Safety planning is a very concrete, specific process, but you may need to break plans down into very small steps when working with a victim who has a TBI. Questions about specific TBI-related issues may be useful.
- Are there any steps she can take to protect her head from future assaults?
- Are there steps she can take to protect her head from
accidental re-injury? Ideas may include:
- Removing tripping hazards such as throw rugs.
- Keeping hallways, stairs and doorways free of clutter.
- Putting a nonslip mat in the bathtub or shower floor.
- Installing grab bars next to the toilet and in the tub or shower.
- Installing handrails on both sides of stairways.
- Improving lighting inside and outside her home.
- Always wearing a helmet when bike riding, rollerblading, skiing, etc.
- Is she aware of, and able to access, TBI-related medical care, rehabilitation and support services?
- Does she depend on her abusive partner for any disability or health-related assistance?
- Does the abuser exploit barriers created by her TBI?
- What assistive devices does she use? Some people with TBI use wheelchairs, but most do not. Many use memory aids, such as voice recorders, timers and blackberries.
- Is it safe for her to take notes or keep notepads by the phone?
- Does she have a way to keep her service animal safe, if she has one?
- Is she short-tempered, irritable or aggressive? If so:
- Does she pick fights with her partner that he uses as an excuse to become abusive?
- Has it strained her relationships with family and friends, depriving her of needed support?
- Is she able to work? If so, how supportive is her employer in terms of both the domestic violence and the TBI?
- Does she have difficulty holding a job?
- Is she getting whatever benefits she might be entitled to?
- Has she filed an application with the Office of Victim Services (OVS)? OVS may pay for services if the TBI was caused by a criminal act. Help her fill out an application and compile needed documentation.
- Does she have a plan to take her service animal and assistive devices with her?
- Is she able to drive or use public transportation on her own? If not, how will she access transportation?
- Does her emergency escape bag include (as needed):
- Spare batteries for assistive devices?
- Back-up assistive devices, and specific information on how and where to get replacements or repairs?
- Instructions for use of technical equipment?
- Medications, medical information, and medic alert systems?
- Contact information for medical personnel, TBI advocates and other service providers?
- Social Security award letter, payee information and benefit information?
- Supplies for her service animal – food, medications, leashes, vet’s contact information, etc.?7
Safety plans should be reviewed frequently and in detail, to help compensate for problems with memory, motivation, initiative and follow-through. An action plan that involves several steps should be sequenced: first do A, then B, then C. In addition, it helps to remember the following:
- A victim who has a TBI may not be aware of how it is affecting her, and may think she is functioning better than she is. Provide respectful feedback on problem areas that affect her safety.
- Depression is common, and may be related to the TBI, the abuse, or both. Remind her of her strengths, which depressed people tend to forget.
- Fatigue is common, and may be related to the TBI, the depression, or both. Be realistic about how much – or how little – she may be able to do in a given day.
For more ideas go to Traumatic Brain Injury and Safety Planning Ideas for Domestic Violence Advocates.