title: TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi process.
abstract: BACKGROUND
  How best to plan and provide psychosocial care following disasters remains keenly debated.
  
  
  OBJECTIVE
  To develop evidence-informed post-disaster psychosocial management guidelines.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychological Medicine and Neurology, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK. bissonji@cf.ac.uk
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Bisson
authors.forename: Behrooz
authors.initials: B
authors.lastname: Tavakoly
authors.forename: Anke B
authors.initials: AB
authors.lastname: Witteveen
authors.forename: Dean
authors.initials: D
authors.lastname: Ajdukovic
authors.forename: Louis
authors.initials: L
authors.lastname: Jehel
authors.forename: Venke J
authors.initials: VJ
authors.lastname: Johansen
authors.forename: Dag
authors.initials: D
authors.lastname: Nordanger
authors.forename: Francisco
authors.initials: F
authors.lastname: Orengo Garcia
authors.forename: Raija-Leena
authors.initials: RL
authors.lastname: Punamaki
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.forename: A Ufuk
authors.initials: AU
authors.lastname: Sezgin
authors.forename: Lutz
authors.initials: L
authors.lastname: Wittmann
authors.forename: Miranda
authors.initials: M
authors.lastname: Olff
mesh_terms: D003697:Delphi Technique; D004190:Disasters; D006801:Humans; D017410:Practice Guidelines as Topic; D016730:Program Development; D011613:Psychotherapy / Q000458:organization & administration*; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*