Skills Training in Affective and Interpersonal Regulation Narrative Therapy Delivered via Synchronous Telehealth: A Case Study of a Rural Woman Veteran With Complex Posttraumatic Stress Disorder

Abstract

The International Classification of Diseases– 11 th Revision (ICD-11) includes the diagnosis of complex posttraumatic stress disorder (CPTSD). Clinical practice guidelines support the use of phased care for individuals with CPTSD. This case study illustrates the use of synchronous telehealth to deliver phased treatment to a rural woman veteran with CPTSD. Mrs. A experienced sexual, physical, and emotional abuse throughout her life, perpetrated by family members, intimate partners, and military authority figures. She sought treatment for posttraumatic nightmares and body image issues; she also had pain related to fibromyalgia and chronic migraine headaches. Mrs. A participated in 19 sessions of Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative therapy via synchronous telehealth. Trauma and eating disorder symptoms were assessed before and after treatment and the patient demonstrated clinically significant improvement on measures of these disorders. Patient-provider working alliance and quality of life were assessed post-treatment. Synchronous telehealth use drastically increased with the onset of COVID-19; however, little information on treating CPTSD via synchronous video teleconferencing is available. This case study illustrates an evidence-based, phased therapy for CPTSD while highlighting the feasibility and value of in-home delivery of psychotherapy for CPTSD via synchronous telehealth.

When the Perpetrator is Found Not Guilty: Implications for the Treatment of Adolescent Sexual Assault Survivors

“…Individuals who have experienced a significant trauma have experienced significant symptom improvement (improvement on measures of PTSD symptoms, depressive symptoms, emotional regulation, and social engagement) after as few as 5 sessions of STAIR (Jain et al, 2020). STAIR was also selected due to its effectiveness in the telehealth environment, where its skill-focused treatment has been shown to be related to significant improvements in social functioning and emotional regulation and decreases in depression and PTSD symptoms (Weiss et al, 2018; Zaccari et al, 2023). STAIR also combines well with other treatment modalities to improve emotional regulation skills, enhance coping, and facilitate engagement with more intense forms PTSD treatment (Tissue et al, 2022).…”