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TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi process


Bisson, J I; Tavakoly, B; Witteveen, A B; Ajdukovic, D; Jehel, L; Johansen, V J; Nordanger, D; Orengo Garcia, F; Punamaki, R L; Schnyder, U; Sezgin, A U; Wittmann, L; Olff, M (2010). TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi process. The British Journal of Psychiatry, 196(1):69-74.

Abstract

BACKGROUND: How best to plan and provide psychosocial care following disasters remains keenly debated. AIMS: To develop evidence-informed post-disaster psychosocial management guidelines. METHOD: A three-round web-based Delphi process was conducted. One hundred and six experts rated the importance of statements generated from existing evidence using a one to nine scale. Participants reassessed their original scores in the light of others' responses in the subsequent rounds. RESULTS: A total of 80 (72%) of 111 statements achieved consensus for inclusion. The statement 'all responses should provide access to pharmacological assessment and management' did not achieve consensus. The final guidelines recommend that every area has a multi-agency psychosocial care planning group, that responses provide general support, access to social, physical and psychological support and that specific mental health interventions are only provided if indicated by a comprehensive assessment. Trauma-focused cognitive-behavioural therapy (CBT) is recommended for acute stress disorder or acute post-traumatic stress disorder, with other treatments with an evidence base for chronic post-traumatic stress disorder being made available if trauma-focused CBT is not tolerated. CONCLUSIONS: The Delphi process allowed a consensus to be achieved in an area where there are limitations to the current evidence.

BACKGROUND: How best to plan and provide psychosocial care following disasters remains keenly debated. AIMS: To develop evidence-informed post-disaster psychosocial management guidelines. METHOD: A three-round web-based Delphi process was conducted. One hundred and six experts rated the importance of statements generated from existing evidence using a one to nine scale. Participants reassessed their original scores in the light of others' responses in the subsequent rounds. RESULTS: A total of 80 (72%) of 111 statements achieved consensus for inclusion. The statement 'all responses should provide access to pharmacological assessment and management' did not achieve consensus. The final guidelines recommend that every area has a multi-agency psychosocial care planning group, that responses provide general support, access to social, physical and psychological support and that specific mental health interventions are only provided if indicated by a comprehensive assessment. Trauma-focused cognitive-behavioural therapy (CBT) is recommended for acute stress disorder or acute post-traumatic stress disorder, with other treatments with an evidence base for chronic post-traumatic stress disorder being made available if trauma-focused CBT is not tolerated. CONCLUSIONS: The Delphi process allowed a consensus to be achieved in an area where there are limitations to the current evidence.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Psychiatry and Psychotherapy
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2010
Deposited On:25 Mar 2010 08:33
Last Modified:05 Apr 2016 14:03
Publisher:Royal College of Psychiatrists
ISSN:0007-1250
Publisher DOI:https://doi.org/10.1192/bjp.bp.109.066266
PubMed ID:20044665
Permanent URL: https://doi.org/10.5167/uzh-33009

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