Invisible Epidemic: Addressing Traumatic Brain Injury, Strangulation and Domestic Violence (Part 2)

Invisible Epidemic: Addressing Traumatic Brain Injury, Strangulation and Domestic Violence (Part 2)
Duration: 60 Minutes
Module 1 Module 1
Recorded on: 2022-08-30
Unit 1 Presentation Materials: Invisible Epidemic
Unit 2 Transcript: Invisible Epidemic
Unit 3 Workbook: Invisible Epidemic
Unit 4 Recording: Invisible Epidemic

This is the second installment of the Justice Clearinghouse webinar series on the Invisible Epidemic – Traumatic Brain Injury (TBI) and Strangulation in Domestic Violence (DV) cases. The first part looked into the importance of addressing head injuries in the DV setting, the functions of the brain and how damage within manifests, survivors’ experience with head injuries and strangulation, and their long-term effects. This session unpacks Ohio’s approach and tools to better identify TBI and strangulation in DV cases and provide survivors with resources in response to this.

Rachel Ramirez is back to continue the discussion on this webinar. She is the Founder and Director of The Center on Partner-Inflicted Brain Injury, a project of the Ohio Domestic Violence Network (ODVN). She led statewide initiatives and trainings on the topic and also co-authored Ohio’s Promising Practices and Protocols for DV Programs and their evidence-based CARE Tools.

Specifics of the webinar are about:

  • How issues that involve head trauma in DV situations require an interdisciplinary approach.
  • The central role of the brain in our bodily functions and how injuries to the brain can impact different areas of our lives.
  • Reorienting the commonly recognized intersection between DV and trauma to one that incorporates brain injury into the dynamic.
  • The known prevalence of head injuries occurring in DV situations and the disconnect with recognizing how it can lead to TBI.
  • The types of TBI based on how long consciousness was lost, and the incidents that typically cause TBI.
  • The tragic statistics on TBI and how TBI remains undetected and underreported.
  • Survivors’ DV experiences that lead to TBI, exacerbate TBI injury, delay healing, and affect brain processes.
  • The clinical diagnosis required for TBI and the lack of a test or procedure to effectively identify TBI.
  • Manifestations of brain function disruptions due to TBI and how athletes are screened based on these but DV survivors are not.
  • A glimpse into the inner processes that happen to the brain, its tissues, cells, and neurons during a TBI.
  • What strangulation is, the physiological processes that transpire, and the damage during strangulation.
  • Reasons why strangulation is undetected in DV Incidents due to the survivors’ potential altered consciousness, lack of visible injuries, barriers for survivors to access medical care, and the system’s lack of awareness to inquire about strangulation.
  • How a felony strangulation legislation holds abusers accountable through enhanced charges when evidence of strangulation is established.
  • The long-term impact of strangulation on the survivors’ brain functions, the power dynamic in the relationship, and the survivors’ safety, health, well-being and life.
  • Ohio’s trauma-informed framework to address head injuries through the CARE Approach.
    • What the the Connect, Acknowledge, Respond, and Evaluate components look like when it comes to service providers.
    • Encouraging a shift in perspective when working with survivors by understanding that they are not deliberately being uncooperative but are experiencing challenges to effectively do so due to the effects of the TBI on their abilities.
    • A rundown of the CARE tools available through the Ohio Domestic Violence Network to help service providers in their work and raise awareness for survivors.

Questions from the webinar participants are about:

  • Statistics comparing DV survivors with TBI to football athletes.
  • The type of care to provide survivors with and refer to when existing medical procedures are unable to detect TBI.
  • Addressing TBIs through specialized rehabilitation and management.


Other Webinars with this Speaker:


Or click here to view and register for other upcoming Victim Assistance webinars and recordings on the JCH Platform.


Resources and Handouts


Audience Comments

  • “I learned so much about this webinar and I’ve very fortunate to have been able to attend! Lots of important and relevant information that I have received that I believe will benefit me greatly in working as a victim advocate!” — Karla
  • “All of the information as it pertains to domestic violence was so on point and is definitely something I can see in clients. It definitely helps validate their experiences and look at their services through a new and more compassionate lens. I love how passionate the speaker was on this topic. Even with the technical difficulties, I loved hearing her present and could have listened to her for another hour.” 🙂 — Samantha
  • “Amazing details, a series would be highly demanded on this particular topic.” — Roman
  • “All of it was great. I plan on sharing the information learned with my clients and work colleagues. Thank you.” — Melissa
  • “All of the information was valuable and informative, thank you!!” — Jennifer
  • “The can’t vs won’t perspective was very helpful in understanding the behaviors of some clients I work with.” — Chelsea
  • “I found the statistics of DV brain injuries in comparison to certain sports injuries informational. It helped create a scale for just how common it is. I also liked knowing that strangulation has increased lethality. Perhaps a new topic could investigate why victims of DV, strangulation specifically, are shielding the abuser from legal punishment. Is there a statistic for how likely that is? I find that victims are often in the office signing affidavits for their abuser and wanted the case dropped.” — Zoe
  • “OMG, I could listen to Rachel all day. The kids I work with have been abused (physically or mentally). Many have brain injuries. Listening to Rachel helps me understand them and me.” — Margaret
  • “All useful information. The total impact that TBI and strangulation can have on the victim’s cognitive and physical abilities. Did not realize the totality of the physical & mental consequences.” — Cheryl
  • “Thanks for this very informative and much-needed learning opportunity, the presentation was amazing!” — Celeste
  • “I have been a DV/SA/CV advocate for ten years and there is always room for more information and trainings on how to help our clients. Thank you RachelR and JC for this particular webinar…I know there is a great deal more to what she shared and I am so glad she posted her website!” — Teresa
  • “Fantastic!!!! I loved her enthusiasm and obvious care for the subject of traumatic brain injuries.” — Russell





NACP and D-SAACP Advocates can earn 1 CEU by attending this webinar through the National Advocate Credentialing Program (NACP)® and the DoD Sexual Assault Advocate Certification Program (D-SAACP). Founded in 1975, the National Organization for Victim Assistance (NOVA) is the oldest national victim assistance organization of its type in the United States and is the recognized leader in victim advocacy, education and credentialing.  To learn more about NOVA, visit




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