According to the Veteran Affairs Office of Rural Health, 4.7 million veterans live in the rural United States. Of these rural veterans, 8% are women. According to a 2014 Journal of Rural Health article, rural women veterans were less likely than their urban counterparts to seek mental healthcare from Veterans Affairs (VA) facilities. The VA Palo Alto Health Care System (VAPAHCS) in California is working to increase access for these women and other veterans through telemental health.
STAIR (Skills Training in Affective and Interpersonal Regulation) targets rural women veterans, especially those with military sexual trauma (MST) and other military-related trauma. According to the VA, one in three women veterans seeking VA services reported having experienced MST. Although women are a specific target population, the program is open to all genders and has similar effectiveness across populations.
Methods
Clients can choose to receive individual or group treatment via teleconferencing either in the nearest community-based outpatient clinic (CBOC) or in the clients’ own homes. They can also use webSTAIR, a web-based version of STAIR paired with expert coaching through telemental health, at select VA systems across the country.
STAIR works to reduce PTSD and increase participants’ social functioning. The 10-week program helps veterans build skills such as mood management, relationship building, and social functioning.
Results
VAPAHCS therapists reported that more clients felt safer and attended more sessions when they could do so in their homes or in a clinic familiar to them. Clients reported that the facility and staff provided a positive environment, and many clients would recommend the STAIR program to others.
webSTAIR was launched in 2017 as an Enterprise Wide Initiative supported by the VA Office of Rural Health. The initiative is being offered to rural veterans with therapist guidance at the VAPAHCS; Michael E. DeBakey VA Medical Center in Houston, Texas; and the Edward Hines, Jr. VA Hospital in Hines, Illinois. From 2017 to 2022, webSTAIR expanded through a training model available to all VA clinicians. Clinicians were provided with training in the webSTAIR platform and provided access to use the program with veterans they serve.
Population of Focus: Veterans
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