EMDR Training Agenda/Outline ( In-person and Live Webinar)

 

 

Day 1. 8:30 -6:00        There will be a 15-minute break at 10:00 and 3:30. Lunch will be from 12:00-1:00

         

Background, Introduction

 Learning Objectives, What is EMDR?  (EMDRIA Definition) (.75 hour instruction)

 Adaptive Information Processing, Explanatory Model of EMDR (1 hour instruction)                                                  

• Basic trauma concepts.

• AIP definition

• Clinical Implications guides case conceptualizations, treatment planning, targeted interventions, and prediction of treatment outcomes.

                   Methodology:   Overview of the Eight-Phases

• Significance of each phase and the importance of maintaining fidelity in each phase for treatment outcome.

 

Phase I.  History taking, Case Conceptualizations and Treatment planning (1 hour instruction)

• Single incident verses many traumatic events effects approach.

• Discuss impact of trauma and effects on development.

• Introduce three prong approaches to identifying targets.

• Evaluation of client readiness, current safety, and functioning.

• Conduct YSQ: Schemas and character structure (Young’s Schema Questionnaire assist identifying negative cognitions and schemas)

• Ten most traumatic events, timeline, touchstone events.

• Evaluate for Dissociation- Introduce DES scale.

• Clinician awareness of clinical signs of dissociation.

• Recognition of racism, discrimination, oppression, intergenerational trauma, as trauma factors.

• Support systems, explore issues that might impede processing.

  1. Secondary gain issues

  2. Present stressors

  3. Timing issues

  4. Medical concerns, history of seizures 

  5. Legal issues potential effects to testimony

 

Phase II.  Client Preparation (1.5 hours instruction)

• Establish rapport, Explanation of EMDR and how it works

• Informed consent of potential strong affect

• Seating arrangements and BLS, testing speed and distance, alternatives to eye moments

• Asking client to accurately report what happens, Demonstrating the stop signal

• Resource Development Implementation. Prepare client by teaching container exercise, safe place exercise, and other resources for complex trauma to increase emotional stability if needed and containment skills when processing is incomplete or in-between sessions.

• Review precautions and client concerns

• Demonstrate resourcing

 

Phase III. Assessment – Explanation of all the components of assessment (.75 hours instruction)                                        (worksheet handout used to target memory and maintain fidelity of protocol.)                                       

• Targeted memory/image/picture

• Negative Cognition (appropriate and inappropriate)

• Positive Cognition (examples of appropriate and inappropriate and possible changes after desensitization phase

• Validity of Cognition (VOC) 1-7

• Emotions

• Subjective Units of Distress Scale (SUDS) 0-10

• Body Sensations

• Demonstration of Assessment phase

             

Supervised Practice- With a partner, take turns practicing Phases 1-3, including role play of the assessment phase until confident. Questions and classroom discussion will be provided at the end of practice. (3 hours)

                                             

 Day 2.  8:30 -6:00        There will be a 15-minute break at 10:00 and 3:30. Lunch will be from 12:30-1:30

         

Review Phases I-III (.75 hours instruction)

 

Supervised Practice- With a partner, take turns practicing a role play of the assessment phase. Questions and classroom
discussion will be provided at the end of practice. (1.00 hour)

 

Phase IV: Desensitization- Accelerated Reprocessing of Memory (Phases IV, V, VI, 1.25 hours instruction)

• Remind the client to let whatever happens happen.  Emphasize there is no right or wrong responses with what material that surfaces.

• As the therapist, maintain an empathic connectedness while allowing the client to process without unnecessary intrusion.

• Follow the client’s processing to determine the length of BLS/eye moments. Use alternative BLS when necessary.  When using rapid eye movements start on the average of 24 per set. Adjust to clients need thereafter.

• Reduction in the client’s disturbance and SUDs score as close to zero as possible

• Associative Channels of Processing changing images, new memories/ feelings/body sensations become the target for processing

• As each channel clears disturbance reduces/ new insights/emotions/body sensations

• Blocking Beliefs/ plateaus that interfere with processing

• Reassess and target for another EMDR session if belief interferes

• Strategies to jump start the processing, changing directions and/or 

            speed of eye moments, focus on body sensations, return to target

• Reprocess past event and present stimuli

• Unexpected material may present, therapist must decide whether to process now or save for another session.

• Use three-prong approach- past, present, and future.

 

            Phase V: Installation- Integration of positive self-assessment.

• Check to see if the initial positive cognition is valid

• Think of the incident, and hold it with the positive cognitions

• How true does the positive cognition feel now

• Install bringing the VOC score to a seven.

• Usually, you use a reduction in eye moments to install

• Install positive future template

• Check for blocking beliefs/feeder memories if 7 is not achieved

 

Phase VI: Body Scan

• Have client hold original memory and positive cognition together any physical sensations or tightness in the body.

• If tension exist addition eye moments focusing on body sensations

• New material may arise, process if time permits or note for future sessions

• Completion is achieved when there is no residual tension found in the body.

 

Demonstrate (live or video) a sample EMDR session with discussion following. (1 hour instruction)

 

Supervised Practice- With a partner, take turns practicing a role play of the Phases II-VI. Questions and classroom
discussion will be provided at the end of practice. (4.00 hours)

 

 

DAY 3. 8:30 -6:00        There will be a 15-minute break at 10:00 and 3:30. Lunch will be from 12:30-1:30

          

Review and Phase VII: Closure. (1.5 hours Instruction)                   

• Incomplete Session

• Assess client’s emotional state at the end of the session

• Use containment if necessary

• Visualization, relaxation, safe place exercise

• Debrief client and have them keep a log of any insights, thoughts, or material that may arise.

• Normalize continued processing as information to be reviewed for next session

• View an EMDR session

 

Supervised Practice- With a partner, review/practice Phases 1-6 (1 hour)

 

Answer questions before Actual EMDR Practice (.25 hours instruction)

 

Supervised Practice- With a partner, take turns conducting an EMDR session on a small “t” trauma (3 hours)

 

Discussion of the EMDR session (.5 hours instruction)

 

Phase VIII: Reevaluation (1 Hour Instruction)

• Review previous EMDR session

• Any disturbance left 0 SUDs or has VOC remained a 7

• Any new targets presented from log

• Is there an adaptive resolution that has taken place where the participant feels they have mastered the trauma?

• If past event is resolved, are there present stimuli?

• Address anticipatory fears and “positive template” for future. 

        

            History and Research (.75 hour instruction)

• First pilot study, Shapiro, 1989

• Treatment Guidelines, protocols developed through clinical observation and research.

• Switch from Desensitization to Adaptive Information Processing.

• Current Research, Abstracts, finding an approved consultant is located on EMDRIA Web page at emdria.org. 

 

Day 4. 8:30 -6:00        There will be a 15-minute break at 10:00 and 3:30. Lunch will be from 12:30-1:30

 

Future Template (.75 hour instruction)

• Third Prong of the protocol

• See demonstration of a future template

 

Working with Abreactions and Blocks (1 hour instruction)

• Guidelines for facilitating Abreactions

• Blocked processing-looping

• Strategies for dealing with blocked processing

• Addressing feeder memories (float back technique)

• Blocking Beliefs- Schemas and life Traps

• Fear of Fear

• Fear of change

• Wellspring of Disturbance

• Demonstration of working with blocking and looping

   

 Cognitive Interweave Strategy (1 hours)

• Unlocking stuck beliefs related to Responsibility, Safety and Choices

• Four occasions when using the interweave is appropriate

• Interweave Techniques: “fitting the intervention to the client”

  1. New information

  2. I’m confused

  3. “What if it were your Child”

  4. Metaphor/Analogy

  5. “Let’s Pretend”

  6. Education regarding choices for future  

• Demonstration of Cognitive Interweave

 

Supervised Practice: Clinicians will work in groups of two completing EMDR session from the day before by starting with Reevaluation to determine whether to complete the target memory, move a new target or do a future template. Direct consultation and observation will take place throughout the practice sessions. Clinicians will practice advanced techniques. (4 hours)

 

EMDR Neuro biology, hypothesis of mechanisms, other interventions (.75 hour instruction)

• Dovetailing with other models and differences.

• Orienting response of dual attention stimulation as a hypothesis

• Neurobiological speculation on EMDR and research

                                                                 

Ethical, legal considerations, changes in protocol for specific situations. (.5 hour instruction)

 

Day 5. 8:30 -6:00        There will be a 15-minute break at 10:00 and 3:30. Lunch will be from 12:30-1:30  

 

Special Protocols (.5 hour instruction)

1. Recent events

2. Anxiety Phobia

3. Illness and somatic disorders

4. Grief

 

Special Populations: Introduction (2 hours instruction)

• Children

  • Couples

  • Sexual Abuse Victims

  • Complex PTSD or DESNOS

  • Dissociative clients

  • Military

Telescopic Processing, R-TEP, Early Intervention (1 hours instruction)

 

Supervised Practice: Clinicians will break into dyads or triads and practice seven of the eight phases of the EMDR protocol.  Each clinician will address three-prong past, present, and future targets as well use alternative strategies to address blocked processing, including the Cognitive Interweave.  (4 hours)

 

Review using the EMDRIA Assessment questions on material covered (.5 hour instruction)

 

CONSULTATION SCHEDULE (10 hours) These hours do not count toward continuing education credit

 

The follow up consultation groups will start after the training and meet every other week for 2 hours.   The schedule will be set during the training to accommodate the participants’ schedules. New researched protocols will be introduced and more opportunity to discuss working with special populations will be provided.

 

EMDR Training

Learning Objectives:

 

1. Describe the definition of EMDR. 


2. Summarize the history and origins of EMDR. 


3. Summarize the AIP model 


4. Utilize the AIP in case conceptualization and treatment planning

5. Identify research findings which support the efficacy of EMDR 


6. Differentiate which clients and issues benefit from EMDR 


7. Identify 5 types of Resource Development 


8. Employ skills in using all phases of the EMDR protocol. 


9. Create a safe environment for disclosing traumatic events 


10. Identify and assess client readiness 


11. Identify 5 trauma based components to a clinical history for EMDR

12. Recognize and identify target events to be processed with EMDR 


13. Recognize professional, legal and ethical issues in employing EMDR


14. Identify protocols for working with special issues 


15. Identify strategies for working with specific populations 


16. Recognize dissociative disorders and the appropriateness in using EMDR with this population. 


17. Describe strategies for dealing with abreaction 


18. Exhibit different strategies for closing incomplete sessions 


19. Apply techniques, including cognitive interweave, for address blocking and problems with looping and other problems that arise in processing painful material 


20. List and describe the 8 phases of the protocol