“I feel like a budding musician who started out in the basement! During COVID we weren’t able to get into a studio or anything like that so I literally developed these videos in my basement using audio on my phone.”
The Self-care Traumatic Episode Protocol fits into a neat little acronym – STEP! Was this one of those programs that worked backward, to shoehorn its description into an easily-remembered four-letter word? Dr. Judy Moench says no.
“It was named that on purpose because it’s a modified version of a protocol that was developed called EMDRGTEP – which is the Eye Movement Desensitization and Reprocessing Group Traumatic Episode Protocol.”
Nobody worked backward, I think we can assume, to make EMDRGTEP a neat little acronym!
Dr. Moench is a registered psychologist in Alberta with a private practice, and also an adjunct professor at the University of Alberta. During COVID, she’s been working on a number of protocols that might be helpful in the community. One is a school-based program, focused on the universal promotion of emotional health with an emphasis on the well-being of students. Prepped 4 Learning is a self-regulation program that starts with teachers and parents helping kids regulate to learn, all the way up to what to do if there is a crisis in school. Dr. Moench thinks STEP might be helpful in this setting as well, for teachers in particular, and they are beginning research with school staff soon.
STEP was launched during the pandemic to assist mental health clinicians, medical staff, and other front line workers to decrease stress and increase coping. The idea was that because people were unable to meet in person a computer-delivered protocol was necessary. This was not intended to be a substitute for psychological treatment or medical diagnoses, but that a 90-minute session with STEP videos could develop containment strategies that would allow them to continue working on the front lines through this time of overwhelming stress. Eye movement is part of the process.
“Eye movement is part of EMDR Therapy, an approach that has an eight-phase model, and you go through all the phases with a client to help them resolve unprocessed material and recover from distressing life experiences. STEP is an adapted protocol but it still uses eye movements and goes through modified phases of treatment – you print out a worksheet, and the person taps from one side of the protocol sheet to the other side and follows with their eyes as they’re doing that. The eye movements help to add distance and give calmness around the event that is being processed. It helps to consolidate the memory in a more cohesive way.”
Normally Dr. Moench and her team would do this kind of activity in groups in the office. You know, in the before-times. Now, this program has to be modified for online delivery, which means a few steps have been adapted. Typically, EMDR treatment would involve an extensive history with the client – with STEP, this has been modified to a few specific questions up front that ensure the person is ready and eligible to use the protocol. For example, someone who was thinking about suicide, or had a complex trauma history, may be better served with one-to-one EMDR Therapy.
Another thing that sets STEP apart is that it is designed to deal with only one very specific trauma episode at a time – right now, the trauma brought on most recently by the COVID-19 pandemic. Dr. Moench calls this ‘titration’, and it narrows the focus to that one episode and excludes the larger history that might otherwise be part of treatment.
“With STEP, the research study we did focused exclusively on COVID. Since then, I’ve used it with other things that aren’t specifically COVID-related…even though right now everything is kinda COVID-related! But there are other events that are happening along with the pandemic.”
The STEP protocol has been used in Alberta with mental health clinicians, with a small group of staff from the United Nations, and with other national and international groups in which Dr. Moench is a member. Right now, she and her team are making a more professional version of the current STEP videos – after all, the originals were shot in her basement with audio from her phone! Only time will tell if this psychology-as-garage-rock-band will be a pandemic-specific flash in the pan (like the Strokes) or a longer lasting international sensation (like U2).
Hey…that’s got us thinking now. How come there hasn’t been a Live Aid / Live 8 pandemic relief show yet? Those were always super-distanced!