STAIR Narrative Therapy

Abstract

Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy is an evidence-based psychosocial treatment that provides a combination of traditional PTSD trauma-focused work (Narrative Therapy) with skills training that addresses a wide range of problems in day-to-day functioning that emerge from difficulties in emotion and relationship management. There are many therapies that are effective in reducing PTSD symptoms, and the most effective of these include the review and reappraisal of traumatic memories. However, even when PTSD symptoms resolve, functional impairment frequently remains. The primary goal of STAIR Narrative Therapy is to improve functioning by reducing PTSD as well as by improving or rehabilitating emotion regulation and interpersonal skills. Traumatic events diminish social and emotional resources for managing day-today life. Post-event, emotions typically become raw or get shut down, relationships can become conflict-ridden, hostilities and misunderstanding develop, and social networks by dint of the trauma (e.g., natural disasters, wars) become frayed or fall apart. While many people recover their equilibrium, others-in addition to developing PTSD-seem to lose the ability to rely on friends, family, and community as part of the recovery process, and old coping strategies for managing distress do not seem equal to the task. STAIR was developed to rehabilitate or strengthen important emotion management and social skills that are adversely affected by traumatic events. STAIR was initially created for individuals with childhood trauma, who, as a result of repeated and chronic traumatization (e.g., sexual or physical abuse), did not appear to have developed strong emotion management and social skills. However, years of clinical practice indicated that, even among those confronting trauma for the first time in adulthood, such experiences, particularly those that are sustained (e.g., civil wars and conflicts), wear down emotion regulation and social engagement capacities. Paradoxically, of course, emotional regulation and social engagement are resources that facilitate trauma recovery and more generally are critical for effective living. Thus, the purpose of STAIR interventions are to provide strategies for recouping from psychological and social resource losses which are integral to the trauma experience but without which one does not fully recover. In its philosophy, structure, and interventions, STAIR Narrative Therapy emphasizes the maintenance of a balance between attending to past events via recollection of traumatic events while responding effectively to the demands of the present by strengthening important emotion management and social skills. This chapter will provide a review of the rationale for the development of the treatment, a summary of the treatment protocol illustrated with a case example, potential challenges in the implementation of the treatment, and a summary of the research on STAIR Narrative Therapy. (PsycInfo Database Record (c) 2020 APA, all rights reserved)