TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi process.
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.
Bisson
Jonathan I
JI
Department of Psychological Medicine and Neurology, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK. bissonji@cf.ac.uk
Tavakoly
Behrooz
B
Witteveen
Anke B
AB
Ajdukovic
Dean
D
Jehel
Louis
L
Johansen
Venke J
VJ
Nordanger
Dag
D
Orengo Garcia
Francisco
F
Punamaki
Raija-Leena
RL
Schnyder
Ulrich
U
Sezgin
A Ufuk
AU
Wittmann
Lutz
L
Olff
Miranda
M
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*