During this phase, we focus on building a strong foundation for healing. I employ body-based awareness, emotional regulation techniques, and mindfulness practices based on the STAIR Protocol (Skills Training in Affect and Interpersonal Regulation). These tools help you manage symptoms and regulate your emotions, providing a sense of safety and grounding. The length of this phase is entirely individualised and varies according to each client's resources and progress.

What is STAIR?

Treatment Overview: (Cloitre et al., 2020)

Skills Training in Affective and Interpersonal Regulation (STAIR) is a manualised, evidence-based cognitive behavioural therapy which was originally designed for adults with a history of childhood abuse who suffer from posttraumatic stress disorder (PTSD) symptoms and experience difficulties with emotion management and interpersonal relationships. Over time, it was broadened to apply to people with a range of traumatic experiences and symptoms. Traumatic experiences overwhelm the emotional system, creating both emotional chaos and numbing, undermining our ability to think and act effectively, and disturbing our sense of self and our relationships. Research has shown that children growing up with repeated exposure to trauma often have difficulties in managing emotions and relationships as adults. The coping and interpersonal skills developed in childhood might have been adaptive and necessary to survival at the time but may no longer be adaptive in adult life. The skills training and practice introduced in this treatment are designed to help individuals leave behind old patterns and develop new interpersonal behaviours and emotion management skills more consistent with their current life goals.

Emotional and social skills are not innate, they are learned. Survivors of childhood abuse are therefore at risk of developing patterns such as substance abuse, angry outbursts, avoidance and prevent themselves from achieving success in other areas of their lives such as employment or relationships. It is important to note that avoidant strategies only make the world smaller. STAIR provides skills to fill these deficits and helps individuals reach their goals.

To address emotion regulation difficulties, STAIR focuses on:

• Emotional Awareness which includes identifying feelings, self- monitoring of emotions and learning the skill of Focused Breathing.
• Emotion Regulation which includes psychoeducation on how we respond to physiological, cognitive, and behavioural channels. Thought Shifting, Positive Imagery and working with fear and anger.
• Emotionally Engaged Living which includes identifying goals, distress tolerance and acceptance of negative emotions.

To address changing relationship patterns, STAIR focuses on:

• Assertiveness and agency in relationships and changing relationship models.
• Maintaining respect for self and others irrespective of power balances.
• Increasing the ability to be close to others despite conflicts.
• The importance of self-compassion.
• Revising interpersonal expectations.
• Understanding the self-fulfilling nature of trauma-based relationship models.

In this phase, there is an option to safely process traumatic memories if you choose to do so. My trauma processing therapies include:

Cognitive Processing Therapy (CPT): This evidence-based approach is a Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) that aligns with the National Institute for Health and Care Excellence (NICE) guidelines.

Emotional Freedom Techniques (Tapping): Tapping is a powerful method for addressing trauma and its associated emotions.

Imagery Reprocessing and Rescripting Technique (IRRT): This technique helps individuals reprocess traumatic memories and create healthier narratives.

Brainspotting: Brainspotting is a non verbal therapeutic approach that identifies and targets areas of the brain related to trauma processing which complements traditional talk therapy. Please see https://bspuk.co.uk/ for more details.

Dream Completion Technique: Dreams can hold valuable insights and emotions related to trauma, and this technique allows us to explore and process these experiences.

NET Narrative Exposure Therapy: NET is an evidence based psychotherapeutic intervention designed for survivors of multiple and complex trauma. Through chronological narration, fragmented traumatic memories can be integrated into an autobiographical life story. This document will be given to the client and can be used for human rights advocacy. For more information please see https://www.net-institute.org/whatisnet

Prolonged Exposure Therapy: Imaginal exposure occurs in session where the client narrates their trauma memories in detail with the therapist by their side. Through repeated telling of the trauma memories, the traumatic events are organised into a coherent life story, firmly placing the trauma in the past. This form of habituation reduces PTSD symptoms and the fear related to the event.

The final phase is dedicated to post-traumatic growth. As we reduce symptoms and improve your emotional well-being, you can look forward to a future where you feel more resourced and informed. You'll gain the tools and insights necessary to manage your emotions and achieve a greater sense of calm in your everyday life.