Open Access Open Badges Study protocol

A multi-site single-blind clinical study to compare the effects of STAIR Narrative Therapy to treatment as usual among women with PTSD in public sector mental health settings: study protocol for a randomized controlled trial

Marylene Cloitre12*, Clare Henn-Haase2, Judith L Herman3, Christie Jackson24, Nadine Kaslow5, Constance Klein6, Michaela Mendelsohn3 and Eva Petkova2

Author Affiliations

1 VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025, USA

2 New York University Langone Medical Center, 550 First Ave, New York, NY 10016, USA

3 Harvard University Medical School, Cambridge Health Alliance, 1493 Cambridge, St. Cambridge, MA 02139, USA

4 VA New York Harbor Healthcare System – Manhattan Campus, 423 E 23rd Street, New York, NY 10010, USA

5 Grady Department of Psychiatry, Health System, Emory University School of Medicine, 1648 Pierce Drive, NE, Atlanta, GA, 30322, USA

6 The Nathan S. Kline Institute for Psychiatric Research, of New York State Office of Mental Health (OMH), 140 Old Orangeburg Rd, Orangeburg, NY 10962, USA

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Trials 2014, 15:197  doi:10.1186/1745-6215-15-197

Published: 29 May 2014



This article provides a description of the rationale, design, and methods of a multisite clinical trial which evaluates the potential benefits of an evidence-based psychosocial treatment, STAIR Narrative Therapy, among women with posttraumatic stress disorder (PTSD) related to interpersonal violence who are seeking services in public sector community mental health clinics. This is the first large multisite trial of an evidence-based treatment for PTSD provided in the context of community settings that are dedicated to the treatment of poverty-level patient populations.


The study is enrolling 352 participants in a minimum of 4 community clinics. Participants are randomized into either STAIR Narrative Therapy or Treatment As Usual (TAU). Primary outcomes are PTSD, emotion management and interpersonal problems. The study will allow a flexible application of the protocol determined by patient need and preferences. Secondary analyses will assess the relationship of outcomes to different patterns of treatment implementation for different levels of baseline symptom severity.


The article discusses the rationale and study issues related to the use of a flexible delivery of a protocol treatment and of the selection of treatment as it is actually practiced in the community as the comparator.

Trial registration identifier: NCT01488539.

PTSD; Community mental health clinics; Women’s health; Flexible service delivery