EMDR vs STAIR
A side-by-side comparison: mechanism, evidence, the conditions each treats, philosophical roots, and where they actually disagree clinically.
At a glance
EMDR
- Tradition
- Trauma-Focused
- Founder
- Francine Shapiro (1989)
- Evidence
- Guideline-recommended
- Focus
- Processing
- Format
- Individual
- Duration
- Short-medium
STAIR
- Tradition
- Cognitive-Behavioral
- Founder
- Marylene Cloitre (2002)
- Evidence
- Guideline-recommended
- Focus
- Skill + Processing
- Format
- Individual
- Duration
- Short (16)
How they work
EMDR
Core mechanism: Bilateral stimulation during trauma memory processing facilitates adaptive information processing and memory reconsolidation (proposed)
Ontology: Unprocessed trauma memories stored dysfunctionally with original affect, sensation, and cognition
STAIR
Core mechanism: Phase 1 builds emotion regulation and interpersonal skills; Phase 2 uses modified narrative exposure with these new capacities
Ontology: Complex trauma disrupts both affect regulation and interpersonal functioning; skills needed before narrative processing
Conditions treated
2 shared · 6 EMDR-only · 0 STAIR-only
Both treat
Only EMDR
What each assumes — and misses
EMDR
Philosophical roots: Merleau-Ponty (body holds memory); Bion (processing/containment); Pavlov (orienting response); Shapiro (adaptive information processing — pragmatic, not philosophically derived)
Blind spots: Mechanism debate unresolved; protocol fidelity varies; may be applied to conditions beyond its evidence base
Therapeutic voice: Bring up the image and the negative belief. Notice what you feel in your body. Now follow my fingers.
STAIR
Philosophical roots: Herman (phase-oriented treatment); Cloitre (skills before exposure); developmental psychopathology; attachment theory
Blind spots: Two-phase structure lengthens treatment; Phase 1 skills focus may feel slow for clients ready to process
Therapeutic voice: Let's practice naming what you're feeling with more precision — not just 'bad,' but specifically what kind of bad.
Choosing between them
EMDR (Trauma-Focused) and STAIR (Cognitive-Behavioral) come from different traditions, which means they assume different things about what a person is, what causes suffering, and what the therapeutic relationship is for. The choice between them is often less about "which works better" and more about which set of assumptions fits the client and the therapist.
For deeper coverage: see the full EMDR and STAIR pages, or use the interactive comparison tool to add more modalities to this comparison.