Major trauma is a leading cause of death and disability. Specialised care in major trauma centres has been associated with improved outcomes and prehospital triage tools are used to ensure injured patients are treated in the right place and the right time. However, there is a trade-off between under- and over-triage, and this study aimed to externally validate current and newly developed major trauma triage tools. A diagnostic case-cohort study was performed between November 2019 and February 2020 in 4 English regional trauma networks as part of the Major Trauma Triage Study (MATTS). The accuracy of 22 adult major trauma triage tools, including 3 newly developed MATTS tools was evaluated. Consecutive patients with acute non-trivial injury presenting to participating ambulance services were included and matched to data from the English national major trauma database. Theoretical accuracy was examined, with index tests assessed according to objective ambulance service data, regardless of the final triage decision or hospital destination. The primary reference standard was a consensus definition of serious injury that would benefit from expedited major trauma centre care. The case-cohort sample consisted of 2,607 patients, including 928 primary reference standard positive patients. The population weighted prevalence of major trauma meeting the primary reference standard definition was 3.1% (95% CI 2.3-4.0). Four optimally performing triage tools were identified with Pareto decision analysis: the Trauma score (sensitivity 0.1, specificity 0.99), MATTS specific tool (sensitivity 0.37, specificity 0.95), MATTS balanced tool (sensitivity 0.58, specificity 0.87), and the MATTS sensitive tool (sensitivity 0.72, specificity 0.76). This finding was unchanged in subgroup analyses of different age-groups and injury mechanisms; secondary analyses examining alternative reference standards (ISS ≥ 16, US consensus definition); and sensitivity analyses exploring missing data. Four optimal triage tools, demonstrating a trade-off between sensitivity and specificity, were identified by this validation study. The choice of ideal tool will depend on prevalence of major trauma, and valuation of false positive and false negative cases. Further prospective investigation of real-life triage tool performance, including compliance and clinical judgment, is necessary.

ABSTRACT The current research introduces trauma-informed courtroom observational rubrics specifically designed to assess the integration of trauma-informed practices within adult and juvenile court systems. Given the high prevalence of trauma among justice-involved individuals, this research addresses a critical gap in evaluating how court proceedings and environments meet trauma-informed care (TIC) principles. The rubrics assess courtroom communication, procedures, and environmental factors, with adaptations for adult in-person, virtual, and juvenile settings. Inter-rater reliability analysis confirmed substantial to nearly perfect agreement between two researchers, which emphasized the rubrics’ consistency across evaluators. However, challenges such as the adversarial nature of court proceedings and variations in trauma responses highlight areas for refinement. While the rubrics demonstrate reliability, they also reveal a need for contextual flexibility to accommodate diverse legal systems and trauma. This current study provides a comprehensive framework for courts to systematically implement trauma-informed practices, ultimately promoting more supportive and emotionally safe legal environments.

Tigray War, which started in November 2020, has doubled the burden on healthcare professionals, causing both direct violence and indirect effects as they care for trauma survivors. Vicarious trauma refers to harmful changes that occur in professionals' views of themselves and/or others as a result of deep empathic engagement and repeated exposure to details of trauma survivors. There is insufficient data to determine the prevalence of vicarious trauma among healthcare workers in the region. Therefore, this study assessed the extent of vicarious trauma among healthcare providers working in the war-torn Tigray region of Ethiopia. A health facility-based cross sectional study design was used to recruit 2,374 healthcare providers from August to September 2023 in the war affected Tigray region of Ethiopia and the study participants were selected using stratified random sampling techniques. Data were collected using the Open Data Kit (ODK) and exported to SPSS version 23.0 for analysis. Vicarious trauma was assessed using a 7-item standard tool with likert scale responses ranging from very often (5) to rarely (0). The total score from the responses on these 7 items was categorized as low risk (0-14), moderate risk (15-21), high risk (22-28), and extremely high risk (29-35). Ordinal multivariable logistic regression was used to identify the association of various factors with vicarious trauma. Statistical significance was reported when p-value was less than 0.05. Prevalence of moderate and above vicarious trauma was revealed as 81.6% (95% CI: 80.0, 83.1). Specifically, the burden was identified as 32.4%, 33.3%, and 15.8% for moderate, high,and extremely high levels of vicarious trauma respectively, with significant variability across the administrative zones of the region. Risk of vicarious trauma increases with increasing age 30-39 years (AOR = 1.3, p-value = 0.002), 40-49 years (AOR = 1.5, p-value = 0.01), 50 years and above (AOR = 2.3, p-value = 0.0001), having a larger family size (AOR = 1.2, p-value = 0.03), among those who live far from their work place (AOR = 1.3, p-value = 0.04), and among those in leadership positions (AOR = 1.5, p-value = 0.0001). Healthcare workers in Tigray region experienced high level of vicarious trauma (8 out of 10). This was worse for older workers with larger families, those living and walking farther to work, and those working in heavily conflict-affected central and northwest Tigray. This calls for the government and stakeholders urgently collaborate to provide training on mental resilience, coping strategies, and support resources, offer age-specific psychoeducation, consider adjusting work hours for older employees, support affected employees and their families, improve transportation, and reduce administrative burdens on managers to prioritize staff well-being.

Up to 22% of bariatric and metabolic surgery (BMS) candidates experience trauma or stressor-related symptoms and/or diagnoses (trauma-related distress), such as post-traumatic stress disorder (PTSD), yet research assessing their impact on surgical outcomes remains limited. To our knowledge, this is the first systematic review examining how presurgical trauma-related distress affects postsurgical BMS outcomes. Five electronic databases and five grey literature sources were searched from inception to April 2025 for quantitative studies of adults undergoing BMS with current symptoms or diagnoses of trauma-related distress. Studies had to report associations between presurgical trauma-related distress and postsurgical outcomes. The Newcastle-Ottawa Scale was used to assess study quality. Narrative synthesis and vote counting by direction of effect was utilized. Nine observational studies (n = 5457) met inclusion criteria, ranging from poor to fair quality. PTSD was not statistically associated with postoperative weight loss in any study (n = 4). In one study, PTSD was associated with other mental health disorders, including major depressive disorder. Another study showed that people presenting with PTSD had worse mental health-related quality of life (QoL) than controls. Adjustment disorders showed no significant effect on postoperative weight loss (n = 1). Despite the high prevalence of trauma in this population, high-quality research on its impact on BMS outcomes is scarce, with methodological heterogeneity further limiting robust conclusions. The limited available evidence suggests PTSD and adjustment disorders do not significantly affect post-surgical weight loss, but QoL may be reduced in this population. Future research should employ standardized trauma measures, larger samples, and long-term follow-up to clarify how active trauma-related distress impacts BMS outcomes.

Psychological trauma, such as witnessing an untimely or gruesome death, commonly provokes intrusive memories that might persist for days to years with adverse effects on individual mental and physical health and functioning. Despite the global prevalence of trauma, scalable evidence-based interventions are absent. Reducing the impact of intrusive memories is crucial for people frequently exposed to trauma, such as health-care workers. This study aimed to determine whether a brief digital imagery-competing task intervention (ICTI) reduced intrusive memory frequency after 4 weeks. Harms were also assessed. The GAINS-02 decentralised digital, parallel-group Bayesian adaptive randomised controlled trial tested a brief ICTI against an active control and treatment as usual to determine the effect on reducing intrusive memory frequency. Health-care workers in facilities that admitted patients with COVID-19 during the pandemic, who had experienced one or more traumatic events and reported at least three intrusive memories in the week before screening were randomised 2:2:1 (ICTI to active control to treatment as usual) via block randomisation (web-based). ICTI and active control participants were masked to treatment allocation, and both had one guided session then optional self-use. ICTI involved image-based memory retrieval then Tetris computer gameplay with mental rotation. The active control involved a music-listening task. Study statisticians were masked to ICTI and active control group. The primary outcome was the number of intrusive memories in week 4 (controlling for baseline), which was evaluated on an intention-to-treat basis. Treatment effects for the intervention group versus the comparator groups were assessed using Bayes regression analyses. Harms were assessed through adverse event reporting and interim analyses on primary outcome. People with lived experience were involved from study conception and throughout the research and writing process. The trial was pre-registered at clinicaltrials.gov (NCT05616676) and is completed. Between Dec 8, 2022, and Sept 15, 2023, 176 participants were screened and 99 included (ICTI n=40, active control n=39, treatment as usual n=20) with mean age 41·2 years (SD 10·2; range 21-62). Of these 99 participants, 85 (86%) self-identified as women and 89 (90%) as White. Bayesian analyses gave robust evidence that ICTI reduced intrusive memories at week 4: ICTI participants reported fewer intrusive memories (median 0·5 [IQR 0·0-5·0]) compared with the active control (active control 5·0 [3·0-11·5]; Bayes factor [BF]active control>ICTI vs active control=ICTI 114·1; βactive control>ICTI 1·29 [95% CrI 0·64-2·00]) and treatment as usual (median 5·0 [IQR 2·5-8·0]; BFtreatment as usual>ICTI vs treatment as usual=ICTI=15·8; βtreatment as usual>ICTI 1·21 [95% CrI 0·49-1·98]) groups. No harms were detected for ICTI relative to the active control and treatment as usual. The most reported adverse event (n=7) was COVID-19. Two adverse events involved burden of diary recording. Serious adverse events were hospitalisations unrelated to study procedures (n=6). This study shows that ICTI reduces intrusive memory frequency and post-traumatic stress disorder symptoms among health-care workers exposed to trauma. As a brief, scalable digital intervention, ICTI shows promise for mitigating consequences of trauma on mental health, an important and unmet need for health-care personnel and systems worldwide. Wellcome Trust, Swedish Research Council, UK Medical Research Council, and National Institute for Health and Care Research.

Conflicts and forced displacement often leave behind severe health consequences, including a significant burden of eye diseases and injuries. Refugees and internally displaced persons (IDPs) face increased risk due to limited access to eye care services and exposure to trauma. This systematic review and meta-analysis aimed to assess the prevalence and outcomes of ocular injuries and diseases in displaced and conflict-affected populations. A comprehensive literature search was conducted across PubMed, Google Scholar, and ScienceDirect databases for studies published between January 2000 and April 2025. Nineteen studies met the inclusion criteria. Data extraction, risk of bias assessment using the Newcastle-Ottawa Scale, and meta-analyses were conducted following PRISMA guidelines. Prevalence estimates were pooled using a random-effects model, and subgroup analyses were performed by study design. The review included 19 studies from 14 countries, with a combined sample of 59,728 participants. Ophthalmic trauma had a pooled prevalence of 22.7%, while phthisis bulbi, a severe outcome of eye trauma, had a prevalence of 3.6%. Among non-traumatic conditions, cataract was the most frequently reported, with a pooled prevalence of 5.5%, followed by glaucoma (1.7%) and refractive errors (26.0%). Blindness affected 2.5% of the studied populations, while severe visual impairment had a pooled prevalence of 7.3%. Reliable pooled estimates for mild and moderate visual impairment were heterogeneous and variably reported, and therefore a single consolidated range (e.g., 7.3%-19.4%) may overstate precision and should be interpreted cautiously. Displaced and conflict-affected populations bear a substantial burden of both traumatic and non-traumatic eye conditions, often worsened by limited access to timely diagnosis and treatment. The findings highlight the urgent need for integrating eye health services into humanitarian response plans, with a focus on early detection, rehabilitation, and continuity of care to reduce preventable vision loss.

Primary and Secondary Prevention of Child Trauma.

ABSTRACT This study investigates social work students’ preparedness to implement Trauma-Informed Care (TIC) while exploring predictors of their readiness. Despite the significant societal prevalence of trauma and social workers’ position as the largest group of professionals providing mental healthcare, social work curricula lag in preparing graduates to engage with traumatized individuals. This quantitative, cross-sectional study used a convenience sample (n = 154) of social work students at a Midwestern public university. The Knowledge, Attitude, and Practice Related to Trauma-Informed Care (KAP) scale and author-created Self-Rated Competence (SRC) for TIC scale was used to assess participants’ TIC preparedness. Findings indicate that social work students rate high on TIC KAP, yet SRC for TIC was low. MSW students, participants who took a class on trauma, and those who have personally experienced potentially traumatic events reported higher SRC. Personal experiences with adversity and trauma may predict SRC, although this is not an ideal way to gain competence and suggests a continued emphasis on trauma-informed classrooms. Findings suggest trauma-focused coursework is an effective competence-building experience and should be included in social work education. This study also highlights the need for TIC measurement tools for social work practice.

Background: Respiratory Background: Ocular trauma is one of the major causes of monocular blindness that can be prevented among the age group. It also leads to visual impairment. Aim: This study was aimed at determining the pattern and causes of ocular trauma among patients attending the Ophthalmology Department of Aminu Kano Teaching Hospital (AKTH) and Murtala Muhammad Specialist Hospital (MMSH). Methods: It was a five-year retrospective study conducted at both Hospitals, involving all patients with ocular trauma who were examined and managed in the eye clinics from 2019 to 2023. All records of patients with ocular trauma were reviewed and recorded on the data sheets. Data collected were analysed using Statistical Product and Service Solution (SPSS) version 27.0. Results: A total of 1280 folders in both hospitals were retrieved from the record offices, ocular trauma was recorded in 485 folders, making the prevalence of ocular trauma 37.9%. The mean age and standard deviation (SD) were 18.2 ±17.7 years. There were 354 male patients (73.0%) and 131 female patients (27.0%). Car accident was the common cause of ocular trauma (57.6%), and assault was the lowest (2.7%). Closed globe injury was the commonest type of ocular trauma in 260 (53.6%) patients. Conclusion: The closed globe injury and car accidents were the commonest known types and causes of ocular injuries. There was a significant association between age and gender and the causes of ocular trauma.

Especially for women with high prevalence and incidence of victimization and trauma, taking part in a life story interview has potential for positive benefits, but it also may leave the study participants seeing their lives and themselves in a negative light. Study participants were 116 women with repeated criminal convictions and a history of substance misuse. They were from a population known to have high prevalence of victimization of multiple types and exposure to violence. To investigate the effects of telling their life stories and to identify strategies interviewers use to maximize positive and minimize negative effects of the interviews, study participants were asked to reflect on the experience and the effects of telling their stories during an interview. Most participants identified benefits from the experience. Specifically, they felt relief from talking about negative events, they saw growth over stages in their life, they realized how negative past events led to preset positive outcomes, they clarified future steps based on their stories, and they saw how their stories could help other people. Alternatively, more than has been shown in prior research, some interview participants saw themselves as permanently contaminated, and they expressed despair about how their lives turned out. Examination of the dialogue between participants and interviewers revealed how interviewers maximized positive benefits by providing esteem and emotional support, emphasizing the value of the story to other people, and directing attention to the present and the future rather than the past. Findings are relevant to training and application for the widely used method of gathering life stories to understand both victimization and breaking the law. Findings also show the need for future research on positive strategies to use in interviewing other groups with very adverse life experiences, such as combat veterans, transgender individuals, and targets of racial/ethnic discrimination.

Neglect of oral health issues among athletes poses health risk for athletes and affects their performance. Despite that, there is a significant research gap concerning the oral health of athletes to better comprehend the prevalence and type of oral health disorders in this population. The goal of this study is to gather evidence to determine the prevalence and types of oral diseases among athletes and analyze the differences in oral health issues between elite and paralympic athletes. A systematic search approach was applied to 3 web-based scientific databases. Studies involving athletes, such as elite/Olympic or paralympic athletes, and reporting oral health were accepted as eligible for inclusion. A pooled prevalence using random effect model was calculated to estimate the burden of the oral health problems reported in the studies. Heterogeneity and publication bias was assessed using Q statistic distribution, Egger regression, and funnel plot, respectively. Subgroup analysis was performed where applicable. Out of 1248 results yielded on database search, 34 studies met the final inclusion criteria. The pooled prevalence of dental caries, periodontitis, dental trauma, and dental erosion was found to be 44%, 47%, 15%, and 30%, respectively. Elite athletes and paralympic athletes have a high prevalence of oral health problems despite being physically fit. Therefore, it is necessary to assess oral health as a critical component of routine health assessment of athletes.

Prevalence and risk factors of orofacial trauma among child and adolescent athletes in Damascus, Syria: a cross-sectional study.

This prologue introduces the Language, Speech, and Hearing Services in Schools forum, Addressing Childhood Trauma and Maltreatment Through the Lens of the ICF. The goals of the forum are twofold: first, to draw attention to the prevalence of children who have experienced trauma and maltreatment and how it affects their language and literacy development, and second, to provide an overview of the International Classification of Functioning, Disability and Health (ICF) framework and how it can be used to conceptualize assessment procedures and tailor interventions to meet the individual needs of the child while providing compassionate trauma-informed care. This prologue provides an overview of the prevalence of childhood trauma and how it affects children's language and literacy development. By extension, this prologue also underscores why speech-language pathologists (SLPs) should carefully consider this topic. Importantly, SLPs treat children in context, and although other professionals such as psychologists or social workers are the professionals expected to provide direct services in this area, SLPs still have an obligation to provide compassionate trauma-informed care, and they have expertise in areas that can support children in being able to better benefit from and participate in therapeutic treatments. To this point, this prologue also provides an overview of the ICF and provides examples of how the ICF may be used to support children with histories of trauma or maltreatment. As such, this prologue introduces the topics covered by seven articles as well as the epilogue. These articles cover reviews, tutorials, case studies, clinician development, and professional programming. Children who have experienced trauma or maltreatment are at an increased risk for experiencing neurological disruptions that affect their language and literacy development, which increases the likelihood SLPs will encounter children with these experiences on their caseloads. The articles included within this forum underscore the various ways children might be affected by traumatic experiences and how SLPs can use the ICF framework to identify barriers and facilitators when engaging in assessments and developing interventions.

Estimating trauma prevalence from incompletely preserved human skeletal samples: A comparison of two approaches

IntroductionWelding poses significant ocular hazards in Nepal’s industrial settings; however, data on trauma prevalence and protective barriers remain limited. This study assessed the burden of ocular trauma, personal protective equipment (PPE) practices, and associated risk factors among welders in Hetauda, Nepal.MethodsThis cross-sectional study conducted in 2024 included 111 welders in Hetauda. Participants underwent comprehensive eye examinations and structured interviews. Logistic regression was used to assess factors associated with ocular trauma.ResultsThe prevalence of ocular trauma was 62.16%, primarily caused by metal chips (60.87%) and flames (37.84%). Although 78.39% of welders reported using PPE, 72.97% relied on non-certified sunglasses, and only 1.80% used certified protective goggles. Key barriers to appropriate PPE use included the absence of workplace mandates (62.50%) and a belief that protection was unnecessary (64.52%). Significant risk factors for trauma included male gender, lack of safety training (43.48%), and age between 46 and 60 years. Common ocular morbidities were corneal opacity (20.72%) and conjunctival congestion (10.36%).ConclusionsDespite reported PPE usage, the continued high rate of ocular trauma highlights deficiencies in equipment quality and training. Mandating certified eye protection, enforcing workplace safety policies, and integrating occupational health education are critical steps for preventing eye injuries in Nepal’s industrial sector.

Mine-blast wounds and lower limb injuries leading to amputations have spiked, which increases the risk of mental disorders and incapacitation of a significant number of military personnel. This study presents adapted physical training as a core method of medical and social rehabilitation of military personnel with disabilities who have continued their military service. The paper provides a comprehensive analysis of the structure of combat injuries in contemporary armed conflicts with a focus on mine-blast injuries and their effects on the performance status of military personnel. The content analysis and comparison of historical and comparative data showed persistent prevalence of mine-blast trauma associated with a high frequency of lower limb amputations and a complex range of early and long-term complications. It is noted that amputations in military personnel cause pronounced mental distress mainly manifested by reactions to severe stress, anxiety, and depressive disorders, which increases the risk of cognitive dysfunction and requires psychological and neurocognitive modules in rehabilitation programmes. The study identifies target areas for improving the physical training of military personnel with lower limb amputations by boosting strength endurance and core stability, teaching energy-efficient walk on prostheses, preventing pain syndromes and secondary deformities, and integrating adapted physical training in interdisciplinary rehabilitation and professional reintegration protocols. The findings confirm the need to develop standardized adapted physical training methods aimed at faster functional recovery and return to service.

Trauma prevalence is vast globally. Evidence-based digital treatments can help, but most require human guidance. Human guides provide tailored instructions and responsiveness to internal states, but limit scalability. Might generative AI and neurotechnology provide a scalable alternative? Here we provide a first test of ANTIDOTE, combining AI guidance and pupillometry to automatically deliver and monitor the Imagery Competing Task Intervention (ICTI). ICTI is a digital intervention developed by our group to reduce intrusive memories after psychological trauma, previously delivered with human guidance. One hundred healthy volunteers were exposed to videos of traumatic events and randomized to an intervention or active control condition. As predicted, intervention participants reported significantly fewer intrusive memories over the following week. Post hoc assessments confirmed the AI guide delivered the intervention successfully. Pupil size tracked intervention engagement and was associated with symptom reduction, providing a candidate biomarker. These findings suggest a path towards developing AI-guided digital interventions with scalability potential.

Trauma-informed coaching is an emergent area in the coaching literature with limited academic research (Cooper-Dickson et al., 2023; Spence & Joseph, 2016). This qualitative study explores how supervisors experience trauma-related content in coaching supervision and how they respond to it. Semi-structured interviews were conducted with fifteen coach supervisors. Reflexive thematic analysis was used to develop three themes from the data collected: (1) It is as much about the coach’s trauma experiences as the client’s; (2) Coaches are working in the presence of trauma, not with the trauma itself; and (3) Do not be afraid of trauma content; focus on the fundamentals. The study’s findings indicate that there is a need for greater awareness and education about the prevalence of trauma and the way trauma content can show up in coaching and supervision. It concludes with some practical recommendations so coaches and supervisors can better prepare for when trauma-related content arises. This study contributes new knowledge to the developing field of trauma-informed coaching and supervision, whilst encouraging further research on the topic.

BackgroundChildhood adversity and trauma are prevalent risk factors for the development of mental health conditions. This two-part paper describes the conceptual basis and pilot implementation of a tiered model of pediatric population mental health, highlighting the local socioecological context in which it was developed and the trauma-informed approach used.MethodsUsing retrospective record review of three datasets from the primary and secondary care pediatric clinics of a large academic medical center, which were harmonized to cover the study period from July 1, 2023 to June 30, 2024, we conducted descriptive analyses of patients across three levels: pediatric primary care (n = 9535), an integrated primary care program, which embeds mental health clinicians in primary care (n = 267), and family-centered trauma-informed psychotherapies in secondary care (n = 63), designed to address emotion dysregulation in pre-adolescent children. Demographics and lifetime history of trauma and adversity (assessed with a comprehensive 19-item list coded based on standardized screeners) were assessed through electronic medical records.ResultsRelative to the pediatric primary care population, more patients in the integrated primary care program and trauma-informed psychotherapies identified as White. Using our 19-item assessment, the lifetime prevalence of adversity or trauma was nearly universal among patients in the integrated primary care (94.4%) and trauma-informed psychotherapy (98.4%) programs. However, the lifetime prevalence of childhood adversities differed significantly across the two programs (integrated primary care: 76.8%; trauma-informed psychotherapy: 98.4%) when we assessed prevalence based only on the 10-item Adverse Childhood Experiences Questionnaire (Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS, Am J Prev Med 14:245–58, 1998). There was a higher prevalence of family and parent-related adversities in the trauma-informed psychotherapy program.ConclusionsFindings support the need for trauma-informed, population mental health approaches in pediatric care. Developmentally tailored, family-centered, transdiagnostic screening and interventions are essential. Study findings, including gaps in programmatic fiscal sustainability, suggest avenues for policy reform to support and scale trauma-informed programs like ours. Programs seeking to implement trauma-informed approaches should leverage implementation and participatory research to ensure effectiveness and equitable accessibility for patients of diverse identities.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-025-13356-7.

Trauma has a profound and lasting impact on individuals. Trauma prevalence continues to rise nationally, yet few health care providers are trained to intervene and address trauma appropriately. Occupational therapy practitioners (OTPs) have a unique role in addressing trauma due to our profession's ability to intervene across the lifespan. This study investigated the education and training OTPs received in trauma-informed care (TIC) practices and their perceptions and confidence levels in utilizing these approaches in practice. Three hundred twenty-one participants were recruited online using convenience, purposeful, and snowball sampling methods. Participants completed an anonymous 14-question online survey. The study indicated that over half the participants (51%) felt only moderately confident in applying TIC methods. A substantial percentage (46%) did not learn these practices during their occupational therapy education. For those who did, the training was typically limited to a single chapter or unit, suggesting a need for more in-depth curriculum integration. The findings of this study highlight the critical need for TIC education and training early in OTPs' careers. While therapists recognize the importance of TIC approaches in their practice, they require additional education and support to integrate these approaches confidently. Addressing this gap through comprehensive TIC education in occupational therapy training programs is essential to enhancing the capacity of OTPs to provide TIC effectively. (PsycInfo Database Record (c) 2025 APA, all rights reserved).