Skills Training in Affective and Interpersonal Regulation for Refugees Integrated With Narrative Exposure Therapy: A Case Study on the Treatment of PTSD and Emotion Dysregulation for Refugees and Asylum-Seekers

Abstract

The prevalence of post-traumatic stress disorder (PTSD) in individuals affected by war and conflict is high, with approximately 1 in 3 refugees and asylum-seekers meeting diagnostic criteria for PTSD. PTSD in refugees and asylum-seekers is associated with significant emotion dysregulation which may arise from chronic trauma exposure and post-migration stressors and lead to impaired day-to-day functioning. There is evidence that treatments that target emotion regulation skills prior to implementing exposure-based therapies lead to improved treatment response and reduced attrition in survivors of interpersonal traumas such as sexual abuse. The current case study details the use of a novel adaptation of one such treatment – Skills Training in Affective and Interpersonal Regulation for refugees and asylum-seekers (STAIR-R). In this case study, we report on the implementation of STAIR-R in combination with Narrative Exposure Therapy (NET) with Sara, a 60-year-old Iraqi woman who presented with high levels of nightmares, avoidance and emotion dysregulation following exposure to war- and conflict-related trauma and post-migration stressors. In this case study, we explore the intersection of emotion regulation skills training (in STAIR-R) and exposure therapy (in NET), and the potential for this combined intervention to improve emotion regulation skills, enhance coping with post-migration stressors and facilitate engagement with exposure-based treatment for PTSD.

Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: a systematic review

“…There is evidence for effective intervention programs from non-refugee studies [ 83 ]. Studies with refugees that focused on interventions for cPTSD or used culturally sensitive interventions also show promising results [ 84 , 85 ]. The present results also highlight that bereaved refugees often suffer from PGD, alone or in combination with PTSD ICD-11 symptoms.…”

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

“…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).…”