COMPLEX PTSD
COMPLEX PTSD
Skills Training for Affective and Interpersonal Regulation (STAIR)
STAIR is "a cognitive behavioral therapy that focuses on building emotion management and interpersonal skills necessary to both give and received social support and to maintain healthy relationships. STAIR Narrative Therapy has been studied in four clinical trials of adults with PTSD including childhood abuse survivors, individuals with PTSD related to 9/11, and individuals with PTSD and multiple comorbidities with a range of traumatic exposures" (Cloitre, et. al, 2016, p. e184).
STAIR consists of 16 sessions with a clinician (Cloitre, et. al, 2016, p. e184):
Session 1: Treatment overview, identification of interventions mapped to symptoms, confirming commitment to treatment
Session 2: Emotional Awareness: Identifying and monitoring feelings
Session 3: Emotion regulation: Focus on the body, thoughts, and behavior
Session 4: Emotionally engaged living: Acceptance of feelings/distress tolerance in the service of valued goals, identify and work towards a goal
Session 5: Identify relationship patterns: interpersonal schemas
Session 6: Changing relationship patterns: alternative interpersonal schemas and role play
Session 7: Building appropriate assertiveness skills: schemas and role play
Session 8: Increasing flexibility in interpersonal expectations: schemas and role play
Session 9: Motivating and planning for narrative work
Session 10: Practice building a narrative with neutral memory, first trauma narrative
Sessions 11–15: Continue to conduct narratives of different traumas, focus on different affective themes including fear, shame, guilt, and sadness.
Session 16: Closure: Identify gains, discuss future goals and relapse prevention plans
Skills Training in Affective Interpersonal Regulation for Refugees (STAIR-R)
STAIR is a PTSD and C-PTSD intervention that is often used with refugees and asylum-seekers. Approximately 1 in 3 refugees and asylum-seekers meet the criteria for PTSD (Tissue, et. al, 2022). In studies, Skills Training in Affect and Interpersonal Regulation (STAIR) has proven to be an excellent intervention used in conjunction with Narrative Therapy (Maerker, et. al., 2019).
Skills Training in Affective Interpersonal Regulation for Refugees (STAIR-R) is a modified version of STAIR, focused on the specific needs of individuals with a refugee and asylum-seeker background, specifically those from a Middle Eastern background.
STAIR-R is a brief, manualized emotion regulation skills training program in which refugee clients are taught emotion regulation skills across three areas:
the body (self-care),
actions (behavioral activation)
the mind (positive coping statements)
STAIR-R was written in simplified language which can be easily interpreted into other languages, presented information using visual graphics, used culturally appropriate metaphors to help clients understand emotion regulation difficulties in their cultural context and incorporated a focus on interpersonal emotion regulation and increased emphasis on connection with one’s community in recognition of the interdependent or collectivist self-construal of many refugee clients from Middle Eastern backgrounds. (Tissue, et. al, 2022)