TBI and Domestic Violence

Traumatic Brain Injury and Domestic Violence

If you or someone you know is in a domestic violence situation, and/or if you need immediate information and assistance:

Domestic Violence and Intimate Partner Violence

Domestic violence (DV) and intimate partner violence (IPV) are a common cause of traumatic brain injury (TBI). While a disproportionate amount of these individuals are adult women, both adult men and children can be victims of the severe physical violence that causes these injuries in a domestic setting.

Intimate Partner Violence (IPV) includes any behaviors that one intimate partner (current or former) uses over another to establish power and control. This can include:

  • Physical or sexual violence
  • Financial
  • Emotional and psychological
  • Cultural and spiritual
  • Reproductive
  • Other controlling behaviors

Some forms of IPV can be perpetrated electronically through mobile devices and social media sites, as well as in-person. IPV can occur regardless of whether the individuals live together or not. This is usually what separates IPV from DV.

Domestic Violence usually refers to violence occurring between residences within one single location. It is a pattern of controlling behavior used to maintain power in a relationship by one partner over the other.

What is a Traumatic Brain Injury? 

A traumatic brain injury (TBI) is an injury to the brain caused by physical trauma, including physical assaults. A TBI can result in changes to one or more of the following areas: cognition; language memory; attention; reasoning; abstract thinking; judgment; problem solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; or information processing. 

A victim of DV or IPV may sustain a TBI without their knowledge, especially if there are no signs of obvious signs of trauma or other TBI-related symptoms. Many individuals may receive no medical care or intervention, thus dramatically increasing the likelihood of recurrent TBI(s), which may result in more severe neurological damage.

Common causes of closed head injuries among DV or IPV victims:

  • Objects striking the head or neck
  • Pushed against a wall or other surface
  • Pushed down a flight of stairs
  • Violent physical shaking
  • Choking or strangulation

An individual that has sustained a TBI may not recognize they are experiencing issues related to a TBI because many of the associated symptoms are common in everyday life. The most widely reported TBI-related symptoms are headaches, severe neuro-fatigue, working memory issues, anxiety, depression, and impairments in social communication.

TBI Screening

Screening for TBI among people who have experienced or are experiencing DV can potentially reduce the physical, behavioral, and cognitive consequences of a TBI by identifying and supporting proper treatment and resources. The high probability of recurrent physical injuries without any medical intervention facilitates a situation where individuals are more likely to experience severe TBI-related symptoms over a prolonged period. Screening for TBI among survivors of DV is essential. A brief screening tool designed to be used by professionals who are not TBI experts is known as HELPS Screening Tool.

Providers and Trauma-Informed Care

Service providers with a trauma-informed approach can aid in the healing process and allow for the best possible outcomes for survivors of DV and IPV. To be trauma-informed in practice means establishing a pathway that will not further re-victimize the individual seeking services. In accomplishing this goal, the service provider will be holistically supporting victims of DV and IPV in their recovery and healing trajectories.

A TBI can make it harder for a survivor to:

  • Remove themselves from an abusive environment.
  • Assess potential dangers and react appropriately.
  • Engage in educational opportunities.
  • Access service providers that can enable independent living.
  • Adapt to living in a DV shelter.   The victim may become anxious and confused or disruptive or have trouble understanding or remembering shelter rules and procedures.

Working with survivors after a TBI:

  • During meetings, reduce unnecessary distractions, such as bright lights and noise.
  • Develop safety planning in smaller and frequent steps.
  • Aid in the development of checklists, goal creation, and time management.
  • Allow extra time to complete tasks (e.g., forms, phone calls, decision-making, etc.).
  • Be factual, realistic, and concrete in your statements.
  • Break information down into small pieces.
  • If safety allows, write important information down in a journal or calendar, such as court dates, contact numbers, directions, order of protection information, to-do lists, etc.
  • Coordinate with the individual to optimize the management of their lives, in terms of accessing benefits, rehabilitation and support services, assistive devices (voice recorders, timers, PDAs, post-its, etc.) service animals, and independent living.
  • Provide respectful feedback on problem areas that affect the safety and possible consequences of long-term/short-term decisions.

Visit I am a Provider and Person-Centered Care and Practices for more information and resources.

Additional Information and Resources

Learn more about:

  • RCW 74.31.070 on the statewide response to traumatic brain injuries suffered by domestic violence survivors;
  • and how it supports RCW 10.99.030 on Peace officers’ powers and duties when responding to domestic violence calls (under 4b).

Access eLearning Network training and downloadable materials from the Ohio Domestic Violence Network (ODVN) Resource Center, like:

Access our Building Capacity: Brain Injury Workshop Library and register for upcoming learning opportunities

Access our TBI Capable Caregiver training manual and other useful learning materials

Access research, learning, and advocacy resources: