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

Br J Psychiatry. 2010 Jan;196(1):69-74. doi: 10.1192/bjp.bp.109.066266.

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.

Publication types

  • Consensus Development Conference
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delphi Technique
  • Disasters*
  • Humans
  • Practice Guidelines as Topic*
  • Program Development
  • Psychotherapy / organization & administration*
  • Social Support*
  • Stress Disorders, Post-Traumatic / therapy*