STAIR Therapy

What is the goal of STAIR Therapy?

STAIR Therapy was initially designed to help alleviate trauma-related problems in child abuse populations. A 2005 study conducted among women who suffered from childhood abuse revealed issues in how they handle emotions and relate to others, which affects their ability to function well (Cloitre et al., 2005). 

So, STAIR Therapy stems from the idea that along with treating PTSD symptoms, it's essential to learn to manage emotions and improve relationships for better recovery, making these the main goals of said therapy. 

Overview of the STAIR Therapy process

STAIR Therapy is a multi-component therapy phase-based treatment. It begins with Skills Training in Affective and Interpersonal Regulation, lasting up to ten sessions. During this phase, social and emotional competencies are rehabilitated or strengthened. The ten sessions are divided into two, with five sessions allocated each to emotion regulation and enhancing social and relational capacities.

Following this is the narrative therapy phase, a modified version of exposure therapy that concentrates on making meaning from the client's trauma stories. This phase spans eight weekly sessions. In total, STAIR narrative therapy consists of 18 sessions.

Interventions of STAIR Therapy

STAIR Therapy involves various interventions for its components. To explore these interventions, here are those outlined by Cloitre during a Mental Health Forum hosted by the Harvard T.H. Chan School of Public Health in 2021. Beginning with interventions for emotion regulation, they encompass the following:

• Tracking emotions daily: The intervention involves monitoring the patient's daily emotional experiences.
• Practicing emotion regulation strategies: This involves employing strategies like soothing senses, thought shifting, and positive activities.
• Developing distress tolerance for valued goals. This includes building resilience and perseverance in the face of emotional challenges to continue pursuing essential objectives (finishing therapy).

Meanwhile, for the relational capacities part, interventions include:

• Practicing interpersonal skills: This intervention includes engaging with others and standing on one's ground with compassion.
• Cognitive re-appraisal about oneself and others: The focus is on reframing thoughts and perceptions related to oneself and others more positively or constructively.
• Cognitive re-appraisal (not confrontational, but aspirational): When approached aspirationally, it involves reinterpreting situations and beliefs to pursue personal growth and desired outcomes while acknowledging and validating old beliefs based on past experiences or trauma.

Who can benefit from STAIR Therapy?

STAIR Therapy's goal is to help individuals with PTSD. Specifically, here are the different groups that can benefit (Harvard T.H. Chan School of Public Health, 2021; National Center for PTSD, n.d.):

• Childhood abuse survivors: They can be assisted in recovering from prior traumas, developing coping techniques, and re-establishing a sense of safety and confidence in themselves and others.
• Refugees: Refugees are given tools to help them deal with the emotional discomfort and cultural adjustment issues connected with forced migration, enabling them to settle into new contexts.
• Survivors of domestic violence: They can rebuild self-esteem, set boundaries, and process trauma to break free from cycles of abuse and rebuild their lives.
• Adverse childhood experiences (ACE) plus adult traumas: For people who had tough times growing up and faced more challenges later in life, the therapy makes them stronger. Furthermore, it helps them feel better emotionally and aids in their growth.
• Combat survivors: Through coping strategies, the therapy can help with the aftermath of combat trauma by managing symptoms and improving daily functioning for veterans and active-duty service members.
• Accident survivors: Those who have experienced accidents can benefit from STAIR Therapy by learning techniques to regulate emotions and navigate interpersonal challenges resulting from the trauma.
• Sexual assault survivors: Survivors of sexual assault are empowered to heal and move forward with tools to help them address emotional distress and rebuild interpersonal connections.

By working through structured exercises, they gain tools to handle distress, navigate social situations, and break old patterns that no longer serve them. The therapy is practical, flexible, and designed to meet clients where they are in their healing journey.

Takeaway

STAIR Therapy helps people heal from childhood trauma by building practical coping skills. Many survivors struggle with negative mood regulation, making it hard to manage overwhelming emotions, especially when faced with reminders of past experiences. This therapy focuses on strengthening emotion regulation skills first so clients feel more in control before processing deeper traumatic stress.

Since trauma often affects relationships, STAIR also helps improve interpersonal functioning by teaching healthier communication methods and setting boundaries. For those who have experienced physical abuse, these skills can be life-changing, allowing them to rebuild trust and confidence in themselves and others. In clinical psychology, STAIR leads to positive treatment outcomes, helping clients feel more stable and resilient.

Instead of only revisiting painful memories, STAIR Therapy equips clients with what they need to move forward. It helps clients feel more in control, connected, and hopeful about their future.

References

Cloitre, M., Miranda, R., Stovall-McClough, K. C., & Han, H. (2005). Beyond PTSD: Emotion regulation and interpersonal problems as predictors of functional impairment in survivors of childhood abuse. Behavior Therapy, 36(2), 119–124. https://doi.org/10.1016/s0005-7894(05)80060-7

Harvard T.H. Chan School of Public Health. (2021). Mental health forum: STAIR narrative therapy. In YouTube. https://www.youtube.com/watch?v=WCO9KoU4vvA

Hassija, C., & Cloitre, M. (2015). STAIR narrative therapy: A skills focused approach to trauma-related distress. Current Psychiatry Reviews, 11(3), 172–179. https://doi.org/10.2174/1573400511666150629105544

National Center for PTSD. (n.d.). STAIR basics: What is STAIR?https://www.ptsd.va.gov/apps/STAIR/STAIROverview/010201----.htm#