Adaptation and Outcomes from a Pilot 6 Session STAIR Group Protocol for Rural Women Veterans

VA psychologists are expanding the understanding and access to care for Veteran's all over the United States. Additionally, VA psychologists have been recognizing increasing amount of women Veterans seeking VA health care and the unique mental health needs of this population. This pilot group protocol may be helpful in providing evidenced based care and increasing mental health wellbeing to this underserved population. As psychology evolves and the needs of Veteran's continue to change, VA psychologists need opportunities to adjust standard protocols to meet the increasing needs and demand for mental health services, particularly for rural women Veterans. 

Research suggests that STAIR (Skills Training in Affective and Interpersonal Regulation) is an effective treatment for individuals with emotion regulation and interpersonal difficulties (Cloitre et al., 2010). Furthermore, STAIR skills training in a group setting is also efficacious in reducing symptoms pf PTSD and depression while increasing emotion regulation and interpersonal skills (MacIntosh et al., 2018; Jackson, Weiss, & Cloitre, 2019). These studies were conducted using a mixed-gender format and a 12-session protocol, suggesting a need for further research on specific populations of veterans, including women veterans in a rural setting. The present study piloted an adapted 6-session STAIR protocol for rural women Veterans in a group setting. Adaptations included refining the session content to target specific psychoeducation, emotion regulation, and interpersonal effectiveness skills that would be most helpful for rural women veterans. Participants were 3 women who had a history of trauma, although a formal diagnosis of PTSD was not required. Participants completed pre and post measures of depression, anxiety, and PTSD symptoms as measured by the PHQ9, GAD7, and PCL5. Initial outcomes suggest the group was effective in reducing symptoms of depression, anxiety, and PTSD as evidenced by the average difference between pre- and post- scores (PHQ9 M: 7.67 SD: 7.23; GAD7 M: 11.50 SD: 7.78; PCL5 M: 21.33 SD: 23.09).