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Coercive Control — DFSRH MCQ

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EasyCoercive ControlDFSRH

A 36-year-old woman attends a sexual health service in England for contraception. While alone, she discloses that her former partner monitors her movements, controls access to money and repeatedly threatens to take their 9-year-old son away unless she resumes the relationship. He makes the child report whom she telephones and has smashed household objects during video calls. The child now hides during calls, has recurrent nightmares and has told his teacher that he fears his mother will be killed. Mother and child are currently staying at an address unknown to the former partner. There is no injury or immediate threat requiring an emergency response today. She has capacity and accepts safety planning but refuses police, specialist domestic-abuse and children's social-care involvement because she fears losing custody. Which is the most appropriate management plan?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Make a referral to local authority children's social care despite her refusal, informing her if safe and continuing safety planning

Explanation lettering: C = shown as A · D = shown as B · E = shown as C · B = shown as D · A = shown as E

The child is not merely a witness to adult abuse. He is being used to monitor his mother, has experienced threatening and destructive behaviour, and has developed symptoms indicating significant emotional impact. Under the Domestic Abuse Act 2021 framework, a related child who sees, hears or experiences the effects of domestic abuse is recognised as a victim in their own right. These features require prompt sharing with local authority children's social care under local safeguarding procedures. Working Together to Safeguard Children 2026 states that consent is not necessary when information is shared on an appropriate lawful basis to safeguard a child. The mother should normally be informed and involved, but only where doing so is safe; her own safety planning and offers of specialist support should continue. B over-applies the confidentiality owed to a capacitous adult: her refusal does not veto proportionate child-safeguarding information sharing. C is inappropriate because there is no immediate emergency and police involvement does not replace direct referral to children's social care. D understates the concern: early help may suit lower-level emerging needs, whereas coercive use of the child, fear of maternal death and trauma symptoms require statutory assessment. E introduces unsafe delay and improperly transfers the clinician's safeguarding responsibility to primary care.

Reference: Working together to safeguard children 2026 (18 March 2026) — https://www.gov.uk/government/publications/working-together-to-safeguard-children--2 Domestic Abuse: statutory guidance (July 2022) — https://www.gov.uk/government/publications/domestic-abuse-act-2021/domestic-abuse-statutory-guidance-accessible-version