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IPV and Women’s Wellness: Toward Enhancing Survivor Support

Intersection of TBI and IPV in Harris County

Intimate partner violence (IPV) is abuse by current or former intimate partners, and it exists in many forms (Breiding et al., 2015). The Center for Disease Control and Prevention (CDC) defines and assesses five types of IPV including sexual violence, physical violence, stalking, psychological aggression, and control of reproductive or sexual health (Black et al., 2011). IPV is a prevalent health crisis among women. In the United States, approximately 1 in 5 women experience severe physical abuse by intimate partners. Further, severe physical abuse and violence by intimate partners can be a precursor to homicide. The CDC finds that murder is one of the leading causes of death for women 44 years and older (Center for Disease Control and Prevention, n.d.). Moreover, the stay-at-home orders during the COVID-19 pandemic have increased the concern about the prevalence and lethality of IPV (Kaukinen, 2020; Wood et al., 2020).
The ubiquity of IPV has led researchers to identify the impact of IPV. Numerous studies consistently find that IPV can have lasting impacts on women’s wellness (Becker et al., 2010; Campbell, 2002; Coker et al., 2000; Valera & Kucyi, 2017). For example, chronic health problems and central nervous system issues such as fainting and seizures, as well as traumatic brain injury can arise as a result of IPV-related injuries and trauma (Campbell, 2002; Valera & Kucyi, 2017). Most women who have suffered from physical and/or sexual abuse by their intimate partners do not present with obvious injuries. However, when injuries exist, battered women are more likely to present physical injuries to their head, face, neck, thorax, breasts, and abdomen (Campbell, 2002). IPV has also been associated with cardiac and gastrointestinal disorders (Campbell, 2002). Women of sexual violence are also at risk for sexually transmitted infections such as HIV, trichomonas, and gonorrhea (Gaensslen & Lee, 2001).

While much of the existing research focuses on the physical consequences of IPV, the effects of emotional and psychological abuse by intimate partners can also be damaging. Mental health consequences of IPV can linger long after physical wounds heal. Depression and post-traumatic stress syndrome (PTSD) are two of the most commonly reported mental health consequences of IPV (Black et al, 2011; Breiding et al., 2015). Women are also at risk for suicidal ideation after IPV (Campbell, 2002). In efforts to cope with the trauma of IPV, women may engage in maladaptive methods including drug and alcohol abuse (Campbell, 2002).
Though recent estimates of IPV emphasize its prevalence and negative consequences, violence against women, especially violence committed by intimate partners, is rarely reported. Only about one-third of women report IPV to police (Akers & Kaukinen, 2009). Given the significant gap between victimization and reporting, as well as the impact of violence against women, researchers and policymakers have attempted to understand the nature of IPV and develop strategies to adequately support survivors.

Strategies and Tips for Support Providers

After experiencing abuse, women may seek help from informal networks, such as family, friends, and coworkers. They may also seek formal help from police, medical personnel, or advocacy agencies. Service providers’ treatment of survivors can influence survivors’ well-being and their downstream decisions to seek further help if needed. For example, when survivors experience blaming attitudes and mistreatment by support providers, they may become retraumatized and withdraw from seeking help. This puts survivors at risk for exacerbated negative physical, mental, and emotional outcomes and revictimization.
Accordingly, support providers should consider implementing the following recommendations to adequately meet survivors’ needs. First, when survivors seek help, their needs may be multi-layered. For example, they may need shelter, treatment for physical injuries, and emotional support. Therefore, advocacy agencies, police, and medical personnel should collaborate in assisting survivors with multiple needs. Second, culturally-sensitive and survivor-centered responses are critical to appropriately respond to women’s needs from various racial-ethnic backgrounds. Thus, support providers should consider the intersections of race, socioeconomic class, sexuality, and IPV when women seek help to promote positive rapport building and engagement with survivors from different backgrounds. Importantly, this knowledge can assist support providers in addressing survivors’ explicitly and implicitly stated needs. Not least, support providers should engage in outreach services. These efforts are essential to providing education to the community about the prevalence and impact of IPV as well as available resources. Outreach endeavors also actively demonstrate agencies’ commitment to serving their communities which is important for establishing and maintaining community trust.

Conclusion

IPV is a ubiquitous health crisis with lasting physical, mental, and emotional consequences. Though formal assistance for IPV is underutilized, survivors can experience positive health outcomes when they seek help. Therefore, support agents should collaborate to provide holistic care for survivors while utilizing culturally-sensitive and trauma-informed practices. Support providers should also extend their services to outreach endeavors to educate and build community relations.

REFERENCES

Akers, C., & Kaukinen, C. (2009). The police reporting behavior of intimate partner violence victims. Journal of Family Violence, 24(3), 159-171.

Becker, K. D., Stuewig, J., & McCloskey, L. A. (2010). Traumatic stress symptoms of women exposed to different forms of childhood victimization and intimate partner violence. Journal of Interpersonal Violence, 25, 1699-1715.

Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., . . .Stevens, M. R. (2011). The national intimate partner and sexual violence survey (NISVS): 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Center for Disease Control and Prevention.

Breiding, M., Basile, K. C., Smith, S. G., Black, M. C., & Mahendra, R. R. (2015). Intimate partner violence surveillance: Uniform definitions and recommended data elements, Version 2.0. Atlanta (GA): National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Campbell, J. C. (2002). Health consequences of intimate partner violence. The Lancet, 359(9314), 1331-1336.

Center for Disease Control and Prevention (n.d.). Fast Facts: Preventing Intimate Partner Violence. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html

Coker, A. L., Smith, P. H., Bethea, L., King, M. R., & McKeown, R. E. (2000). Physical health consequences of physical and psychological intimate partner violence. Archives of Family Medicine, 9, 451-457.

Gaensslen, R. E., & Lee, H. C. (2001). Sexual assault evidence: National assessment and guidebook. National Institute of Justice, Washington DC, USA.

Kaukinen, C. (2020). When stay-at-home orders leave victims unsafe at home: Exploring the risk and consequences of intimate partner violence during the COVID-19 pandemic. American Journal of Criminal Justice, 45(4), 668-679.

Valera, E., & Kucyi, A. (2017). Brain injury in women experiencing intimate partner-violence: neural mechanistic evidence of an “invisible” trauma. Brain imaging and behavior, 11(6), 1664-1677.

Wood, L., Schrag, R. V., Baumler, E., Hairston, D., Guillot-Wright, S., Torres, E., & Temple, J. R. (2020). On the front lines of the COVID-19 pandemic: Occupational experiences of the intimate partner violence and sexual assault workforce. Journal of Interpersonal Violence, 1-22.

About the Author

Dr. Shamika M. Kelley is the research director at Texas Forensic Nurse Examiners – The Forensic Center of Excellence where she creates and implements a structured research agenda focusing on the needs of crime victims and criminal justice stakeholders to enhance support and case processing. She received her doctoral degree in Criminal Justice from Sam Houston State University. Her research focuses on survivors’, criminal-legal, and medical responses to sexual assault with special attention to survivors of Color.

Her work appears in Crime & Delinquency, Journal of Interpersonal Violence and Journal of Police and Criminal Psychology. She is also a forensic DNA consultant who provides forensic reports, DNA reviews, and expert testimony in criminal cases. Shamika was recently awarded the American Society of Criminology, Division on Women and Crime’s Saltzman Award for Contributions to Practice, which recognizes a criminologist whose professional accomplishments have increased the quality of justice and the level of safety for women.

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Op-eds TBI

The Intersection of TBI and IPV in Harris County

Intersection of TBI and IPV in Harris County

According to the Brain Injury Association of America, approximately 67% of women who experience domestic violence also have symptoms of traumatic brain injury. It is important that programs screen for TBI and also encourage law enforcement and healthcare partners to do the same.

Our Senior Program Director, Abeer Monem shares below facts about traumatic brain injury:

TBI as a result of head injury(ies) and/or strangulation, suffered at the hands of the perpetrator, can be mild to severe and cause many detrimental effects that impede the pursuit of safety and economic stability. Examples of the devastating cognitive effects of TBI that would clearly be impediments to obtaining and/or maintaining employment and, thus, economic stability, are as follows:

– Decreased concentration, attention span

– Difficulties with executive functioning (goal setting, self monitoring, planning, ability to solve problems, learn and organizing tasks)

– Memory loss

– Difficulty displaying appropriate emotional/communication responses

– May appear disorganized and impulsive

– Difficulty spelling, writing, and reading

– Difficulty understanding written or spoken communication

– Difficulty feeling initiative, sustaining motivation

– Depression

There are also behavioral and physical effects that include:

– Changes in behavior, personality or temperament

– Increased aggression and/or anxiety

– Decreased or increased inhibitions

– Quickly agitated or saddened

– Changes in emotional expression (flat, non-emotional, inappropriate or overreactions)

– Avoidance of people, family, friends

– Difficulty sleeping

– Increased irritability or impatience

– Hearing loss

– Headaches, neck pain

– Nausea and vomiting

– Changes in vision

– Ringing or buzzing in ears

– Dizziness, difficulty balancing

– Decrease in, or loss of, smell or taste

– Decreased coordination

– Loss of bowel or bladder control

– Increased sensitivity to noise or bright lights

– Seizures

– Weakness or numbness

A woman with a TBI who enters the criminal justice or family law system may face additional challenges. She may appear to be disorganized, aggressive, temperamental or confused. If her behaviors are misunderstood or misdiagnosed as indicating a mental health disability, which often happens, she may have difficulty obtaining custody or being credible as a victim or reliable witness.

Maricopa County, Arizona (Phoenix area) has paved the way for our county to incorporate their innovative approach to Harris county’s law enforcement response to an IPV incident.

· Officers and detectives do not limit testing to strangulation or sexual assault cases but offer ConQVerge Near Point Convergence (NPC) testing to all IPV victims reporting head trauma.

· Social workers and advocates assumed a larger role in testing and guiding victims through the process.

· Concussion information will be given out at the scene by nurses, officers, advocates an social workers as a part of an awareness campaign on the dangers of TBI for IPV survivors.

Why can’t we do something similar in Harris County? What are the possibilities that can be reality and really address the impact of IPV in Harris County?

• Add TBI screen questions Strangulation supplement that officers already complete?

• Establish concussion protocol when law enforcement responds to an IPV incident? Use advocates or forensic nurses to conduct the concussion protocol?

• Develop neurofeedback program – the only evidence-based treatment option – for our survivors to give them a chance to truly recover from the debilitating impact of head trauma?

• Develop a coordinated care system so no matter where the touch point for a survivor is, they receive the care they need after head trauma resulting from IPV?

 

For more information, please contact Abeer Monem.

About the Author

Abeer Monem is the Director of Housing and Innovative Services for HCDVCC and has worked in the field of domestic violence for over 25 years in both Harris and Fort Bend counties as a domestic violence advocate, trainer and programs director.

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TBI and Neurofeedback

This episode of Down The Rabbit Hole our Abeer Monem joins TCFV to talk about the intersection between traumatic brain injury (TBI) in people who have experienced domestic abuse, and an invaluable healing modality called neurofeedback. Please note that this episode carries a trigger warning for domestic violence.
Joining us we have two experts who are widely experienced in the field of helping survivors heal: Josh Brown from Fort Bend Women’s Center and Abeer Monem from the Harris Country Domestic Violence Coordinating Council. We start by learning that neurofeedback (also known as neurotherapy) teaches self-control of brain functions to develop healthier emotional patterns, before diving into the program that Abeer and Josh created that is pushing neurotherapy to the frontline of survivor care and support. You’ll hear Abeer describe the lightbulb moment when she realized the missing neurological information necessary for her patients’ healing, how she teamed up with Josh Brown, and the long road that led to the creation of the program. We also touch on issues of transport and hear some visionary steps to create much-needed mobile advocacy services. Finally, you’ll hear some moving testimonies of the truly transformational impact that neurofeedback has!
Find the Fort Bend Women’s Center HERE. Other resources mentioned in this episode include the National Resource Center on Domestic Violence and VAWnet. If you want more information on this episode, you can email TCFV.

About the Author

Abeer Monem is the Director of Housing and Innovative Services for HCDVCC and has worked in the field of domestic violence for over 25 years in both Harris and Fort Bend counties as a domestic violence advocate, trainer and programs director.

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Use Your Voice Through Voting

Use Your Voice Through Voting

Thank you Dr. Toby Myers (Board Member and Domestic Violence Expert) for sharing this important information on using the Mail-In Ballot

Editor’s Note:

The data is clear. People who receive mail-in ballots vote at a substantially higher rate than people who go to the polls in person. That’s why this information is so important. Please review the info below and take the appropriate action for yourself. AND PLEASE share this info with others who typically vote by mail, especially if they are not likely to have a computer or printer.

I hope there will be more public service announcements about these changes in the future, but we can’t afford a “wait and see” attitude. People who have routinely received an application for their mail-in ballot in the mail might not realize that the application didn’t arrive. And by the time they realize they don’t have a mail-in ballot it might be too late to apply for and receive one.

1. The process for obtaining and filing an Application for a Mail-in Ballot has changed.

If you or someone you know votes by mail, there are some important changes in the process. People who are unaware of these changes may end up being unable to vote by mail. For some, that will make them unable to vote at all.

Senate Bill 1 prohibits the distribution of mail-in ballot applications by the Election Administrator (EA).

If you have voted by mail in the past, you probably received an application for a mail-in ballot automatically each year, which reminded you to apply. You simply filled out the application and sent it in. You will no longer receive that application automatically. Instead, if you want to vote by mail, you must affirmatively request an application.

2. You can obtain a Vote by Mail Application in one of two ways. Go to the www.HarrisVotes.com website and click on “Voting by Mail.” There you’ll find a downloadable vote by mail application , a mail ballot tracker to monitor the process of

your application, and answers to any questions you might have. Just print the application, fill it out and mail it in.**

OR, if you do not have internet access or a printer and are unable to print an application on line, simply call the Election Administrator’s office at 713-755-6965 and ask them to mail you an application. They have personnel who will take your call and assist you.

Don’t delay! If you want to vote in the Primary, your application for a mail-in ballot must be received by the EA’s office no later than Friday, February 18, 2022. So to be safe, it should be mailed on or before Monday, February 14. Because mail delivery has slowed, apply now to be sure your application will arrive in time to be completed and sent back to Harris Votes well in advance of February 18. (If you miss the February 18 deadline, you won’t be able to vote in the primary BUT you will be able to vote in the November election.) ***

Senate Bill 1 creates new ID requirements for voting by mail.

SB1 establishes additional identification requirements for voting by mail. For the first time, the application for a mail-in ballot will ask for your full driver’s license number or the last four digits of your Social Security number. The same form of identification also must be included on the envelope you will use when you return your completed ballot. SB1 also requires that this identification information must match what is already on file in your individual voter record. In other words, the ID you provide now, in 2022, must be the same that you used when you registered to vote.

If you registered long ago, you may not remember which form of ID you used. However, the application and current voter registration forms ask for the last 4 digits of your SSN only if you don’t have a driver’s license. So using your driver’s license number would seem to be the best choice.

3. What if your ID information does not match what is in your voter record?

Don’t panic. Under this heading on the HarrisVotes website (see the link to “Senate Bill Election Law Effective December 2, 2021), the following statements appear:

Harris County Elections is here to ensure any simple mistakes are addressed.

  • If we spot any mistakes, we will proactively reach out to you directly to address any inconsistencies if you included a phone number or email when registering to vote. If not, we will mail you a letter with follow up information.
  • Still have questions? Call us at (713) 755-6965. Email: vbm@harrisvotes.com

NOTES:

** If you are 65 or older or are disabled, be sure to choose the “annual” ballot option. That option assures you will receive a ballot for all elections in the calendar year.

*** If you submit your application by FAX or EMAIL you must also submit it by mail and it must be received by the early voting clerk not later than the fourth business day after the transmission by fax or email is received. (TEC 84.007). · Email: vbm@HarrisVotes.com Fax: (713)-755-4983 or (713)-437-8683 Visit www.harrisvotes.com for more information. At the top of the welcome screen, you will see a red line that says “Senate Bill 1 Election Law Effective December 2, 2021. More info here.”

About the Author

Board Member of HCDVCC & DV Expert,

Dr. Toby Meyers

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Press Release

3rd Annual Impossible2Possible PR

Harris County Domestic Violence Coordinating Council to Host Domestic Violence Awareness Month Activities Through October

The Harris County Domestic Violence Coordinating Council is set to host their 3rd Annual Impossible2Possible event to spread awareness of the dangers and reality of domestic violence.

Houston, Harris County, Texas — Domestic violence is a scary reality for approximately 10 million women and men each year. Unfortunately, nearly 67% of survivors of domestic violence suffer in silence and never report the abuse they are receiving from those that should be considered their safe space.

What makes domestic violence even worse is that a vast majority of those suffering believe there is simply no way out of the situation, whether it be fear of losing (or harm being inflicted on) children or having no place to call home.

The good news? There are resources to help these survivors, and while these resources are available upon request, the month of October helps bring further awareness to the situation and connect survivors with the necessary help – all thanks to Domestic Violence Awareness Month.
Domestic Violence Awareness Month was first established in October 1987 and has been a welcome method of spreading awareness ever since.
In Harris County, TX, the Harris County Domestic Violence Coordinating Council (HCDVCC) takes pride in the work they do to not only spread awareness, but help survivors in whatever way they can.

Whether working with local law enforcement agencies, advocacy organizations, victim support services, policymakers, or the community itself, HCDVCC strives to ensure that victims of domestic violence in Harris County, Texas are served by the people and resources they so desperately need.” says Executive Director, Barbie Brashear.

Harris County has several educational events planned throughout October, including the 3rd annual Summit Event – Impossible2Possible: Be the Catalyst for Survivors with Disabilities. Topics that will be covered include how to make programs accessible to those with disabilities, how to create an inclusive space for survivors of domestic violence and their families, as well as ableism and accessibility.
This year’s speakers will include:

  • Heidi Lersch: Disability Services Educator and Training Coordinator
  • Sashi Nisankarao: Licensed Texas Attorney & ADA Specialist
  • Marilyn Gilbreath: MS, Family Studies/Counseling
  • Heather Daley: Hotline Advocate – National Deaf Domestic Violence Hotline

 

About Harris County Domestic Violence Coordinating Council: With a vision of a community where all persons have relationships that are safe, healthy, and free from domestic violence, HCDVCC leads efforts to build collaborative systems and innovative programs that help increase access to services and safety for those suffering from domestic violence.

Contact: To learn more about Domestic Violence Awareness Month or Harris County Domestic Violence Coordinating Council, please direct all questions to Thecia Jenkins at theciajenkins@hcdvcc.org or by phone at (281) 400-3680.

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