has been separated for a long time, with no contact or threat, still goes through session 1, because the danger assessment is never skipped, then through a session 2 reduced to the essentials, and joins the programme at session 7.
Three warnings specific to this reason for consultation.
Violence is rarely mentioned first. The person consults for depression, insomnia, panic attacks, exhaustion. If you do not ask the question, you will treat the depression of a person in danger.
Your wish for them to leave is a risk. It is legitimate, and it can make you lose the person, who already has someone deciding for them. Leaving is often the most dangerous moment (section 9): it is prepared, not demanded.
And supervision is not optional. These treatments expose you to helplessness, to anger, to fear for the person, and sometimes for yourself. That is worked on in supervision.
3. Four situations not to be confused
The term "intimate partner violence" covers different realities. The sociologist Michael Johnson showed that what separates them is not the presence of blows but the presence of general control by one partner over the other (M. P. Johnson, 2008). These situations do not call for the same course of action.
1. Coercive control, with or without blows
What you observe. A person who is afraid, who asks permission, who no longer has free use of their money, their phone, their outings or their relationships. Humiliation, threats, surveillance; sometimes physical or sexual violence, sometimes none.
What points the way. Fear between episodes, and the loss of freedom in everyday life. Johnson speaks of intimate terrorism when this control is accompanied by violence; in heterosexual couples, it is mainly perpetrated by men against women (M. P. Johnson, 2008).
What it implies. This is the programme described here, starting with the first phase.
2. Conflict that escalates
What you observe. Arguments that go as far as violent acts, often on both sides, without one partner dominating the other's life and without fear between arguments. Johnson speaks of situational couple violence.
What points the way. The absence of control and of fear. The distinction can only be made with each partner alone, and cautiously, because a person who is controlled often minimises what they are going through.
What it implies. The danger assessment in section 9 is carried out all the same. If situational violence is confirmed, without control or fear, Couple therapy: a therapist's manual describes the strict conditions under which joint work remains possible.
3. Past violence, whose after-effects dominate
What you observe. A person separated for a long time, with no contact or threat, who consults for re-experiencing, depression, distrust of any relationship, persistent shame.
What points the way. The absence of current danger, verified rather than assumed.
What it implies. Session 1, then the second phase. If post-traumatic stress disorder takes up the whole picture, Post-traumatic stress disorder in adults: a therapist's manual is also suitable.
4. Violent resistance, and the person who says they are a victim
What you observe. A person who has hit their partner, sometimes only once, and who presents themselves as violent. Or, conversely, a person who presents themselves as a victim and whose account mainly describes their own control over the other.
What points the way. Who is afraid of whom, who decides, who monitors. Johnson uses the term violent resistance for the act of the controlled person who one day responds with force (M. P. Johnson, 2008); that act does not make them the other's equal.
What it implies. In the first case, the person falls within this programme, and their act is worked on without treating it as equivalent. In the second, the programme does not apply: the person who exercises control falls within a programme for perpetrators, whose measured effects on reoffending remain small (Babcock et al., 2024).
The three sorting questions
"Have you ever been afraid of your partner?" It is among the HAS screening questions, and it targets the heart of coercive control: fear.
"What can you no longer do freely: see someone, spend money, go out, use your phone?" It isolates the loss of freedom.
"At the worst point of an argument, what happens?" It brings out what the words "argument" or "tension" cover.
4. The forms of violence and what they produce
The forms
Physical violence. Hitting, shoving, burns, confinement, and strangulation, which deserves a place of its own: it leaves few visible marks, it can cause loss of consciousness and injuries that only become apparent later, and it is among the most serious markers of danger (section 9).
Sexual violence. Forced intercourse, unwanted acts, coercion through threats or insistence, pressure concerning contraception or pregnancy. It is the form least often disclosed: in the French victimisation survey, women who had experienced sexual violence within the couple were those who least often filed a complaint, 12% of them (Mission interministérielle pour la protection des femmes contre les violences et la lutte contre la traite des êtres humains [MIPROF], 2025).
Psychological and verbal violence. Humiliation, insults, denigration, threats to kill, to leave with the children, to commit suicide or to reveal a secret, and the manipulation that makes the person doubt their memory and their judgement. It is the most frequent form: in the same survey, 74% of women victims reported it (MIPROF, 2025).
Economic violence. Control of money, of bank accounts and of identity documents, forbidding the person to work or sabotaging their work, debts taken out in the person's name. The HAS names it among the forms of violence within the couple (Haute Autorité de santé, 2019), and it can make leaving materially impossible.
Digital surveillance. Reading messages, geolocation, access to accounts, spyware, harassment by message. Most of the time these intrusions require no technical skill: a phone bought by the perpetrator, a shared account, a known passcode or a ready-to-use spy app is enough (Freed et al., 2018).
Coercive control. It is not one more form; it is what links the others. Evan Stark, who proposed the concept, describes the combination of violence and intimidation on the one hand, and of isolation and the regulation of daily life on the other, and argues that what does most harm is often the deprivation of liberty rather than the blows (Stark, 2007).
The cycle. The HAS describes violence that evolves in cycles: rising tension, assault, justification in which the perpetrator blames the victim, then a calm phase in which the perpetrator promises that it will not happen again; without intervention, the cycles repeat and worsen. It draws an important clinical consequence from this: the victim tends to go back on requests for help and on steps already taken (Haute Autorité de santé, 2019). Not everyone recognises a cycle: in coercive control, the pressure is often continuous (Stark, 2007).
After separation. The violence does not always stop when the person leaves: harassment, threats, surveillance, repeated legal proceedings, and use of the children as a means of contact or of pressure.
What they produce
Post-traumatic stress disorder. In an old but frequently cited meta-analysis, conducted on varied samples of women victims of intimate partner violence, its mean prevalence reached 63.8% across eleven studies (Golding, 1999). These means varied widely from one study to another, depending on where the women had been recruited, and they describe groups, not a person.
Depression. It reached 47.6% across eighteen studies (Golding, 1999). The link runs both ways: in women, violence precedes the onset of depressive symptoms, and depressive symptoms precede further violence (Devries et al., 2013).
Suicidal ideation and behaviour. Section 12.
Alcohol and other substances. Alcohol abuse affected 18.5% of women across ten studies, and abuse of other substances 8.9% across four (Golding, 1999).
Control without blows. A meta-analysis of forty-five studies finds moderate associations between coercive control and both PTSD and depression (Lohmann et al., 2024). The absence of blows does not mean the absence of harm.
The body. Chronic pain, digestive disorders, and repeated, poorly explained injuries are among the warning signs listed by the HAS. Blows to the head and strangulation can leave brain injuries: in a sample of 99 women victims, nearly three quarters had sustained at least one partner-related brain injury, and the severity of these injuries was associated with poorer memory and learning performance (Valera and Berenbaum, 2003).
How the person sees themselves. Shame, guilt, a sense of helplessness, low self-worth: the HAS names them among the effects to look for (Haute Autorité de santé, 2019). They are often a first-person repetition of what the perpetrator said over and over for years.
5. What keeps people there, and what maintains the suffering
The question "why doesn't she leave?" is the one the person hears most often, and the one that isolates them most. It has answers, and you need to know them so as not to ask it.
What keeps people there
Fear, often well founded. In a case-control study of women killed by their partner, separation, particularly from a controlling partner, was among the risk factors (Campbell et al., 2003). Staying is sometimes, in the short term, the safest choice.
Material obstacles. Money, housing, papers, a residence permit, work, and the children.
Isolation. Fewer people to help, and fewer outside eyes to say that what is happening is not normal.
Attachment. In a study of women who had just left a violent partner, the intermittency of the abuse and the power imbalance were associated with an attachment that persisted after the separation and decreased by only about a quarter in six months (Dutton and Painter, 1993). The alternation of fear and tenderness binds more than it repels.
The hope that things will change, kept alive by the apologies and promises of the calm phase.
The children: wanting to keep both parents for them, fearing losing them, or giving in to threats aimed at them.
The responses already received. Among women victims who had reported nothing to the police or gendarmerie, a third expressed distrust of the effectiveness of the procedures (MIPROF, 2025).
And the fact that leaving is a process. A review of research on leaving shows that women victims change the way they think about the violence several times before leaving for good, and that some are worse off just after leaving than when they were still in the relationship (Anderson and Saunders, 2003). A return is therefore not a failure of the treatment: it is often a stage.
What maintains the suffering
Real danger. As long as it lasts, vigilance is an adaptation, not a symptom to be reduced.
Loss of resources. Stevan Hobfoll's conservation of resources theory holds that what threatens a person is the loss, actual or feared, of what they value: ties, money, housing, health, self-esteem (Hobfoll, 1989). Violence takes away a great deal of these, and the suffering in turn reduces the capacity to rebuild them: this is the spiral on which one of the programmes evaluated for victims in shelters is based (D. M. Johnson et al., 2011).
Self-blame. "If I had been different, he wouldn't be like this." It often repeats the perpetrator's words verbatim, and it maintains shame and silence.
Avoidance, once the person is safe, as in any post-traumatic stress disorder.
The complete circle
Control isolates and frightens; fear and shame silence; silence reinforces isolation and self-doubt, and control spreads. The first phase of the programme attacks this circle through safety and resources; the second, through meanings and the memory.