Using the Delphi method to develop trauma-informed practice guidelines for neurorehabilitation.
Bibliographic record
Abstract
STUDY OBJECTIVE: Traumatic stress is common in persons with acquired brain injury. Untreated trauma not only negatively affects mental health but can also impact rehabilitation outcomes and overall recovery. However, not every neurorehabilitation professional has the scope of practice to treat traumatic stress, and providers may not feel well equipped to support patients dealing with significant trauma. Trauma-informed practice (TIP) is an approach in health care where traumatic stress is assumed to be common, and where the environment can be made to feel safe and welcoming without needing to address trauma directly. The objective of our study was to create draft consensus guidelines for TIP within the neurorehabilitation context. RESEARCH METHOD: Researchers, trainees, neurorehabilitation professionals, and adults with lived experience of acquired brain injury and traumatic stress were recruited to participate in our study. We used the Delphi method-a methodology used in health care to develop consensus-over the course of 12 months, whereby panelists participated in group meetings and individual qualitative interviews to generate preliminary items for our guidelines. RESULTS: Items from the interviews were rank ordered, and a final set of items was used to create a draft set of guidelines, formatted into a brochure for ease of dissemination. CONCLUSIONS/IMPLICATIONS: The current guidelines can serve as an initial starting point for the implementation of TIP in a variety of clinical settings. Future directions would be for these guidelines to be implemented and tested in diverse rehabilitation environments, in terms of outcome data and patient/provider satisfaction. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.146 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".