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How best to plan and provide psychosocial care following disasters remains keenly debated.
To develop evidence-informed post-disaster psychosocial management guidelines.
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.
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.
The Delphi process allowed a consensus to be achieved in an area where there are limitations to the current evidence.
Activity theory is an interdisciplinary approach to human sciences that originates in the cultural-historical psychology school, initiated by Vygotsky, Leont'ev, and Luria. It takes the object-oriented, artifact-mediated collective activity system as its unit of analysis, thus bridging the gulf between the individual subject and the societal structure. This 1999 volume includes 26 chapters on activity theory by authors from ten countries. In Part I of the book, central theoretical issues are discussed from different points of view. Some topics addressed in this part are epistemology, methodology, and the relationship between biological and cultural factors. Part II is devoted to the acquisition and development of language. This part includes a chapter that analyzes writing activity in Japanese classrooms, and a case study of literacy skills of a man with cerebral palsy. Part III contains chapters on play, learning, and education, and Part IV addresses the meaning of technology and the development of work activities. The final part covers issues of therapy and addiction.