Healthcare and legal systems responses to coercive control: an embodied performance of one woman’s experience

ABSTRACT

This paper uses a drama-based method to illustrate the responses of healthcare and legal systems to women experiencing coercive control. This approach involved writing a play using the first-person narrative voice of a victim-survivor. We presented the play at the Stop Domestic Violence Conference (Gold Coast, Australia) in 2021. The central character, ‘Kate’, provided an embodied performance that enabled the conference participants to see, feel and understand experiences of coercive control from a personal perspective. We followed the trajectory of coercive control from the beginning of an intimate relationship to the time of separation. We showed how the process of coercive control escalates from love bombing, reproductive coercion, isolation, and technology-facilitated abuse until a point of police intervention. As Kate told her story, the conference audience witnessed the barriers and challenges faced by survivors of coercive control, and the emotional, financial, and psychological impacts that are intensified in geographically remote environments. They watched Kate navigate health and other systems meant to help women experiencing domestic and family violence, but that ultimately failed to deliver. Finally, the drama-based approach allowed us to present a feminist embodiment of coercive control and an innovative method for communicating inter-disciplinary research findings on domestic abuse.

KEYWORDS:

• Coercive control
• domestic and family violence
• healthcare systems
• legal systems
• drama-based method

Introduction

According to a recent policy initiative, the Australian National Plan to End Violence Against Women and Children 2022–2032, domestic and family violence (DFV) is at epidemic levels in Australia (Australian Government, 2022). DFV is a gendered phenomenon that encompasses a range of behaviours that perpetrators use to harm, intimidate, manipulate, or terrorise an intimate partner and children (United Nations, 2020). DFV is recognised as a public health issue based on gender inequality that violates the human rights of women and girls (Women’s Safety and Justice Taskforce, 2021, p. 396). At the time of writing this article, 11 women had died as a result of DFV in Australia in the month of July 2023 (Australian Femicide Watch [@ MapFemicide]), more than double the reported average of one woman per week. Globally, one in three women experience intimate partner violence or sexual violence (World Health Organization, 2021). The Australian Institute of Health and Welfare (2019) identified DFV as the main preventable risk factor for illness and death in women aged 18–44 years.

Recent analyses of intimate partner homicide have increasingly examined the prevalence of coercive control (CC) in these cases. CC involves repeated patterns of psychological, emotional, verbal, sexual, financial, and technology-enabled abuse (Stark, 2007) and underpins most male-perpetrated domestic abuse against women (Yount et al., 2016). Although some men are victims of CC, they are less likely than women to feel fear for personal safety (Walklate et al., 2022). A study on femicide found that not all women’s deaths were preceded by other incidences of physical intimate partner violence, but CC was a common theme in the informants’ (family and friends of victims) narratives (Eriksson et al., 2022). While there is a strong correlation between men’s controlling behaviour and their use of physical violence (Yount et al., 2016), CC can also occur within relationships without physical violence (Stark, 2013).

It should be noted that women with disabilities, those from culturally and linguistically diverse (CALD) backgrounds, Aboriginal and Torres Strait Islander women, and LGBTIQ + groups, are at much higher risk of experiencing DFV compared to the general population and may experience CC in different ways (Brown et al., 2021; Fitts et al., 2023; Reeves et al., 2023). For example, a survey conducted in an Aboriginal community in central Australia found over half of the respondents (56%) believed men were superior to women. In this community, ‘jealousing’ was a term often used to describe sanctioned controlling behaviours by men towards their partners (Brown et al., 2021, p. 8).

Coercive control: lasting health and wellbeing impacts on women and children

Women (and children) experiencing CC report adverse mental health conditions ranging from anxiety and depression, to forms of trauma that are directly related to living with this type of ongoing oppression (Brauer et al., 2019; Dokkedahl et al., 2021). Male perpetrators of CC inflict fear-instilling practices such as manipulation, gaslighting, surveillance and isolation (McCallum & Rose, 2021). Such behaviours deny freedom and agency to victims, impacting negatively on their health and wellbeing (Broughton & Ford-Gilboe, 2016; Humphreys & Thiara, 2003). Perpetrators may also manipulate health, social and legal systems to exert power and control over victim-survivors (Beckwith et al., 2023).

Children are directly affected by abuse of their mothers, with the perpetrator of CC typically trying to disrupt or break the mother–child bond (Heward-Belle, 2017; Maher et al., 2021). For children, this results in poorer physical health, deleterious psychological and behavioural outcomes, and reduced academic success at school; these negative effects often continue into adulthood (Beckwith et al., 2023; Saltmarsh et al., 2021).

Background to CC as a stand-alone offence in Queensland

The Australian legal system has long recognised that domestic violence is not just about physical violence. When Queensland Parliament introduced civil protection order legislation in 1989, such orders could be made where a person had experienced ‘intimidation or harassment’ (Domestic Violence (Family Protection) Act (Qld) 1989 ss 4(e) – as originally introduced). The importance of including coercively controlling behaviour in legal definitions of domestic violence became clearer during an inquiry on family violence and the law and, in 2012, the federal government amended the definition in the Family Law Act 1975 (Cth) to ‘violent, threatening or other behaviour … that coerces or controls a member of the person’s family … or causes the family member to be fearful’.

Public interest in CC was heightened in Australia in 2019 with the publication of journalist Jess Hill’s book, See What You Made Me Do. The question of legal responses to CC was galvanised in the State Government of Queensland by the murder of Hannah Clarke and her three young children Trey, Laianah and Aaliyah, in February 2020. They were killed by Hannah’s partner and the children’s biological father, Baxter, who then killed himself. Baxter’s abusive tactics included control over Hannah’s personal grooming, banning certain clothing such as short skirts and wearing pink (Coroners Court of Queensland, 2022, p. 6), and unjustifiably accusing her of having an affair (Coroners Court of Queensland, 2022, p. 10). At the time of her death, Hannah had separated from Baxter, and had sought advice from police and lawyers regarding safety for herself and her children.

In the aftermath of the murder of Hannah and her children, in March 2021, the Queensland Government established the Women’s Safety and Justice Taskforce, an independent, consultative body with its first Term of Reference to examine CC and review the need for a specific offence (Women’s Safety and Justice Taskforce, 2021). It was against this policy backdrop that we created a play performed at the Australian Stop Domestic Violence conference in December 2021. Our conference presentation identified opportunities that institutional systems have, but often miss, to support women experiencing CC.

Method and materials

As a multi-disciplinary research team (anthropology, sociology, law and social work), we chose to write a play to communicate (via a common language) the subtleties of CC, and to highlight the barriers faced by victim-survivors interacting with health and other services. One of our team used her legal expertise to play the role of narrator. Another of our team drew on her lived experience of CC to play the role of Kate. Other team members played the roles of health and other service responses. The play follows the trajectory of CC in one woman’s life from the beginning of an intimate relationship to the time of separation. We created our main character ‘Kate’ as a collage of lived experiences of CC (including one of the author’s own) and drawn from our professional research and practice.

We adopted the method outlined by a social work scholar, Duffy (2010), for creating composite case studies based on real life stories. Women taking experiences into their bodies in a visceral way, literally embodying the pain and emotion, is a long-established tradition in feminist scholarship. It was perhaps most famously played out in Julia Kristeva’s Stabat Mater (1985) where the author’s philosophical treatise on the cult of the Virgin Mary is intertwined with raw, physical descriptions of the birth of her son. In a nod to Kristeva, we invited the conference audience to feel as our character Kate does, and experience CC through an embodied lens. We acknowledge that Kate represents a middle-class, heterosexual, white woman (similar to the researcher whose personal journey greatly informs this play, contributing to its authenticity and reinforcing research validity). While there may be some similarities in Kate’s story of CC to those of CALD women, or Aboriginal and Torres Strait Islander women in Australia, she cannot and does not speak for their experiences; nor are her experiences those of all white women.

In our study, we chose to situate Kate’s embodied experiences of CC within a theatrical framework devised by playwright Bertolt Brecht. He used theatrical techniques to comment on society during turbulent political events of the twentieth Century by communicating directly to the audience so that they might respond and make changes to the world ‘outside of the auditorium’ (Franks & Jones, 1999, p. 192). We used a similar immediacy to speak directly to our conference audience which included health, legal and social service practitioners, and researchers, working in DFV. Moreover, the drama-based approach provided an ethically sound method to examine CC. This approach removes the need for participation of vulnerable people in research and reduces the risk of participant identification. Without direct engagement with clients or research participants, emotional risk for researchers is also reduced (Shaw et al., 2020).

Our play included short montages we called vignettes that incorporated projected images onto a large screen behind the stage where we performed. The images provided contextual backdrops that signposted tactics (Stark, 2007) and outcomes (Dokkedahl et al., 2021) of CC. Specifically, these were love bombing, reproductive coercion, isolation, baby blues, technology-facilitated abuse and police intervention. It is important to note that while these behaviours often escalate, they may also interact with one another. For example, love bombing, and reproductive coercion can be interweaved with other behaviours of abuse, creating cycles of manipulation, fear, reward and gaslighting (Hayes & Jeffries, 2015).

We used a ‘sliding doors’ motif of the doors of a train closing – to consider alternative, more effective, system responses to CC. The narrator used Brecht’s dramatic technique of expert attention by speaking to the audience through direct but rhetorical questions (Franks & Jones, 1999). To clearly convey meanings for readers, rather than a live audience, additional detail (under the sub-heading ‘chorus’) has been added to the vignettes. The ‘chorus’ brings in literature and policy relevant to the main theme of each vignette. While not part of the performance, the term chorus is the shortened form of a Brechtian ‘commentary chorus’, providing social and critical commentary on the actions taking place on stage.

Vignette 1 – Love Bombing

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Kate: When I first met George, he bowled me over. I couldn’t believe he was even interested in me. He was so good-looking and charismatic, and I was so ordinary. I was flattered and in love. I was swept off my feet by the flowers and love messages arriving every day.

Narrator: Kate’s experience is not uncommon. Men who are coercively controlling can seem to their new partner to be devoted and caring – but those traits can morph into possessiveness, jealousy, and constraining rules.

Chorus 1

This opening vignette could signify the beginning of a typical romantic relationship. Yet, the ‘love bombing’ phase can be a red flag for CC when the perpetrator is sending gifts, ‘to ensure her devotion and loyalty, all the while bringing her under his control’ (Blyth, 2021, p. 21). For victims like Kate, it may be extremely difficult to know at this early stage of a relationship whether they are being manipulated by tactics of CC or whether it is a sign of ‘nurturing mutual love and commitment’ (Blyth, 2021, p. 62). A common indicator of CC is a set of constraining rules about how intimate partners should act (Stark, 2013).

Vignette 2 – Reproductive Coercion

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Kate: We had only been dating for about four months, when I realised that I might be pregnant. I was a bit shocked because George had always worn a condom when we had sex. I was terrified to tell him I might be pregnant.

Narrator: Another aspect of CC is reproductive coercion. It is possible that George either slipped off his condom or put a hole in it, if he thought he had found the woman for him and wanted to keep her. Although unintentional pregnancies do not necessarily signal CC, would many health professionals be able to discern whether this was a case of reproductive coercion?

Chorus 2

The term ‘reproductive coercion’ (RC) describes ‘the structural and interpersonal abuse of power over sexual and reproductive health rights’ (Australia, Marie Stopes (M.S.) 2020, p. 15). RC can range from removing or damaging a condom to impregnate a woman, to demanding that she have an abortion, or preventing her from having one, and should be treated as ‘a specific behaviour associated with the CC that underpins DFV’ (Douglas & Kerr, 2018, p. 354).

The civil protection order regime in many states, including the State of Queensland, could cover this kind of conduct (Douglas & Kerr, 2018). In the State of Tasmania, section 9 of the Family Violence Act 2004 (Tas) creates an offence titled ‘Emotional abuse or intimidation’, which was used to prosecute a male perpetrator who prevented his partner from using contraception (Douglas & Kerr, 2018, p. 347). Recently, a number of states and territories have amended their definitions of ‘consent’ (e.g. Justice Legislation Amendment (Sexual Offences and Other Matters) Act 2022 (Vic)). Consent to a sexual act is negated if the agreement was for a condom to be worn, but a condom is not used, tampered with, or removed. Currently, there is a Bill before the Queensland State Parliament taking a similar approach (Criminal Law (Coercive Control and Affirmative Consent) and Other Legislation Amendment Bill 2023).

Vignette 3 – Isolation

(Australian mining town image generated using https://perchance.org/ai-text-to-image-generator)

Kate: When I told him I was pregnant, George just rolled his eyes and said: ‘Oh well, I guess we’d better get hitched’. I was working as an office manager at an electrical goods company in Brisbane. He was keen to get a job in the mines where some of his mates were working – and start raking in the big bucks. Next thing I knew, we were Mr and Mrs Jones and leaving the big smoke to live in a remote mining town where George got work, as a sparky. To be honest, I was a bit nervous as pregnancy made me feel shaky. I’d be leaving all my family, my friends, my whole world behind.

Narrator: Uh oh – more warning signs – Kate is being taken away at a very vulnerable time. George already has friends in the mining community. Kate knows no-one. The geographic isolation of mining towns in Australia means you can be hundreds of kilometres from health and other services. You might get a GP visit every third Thursday of the month, if you are lucky, and it can be nearly impossible to see a psychologist.

Chorus 3

In intimate partnerships with CC, factors like living in isolated regions, dependence on male earnings, and time taken out of the workforce to raise children, create vulnerabilities that perpetrators can exploit to gain further control over their victims (Beckwith et al., 2023; Holmes & Flood, 2013). Further, the lack of immediate support for victims increases safety and wellbeing risks (Walklate et al., 2022). In smaller communities, familiarity between perpetrators and local health workers, and police is more likely, which further inhibits victims from reporting violence or seeking help (Owen & Carrington, 2015). In remote communities, where violence against women is largely invisible (Fitts et al., 2023), it can be more difficult for victims to get help.

The Australian mining industry, and the purpose-built mining towns designed for a predominantly male workforce, are described as ‘a display of masculinity’ (Lozeva & Marinova, 2010, p. 6). The prevalence of DFV has been found to be higher in outback rural (or mining) communities, and paradoxically, less visible due to the more masculinised environment (Owen & Carrington, 2015). Coercive behaviours, including non-consensual sex, may not be regarded as problematic in such hyper-masculinised environments, and compliance with unwanted sex may be a survival strategy women endure to mitigate risks of further violence (Dowds & Agnew, 2022).

While concerned family and friends may not understand why victims remain in abusive relationships, the sense of fear and loss of agency when experiencing CC can make it very difficult for victims to leave (Broughton & Ford-Gilboe, 2016; Stark, 2007). Further, women living in remote communities, especially First Nations women experiencing violence, may choose not to access health and other services due to fears of police intervention and child removal (Fitts et al., 2023). Yet, despite the numerous constraints associated with living in a remote mining town, formal systems have been found to further traumatise women experiencing DFV with assumptions that they are ‘choosing’ to remain in abusive relationships, or ‘failing’ to protect their children from harm (Harris & Woodlock, 2022; Heward-Belle, 2017).

Vignette 4 – Baby Blues:

(Remote health clinic image generated using https://perchance.org/ai-text-to-image-generator)

Kate: After the birth of Tom, George wanted me back home as soon as possible. I was only in the regional hospital for two days. That was such a hard time. I had this tiny baby, no family around, and was exhausted because the baby didn’t sleep and wasn’t feeding properly. As soon as I got home George started hassling me for sex – made me feel guilty about the time I spent with Tom. I thought that visiting the maternal and child health clinic would be an opportunity to get out of the house. Somewhere I could be more myself.

Nurse: Come in. Let’s get that baby on the scales. How is he doing love? He is a bit underweight. Are you feeding him regularly enough?

Kate: I am just so tired all the time (starts to cry). It is so hard to try to feed the baby, then keep him quiet when George comes home from his shift and needs to sleep. George says I need to keep the house cleaner now. But he doesn’t give me money to pay for extra cleaning stuff, and it’s hard enough buying what I need for the baby.

Nurse: I’m sure he is just being super protective. Having a baby is a big change for men, and it takes husbands some time to adjust. Why don’t you see the GP when he is next in town and ask for some Valium, just to tide you over. That will help ward off those baby blues.

Narrator: Kate leaves the clinic feeling like a bad mother and a useless wife.

[Backdrop projection – sliding doors]

Narrator: Imagine this scene if the nurse had asked different questions about what was troubling Kate? She might have been able to tell the nurse more details about what was happening at home, opening an opportunity for referral to appropriate support. What if the maternal child and health nurse had a supportive manager able to provide mentoring and supervision and able to discuss referral options?

Chorus 4

Research has found pregnancy and birth increase the risk of DFV, with 14–17 percent of women in Australia reporting abuse in the first year postpartum (Gartland et al., 2021). Women who experience CC prior to birth are at increased risk of such abuse continuing into the postnatal period (Buchanan & Humphreys, 2021). An Australian study of 16 separated women who had experienced CC during pregnancy, birth, and the postpartum period, found that only two were identified by health staff as victim-survivors of DFV. One was screened by a midwife and referred to a social worker while the other referred by a nurse to a DFV support service (Buchanan & Humphreys, 2021).

Work is still needed to improve referral and coordination between health and other DFV services to assist women, and particularly new mothers, experiencing CC (Adams et al., 2022). Women who are victims of CC need time and confidence in healthcare providers to disclose (Adams et al., 2023). Further, health care staff require screening tools that include questions relevant to CC, including sexual, emotional, and financial abuse (McCallum & Rose, 2021). While there is some evidence that maternal child health nurses have improved their ability to screen and refer patients for DFV, it requires a relationship built on trust (Adams et al., 2023) and continuity of care by the same nurse-provider (Hollingdrake et al., 2022). These conditions are not always possible in overstretched health systems or when women live in remote communities with far fewer health facilities and resources (Fitts et al., 2022). Where resources are available, there should be consultation across systems with staff who work in alcohol and other drug services, mental health systems, child safety and family support (Beckwith et al., 2023; Tsantefski et al., 2021).

Vignette 5 – technology-facilitated abuse

(Original image created in PowerPoint by authors A and B)

Kate: Things are getting much worse and my nerves are shot. George sent this horrible text this morning, demanding more sex and accusing me of giving a blow job to the truckie who delivers our water. George has now shut down my Facebook account, and only turns on the internet when he’s home. I feel so trapped and alone. God, I wish mum was here! George has no patience with Tom’s crying and blames me. I think George might be tracking me – using some new app he’s put on my phone. When I go to get groceries, he grills me if I take too long, or if I have made other stops. I picked up a pamphlet about separation from the local library, and will find time to read it, if I can.

Narrator: At this point Kate’s mental health is deteriorating and her family is starting to worry. Her friends back in Brisbane cannot understand why she doesn’t just leave. Kate doesn’t know where to turn for advice, or who to trust. Technology-facilitated abuse is an ever-increasing form of CC but has been hard to capture in criminal law.

Chorus 5

The term ‘technology-facilitated CC’ encompasses technological and social aspects of abuse (Dragiewicz et al., 2018; Harris & Woodlock, 2019). This kind of abuse occurs on digital platforms using devices such as smart phones, but may also involve other technology, including computers, cameras, or apps, used to monitor and control victims. Technology has become ubiquitous and yet continues to change along with tactics for facilitating CC. Further, there is a lack of awareness amongst some groups, including CALD women, about the use and legality of CC facilitated by technology due to language barriers and different cultural interpretations (Louie, 2021; Zamora et al., 2023).

Ongoing technology-facilitated abuse exacerbates a victim’s already fragile mental health. For instance, abusive text messages pose an immediate threat to wellbeing and, because they come on to a phone, a personal device often used and close to the body, they can be an indelible reminder of ongoing abuse (Dokkedahl et al., 2021; Dragiewicz et al., 2018). CC can involve serious outcomes including Post-Traumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (C-PTSD). The latter is generally associated with a victim’s previous experiences of trauma (e.g. childhood sexual abuse) (Dokkedahl et al., 2021; Tsantefski et al., 2021).

A feature of technology-abuse is ‘image management’ (Saltmarsh et al., 2021) whereby perpetrators of CC create a public online image of themselves as a loving and caring husband/ father while controlling and terrorising their family in private. At the Inquest into Hannah Clarke’s death, Baxter was described as a ‘master of manipulation’ who used ‘impression management techniques’ to excuse, minimise or justify his violence (Coroner’s Court of Queensland, 2022, pp. 70–71). These commentaries raise questions about which aspects of CC might be reinforced via technology-facilitated abuse and what kinds of protections could be built into technology to minimise the mental health impacts. Technology can also be harnessed for support, with some online DFV platforms providing information and services that can help victims, with most sites offering quick exit buttons for safety.

Vignette 6 – Police intervention

(Police on doorstep image generated using https://perchance.org/ai-text-to-image-generator)

Narrator: Kate left that pamphlet on the kitchen table. George has just come home from work. Kate is playing with Tom in his bedroom. George sees the pamphlet and goes off – yelling and screaming and slamming doors – a neighbour overhears and calls the police.

[Police arrive – Kate is visibly upset, crying and trembling]

Police Officer 1: I’ve just spoken to your husband – he’s really worried about you. He was just calling out to you because he’s concerned that you’re not coping mentally. He thinks your drinking combined with your medications is getting out of control. He’s worried that you will do something to hurt yourself. Or the child.

Kate: Well, I have been under a lot of pressure. I know George worries about me being at home all day with Tom.

Narrator: So instead of referring Kate to health or other support services, the police refer Kate’s case to child protection due to concerns about her mental health and substance use. What happens when intervention services like police fail to recognise CC as the main cause of Kate’s poor mental health and need for prescription medication?

[Backdrop projection – sliding doors image]

Narrator: What might have happened if the police officers had been trained in recognising signs of CC?

Police Officer 2: I’ve just spoken to your husband. He’s told us his side of the story. My partner is going to stay inside with George, so we can have a private conversation. Tell me about what’s going on from your perspective.

Kate: Look, I am actually a bit frightened. He hasn’t hit me, but he’s getting pretty nasty. I want to leave but I am scared he might take my son. I don’t know what to do.

Narrator: This interaction would give police an opportunity to provide a range of referral options to Kate. If CC was an offence, would arrest be likely in this case?

Chorus 6

Police are important frontline responders to DFV, yet often fall short of the expectations of victims (Douglas, 2019; Richards, 2022). Evidence shows police often fail to understand how mental health and substance use are weaponised by perpetrators against women. This failure results in a focus on the victim and renders the abuser without blame (particularly if there are children) increasing the likelihood of wrongful arrest (Douglas, 2019). Although CC is gaining greater recognition across criminal justice systems, identification of coercive and controlling behaviour is still less likely to lead to convictions or arrest, compared to identification of physical abuse (Barlow & Walklate, 2021; Pugh, 2023). In the following sections we provide some suggestions for improving health, policing, and legal system responses to CC. While this discussion is not intended to be comprehensive, it draws on recent literature and policy that have made inroads in these areas.

Improving healthcare systems’ responses to CC

Healthcare systems have been slow to respond to women experiencing CC, despite their more frequent attendance across a range of health services including general practice, emergency departments, antenatal care, and child and maternal health clinics (Hegarty et al., 2020). Healthcare systems have been identified as the main gateway to supportive health and other service provision for victims of DFV (Adams et al., 2022), with some positive initiatives in this space (García-Moreno et al., 2015). Examples include, ‘empowerment counselling’ delivered by health practitioners in person or online, which increases safety planning for women and reduces symptoms of depression (García-Moreno et al., 2015, p. 1572). However, it is apparent that there is still a need for greater investment in education, training, screening, and referral pathways for health care professionals, particularly around CC (García-Moreno et al., 2015). Such training is important for all healthcare workers, especially nurses, who make up over half of all registered health professionals in Australia (Hollingdrake et al., 2022).

Frontline health professionals, including emergency department doctors, midwives, GPs, and child and maternal health nurses, need to be trained to identify and name CC, to support women’s decision-making and to refer victims to social workers (Buchanan & Humphreys, 2021). This process needs to be trauma-informed to enable holistic care that supports women’s decision-making (Tsantefski et al., 2021). However, the biomedical healthcare model tends to focus on physical symptoms rather than mental health harms associated with DFV (Broughton & Ford-Gilboe, 2016). Consequently, when victims report mental health issues, they are usually offered medication rather than counselling support, with counselling more helpful in exposing and supporting CC (García-Moreno et al., 2015; Humphreys & Thiara, 2003).

The Royal Australian College of General Practitioners [RACGP] (2022) recognises the importance of responding to CC in healthcare settings. The White Book (RACGP, 2022) calls for systemic change, including training for all healthcare professionals when violence is suspected or identified. This includes understanding of how to function within professional boundaries; knowledge of legal frameworks and options for patients, such as different types of protection orders and reporting to police; referral pathways for patients, including to sexual assault services; the reasons why patients might not report to police or take up referral options; and documentation of violence and abuse. This training should be integrated into undergraduate and postgraduate education and in continuing professional development (RACGP, 2022).

The value of training for healthcare providers and other professionals needs to be augmented with community education on CC. While the broader Australian community mostly recognises physical violence, knowledge of CC has increased in Queensland in recent years (Queensland Government Statistician’s Office, 2020). Increased community understanding is reflected in the attitudes of informal social networks, comprised of family, friends and neighbours, and professionals and makes it easier for victim-survivors to seek and access support for CC. Conversely, lack of community recognition hampers both help-seeking and professional responses. Media campaigns targeting the whole community are therefore required, along with education in schools on respectful relationships (Beckwith et al., 2023).

Improving other systems’ responses to CC

Like health, improvements are needed in police training on CC, including using more nuanced screening tools. However, some scholars are sceptical about whether ‘an updated risk assessment tool will effectively shift police officers’ focus from responding to what is measurable (i.e. incidents of physical violence) to process (i.e. CC)’ (Barlow & Walklate, 2021, p. 900). Professionals working in the criminal justice system more broadly also need a cultural shift to help them move from the violent incident response to ‘one that recognises the patterned nature of abuse over time and the insidious nature of CC’ (Women’s Safety and Justice Taskforce, 2021, Vol 3, p. 479). Aware of the subtlety and complexity of this issue, the Taskforce advises:

Professionals working across the justice and service systems must be proficient in supporting victims through the process of help-seeking.

Yet, the Taskforce points out that ‘training alone is not enough’, noting:

Training to enhance capability must be complemented by motivation and opportunity delivered through organisational, structural, and cultural change (Women’s Safety and Justice Taskforce, 2021, Vol 3, p. 478).

A critical component of this is forming partnerships with Aboriginal and Torres Strait Islander populations (Recommendation 24, Report 1, Vol 3, p 482). Concerns have been expressed by Aboriginal and Torres Strait Islander women, who are prone to incarceration in the context of DFV (Australian Law Reform Commission, 2017; Sisters Inside and the Institute for Collaborative Race Research, 2021). A survey of over 1200 victims of CC found only 31% of First Nations women believed that criminalisation of CC would improve their safety (Fitz-Gibbon et al., 2023, p. 10). The Queensland Domestic Violence Death Review and Advisory Board has called for better training for responders, advising:

Acts calculated to maintain control are often intensely personal within the context of the relationship. Coercive and controlling behaviours are accordingly unlikely to present as ‘textbook’ behaviours. The Board considers there are opportunities for agencies to better understand this and tailor their responses accordingly (Queensland Government, 2022, pp. 49–50).

The Queensland Police Service is trialling a co-responder model involving collaboration between law enforcement agencies, mental health experts, and allied health professionals, such as social workers (The State of Queensland, Queensland Police Service, 2022). The co-responder model involves police working alongside specialist DFV services to improve identification of perpetrator patterns of behaviour; reduce the likelihood of misidentification of the person most in need of protection; provide early support to victim-survivors; hold perpetrators to account; and improve service system integration (The State of Queensland, Queensland Police Service, 2022, p. 31). This approach aligns with the aim of integrated responses that unite professionals from disparate sectors in their efforts to curb DFV, including CC.

Finally, to mitigate the potential for perpetrators of DFV to exploit health and other systems, services need a consistent definition and approach to CC. Training therefore needs to include all services in contact with both perpetrators and victim-survivors. This training would also reduce abuse by systems designed to protect women, for example, through misidentification of victim-survivors as perpetrators.

Conclusion

Our intention in this article, which describes a drama-based performance, was to invite DV practitioners, and researchers, to reflect on their practices to support victims of CC. Our play highlighted the stages of CC from love bombing from reproductive coercion, technology-facilitated abuse, to police intervention. By using intensely personal vignettes told from our character Kate’s perspective through a feminist, embodied performance, we were able to reveal the subtle and insidious practices of CC from her male partner.

By illuminating pivotal moments in the play, where health providers and police could have intervened to identify CC and assist Kate, we pointed to systemic weaknesses. While there is evidence that healthcare systems have become increasingly capable of delivering coordinated and integrated responses to victim-survivors experiencing DFV, vulnerabilities persist (ANROWS, 2020). This is particularly the case for women and children living in rural and remote communities, where access to healthcare is challenged by geographic distance and lack of staffing expertise (Fitts et al., 2022; Humphreys & Healey, 2017).

Postscript: update on the changing CC legal landscape

Prior to December 2021, when our play was performed, Tasmania was the only state in Australia which criminalised CC, although the term CC was not used in the legislation (Tasmania Family Violence Act, 2004, (Tas)). Since then, in November 2022, New South Wales legislated a Crimes Legislation Amendment (Coercive Control Act 2022). Following that, in October 2023 the State Government of Queensland followed recommendations from the Women’s Taskforce on Safety and Justice and introduced the Criminal Law (Coercive Control and Affirmative Consent and Other Legislation Amendment Bill 2023), to make CC a stand-alone offence. These changes to the law confirm the importance of encouraging professionals to reflect on their practices in identifying and supporting victims of CC.

Acknowledgement

While we received no research funding for this project, we would like to acknowledge the support of the Disrupting Violence Beacon at Griffith University in supporting two authors attendance at the Stop Domestic Violence Conference.

Disclosure statement

No potential conflict of interest was reported by the author(s).