Traumatic Brain Injury and DV
Freedom House looks at Traumatic Brain Injury as it relates to Domestic Violence.

According to the Center for Disease Control a Traumatic Brain Injury is “a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.”

It is important as professionals working in the field of domestic violence (DV) that we understand Traumatic Brain Injury (TBI) as it relates to our work with survivors.

Many domestic violence victims who have experienced a blow to the head during abuse may have suffered TBI, but may not be aware of the injury and its potentially chronic impact on their daily lives. We as service providers need to recognize the signs and ask the basic questions to understand if this person has suffered a brain injury.

During physical incidents of violence people are often punched in the head, strangled, or their head is pushed into an object such as a wall. Sometimes these injuries occur repeatedly. For example, a woman may say, “he hit me in the head and apologized and said he would not do it again but two weeks later he slammed me against the wall and strangled me.”

Many domestic violence victims may be suffering silently, unaware that they have TBI, thinking that certain symptoms and issues they live with are related to stress. In fact, it may be TBI causing difficulties such as:

Following through with or completing tasks
Being unable to keep appointments
A brain injury can even cause increased anxiety or depression. Basic questions to ask according to the “HELPS Brain Injury Screening Tool”

Have you ever hit your head or been hit on the head?
Were you seen by a doctor because of an injury to your head?
Did you ever loose consciousness or experience a period of being dazed and confused because of an injury to your head?
Do you experience any problems in your daily life since you hit your head?
Any significant sicknesses since you got hit on the head?
Click here to learn more about H.E.L.P.S

For additional information about Domestic Violence and Brain Injuries please visit the Brain Injury Association of New York State website http://www.bianys.org/

They have a wealth of information for domestic violence providers including handouts on:

“Working with Victims with Brain Injuries in Domestic Violence Shelters”
“Domestic Violence Victims with Brain Injuries in Support Groups”
“Traumatic Brain Injury and Safety Planning Ideas for Domestic Violence Advocates
“Safety Planning for Domestic Violence Victims who Have Been Hit on the Head”

Survivor’S Story

Ms. A is 25 years old and has two children, ages one and six who came to Freedom House Emergency Shelter in July of 2012.

During the last incident of violence her abuser punched her repeatedly in the head and broke two vertebrae by stomping on her back. Ms. A lost consciousness for an undetermined amount of time.

When she woke up she was unable to walk. She waited for the abuser to leave for work and called 911. Ms. A was taken to the hospital where she received treatment for her spinal injury only. Ms. A complained of bad headaches but the emergency room doctors told her to return only if they worsened.

Ms. A stayed with her mother while she recovered from the spinal injury for one month and then went to Freedom House. While completing her assessments with her social worker, Ms. A complained of headaches, feeling confused often, and having memory problems. Ms. A attributed the symptoms to stress and pain from her back injury.

Her Freedom House Social Worker and various staff including childcare, entitlements and Freedom House family services observed that Ms. A missed several appointments and seemed very overwhelmed. When her social worker was completing the intake she noticed Ms. A had difficulty spelling her name and could not remember conversations they had together, both signs of TBI.

At this point, the team suspected Ms. A suffered a brain injury from the last incident of violence. The team administered the H.E.L.P.S brain injury screening tool (see above) and Ms. A answered many of the questions positively. Ms. A was referred to a neurologist for medical care and to an agency specializing in TBI assistance.

In addition, Freedom House staff worked as a team to assist Ms. A during her stay by reminding her of appointments and giving her a planner. She also worked with the Occupational Therapy department to learn new memory techniques. Ms. A completed the program at Freedom House and moved into another shelter to wait for permanent housing.

She continues to go to the Freedom House after-care group Beyond Freedom. (See Breaking Barriers September 2012 article, click here.)