Working with abused women with TBI
Not everyone with a brain injury has the same problems or needs, but it helps to pay attention to common effects of brain injury when talking with someone who has a TBI. The following are simple strategies to use when working with a victim of domestic violence who has a brain injury.
Attention and concentration
- Minimize distractions, such as phone calls and interruptions. Meet in a quiet location.
- Meet with her alone, unless she wants someone else included. (She may have difficulty tracking the conversation in a support group – or she may not.)
- Minimize bright lights.
- Limit length of meetings and build in short breaks.
- Work on one task at a time, which also helps with fatigue.
- Speak clearly and concisely.
- Phrase questions positively. For instance, ask “Do you think about leaving him?” instead of ‘“Don’t you think about leaving him?”
Information processing and memory
- Talk slowly and stay on point.
- Focus on one thing at a time.
- Break information down into small pieces and repeat it as often as necessary.
- Double-check to be sure she has understood you – encourage her to ask you to repeat or rephrase information.
- Be factual, not abstract (e.g., talk about what happens in court, not the meaning of justice).
- Ask yes-or-no questions, rather than open ended ones.
- Repeat, repeat, repeat.
- Break tasks down into sequential steps.
- If it is safe to do so, write down or tape important information, such as court dates, appointments, contact numbers, directions to places she needs to go, orders of protection, and to-do lists.
- Develop checklists.
- Help her prioritize goals and break them into small, tangible, sequential steps.
- Write out steps to a planning or problem-solving task.
- Help her fill out forms and make important phone calls.
- Allow extra time for her to complete tasks (e.g., to fill out a form).
- Point out possible short- and long-term consequences of specific choices.
- Provide clear and specific feedback.
- Provide reassurance and structure to help decrease her anxiety.
- Provide access to education about head injury and services for dealing with it, available through the Brain Injury Association of NYS and through their Family Help Line, 800-228-8201.
- Help her identify available social and medical supports and communicate with them.
- Encourage as much self-determination as possible. Ensure that she participates in the process of developing plans. Remember the slogan of many disability rights activists: “Nothing about us without us.”
- Role-play upcoming stressful situations, such as meeting with prosecutors or going to court.
Most important, be familiar with TBI resources and services in your community. State Brain Injury Associations, in particular, are excellent resources. In New York State, visit the Brain Injury Association of NYS.