STAIR and STAIR/NT as a Treatment for Posttraumatic Stress: A Systematic Review

Background: Current guidelines recommend phase-based approaches such as Skills Training in Affective and Interpersonal Regulation/ Narrative Therapy (STAIR/NT) for the treatment of posttraumatic stress disorder (PTSD) following complex traumatization. However, to date there is no systematic review on the efficacy of STAIR as initial treatment phase and STAIR/NT. Methods: Searching various databases, we conducted a systematic review on studies with and without control condition investigating the efficacy of STAIR, STAIR/NT, and their adaptations. Results: Overall, k = 10 studies (including 5 studies with control condition) on STAIR/-adaptations and k = 5 studies (including 4 studies with control condition) on STAIR/NT/-adaptations were identified. In 7 studies on STAIR/- and 4 studies on STAIR/NT/-adaptations, samples consisted of at-risk groups for complex traumatization. Both STAIR/- and STAIR/NT/-adaptations revealed positive effects on posttraumatic stress, affective dysregulation, and interpersonal problems. When compared to passive and active control conditions, STAIR/- and STAIR/NT/-adaptations were equally or more effective. Discussion: Findings on the efficacy of STAIR/- and STAIR/NT/-adaptations are mixed. Evidence is limited by the small number of studies, heterogeneous adaptations, often uncontrolled study designs, subclinical samples, and small sample sizes. Future studies should investigate the efficacy of STAIR/NT among patients with complex PTSD.