Office for the Prevention of Domestic Violence

Information for Professionals

Domestic Abuse and Traumatic Brain Injury Information Guide

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Domestic violence (DV) is a common cause of brain injury in women, who constitute the vast majority of victims of severe physical violence by an intimate partner.

The head and face are common targets of intimate partner assaults, and victims often suffer head, neck and facial injuries.One study of women in shelter found that the vast majority had been hit in the head or severely shaken by their partners, most more than once. The more times they had been hit in the head or shaken, the more severe, and the more frequent, were their symptoms.1

What is Traumatic Brain Injury?

Traumatic brain injury (TBI) is an injury to the brain that is caused by external physical force.

A victim of domestic violence may suffer a TBI without knowing it if she had no severe trauma or obvious symptoms at first, or if she did not lose consciousness, or received no medical care.

NOTE: While a TBI can lead to aggressive behavior, it does not cause or excuse the targeted pattern of coercive control usually seen in DV. If a woman thinks her partner is violent because he has suffered a TBI, she might want to try and get an evaluation for him, but she should also be helped to plan for safety.

Difficulties caused by Traumatic Brain Injury

TBI can lead to impairments, ranging from to mild to severe, in cognition (thinking), emotions, behavior, and physical functioning. The person with a TBI may or may not recognize that they are having problems. The most common symptoms reported are headaches, severe fatigue, memory loss, depression, and difficulty communicating. Other problems experienced by people who have brain injuries include:

Information For Service Providers

TBI service providers. Living with domestic violence can make it harder to recover from a brain injury. You can more effectively serve your clients if you routinely screen for DV. Screening can help you identify clients who have been assaulted by intimate partners. Some may have suffered multiple brain injuries due to multiple assaults, and some may have partners who still assault them on an ongoing basis. Others may have partners who try to prevent them from accessing services, which is common among batterers.

When a victim discloses that she is being abused, support her right to make her own decisions as far as possible, even if living independently is not a realistic possibility for her. Don’t try to take control or tell her what to do. Connect her with domestic violence services. If she wishes, reach out to the domestic violence agency with information about TBI, what support she needs, and what services are available to her. Look for ways that you can work together to provide effective advocacy for both problems.

Brain injury can make it harder for a victim of domestic violence to:

Domestic violence service providers. Screen everyone who seeks DV services for TBI. A brief screening tool that was designed to be used by professionals who are not TBI experts is the HELPS.2

HELPS is an acronym for the most important questions to ask:
H = Were you hit in the head?
E = Did you seek emergency room treatment?
L = Did you lose consciousness? (Not everyone who suffers a TBI loses consciousness.)
P = Are you having problems with concentration and memory?
S = Did you experience sickness or other physical problems following the injury?

If you suspect a victim has a brain injury, or she answers “yes” to any of these questions, help her get an evaluation by a medical or neuropsychological professional – especially if she has suffered repeated brain injuries, which may decrease her ability to recover and increase her risk of death. If she wishes, reach out to the TBI service provider with information about DV, what support she needs, and what services are available to her. Look for ways to work together.

Working with abused women who have a TBI

The following strategies can help when a victim has difficulties with attention, concentration information processing, memory and executive functioning.

Safety Planning

Safety planning is a concrete, specific process. When working with a victim who has a TBI, you may need to:

Resources

Brain Injury Association of New York State

Brain Injury Information Network - links to many other online resources

Brain Injury Resource Center: information, links to online support, and tools for self-advocacy. Also offers a Head Injury Hotline, 206-621-8558.

CDC, National Center for Injury Prevention and Control, Victimization of persons with traumatic brain injury or other disabilities: A fact sheet for professionals.

Office of Victim Services (OVS)

Picard, N., Scarisbrick, R. & Paluck, R., (1999). HELPS (Grant # H128A0002). Washington, DC: US Department of Education Rehab. Services Admin., Intl. Center for the Disabled.

National Association of State Head Injury Administrators Technical Assistance Center


  1. Jackson, H., et al. (2002). Traumatic Brain Injury: A Hidden Consequence for Battered Women. Professional Psychology: Research and Practice, 33, 1, 39-45.
  2. International Center for the Disabled, HELPS Screening Tool, 1992