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Non-Traditional Intervention Yields Extraordinary Client Outcomes

Traditional victim service options have been slow to evolve or grow since 1980. The addition of HUD housing, licensed psychotherapy and mobile advocacy in the late 1990’s by  Fort Bend County Women’s Center (FBWC) was considered innovative beyond the traditional shelter and advocacy service package.

In the last 10 years however, a dialogue began that offered a new take on what survivors may be dealing with. It inspired research into new options to reduce the impact of trauma suffered as a result of both the physical and psychological wounds resulting from violence against women. Head trauma caused by blunt force trauma, strangulation, and violent shaking can cause traumatic brain injury (TBI). TBI can be measured on a spectrum of mild to severe. There is no FDA approved medication to take for TBI and honestly, very little is done after head injuries, other than being advised not to sleep and take it easy. Concussions, although considered mild on the spectrum of head injury, can result in death or long term damage if multiple are sustained.

Violent relationships tend to have explosive incidents regularly. On top of possible TBI, PTSD, clinical depression and anxiety disorders, as well as paranoia are psychological injuries that may co-occur with survivors. Clients experience intense repercussions from always living in fear. Surviving intimate partner violence can be likened to serving in the military, active duty. Both veterans and survivors face TBI and PTSD and treatment of one can exasperate the other. Other groups that have recently been associated in the news to TBI are football players and boxers. NFL players who have committed suicide and donated their brains to be studied, have been observed to have chronic traumatic encephalopathy (CTE). The work has just begun to understand the impact of CTE. I would be willing to bet that if studied, brains of survivors of intimate partner violence would also show lots of CTE.

Before all the news on the NFL players, back in 2008, a webinar by VAWnet on the intersection of TBI and intimate partner violence caused me to add TBI screening to our intake process. After tracking the results of the screens for a year, it was eye opening that half of our survivors screened positive for the potential of TBI. The screen contains a list of problems that have occurred since the head injury and our clients had many and for a long time. Problems like trouble planning, decision making, aggression, feeling hopeless, etc. The new information coupled with years of experience with clients not being able to achieve or sustain self-sufficiency started the search for a solution to this problem that was keeping survivors ultimately unsafe. Research on treating TBI led to neurofeedback and collaboration with a local community partner. He agreed to talk to the team at FBWC about TBI and PTSD and how neurofeedback was one of few options to treat both simultaneously. He was an ex-military veteran and had personal experience with both. He detailed what we needed to provide neurofeedback, and we started trying to get the funds.

Finally, in 2014, we got a break and were able to get the equipment funds. The same year, we found another provider who could offer EEG brain mapping at a lower cost, saving over $500 on each, as well as lower training session and mentoring costs too. In a wonderful twist of fate, a grant was also secured to fund a contract with that provider, and the plan was to have the new provider teach our counselors to administer neurofeedback for free to survivors. Paying clients spend $1500 per EEG and $150 per session for a treatment protocols that average 40 sessions.

The pilot project has provided some very promising preliminary outcomes with major reductions in negative symptomology being reported by those who complete training. The next step is implementing al research project and publish the results to share all over the country. Survivors will have another tool in their tool belts to overcome the destruction they suffered at the hands of someone who told them I love you.

Abeer Monem, Contributing Blogger

Abeer Monem is the Shelter Director for Fort Bend County Women’s Center and Project Director for the Harris County Domestic Violence Coordinating Council.  She is passionate about developing programs and systems impacting survivors of intimate partner violence who face multiple barriers.   Her dedication to assisting survivors in obtaining stable housing led to the innovative programming at FBWC focusing on the correlation between intimate partner violence and traumatic brain injury.