The Long-Term Impacts of Non-Fatal Strangulation

The Long-Term Impacts of Non-Fatal Strangulation
Duration: 60 Minutes
Module 1Module 1
Recorded on: 2023-04-13
Unit 1Presentation Materials: The Long-Term Impacts of Non-Fatal Strangulation
Unit 2Transcript: The Long-Term Impacts of Non-Fatal Strangulation
Unit 3Workbook: The Long-Term Impacts of Non-Fatal Strangulation
Unit 4Recording: The Long-Term Impacts of Non-Fatal Strangulation

Strangulation is the ultimate act of power and control – the ability to inflict pain and even cause death with just the abuser’s hands. It becomes even more harrowing when the person inflicting the harm is a person you love and trust as seen in domestic violence cases. This webinar unpacks brain injuries in DV settings particularly Hypoxic-Anoxic Brain Injuries, better known as strangulation.

Leading the discussion is, Rachel Ramirez, the Founder and Director of The Center on Partner-Inflicted Brain Injury. She leads statewide initiatives and trains hundreds of professionals on the topic of domestic violence and brain injuries. She also co-authored Trauma-Informed Approaches: Promising Practices and Protocols for Ohio’s Domestic Violence Programs.

Points covered during this session include:

  • The Ohio Domestic Violence Network (ODVN), their composition and work done to assist DV survivors and raise awareness on DV issues specifically traumatic brain injury in the DV context.
  • A survey conducted by the ODVN that revealed the prevalence of DV survivors being hit in the head or strangled which creates head trauma or concussions that are not identified or addressed.
  • How brain injury is typically not considered in the context of DV and how understanding the connection can help survivors receive proper treatment for its immediate and long-term effects.
  • The different types of concussions and brain injuries and zeroing in on one specific type: Partner-Inflicted Brain Injury.
  • The highly complex and distinct characteristics of brain injury which creates just as complicated and unique impacts to victims.
  • The value of immediately identifying and providing support for healing in brain injuries and how it is complicated to treat even with elite athletes who get immediate and top-notch services.
  • How repetitive head trauma aggravates the victims’ condition and may result in more severe symptoms and chronic brain injuries.
  • The different ways brain injury is inflicted and the brain is hurt, and how these co-occur in DV cases.
  • The ways survivors experience strangulation in the DV context and how it affects them immediately and long-term when unrecognized and unaddressed.
  • The increased lethality risks of strangulation, the danger of abusers who strangle, how it causes severe damage without visible manifestation, and how it causes brain injuries.
  • The value in viewing both the neurological and psychological impacts of domestic violence, particularly brain injuries.
  • A rundown of the ways brain injury manifests and its immediate signs and long-term cognitive, physical, and emotional symptoms.
  • The key takeaways that victims of domestic violence must be screened for potential brain injury and understanding that cognitive/physical/emotional limitations are results of their unaddressed brain injury.
  • The CARE Approach and tools: How it provides a holistic model to respond to and raise awareness on brain injury that stemmed from DV, and the scope and limitations of this programming,

Questions from the webinar attendees are about:

  • The link between TBI and early onset dementia.
  • Longitudinal studies on brain injuries.
  • Protocols and questions to ask an individual who potentially suffered from head trauma, strangulation, or brain injury.
  • Medical procedure and diagnostics for strangulation victims.


Other Webinars with this Presenter


Click here to view and register for other upcoming Victim Advocate/Assistance webinars and recordings on the JCH Platform.

Or Click here to view and register for other upcoming Domestic Violence webinars and recordings on the JCH Platform.



Resources and Handouts



Audience Comments

  • “Just in general that we’re starting to recognize the connection between head/brain trauma and domestic violence victims – and really everything that stemmed from that overall fact! Thank you for a great webinar!!!!” — Amber
  • “In general, this is such an important topic that is not understood or recognized by many. It’s a great reminder to not pre-judge our victims for their outward behavior.” — Jill
  • “Rachel is really good. Kudos!” — Patrick
  • “I like the visuals and the printouts so we can refer back to and educate others.” — Veronica
  • “[I liked] the data. Please thank the presenter for sharing her time and knowledge.” — Rose
  • “I learned that strangulation injuries are different from TBIs, I had no idea that brain injuries varied the way they do. I loved this webinar, it was incredibly informative and I appreciated how knowledgeable Rachel was on the topic, she was pretty cool.” — Summer
  • “The knowledge and compassion of the Presenter were WONDERFUL for such a sensitive topic. THANKS.” — Vivian
  • The overlap between strangulation and head hitting was something I never knew before! Love the topic and presenter.” — David
  • “Info about the Maddox Score and screening. Such an eye-opening webinar.” — Julia
  • “Rachel was an excellent and passionate presenter. She really knows her subject. The presentation really highlights how far there is to go in researching and addressing strangulation in DV.” — Michele
  • “MORE, MORE, MORE!! The presenter is knowledgeable, engaging, and insightful.” — Andrea
  • “It is hard to account for the most valuable thing that I learned from this webinar as I felt it was jam-packed with good info. One big takeaway is truly emphasizing the seriousness of strangulation with or without any noticeable bruising.” — NaCasha
  • “I have been doing victim work for 13 years and today I had an A-Ha moment. As a society, we have embraced the effects of a concussion in sports, yet we don’t apply concussions in DV having the same effects. You have connected dots that were there all the time. These trainings are perfect! The length is just short enough to step away from daily work, and the info is just enough to make me realize “I didn’t know that!” We don’t need to be subject-matter-experts, we just need to be aware that we are not!” — Betty Lou
  • “The speaker was very engaging and knowledgeable about the information that she presented.” — Ja’Tiona





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




Additional Resources
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Thoughts about Dangerous Abusers from Rachel Ramirez
Rachel Ramirez had so many great insights during her webinar, The Long-Term Impacts of Non-Fatal Str […]
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Thoughts about Domestic Violence TBIs from Rachel Ramirez
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After the Webinar: The Long Term Impacts of Non-Fatal Strangulation. Q&A with Rachel Ramirez
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