Skills Training in Affective and Interpersonal Regulation for Adolescents (STAIR-A & STAIR/NST) - Promising Futures

• Individual
• Group
• Individual & Group

• In-person

• Licensed/Certified Professional Led

• Child Abuse
• Neglect
• Community Violence
• Domestic Violence
• Verbal/Emotional Abuse
• Sexual Abuse
• Other Types of Experiences Addressed

• Talk-based
• Other Engagement Methods (see Program Details)

• Intervention

• Greater than 12 weeks

• Hospital-based
• Mental Health Settings
• Health Services
• Residential
• Community-based Agency
• School
• Other Settings

Type of services provided:

STAIR-A is a manualized, skills-based cognitive behavioral therapy (CBT) intervention designed to improve emotion regulation and interpersonal and social problems among adolescents exposed to multiple trauma. The STAIR component targets social and emotional competency building. Key interventions include emotional regulation skills, social skills development, positive self-definition exercises and goal setting and achievement.

There are three versions of STAIR-A:

• Inpatient (3 session version serves as support and bridge for other services upon discharge)
• Individual (8-10 sessions in outpatient settings)
• Group (10-12 sessions for school-based settings)

STAIR/NST is a two-module treatment that includes STAIR as described above plus a second phase of six individual sessions that focus on the emotional processing of trauma in detail within the context of developing a positive life narrative and future plan.

Program setting:

Inpatient, outpatient, schools

Length of program/number of sessions:

Inpatient (3 sessions); outpatient (8-10 sessions); group (10-12 sessions)

Type(s) of trauma/concerns addressed:

Physical and sexual abuse, a range of other trauma including community violence, domestic violence and sexual assault

Symptoms addressed:

Posttraumatic stress disorder (PTSD), depression

Education level of providers:

Therapists

Additional information:

None

Unique/Innovative Characteristics:

STAIR-A is a skills-based, flexible intervention that can be adapted to different settings (inpatient, outpatient, schools). STAIR-A was designed to promote resilience and reduce symptoms among adolescents that have experienced multiple trauma. STAIR was initially developed as an 8-session, skills program for adults with early-life trauma (see review for STAIR by the California Evidence-Based Clearinghouse).

Date Added/Updated:

1/3/18

• 6-12 (Childhood)
• 13-17 (Adolescent)
• 18-25 (Young Adult)

• English

• Child

Age range of children served:

12-21 years old

Are parent/adult caregiver(s) included in intervention?

No

Ethnic/racial and other groups served:

See NCTSN profile

Specific cultural adaptations:

See NCTSN profile

Languages that service/resource is available:

English

Goals of the program/services:

Primary goals of STAIR-A are:

• Help patients identify their fears, triggers, thoughts, emotions and behaviors
• Examine patients’ usual maladaptive responses to trauma triggers
• Provide emotional regulation strategies through breathing, self-statements and mindfulness
• Identify and tolerate negative emotions related to trauma
• Promote new behaviors that improve interpersonal functional and facilitate self-mastery

Has there been any evaluation?

Yes

Key evaluation results:

Gundino and colleagues (2016) conducted a pilot study utilizing a matched assessment-only comparison group designed with racial/ethnic minority adolescent girls. STAIR-A was delivered in a 16-week school-based group format. At post test, following completion of the sessions, girls in the intervention group reported:

• Less severe levels of depression than girls in the comparison group
• Fewer feelings of nervousness, worry and fear or tendency to be overwhelmed by problems compared to girls in the comparison group
• Feeling less stress and tension in personal relationships, fewer feelings of being excluded socially and better perceptions of social relationships and friendships with peers compared to girls in the comparison group
• Higher levels of internal locus of control compared to girls in the comparison group

Is there an evaluation currently in progress or planned?

None indicated

Publications about the program:

Gudino OG, Leonard S, Cloitre M. STAIR-A for Girls: A pilot study of a skills-based group for traumatized youth in an urban setting. Journal of Child & Adolescent Trauma. 2016;9(1):67-79.

Rated/Reviewed by Evidence Based Registries:

STAIR-A: SAMHSA’s National Evidence Based Practice Resource Center 
STAIR/NST: The National Traumatic Stress Network Treatments and Practices, Trauma Interventions 

• English

• Yes

Training manuals/protocols:

Yes

Not Specified

Marylène Cloitre, PhD
(212) 263-7300
marylene.cloitre@va.gov