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The Role of Consultation in EMDR Certification: Finding Support and Mentorship

By
Mary Ray, LCSW, Senior Faculty and Master EMDR Therapist

Interested in working towards EMDR certification through EMDRIA?  

Confused about the next leg of your EMDR journey?  

Looking for feedback and guidance on your more complex cases? 

 

If you answered yes to any of these questions, EMDR Case Consultation is for you 

 

Exploring EMDR case consultation 

Navigating the intricacies of EMDR clinical work can be challenging even for experienced EMDR therapists. Whether you are newly trained and interested in EMDR certification or have been trained for years and want to deepen your knowledge and refine your skills, Case Consultation is the way to go.  

 

Why begin case consultation right after EMDR Basic Training? 

As a facilitator for EMDR Therapy Basic training through The Center, I have noticed that getting into EMDR Case Consultation right away greatly increases the chances the newly trained therapist will continue to utilize EMDR. EMDR is simple, however its application is complex.  

 

After EMDR BT some trainees are not confident enough to use EMDR with clients, then feel like they cannot do case consulting because they are not using EMDR with clients. After EMDR BT, get right into case consultation to build your confidence in using EMDR! 

 

Gain support 

Ongoing Case consultation is a collaborative learning and support system. Embrace it as an opportunity to enhance your skills, ensure the best outcomes for your clients and stay at the forefront of this powerful therapeutic approach. This collaborative process focuses on you and your client’s work together, ensuring you are effectively utilizing EMDR techniques, while adhering to ethical guidelines and best practices.  

 

In addition, group Case Consultation provides you the benefit of listening to others’ cases and questions as well as presenting and getting feedback on your own cases. 

 

What are some of the benefits of EMDR case consultation? 

Enhanced clinical skills  

  • Receive feedback on your implementation of EMDR protocols, fostering deeper understanding and improving your therapeutic interventions. 

Increased confidence       

  • Discuss complex cases, explore alternative approaches, and gain the assurance you're on the right track, leading to improved client outcomes.  

Ethical guidance      

  • Navigate challenging situations, address ethical dilemmas, and ensure you're providing safe and responsible EMDR therapy. 

Professional development       

  • Stay abreast of the latest EMDR research and best practices, enhancing your knowledge and expertise. 

 

 

Who can benefit from EMDR case consultation? 

New EMDR therapists       

  • Gain confidence and learn the ropes under the guidance of a seasoned professional as well as working toward EMDR certification. 

Experienced therapists       

  • Seek feedback on complex cases, explore alternative approaches, work to attain best use of self, and stay updated on evolving practices. 

Therapists working with specific populations 

  • Address unique challenges encountered when working with children, adolescents, or clients with specific diagnoses. 

 

My journey into EMDR therapy and Case Consultation 

I trained with Francine Shapiro in 2000 and followed Francine’s direction that I go into Case Consultation right away with Deany Laliotis. (You would have too, as Francine was quite a force). Throughout the past 24 years I have learned a lot about myself and how to use EMDR Case Conceptualization to determine the course of treatment.  

 

I understand that my relationship to a client as well as the client skills and capacities guide me when we get into reprocessing work. I know that people with many traumas are often very resilient. I know that when I show up fully myself, my clients have our relationship to lean into through difficult reprocessing experiences.  

 

I remain in Case Consultation with Deany to this day. Ongoing Case Consultation makes it possible for me to continue to grow professionally and personally; to navigate complex cases; to co-create conditions which make it possible for my clients to do the work and for my consultees to go there with their clients; to discover how I am getting in my own way and assist my consultees from getting in their own way of facilitating client change; consultee growth and much more.  

 

I do not imagine stopping Case Consultation. Benefiting immensely from my own ongoing Case Consultation leads me to want to share this with others. Why not grow in as many ways as possible as long as possible?  Why not become excellent in providing EMDR therapy?  

 

Some of the questions I find myself asking consultees regularly are:  

  • What brought them to come to see you and why now? 
  • Why do you think you are struggling with this case?  
  • What are you learning about yourself in relation to this case? What feels doable and why? 
  • What are we doing here? Does your client have curiosity to understand what is happening and why, so they can commit to do the work to change? How do they understand their suffering? 
  • Do you have a client? Do they want to be different in how they live their lives? Are they willing to develop more workable solutions to problems instead of using childhood adaptations as adults? 

 

Knowledge that I apply to consultation 

If we show up more ourselves in sessions with our client and raise our expectations of this client, they will also show up more fully in response. 

 

Often our clients get confused – they were alone and did not have power or choices as a child. As adults they have many choices, and we will accompany them through these experiences. It can take a while to come to these realizations. This is often some of the work before the work.  

 

It is a disservice to be indirect. When we are real and direct with our clients (and our consultees), bringing kindness and compassion to our directness, we help them see what we see. Once we are on the same page we can move forward together. 

 

Symptoms point to problems – unprocessed childhood pain, attachment failures and traumas. Strengthening positive changes with clients increases their adaptive memory networks. Changes that feel small are huge for certain clients. Instead of being a moth to the flame of trauma, notice even small changes the client is making that are positive. Share with the client your excitement about their changes and co-create a moment of celebration making a positive adaptive memory in that moment. 

 
Client case study from consultation 

Following is an example from case consultation where an EMDR therapist was at a crossroads, and how EMDR case consultation helped guide the way to a clearer outcome. 
 

Case of unrelenting anxiety  

Why did the client come in and why now? 
Client is having difficulty in her current workplace due to noise volume taking her stress levels out of her window of tolerance. The client is 10 months into recovery from a substance use disorder. Client works in a cube environment so she can hear what other people are saying and doing. Client fears loss of her job as she retreats to the bathroom several times a day for extended periods of time to decrease her stress.  

 

The therapist explored the client’s history of childhood abuse at hands of both parents and being trafficked for sex as a teenager. The client regularly attends 12 step meetings and has a sponsor.  Client experiences intermittent dissociative episodes. Therapist has been resourcing and educating the client for the past 9 months for fear of the client either returning to drug use or dissociating during reprocessing.  Therapist tried safe place exercise; client could not keep safe place in mind when doing BLS which the therapist took to mean the client was unable to switch emotional states at will. Client continues to spend inordinate amounts of time in the bathroom.  
 

Therapist question to me:  

“How do I move the therapy along without the client relapsing and/or dissociating?”  
 

Why is the therapist stuck?  

Lack of knowledge. Therapist did not know that Safe/Calm place can be done without using BLS, and that trauma underlies addiction. Clients with lots of trauma can be quite resilient. The therapist got caught up in the number of client traumas instead of assessing the many skills and capacities of the client.  

 

What the therapist and I discussed 

We often need to realize it is our own fears about moving forward that are blocking client work. Once we clearly conceptualize the case then we can obtain client consent to proceed. 

 

During Safe/Calm place exercise, some clients find BLS distracting.  I suggested the therapist proceed with the exercise without BLS, note the client’s ability to state change and maintain dual awareness. I brought to the therapist’s attention the importance of considering other clients’ skills and capacities. If good enough, proceed to reprocessing. 

 

There is a direct connection between childhood trauma and addiction. Reprocessing the traumas can make ongoing recovery a possibility. It is important to share with our clients the possible outcomes of our work and obtain consent for each piece of work.  

 

With complex cases we need to determine which of the three prongs to begin our work. Starting by reprocessing a current concern often brings about enough stability to proceed with reprocessing the past. 

 

What the therapist decided to do: 

The therapist discussed their fears of using EMDR with this client. Our coming to understanding and clearly conceptualizing the case alleviated the therapist’s fears which were blocking the work.   
 

The therapist found that the client could change states and maintain dual awareness doing Safe/Calm place without BLS.  Noting that the client had many skills and capacities and in fact was quite resilient, the therapist realized they could move into the work. 

  

Understanding the trauma/addiction connection, the therapist educated the client about the same. The therapist asked the client about her desire to resolve trauma even if she were to relapse. The client chose to reprocess trauma as she had already relapsed and returned to sobriety many times. Client valued decrease of sensitivities at work over fears about relapse.  

 

Therapist and client chose to reprocess a recent issue with a coworker and installed a future template. The client experienced a decrease in her level of disturbance at work. The current day being more stable, the therapist was more comfortable proceeding. With the therapist’s support, the client expressed readiness to move into reprocessing underlying past abuse issues. The client did not relapse during treatment and remains sober today.  

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Why wait to become EMDRIA Certified? 

Why continue to navigate complex cases alone?  

Why train in EMDR without putting it to use with your clients? 

 

Get into EMDR Case Consultation right after EMDR BT with an EMDRIA Approved Consultant at The Center, to build confidence in using EMDR  

Just as using ourselves in relationship to our clients leads to best clinical outcomes, so does collaborating with an EMDRIA Approved Consultant who is an affiliate of The Center of Excellence in EMDR therapy. 

 

Every faculty member of The Center For Excellence in EMDR therapy is in Case Consultation. Come join us in lifelong learning, personal and professional growth as well as camaraderie.  

 

Let’s navigate the difficulties of trauma work together. 

 

EMDRIA Approved Consultants from The Center for Excellence in EMDR therapy are certified by EMDRIA (EMDR International Association). They have personal experience in consultation for their own cases, assist others in working with their cases and have many other areas of expertise. Learn more about The Center’s Approved Consultants:   

https://emdrtherapy.com/about-emdr-training-center/our-approved-emdr-consultants