Parenting-STAIR Modular for Military Fathers and OCONUS Families

The study comprises two trials: A fully powered randomized controlled trial (RCT) (N=162; Trial 1) will be conducted in four continental US (CONUS) Cohen Veterans Network (CVN) clinics in Silver Spring, MD, Lawton, OK, Oklahoma City, OK, and Colorado Springs, CO. A pilot feasibility RCT (N=81; Trial 2) will be conducted in two overseas (OCONUS) CVN clinics at Camp Humphrey's and Osan Air Base in Pyeongtaek, South Korea. Eligible participants will be active-duty Service Members (SM) or their spouses with at least one child aged 2-10 who attest to lifetime trauma exposure and screen positive for PTSD and/or depression symptoms. Participants will be randomized to receive either PSTAIR-M or treatment-as-usual (TAU). PSTAIR-M will be delivered by CVN clinicians. Parenting STAIR (PSTAIR) combines two existing evidence-based treatments (EBT), Skills Training in Affective and Interpersonal Regulation (STAIR) and Parent-Child Care (PC-CARE). Parenting-STAIR-Modular (PSTAIR-M) is a compact version of PSTAIR that includes a 12-session core (Module 1) and up to four additional sessions (Module 2), tailored by a decision rule and shared decision-making based on response to treatment. Assessments will occur at four timepoints: 1) pre-treatment (baseline); 2) mid-treatment (after session 11, approximately 11 weeks after baseline); 3) post-treatment (approximately 17 weeks after baseline); and 4) 6-month follow-up (approximately 41 weeks after baseline). Assessments will include self-report instruments and dyadic parenting observations.