Somatic Experiencing vs STAIR

A side-by-side comparison of recorded mechanisms, evidence review status, related condition topics, and philosophical roots.

By Expert review not yet recorded Updated

At a glance

Source checks, condition-specific assessments and expert review are separate steps. Each assessment applies only to its stated population and use. Topic links do not establish comparative effectiveness.

Somatic Experiencing

Tradition
Somatic
Founder
Peter Levine (1997)
Review status
1 condition assessment available
Official sources
Guidelines and official sources (2)

2 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

Focus
Somatic + Experiential
Format
Individual
Duration
Medium-term

Condition-specific assessments

Each conclusion applies to the population and use described. These source-based assessments do not certify the full entry or replace expert clinical review.

STAIR

Tradition
Cognitive-Behavioral
Founder
Marylene Cloitre (2002)
Review status
1 condition assessment available
Official sources
Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

Focus
Skill + Processing
Format
Individual
Duration
Short (16)

Condition-specific assessments

Each conclusion applies to the population and use described. These source-based assessments do not certify the full entry or replace expert clinical review.

Complex Trauma / Developmental Trauma

Population and scope: Adults aged 18–65 with CAPS-5 PTSD after repeated childhood sexual or physical abuse; eight STAIR sessions followed by 16 EMDR sessions, compared with 16 immediate EMDR sessions. Entry did not require a complex-PTSD diagnosis.

Randomized studies

Van Vliet et al. (2021) reports 135 randomized adults; analyses used 121 after 11 withdrawals before treatment and three delayed eligibility exclusions. Only 28.9% met SIDES complex-PTSD criteria at baseline; this was not an ICD-11 diagnostic interview. Both groups improved, with no statistically significant endpoint advantages for adding STAIR through six months or in treatment dropout. Immediate EMDR showed faster early improvement in self-reported PTSD symptoms, interpersonal problems and post-traumatic cognitions. The authors found no need for a preparatory phase in this sample. The study was not an equivalence trial, did not test standalone STAIR and had no inactive control. Twice-weekly STAIR may have limited time to practise skills between sessions. Exclusions included ongoing abuse, acute suicidality requiring crisis intervention and screened substance misuse/dependence. These findings do not establish that every person with complex PTSD needs, or should avoid, preparation.

Source assessment dated

How they work

Somatic Experiencing

Core mechanism: Alternating in small doses between activation and a settled resource state ('pendulation') is held to complete defensive responses that were interrupted at the time of the threat and remain bound in the body

Ontology: Incomplete defensive responses (fight/flight/freeze) remain bound in the nervous system as undischarged survival energy

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

Related condition topics

These editorial cross-references organize reading. A shared link does not mean both approaches are effective, recommended, or interchangeable for that condition.

2 shared · 4 Somatic Experiencing-only · 0 STAIR-only

Linked to both entries

PTSD & Acute TraumaComplex Trauma / Developmental Trauma

Linked only in the Somatic Experiencing entry

Chronic Pain & Somatic SymptomsAttachment & Relational PatternsPerinatal Mental HealthSexual Dysfunction & Intimacy Concerns

What each assumes — and misses

Somatic Experiencing

Philosophical roots: Reich/Lowen (body holds defense; Levine worked in this lineage but did not study with Reich, who died in 1957); Merleau-Ponty (lived body); Darwin (survival instincts); ethology (Tinbergen, Lorenz: animal defensive responses); James-Lange (emotion as bodily process)

Blind spots: Risk of over-physiologizing psychological meaning; limited manualization makes research difficult; can be vague in application

Therapeutic voice: Let's leave that where it is for a moment and come back to your feet on the floor. When you're ready we'll go back and take a smaller piece of it.

STAIR

Philosophical roots: Herman (phase-oriented treatment); Cloitre (skills before exposure); developmental psychopathology; attachment theory

Blind spots: Two-phase structure lengthens treatment, and Phase 1 can feel slow to clients who are ready to process; the premise itself is contested, since a number of trauma researchers argue that phase-based sequencing delays effective treatment without clear evidence that a skills phase is necessary

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

Somatic Experiencing (Somatic) 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 Somatic Experiencing and STAIR pages, or use the interactive comparison tool to add more modalities to this comparison.