Difficulties to Consider

A survivor might experience:

• Tiredness, particularly in situations requiring mental effort
• Reduced tolerance, coping ability
• Irritability
• Other impairments becoming worse
• Difficulty waking up in the morning and starting tasks
• Difficulty going to school/holding a job
• Difficulty accessing services

How you can help:

• Encourage rest breaks
• Encourage regular bed time and wake time
• Prioritize demanding/important tasks to take place at the time of day she feels best (often morning)
• Make activities shorter, with achievable goals
• Help her fill out lengthy forms, make important phone calls, or other tasks requiring her to concentrate or pay attention for a long period of time

A survivor might:

• Take longer to complete tasks, get ideas together to answer questions
• Have difficulty keeping up with long conversations, or lengthy instructions
• Have difficulty going to school/holding a job

How you can help:

• Allow extra time to complete tasks
• Speak clearly and evenly
• Present information one piece at a time
• Try to not interrupt or answer for her
• Check that she is keeping up
• Meet with her alone, unless she requests to have someone else present
• Help her fill out forms, make important phone calls

A survivor might:

• Appear to not listen
• Miss details
• Forget what was said
• Struggle to maintain concentration
• Be unable to cope with more than one thing at once
• Be easily distracted
• Change subjects frequently
• Not finish what was started
• Get bored easily
• Have difficulty going to school/holding a job
• Have difficulty accessing services
• Have difficulty adapting to life in a shelter

How you can help:

• Use short, simple sentences
• Shorten activities so their completion is realistic
• If safety allows, have her write down important information
• Help her check her work
• Encourage her to do one activity at a time
• Reduce distractions such as noise, people
• If she is distracted, interrupt and help her refocus
• Alternate activities to keep interest
• Meet with her alone, unless she requests to have someone else present
• Help her fill out forms, make important phone calls

A survivor might:

• Have difficulty learning new things
• Forget what was said, forget names, appointments
• Lose things
• Have difficulty recalling what was learned
• Have difficulty making and remembering safety plans
• Have difficulty going to school/holding a job
  

How you can help:

• Check to be sure she understands, repeat information if needed
• Encourage rehearsal of new information
• If it is safe, encourage use of memory aids – diaries, calendars, time tables
• Decide on specific places for storage of belongings
• Provide reminders/prompts to help with recall
• Develop checklists
• Help her fill out forms, make important phone calls
  

A survivor might experience:

• Difficulty working out solutions to problems
• Difficulty generating new ideas
• Disordered approaches to solving a problem
• Difficulty going to school/holding a job
• Difficulty leaving abusive partner, living independently
  

How you can help:

• Help identify achievable goals, clarify the purpose of tasks
• Avoid open ended tasks
• Help her approach tasks in an ordered way
• Help her break down tasks into smaller parts
• Reduce the demands put on her, have her do one thing at a time, start simple
• Help her fill out forms, make important phone calls
  

A survivor might:

• Be unable to adapt to change
• Be stuck in a rut, unable to develop new strategies
• Continue to perform tasks the same way, even when they don’t work
• Repeatedly refer to the same topic, return to that topic when doing something else, i.e., perseverate
• Have difficulty going to school/holding a job
• Have difficulty leaving abusive partner, independent living
• Have difficulty accessing services
• Have difficulty adapting to life in a shelter (stress, anxiety, confusion, disruptiveness, difficulty following rules)
• Have difficulty keeping custody of children
  

How you can help:

• Help her recognize early signs of frustration so that she can stop what she is doing and refocus
• Help her find different ways to complete tasks, so there is choice
• Distract her with another activity if she is continually making errors
• If she is repeatedly off topic, get her back on track by asking specific questions
  

A survivor might experience:

• Difficulty preparing for tasks
• Difficulty working out steps or sequences to tasks
• Difficulty organizing thoughts and explaining things to others
• Difficulty assessing danger and defending herself against assaults
• Difficulty going to school/holding a job
• Difficulty leaving abusive partner, independent living
• Difficulty accessing services
• Difficulty adapting to life in a shelter (stress, anxiety, confusion, disruptiveness, difficulty following rules)
• Difficulty keeping custody of children
• May not consider consequences of her actions
  

How you can help:

• Encourage her to consider what she is going to do before starting an activity
• Point out possible short- and long-term consequences of decisions
• Provide written guidelines outlining steps in a task
• Give prompts to keep her on track
• If safe, help her develop a timetable to establish routine for activities
  

A survivor might:

• Exhibit rigid, concrete thinking style
• Take statements literally
• Have difficulty putting herself in other people’s shoes
• Resist change
• Have a simplistic understanding of emotions
• Show poor judgment and decision-making skills
• Have difficulty going to school/holding a job
• Have difficulty leaving abusive partner, independent living
• Have difficulty keeping custody of children
  

How you can help:

• Use simple, direct language, avoid abstract terms
• Explain changes to routine in advance, provide a reason for the change
• Avoid arguments and emotional undertones
• Provide real life examples that she can relate to, when explaining something
• Point out possible short- and long-term consequences of decisions
  

A survivor might:

• Not follow rules
• Not pick up on errors because she does not check her work
• ‘Hog’ conversations
• Carry on talking even when others are no longer interested
• Have difficulty going to school/holding a job
• Have difficulty accessing services
• Have difficulty adapting to life in a shelter (stress, anxiety, confusion, disruptiveness, difficulty following rules)

How you can help:

• Reinforce the requirements for an activity
• Encourage her to check her work
• Provide immediate feedback to indicate when an error occurs or she is talking too much
• Encourage taking turns in conversations

A survivor might:

• Be unaware of cognitive and physical limitations
• Set unrealistic goals and expectations
• Resist help from carers and staff
• Have difficulty leaving abusive partner, independent living
• Have difficulty accessing services
• Have difficulty adapting to life in a shelter (stress, anxiety, confusion, disruptiveness, difficulty following rules)
• Have difficulty keeping custody of children
  

How you can help:

• Explain the reasons for tasks, or steps in a plan
• Identify realistic, achievable goals, which may be smaller steps in a larger plan
• Point out possible short- and long-term consequences of decisions
• Provide respectful feedback on problem areas that affect her safety

A survivor might:

• Experience sudden changes in mood
• Laugh or cry at inappropriate times

How you can help:

• Identify triggers for mood swings
• Have an alternative approach planned in case of changes
  

A survivor might:

• Experience lack of motivation
• Not complete tasks that she knows how to carry out
• Not act on something until prompted

How you can help:

• Encourage her to get started on an activity
  
• Give prompts in the early steps of a task
• Reward initiative and persistence
• Accept that less activity may be best for her well-being

A survivor might:

• Struggle to interact with others because of the aforementioned problems
• Struggle to relate to others
• Be less aware of social cues
  

How you can help:

• Practise maintaining eye contact, asking questions when they come up, holding a conversation
  
• Practise awareness of reactions and cues when interacting with others