Dr. Kathrine Sullivan’s team will adapt the PSTAIR intervention to address trauma’s effects on mental health, parenting in military moms.
New York, NY – Military-connected mothers (MCM), including service members, spouses and veterans, experience high rates of trauma exposure, which is associated with post-traumatic stress disorder, depression and difficulty parenting. A team led by NYU Silver Associate Professor Kathrine Sullivan has been awarded a two-year, $435,000 R21 research grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) to adapt the Parenting-STAIR (PSTAIR) trauma-informed parenting intervention to address the unique challenges faced by MCM.
“In both military and civilian contexts, maternal trauma exposure, poor mental health, and disrupted parenting relationships are consistently associated with poor child and family outcomes, including elevated rates of maltreatment and child mental health problems,” said Dr. Sullivan. “At the same time, interventions for military populations are most effective if they are informed by military culture.” Given the prevalence of trauma among MCM, there is a pressing need for an effective, culturally compatible trauma-informed parenting intervention.
Dr. Sullivan, who has done extensive research with military families, explained that the adapted intervention, called PSTAIR-M, will improve on other evidence-based trauma treatments (EBTs) for MCM in part by addressing maternal trauma across the life course. “Existing culturally appropriate EBTs focus narrowly on deployment effects, despite new research suggesting that MCM’s exposure to childhood adversity is most predictive of negative outcomes.”
Existing EBTs also rarely involve the family despite MCM’s preference to address child and family issues in treatment. By contrast, therapeutic sessions in which mother and child are treated together are a key feature of PSTAIR and may be further emphasized in the adapted intervention. “Providers suggest EBTs which incorporate the family and focus on child and family outcomes may reduce the effects of mental health stigma, which is dominant in military culture, and increase engagement of MCM in mental health services,” said Dr. Sullivan.
In an NICHD R01 led by NYU Silver Dean Michael A. Lindsey, the study team is already testing PSTAIR in the context of child welfare prevention. In and earlier pilot study of child welfare-involved mothers, they found PSTAIR reduced mental health symptoms, improved parenting, and prevented maltreatment. However, more than a third of participants dropped out before completing the 23-session intervention and just over a fifth didn’t see a sufficient treatment response. To address those concerns, the study team plans to shorten PSTAIR-M into a 10-15 session modular intervention that can be customized based on specific guidelines and shared decision-making between MCMs and their clinicians.
After interviewing MCMs to gain insights for tailoring PSTAIR and developing the PSTAIR-M intervention, the study team will conduct preliminary testing to explore whether it is practical, well-received and shows initial signs of effectiveness. The preliminary data will inform a future randomized controlled trial.
In addition to Dr. Lindsey, the study team includes NYU Silver Research Professor Marylene Cloitre, Professor Emeritus James Jaccard, and University of California, Davis’ Susan Timmer. The study will be conducted with the Cohen Veterans Network, a network of military-focused mental health clinics offering MCMs a community-based alternative to care provided through Department of Defense or VA systems.
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Founded in 1960 and renowned for a strong tradition of excellence in direct social work practice and dedication to social justice, NYU Silver has provided rigorous training to more than 20,000 social work practitioners and leaders in every area of the field, making it the leading destination for students who want to become innovative practitioners at the micro, mezzo, and macro levels of social work practice. The School has four campuses in the heart of New York City, Rockland County, Westchester County, and Shanghai.