Avalon Action Alliance • Connecting our nation’s veterans and first responders to life-changing training and treatment programs.
Get care
Donate

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.

Resources-image

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)

Report
Download

Posttraumatic Growth

2025 Warrior PATHH Year in Review

Author: Boulder Crest Foundation

January 14, 2026
Report
Download

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.

Download Full Report

2025 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 (PTG) 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.

2025 marked a year of significant expansion and deepened impact. We were proud to formally open Boulder Crest Texas, establishing a permanent home for our Mobile Training Teams, and increasing our capacity to serve those in need. This new campus, alongside our primary locations and our partners, allowed us to reach more individuals than ever before.

We are deeply honored to be a part of the Avalon Action Alliance. Alongside our partners – GratitudeAmerica, Camp Southern Ground, Big Red Barn Retreat, Travis Mills Foundation, Permission to Start Dreaming Foundation, and Sheep Dog Impact Assistance – we are championing a new way forward for our veteran and first responder communities. In 2025, this alliance delivered more than 156 programs to 1,213 members of the military, veteran, and first responder communities. By working together, we have strengthened our collective ability to bring life-changing support to those who need it most.

The need for this work remains urgent. Suicide rates among actively serving military members, veterans, and first responders remain alarmingly high. Far too many navigate the hidden wounds of service in silence, often because traditional approaches fall short of addressing their unique needs. At Warrior PATHH, we offer an alternative – a pathway rooted in hope, strength, and the evidence-based science of Posttraumatic Growth.

Download Full Report

Sign up for our quarterly newsletter!