Welcome to STAIRWAYS: The Next Step in Group Treatment for Borderline
Personality Disorder
What is STAIRWAYS?
STAIRWAYS is the one-year, twice monthly advanced group program developed for clients with borderline personality
disorder who have completed the 20-week STEPPS program. The letters in the word STAIRWAYS stand for the skills
you will teach in this program: Setting goals; Trying new things; Anger management; Impulsivity control; Relationship
management; Writing a script; Assertiveness training; Your choices; and Staying on track. We have also included and
expanded The Holiday Season unit from the STEPPS program (Appendix A), for facilitators who wish to use it. Appendix
B contains A Review of STEPPS Skills which should be copied and given to group members as they enter the
STAIRWAYS program.
Facilitators and group members will recognize some of the skills from STEPPS, specifically the skills for goal setting,
interpersonal relationships, and impulsive behaviors (called Abuse Avoidance in the STEPPS manual). Although the names
of some of the skills appear to be the same, the materials are expanded and more detailed, and participants will learn new
ways to apply the skills. The additional skills mentioned above were identified by previous STEPPS group members as
topics they wished to work on. Along with the new skills being taught, the basic emotion management and behavioral skills
in STEPPS will be reinforced and integrated into the additional skills. The Emotional Intensity Continuum and the Skills
Monitoring Cards were reviewed at every STEPPS session. In STAIRWAYS, group members are encouraged to fill out a
continuum for any emotional intensity episodes and to use the skills cards, but they may not be reviewed regularly at every
session. Group members receive a handout for each session and these are added to their STAIRWAYS notebooks.
The main benefits of STAIRWAYS come from: 1) identifying how the additional skills might help overcome some of the
problems participants are still having; 2) reinforcing the skills to manage emotional intensity; and 3) applying the new skills
to specific goals and challenges in their lives, such as getting a job, taking a class, expanding their social life, etc. Another
way to characterize the difference between the STEPPS program and STAIRWAYS is to think of STEPPS as teaching
emotion management and behavioral skills to help those with borderline personality disorder survive; the goal of
STAIRWAYS is to help participants thrive.
STAIRWAYS is not a replacement for individual therapy, but may help group members identify new topics to explore in
greater depth with their individual therapists. As with STEPPS, we strongly encourage members to take their
STAIRWAYS notebook to their individual sessions to share with their therapist. They should also be encouraged to
continue teaching members of their reinforcement team the language they can use to help remind participants to use their
skills at times of crisis. Participants may also wish to share their goals and ask reinforcement team members to help
encourage them as they work on them.
How is STAIRWAYS Structured?
We suggest twice monthly meetings, for two hours each session. The rationale for this schedule is to decrease the
frequency of meetings and to encourage group members to seek out other non-therapy activities between meetings.
However, different settings (e.g., residential treatment, day treatment programs, correctional institutions, etc.) may wish to
continue with weekly sessions to better fit their schedule. As with STEPPS, lessons may be broken down into shorter
components at more frequent intervals, depending on the available time and level of intellectual functioning of participants.
Most STAIRWAYS skills take multiple sessions to complete.
The STAIRWAYS manual includes a section for facilitator guidelines for each lesson, including homework assignments
and materials needed for that session. A sample group process note is included with each lesson plan. In addition, there is a
section titled Frequently Used Forms for those worksheets that are intended to be copied in quantity and used repeatedly
throughout the program.
When group members entered STEPPS, the manual began with the Introductory Lesson and proceeded through the
whole sequence; group members also started at the beginning and completed the 20 weeks together. STAIRWAYS works
a bit differently: the only time you will begin with the Introduction is the first time you introduce the STAIRWAYS
program. After that, new members will enter a group whenever they finish a STEPPS group (we do suggest that new
members wait until the first session of a new skill, rather than entering “in the middle” of a skill that has multiple sessions.)
Therefore we suggest that facilitators meet with prospective STAIRWAYS participants before they actually enter the group
and go through the packet of introductory materials ahead of time. The new members will then stay in the group until they
have completed all 9 skills (24 lessons, or 25 lessons if the optional holiday unit is included). This means that new people
will join the group periodically, and those who have finished all the skills will leave. After completion of the program, group
leaders can discuss whether additional group therapy, individual psychotherapy, or some other treatment would be most
helpful to the individual. In some settings, many participants ask to continue attending the STAIRWAYS program as a way
to stay connected with the program and to continue reinforcing their skills. In some groups, participants ask to be notified
when a particular skill is being taught (e.g., anger control). It is left to group facilitators to establish policies for their
particular settings.
We recommend that facilitators remind an ongoing group ahead of time when new members will be joining and ask for
suggestions to make the newcomers feel welcome. Some groups have brought simple treats whenever new members are
attending for the first time. It is also helpful to have both old and new group members introduce themselves and give a
brief descriptor (e.g., “I am a student,” or “I volunteer at the library,” etc.).
Training for STAIRWAYS Facilitators
It is recommended that group leaders, at a minimum, have a master’s degree in the social sciences with several years of
experience in psychotherapy and counseling, as well as experience with the STEPPS program. If the group is led by two
facilitators, at least one of the facilitators should meet the previously described level of training; the second facilitator may
be less experienced, but would be able to gain the experience to independently lead a future group. On-site training
workshops are available with ongoing consultation.
Continued…
Please scroll down to read the first few pages of the STAIRWAYS
Treatment Manual
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