Resources

Explore our collection of articles, research papers, partner studies and reports, clinical trial data, and more. These resources showcase the work Avalon and our partners are leading, ranging from advancing brain health programs to sharing the science behind Posttraumatic Growth. All materials are available to view and download, and we kindly ask that you respect and cite any content you use.

Traumatic Brain Injury

Implementing Goal Attainment Scaling as a Person-Centered Measurement Tool to Direct Care and Evaluate Outcomes in Neurorehabilitation Settings

Author: Tracey D. Wallace, MS, CCC-SLP, Bridget A. Cotner, PhD, Daniel Klyce, PhD, ABPP, Amber Walter, PT, DPT, NCS, April T. Hodge, PT, DPT, Russell K. Gore, MD, Katy H. O’Brien, PhD, CCC-SLP

Source: Archives of Physical Medicine and Rehabilitation (ACRM)

Posttraumatic Growth

2024 Warrior PATHH Year in Review

Author: Boulder Crest Foundation

February 11, 2025

Substance Abuse

Implementing Goal Attainment Scaling as a Person-Centered Measurement Tool to Direct Care and Evaluate Outcomes in Neurorehabilitation Settings

Author: Tracey D. Wallace, MS, CCC-SLP, Bridget A. Cotner, PhD, Daniel Klyce, PhD, ABPP, Amber Walter, PT, DPT, NCS, April T. Hodge, PT, DPT, Russell K. Gore, MD, Katy H. O’Brien, PhD, CCC-SLP

Executive Summary

The purpose of this Special Communication is to describe barriers and facilitators to implementing goal attainment scaling (GAS) as a patient-centered measurement tool in neurorehabilitation settings. The experiences of 3 distinct neurorehabilitation settings that implemented GAS to enhance person-centered care and measure person-centered goal attainment are described: a neurorehabilitation service at an inpatient rehabilitation facility; an intensive outpatient program serving military service members, veterans, and first responders with a history of mild to moderate traumatic brain injury; and an outpatient clinic serving adolescents and adults with recent history of mild traumatic brain injury. Each setting instituted different methods to implement GAS yet experienced commonalities in barriers and facilitators to implementation and adoption. Experiences were thematically organized using the normalization process theory (NPT), a framework that supports the design and evaluation of clinical process implementation. Barriers clustered in the NPT domains of coherence and cognitive participation, including factors such as staff training requirements, time required to implement, and challenges related to shifting program philosophies. Implementation was facilitated by actions taken in collective action and reflexive monitoring domains, such as integrating processes into workflows, leveraging technology for team communication and measurement, and completing regular audits and staff feedback. Patient-centered measurement tools, such as GAS, provide a framework for capturing patient priorities, enhancing the relevance of care plans, and ensuring treatment goals align with individual patient needs. Evaluating GAS implementation using the NPT provides direction to future clinical implementation efforts, which should continue to integrate clinical experiences with those of the persons served.

2024 Warrior PATHH Year in Review

Author: Boulder Crest Foundation

Executive Summary

At Boulder Crest Foundation, we know that profound strength and wisdom can emerge from pain and struggle. This is the essence of Posttraumatic Growth and the foundation of our Warrior PATHH program. Over the past decade, Warrior PATHH has grown into a nationwide movement that enables our nation’s heroes to transform their struggles into a life of meaning, service, and purpose.

In 2024, this movement continued to grow in both reach and impact. Alongside our Warrior PATHH partners in the Avalon Action Alliance — GratitudeAmerica, Camp Southern Ground, Big Red Barn Retreat, Travis Mills Foundation, Permission to Start Dreaming Foundation, and Sheep Dog Impact Assistance — we delivered more than 150 programs to over 1,100 members of the military, veteran, and first responder communities. We expanded our partnerships and strengthened our ability to bring life- changing support to those who need it most.

The need for our work has never been greater. Suicide rates among actively-serving military members, veterans, and first responders remain alarmingly high, with far too many individuals navigating the hidden wounds of service in silence. The stigma surrounding mental health care persists, preventing many from seeking help. And for those who do reach out, traditional approaches often fall short of addressing their unique needs. At Warrior PATHH, we offer an alternative — a pathway that is rooted in hope, strength, and the evidence-based science of Posttraumatic Growth.

We continue making significant strides to meet the growing demand for Warrior PATHH. The results speak volumes. In 2024, we saw Warrior PATHH participants experience a 58% reduction in symptoms of Posttraumatic Stress, along with significant decreases in depression and anxiety. Posttraumatic Growth outcomes increased by 58%, demonstrating the sustained, transformative power of this program. Beyond the numbers, graduates of Warrior PATHH report a renewed sense of purpose and a deeper commitment to their health, families, and communities. They join a growing network of alumni who continue to support one another and embody the principles of Posttraumatic Growth in their everyday lives.

The work of the Avalon Action Alliance’s Warrior PATHH network is not only transforming lives — it’s reshaping the narrative around mental health. This year, we continued to elevate the conversation, emphasizing that struggle has value and that growth is possible for everyone. Our advocacy efforts gained traction as we worked to bring Posttraumatic Growth into the national dialogue and ensure that more people understand its potential to change lives.

Looking ahead, we remain committed to our mission of helping America’s heroes live fulfilling lives after trauma. We believe that their best days are not behind them but ahead of them, filled with strength, purpose, and the ability to serve others. Together, we can continue to grow this movement and bring hope to those who need it most.

Join us in making this vision a reality. Together, we can transform struggle into strength and create a future filled with possibility.