Adaptation of a Trauma-Focused Parenting Intervention for Military-Connected Mothers and Their Young Children: A Rapid Qualitative Study.

Adapting evidence-based interventions (EBIs) to be sensitive to populations who have experienced trauma has been shown to improve engagement, retention, satisfaction, and effectiveness. Compared to civilian mothers, military-connected mothers (MCM)-including service members, veterans, or their partners-face greater exposure to trauma across the life course, leading to mental health and parenting challenges. These may adversely affect their children's mental health and perpetuate generational trauma. EBIs aligned with people's life experiences and cultural backgrounds are critical to supporting the mental wellbeing and parental functioning of MCM. Informed by the Framework for Reporting Adaptations and Modifications-Enhanced and utilizing rapid qualitative analysis-a rigorous method for quickly identifying key interview themes-this paper describes the process of adapting an innovative EBI, Parenting-STAIR (P-STAIR), which targets maternal trauma, emotion regulation, and parenting. Transcripts from interviews with administrators, clinicians, and MCM at clinics serving military families were systematically summarized, organized into matrices, and analyzed. Four emergent themes informed adaptations to P-STAIR: (a) streamlined treatment and enhanced engagement, (b) flexibility and responsiveness, (c) mental health stigma reduction, and (d) military cultural relevance. Considering these priorities, which were expressed across participant groups, P-STAIR was shortened from 23 sessions to a brief, modular 12-16-session intervention that can be personalized to individual needs and uses approachable language (e.g., distress vs. trauma), which aims to reduce the impact of stigma on engagement and retention. A standalone guide was developed to accompany the intervention manual, which may help clinicians better understand the unique experiences of military families. The outcome of this process, PSTAIR-M, is a briefer, modular intervention we anticipate will be suitable for delivery to MCM.