Invisible Epidemic: The Intersection of Traumatic Brain Injury, Strangulation and Domestic Violence (Part 1)

Invisible Epidemic: The Intersection of Traumatic Brain Injury, Strangulation and Domestic Violence (Part 1)
Duration: 60 Minutes
Module 1 Module 1
Recorded on: 2022-07-21
Unit 1 Presentation Materials: Invisible Epidemic
Unit 2 Transcript: Invisible Epidemic
Unit 3 Workbook: Invisible Epidemic
Unit 4 Recording: Invisible Epidemic

For every athlete that gets a concussion, 5,500 survivors of domestic violence sustain a brain injury. But unlike athletes that get immediate and top-of-the-line care, DV survivors rarely get the care and services they need, and the injuries they suffer from go unrecognized and unaddressed. Rachel Ramirez leads this session to discuss the brain and its functions and how head injuries inflicted in a domestic abuse relationship can have long-term adverse impacts on the survivors.

This session’s instructor, Rachel Ramirez, is the Founder and Director of The Center on Partner-Inflicted Brain Injury, a project of the Ohio Domestic Violence Network (ODVN) where she led statewide initiatives and trained hundreds of professionals on the topic. She also co-authored Trauma-Informed Approaches: Promising Practices and Protocols for Ohio’s Domestic Violence Programs.

Specifics of the webinar include:

  • The prevalence of head trauma in domestic violence settings.
  • The concept of Partner-Inflicted Brain Injury and how this reshapes the commonly recognized intersection between DV and trauma to one that incorporates brain injury into the dynamic.
  • How the DV field dominantly operates using a psychological framework and how incorporating a neurological point of view allows to better understand the survivor’s circumstances and outcomes.
  • Understanding how the brain works, its different parts, and how head injury alters its intricate processes and functions.
  • A deep dive into the frontal lobe’s function which is primarily affected by DV-related head injury and brain trauma and how these typically manifests in survivors.
  • Elements that make brain injury caused by domestic violence distinct from concussions that occur in sports, military, or accidents.
  • How head injury transpires for DV survivors and how its repetitive nature and the inability to be addressed or treated immediately exacerbates its outcomes.
  • Traumatic Brain Injury: What it is, how it is diagnosed, what happens within the brain in a TBI, and identifying features following it that suggest disrupted brain functions.
  • What happens to the body and the brain during strangulation, the common result of being strangled, and how it is rarely addressed and screened for due to lack of visible injuries.
  • How strangulation is used by abusers to enforce power, control and dominance, its lethality risk, and how it leads to brain injuries.
  • A rundown of the most common physical, cognitive, and emotional symptoms and struggles observed in DV survivors that suffered from brain injury.
  • The overlap of trauma and brain injury in DV survivors, and how brain trauma manifests like a chronic condition that affects their thoughts, feelings, behavior, and daily functioning long-term
  • The different factors that determine the pace or recovery progress after a head injury.
  • How brain and body responses tend to be individualized with immediate symptoms as well as secondary symptoms that reveal much later or long-term effects that can manifest throughout the survivors’ lives.
  • Post-concussive syndrome observed months or even years after the concussion and symptoms of which.
  • Basic tips to help facilitate healing from head injury.

Questions from the webinar participants are about:

  • The required education and background to work with domestic violence victims.
  • Encouraging survivors to seek medical attention despite lack of visible physical injuries.
  • Educating first responders to recognize signs and screen for strangulation and head injury.


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

  • “How we typically approach survivors, and our expectations of them, need to be radically altered in the case of brain injury. We need to continually reevaluate our expectations and learn to adapt so survivors can get the services they need and have their best possible experience with us. A very valuable webinar, indeed.” — Lisa
  • “She really brought light to a subject I need to know more about.” — Megan
  • “Rachel did an amazing job, I love the videos, and her slide presentations, she provided an ABUNDANCE of good materials, and I’m signed up for part 2 on August 30, can’t wait! TYSM to Aaron and Christina at Justice Clearinghouse!!”  🙂 — Nicole
  • “Excellent topic and presenter!!!!” — Ximena
  • “How victims being confused or not remembering what happened may be mistaken for drug use or event not truly happening and the awareness surrounding this that needs to be made.” — Dana
  • “Speaker was knowledgeable and engaging, but I do feel it would be valuable to have a medical professional leading the discussion on the physiology of the brain and morbidities associated with TBIs.” — Janie
  • “I liked the analogy of how normal concussion protocol is for football and how we should consider that for working with victims/survivors.” — Kristin
  • “Great webinar! Expanded my understanding of implications associated with such injuries on survivors.” — Johnny
  • “I learned why some of our DV survivors often fail to understand what I’m trying to explain. Some fail to retain information and I have to repeat several times the same content of previous conversations. From now on I will incorporate these questions in my Intake form: did you receive a blow to the head, was there an attempt to strangle etc.” — Arely
  • “Rachel is such a passionate and amazing speaker. Great material, it was my first time being exposed to the idea of TBI with domestic violence victims. It was amazing. Thank you!” — Nathalie






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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