top of page

Stepped Care for Posttraumatic Stress Disorder Study (STEPPS)

STEPPS Logo White.JPG

Less than 20% of people with PTSD receive any treatment.


STEPPS is a research program aimed at helping more patients receive trauma-focused therapy in routine care.

Another goal of this study is to learn the best order to provide various trauma-focused therapies and develop adaptive or stepped interventions for PTSD.

STEPPS uses digital mental health tools and short, focused therapies for PTSD as listed below.
 

WebSTAIR (self-managed): 

  • Ten online modules that patients work on at their own pace, as a self-help program.

  • WebSTAIR is a coping skills-based treatment for PTSD that helps people better manage their emotions and relationships. A person receiving the treatment can (1) develop effective coping skills for distressing feelings; (2) learn how to become more aware and comfortable with their emotions; (3) identify unhealthy relationship patterns; and (4) strengthen skills to improve relationships. This therapy does not include revisiting traumatic memories.
     

WebSTAIR plus community health worker coaching:

  • In this treatment, patients receive access to webSTAIR and will have a coach to guide them through the modules in one-on-one sessions. The coach will be a community health worker. Patients will receive up to five 30-45 minute coaching sessions during this program. During coaching sessions, you will review progress, troubleshoot barriers, and review the next set of modules to complete. This therapy does not include revisiting traumatic memories. This treatment has between session assignments.


Brief STAIR:

  • Delivered by a behavioral health clinician in five or six visits.

  • Brief STAIR is a coping skills-based treatment for PTSD that helps people better manage their emotions and relationships. A person receiving the treatment can (1) develop effective coping skills for distressing feelings; (2) learn how to become more aware and comfortable with their emotions; (3) identify unhealthy relationship patterns; and (4) strengthen skills to improve relationships. This therapy does not include revisiting traumatic memories. This treatment has between session assignments.
     

Written Exposure Therapy (WET):

  • Delivered by a behavioral health clinician in five or six visits.

  • WET is a brief treatment in which patients write about their target trauma for a portion of each session. Patients write about the same trauma for all WET appointments. Writing prompts focus on what you were thinking and feeling during the event and how the event has impacted your life. Revisiting the trauma event will reduce your distress over time and help you get relief from PTSD symptoms. WET does not have between session assignments.

NIMH Logo.png

Funded by National Institute of Mental Health (NIMH)

R01 Project: Adaptive interventions to improve posttraumatic stress (PTSD) treatment access, engagement, and effectiveness in routine care

Study Project Number: 1R01MH138549-01

NIH Reporter

STEPPS Patient Flyer.jpg
STEPPS Patient Flyer_ES.jpg
Need Your WebSTAIR Login Information?

Contact the study at STEPPS@bmc.org for login help or any other questions.

STEPPS Logo White.JPG

Less than 20% of people with PTSD receive any treatment.

 

STEPPS is a research program aimed at helping more patients receive trauma-focused therapy in routine care. Another goal of this study is to learn the best order to provide various trauma-focused therapies and develop adaptive or stepped interventions for PTSD.

STEPPS uses digital mental health tools and short, focused therapies for PTSD.
These include:

  • WebSTAIR: an online program for building emotional and relationship skills

  • Brief STAIR: a shorter version of STAIR therapy

  • Written Exposure Therapy (WET): a writing-based approach to process trauma

Stepped Care for Posttraumatic Stress Disorder Study (STEPPS)

What is Stepped Care?

Stepped care provides treatment in steps. Patients start with the least intense treatment. If there is little to no improvement, then they move to a more intensive or stronger treatment. This approach ensures patients get the right level of care without doing more than needed.

How Does Stepped Care in STEPPS Work?

After enrolling in the study: All participants receive access to webSTAIR at baseline, after completing a set of surveys in the first study visit.
 

After four weeks: Participants are randomized to continue webSTAIR on their own, or will continue webSTAIR and receive up to five 30-minute coaching sessions from a Community Health Worker to support learning.
 

Eight weeks after enrolling: Participants will either continue webSTAIR, or will receive five to six 30-min Brief STAIR or WET therapy sessions from a BMC clinician.

Our Research: What We Want to Learn

Getting Started with webSTAIR


Welcome Session Walkthrough: Part 1
(Coming Soon)

Part 1 of the Welcome session video will show study participants how to navigate the webSTAIR site and what to expect from webSTAIR.

​


Welcome Session Walkthrough: Part 2 
(Coming Soon)

Part 2 of the Welcome session video will show study participants how to navigate the webSTAIR site and what to expect from webSTAIR.

​


Welcome Session Walkthrough: Part 3 (Coming Soon)

Part 3 of the Welcome session video will show study participants how to navigate the webSTAIR site and what to expect from webSTAIR.

​

Welcome Session

The Welcome session video will show study participants how to navigate the webSTAIR site and what to expect from webSTAIR.


Troubleshooting Microsoft Teams (Coming Soon)

This video shows how to use Microsoft Teams for coaching sessions and the features you may use while during sessions.

​

Cognitive Processing Therapy
(CPT)

CPT is an effective type of cognitive behavioral therapy that helps patients learn how to challenge and modify unhelpful thoughts related to trauma. CPT does not require a detailed account of the trauma memory.  

12 Sessions

Written Exposure Therapy (WET)

WET is an effective brief treatment in which patients write about their target trauma memory during session, helping process emotions related to trauma and create meaning of the event.

5-6 Sessions 

Prolonged Exposure (PE)

PE is a type of cognitive behavioral therapy that teaches individuals to gradually approach trauma-related memories, feelings, and cues (e.g., places, situations) to reduce emotional intensity and distress associated with these cues. 

8-16 Sessions

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a structured therapy that encourages the patient to focus briefly on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the intensity of emotion associated with the trauma memories.  

6-12 Sessions

Brief Skills Training in Affective & Interpersonal Regulation
(Brief STAIR)

Brief STAIR is a coping skill-based treatment tailored to the needs of each patient that teaches skills to manage emotions and improve social and relationship effectiveness. This treatment does not require recounting of the trauma memory.

5 Sessions (Coping Skills Only)

Web Administered Skills Training in Affective & Interpersonal Regulation (WebSTAIR)

WebSTAIR is a web-administered self-paced version of Brief STAIR that is available in English and Spanish. WebSTAIR teaches skills to manage emotions and improve relationships. The program includes interactive exercises, worksheets, and audio and video components.

10 Mini-modules

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Trauma–focused cognitive behavioral therapy is evidence–based treatment approach to help children, adolescents and their families overcome trauma–related difficulties, designed to reduce negative emotional and behavioral responses.

12-16 Sessions

Primary Care Intervention for PTSD (PCIP)

PCIP is a brief, low-intensity treatment designed for adolescents with PTSD. PCIP can be delivered in pediatric primary care settings. The therapy focuses on psychoeducation and positive coping strategies.  

3 Sessions

Trauma Systems Therapy for Refugees (TST-R)

TST-R is a trauma-based therapy that helps children and adolescent as well as their families learn skills in self-regulation, increasing their social support networks, minimizing stress related to cultural changes and foster trust between the helping community and the family.

8-20 Sessions

Frequently Asked Questions (FAQs)

General Study FAQs

How many study visits? How long would I be in STEPPS?

There are five total study visits. Participants complete 18 weeks of therapy, with the whole study taking 30 weeks.

Who can enroll? How do I sign up?

BMC patients 18 and older can enroll in STEPPS. Please contact your primary care provider or contact STEPPS@bmc.org.

What are the potential benefits? 

Participants may notice a decrease in trauma‑related symptoms, but it's possible that participants may not receive any benefit. Participation may help us learn the best order to provide PTSD therapies.

Study Flyers

Payment Questions

How do I get paid? 

Participants receive a ClinCard, a prepaid debit card. After each completed study visit, payments are added to the card. Participants are paid for completing study visits, not for therapy or coaching sessions.

How often would I get paid? 

Participants will receive payment on their ClinCard up to five times over the study. For more information, please view the study timeline flyer in the gallery below.

How do I set up my pin for my ClinCard? 

Participants can call Customer Service at (866)-952-3795 and follow the prompts. More information can be found in the ClinCard Cardholder FAQ sheet (English / Spanish / Haitian Creole).

How can I find out how much I have on my ClinCard?

Mastercard debit card ClinCard users: Log onto www.MyClinCard.com or call 866-952-3795.


Visa debit card ClinCard users: Log onto https://myclincard.mycardplace.com/cholder/welcome or call 866-952-3795. 

Payment: ClinCard 

WebSTAIR Program Questions

How much time does one module take?  

It can take 20 – 45 minutes, but typically 30 minutes. Spending time with the modules is important as they provide skills that can be helpful long-term. 

Can I skip portions of a module?

Please do not skip parts of modules; we hope participants can practice different skills from each module and take 1 - 2 skills per module with them. It’s worthwhile to try each skill and part of a module out!

Can I skip modules? 

It is okay to explore webSTAIR, but please finish two modules per week. Doing modules in order works best for building skills.
WebSTAIR coaching participants will meet with their coach after completing assigned modules to support learning.

How long will I have access to webSTAIR? 

Participants can log onto the webSTAIR program throughout the course of their participation in STEPPS, and are welcome to review modules and skills in the site.

How do I make sure I’m getting to the next section of the module?  

A list of topics or table of contents should be on the left side of the screen. After an exercise or a page, click 'Next,’ ‘Continue,’ ‘Finish,’ or ‘Save,’ to move forward. If using a phone, try turning it sideways for a better view.

What should I do if a module or an exercise does not load correctly?

That can be stressful! Select the next chapter in the table of contents, or click the red ‘Next Chapter’ banner at the bottom of the page. Please contact the study team with any issues. Once resolved, the module or exercise can be completed.

If I’m unable to access a worksheet in a module, what do I do?  

Please notify the study team and try opening the worksheet in the 'Resources' tab of the dashboard and select 'Worksheet Quicklinks'.

Technology Questions

I live in Boston. Where can I get help using my laptop or phone?  

Many Boston Public Library branches offer computer and technology classes. On their website they also have a few online resources: https://www.bpl.org/computer-classes/

I don't live in Boston. Where can I get help using my laptop or phone?

Many local libraries can provide support. In Massachusetts, there is a list of libraries: Massachusetts Library Directory. 

​When joining a webSTAIR coaching session, how do I turn my camera or microphone on? 

A menu at the top or bottom of the screen will show camera and microphone icons. If the icons look crossed out then click the camera icon to turn it on and/or the microphone icon to unmute.

When joining a telehealth therapy session, how do I turn my camera or microphone on? 

After joining, a menu gives participants an opportunity to select which camera and microphone they'd like to use. If the site or web browser asks for permission to use them, please select ‘Allow.’ For more information, view this telehealth troubleshooting guide.

I learn better by listening rather than reading. 
What options are there? (Part 1)

  • Read to Me – Chrome extension

  • Read & Write – free for students and teachers with an organization email; works on Mac, Windows, and as Chrome or Edge extensions.

  • Read Aloud – Microsoft Edge by pressing fn + F9 to turn on/off

I learn better by listening rather than reading. 
What options are there? (Part 2)

  • Google Text‑to‑Speech – Android

  • TalkBack – Android

  • Audio Descriptions – iPhone iOS

  • Read & Speak – Mac OS

  • Spoken Content – iPhone iOS

  • VoiceOver – iPhone iOS

bottom of page