Traumatic Brain Injury and Safety Planning: Ideas for Domestic Violence Advocates
When a victim of domestic violence (DV) has a traumatic brain injury (TBI), it is important to consider the effects of the TBI in safety planning. Some people know they have a TBI, but are not aware of specific needs they have. Others have a TBI but do not know it; this is not unusual. Screening for TBI may identify the need for an evaluation.
- Review safety plans frequently and in detail, to help compensate for problems with memory, motivation, initiative and follow-through.
- Make lists of what needs to be done. List tasks in order: first do A, then B, then C.
- Provide respectful feedback on problems that affect safety. She may think she is functioning better than she is.
- Treat her as the expert on what she needs and what works for her.
Managing Her Mood And Energy
- Is she short-tempered, irritable or aggressive? If so, does she pick fights that her partner uses as an excuse to become abusive? Has it strained her other relationships, depriving her of needed support?
- Has she been depressed? Depression may be related to the TBI, the abuse, or both. Remind her of her strengths, which depressed people tend to forget.
- Is she constantly tired? Fatigue is common with TBI (and with depression).
- Does she function better at one time of the day than another?
Hint:Schedule your time with her around her energy level. Plan to spend more time than usual. Be realistic about how much – or how little – she can do in a given day.
- Is she able to work? If so, does her employer know about the DV and/or the TBI? Is her employer supportive?Does she have difficulty holding a job?
- Is she getting whatever benefits she might be entitled to?
- If the TBI was caused by a criminal act that was reported to police, has she applied for crime victims compensation to help pay for services? Help her fill out an application and compile needed documentation.
Hint:People who have had a TBI often expect to be able to do the same work they did before, and may not discover that they can’t until they actually try to go back to work. Support her self-determination, even when independence is not possible.
Accessing Non-DV Services
- Is she aware of, and able to access, TBI-related medical care, rehabilitation and support services?
- Are her health care and brain injury providers aware of the DV?
- Do any of her providers communicate with the abuser?
- Does she need information in alternative formats (audio, large print, etc.)?
- Does she rely on the abuser for essential services, such as help to dress or eat?
- Does the abuser stop her from accessing services? How?
- What assistive devices – a wheelchair, memory aid (voice recorder, smart phone ro timer) does she use? Does she have a service animal? Can she keep it safe?
- Is it safe for her to take notes or keep notepads by the phone?
It might help to ask permission to talk with a provider on her behalf.
- If she leaves her partner, does that mean losing her primary caregiver? Does she have a plan for alternate caregivers? Is she able to live by herself?
- Does she have a plan to take her service animal and assistive devices with her?
- Is transportation an issue? Can she drive or use public transportation on her own?
- Is accessible housing an issue?
- Does her emergency escape bag include (as needed):
- Back-up assistive devices, and specific information on how and where to get replacements or repairs?
- Spare batteries for assistive devices?
- Instructions for use of technical equipment?
- Medications, prescriptions, medical information, and medic alert systems?
- Contact numbers for medical personnel, TBI advocates and other providers?
- Documents: Social Security award letter, payee and benefit information?
- Food, supplies, medications, vaccination certificates, etc. for service animals; vet’s contact information?1
Speaking and acting impulsively is common with TBI, and can be dangerous for DV victims. Help her think about what, if anything, to say to her partner, how and where to do it, and whether she needs to have a supportive person with her.