After Basic Training: EMDR Therapy as a Career Path
After Basic Training: EMDR Therapy as a Career Path
So, you have completed your EMDR Basic Training and have your Certificate of Completion. Congratulations!! Some of you may want to celebrate this achievement. With your brain still full of new information, there may be no desire for a further step on your EMDR journey.
What’s Next
But there are some of you who may be asking “Now what?” EMDR Basic Training, focused on clear and common EMDR procedures and typical challenges, is just that--Basic! It provides all the tools needed to conduct EMDR therapy with clients. But...but...there is much more that may be learned!
Basic Trainers are sometimes asked why Basic training does not cover more complex client presentations such as we see in practice. The main reason is that we are teaching a model that requires clear client examples in order to see how it works. In each of the 8 phases, there are choice points to learn, with options depending on the clients’ stability and reactions. This is well supported by the 40 hours of live or virtual Basic training and 10 hours of Basic consultation that EMDRIA requires.
While it can be quite validating to see examples of an expert EMDR clinician really struggling, (which we all do), or to share complex client sessions that show the many choices in advanced
EMDR clinical work, it is not the most effective way to teach a new protocol. Too many exceptions are confusing and there are enough of those to learn in Basic Training already! Some Basic Trainers have even joked that the answer to many questions about EMDR therapy is: “Well, it depends!” ’
Learn the Standard Protocol Well
Everyone needs to see, hear, understand and implement the standard 8 Phase protocol well, through lecture, demonstration, and practice. The greatest learning comes when we integrate EMDR into our clinical practice. As we work with more EMDR clients, they often present a new issue or diagnosis for us in using EMDR therapy. That is why we not only recommend, but expect trainees to work with clients right away..
Experiences and mistakes equal learning. Many questions trainees have about using EMDR therapy with their own clients are addressed effectively in the required 10 hours of Basic group consultation. It is not just another ‘hoop’ to go through in order to obtain the Certificate of Completion for EMDR Basic training. This is to help trainees to integrate EMDR therapy over time into their specific clinical practices.
Optional further consultation
Ongoing EMDR consultation is always available for specific challenging cases and populations after you are done with Basic Training. Those who want to continue learning can obtain further individual and group consultation as well as easily access the many EMDR specialty books, training, and information now available.
There are EMDR Approved Consultants throughout the world to choose from for case-specific, specialty population-specific, or overall professional growth. If you want to continue on your path to excellence in EMDR therapy, there is much more to enjoy learning! Check out our Consultation page to learn about EMDR & Beyond team’s own Approved Consultants or go to EMDRIA to find more AC’s from which to choose.
No Fee Study or Book Group
If you are fortunate enough to have EMDR colleagues in or near your practice, a most rewarding way to continue your EMDR education is through creating or participating in a free study group. There may also be an EMDR & Trauma Book Group available where you can read, learn, and practice together. Or you can start that yourself as well. I greatly benefitted from a no fee study group with EMDR colleagues for many years, particularly as a newly trained EMDR therapist with no EMDR colleagues in my agency.
Next Career Step: Becoming an EMDR Certified Therapist
Some clinicians choose to continue on into the next available optional step, EMDR Certification, as soon as Basic consultation is completed. Others choose to practice a while, then feel ready to start the certification process. Some therapists don’t care about the credential but continue in EMDR consultation, sometimes for many years, with no interest in being a Certified EMDR Therapist.
EMDRIA Certification Requirements
Certification in EMDR is an optional advanced credential for which you complete an additional 20 hours of consultation with an Approved Consultant of your choice. Ten of these required hours may be group but 10 are required to be individual hours. Here is a link to EMDRIA’s requirements for certification. Many newly trained EMDR clinicians recognize the value of expert consultation through their required Basic hours and decide to continue in EMDR consultation. If you want or need more consultation anyway, why not get a valued credential along with it?
While specialty populations are very briefly covered in most EMDR Basic training, there is no time--nor ability to absorb--more than an overview and possible resources. The required 10 individual certification hours particularly assists in developing and strengthening a solid foundation for EMDR therapy with a broad range of clients. Much practice wisdom can be gained from the consultant that will assist us with our EMDR clients over the course of the 20 hours of certification consultation.
Many Approved Consultants set additional requirements such as presenting video or audio cases, completing required reading, or testing the ability to answer key EMDR therapy questions. In-depth or ongoing video/audio case presentations are a powerful additional learning tool that also provides confirmation of competence. These video or audio clinical samples can reveal common differences between what we say we do in therapy vs. what we actually do. Presenting actual EMDR therapy sessions allow consultants to pick up areas outside the clinician’s awareness that may need to be refined or corrected.
Effective consultation should support and confirm the EMDR clinician’s demonstration of skills and competence for certification. Consultation with an expert EMDR Certified Therapist who is an Approved Consultant is invaluable over time. While additional consultation is not required after certification, sustaining EMDR Certified Therapist status does require 12 hours of EMDRIA Approved specialty training every two years. Membership in EMDRIA is not required to continue Certified Therapist status, but the initial application has a significant discount if you do join.
Most clinicians really enjoy and highly value group consultation, benefiting so much that some choose to continue in their group consultation long after the required certification group hours are completed. Group hours are especially valued for what clinicians may learn from each other. It is also validating and a relief to learn that one’s struggles are shared by others in the group!
Discussing cases with other clinicians facing similar challenges, learning effective interventions for difficult clients and issues, drawing support and practice wisdom from group members, and having the expertise of an advanced EMDR clinician facilitating group consultation can be incredibly helpful. Ongoing group consultation is more affordable than individual consultation as well.
An EMDR Certified Therapist has demonstrated their commitment to doing EMDR therapy well. This adds to credibility and recognition by referral sources and even a few insurance companies! It’s a career step that solidifies clinical skills as well as keeping therapists engaged in ongoing EMDR education.
Advantages of Investing in EMDR Certification:
You can have a long, excellent and successful career as an EMDR therapist without becoming certified in EMDR, a choice several valued colleagues have made. They continue to grow and educate themselves about EMDR and trauma but have not pursued the certification credential. Many of us, however, have chosen to pursue Certified EMDR Therapist status along with our investment in continuing education.
Below are some common benefits of pursuing EMDR Certified Therapist status.
The additional 20 hours of consultation will solidify understanding, application and competence in the EMDR 8 phase standard protocol with a variety of clients over time.
It is an opportunity to review and refine knowledge of each phase, including the order of implementation and exceptions to the standard protocol.
Learning when to utilize specific clinical interventions and processing options, in order to make wise, clinically based decisions when deviating from the standard protocol.
Case-specific and population-specific interventions, recommended reading, training and resources are discussed for further learning and client application.
Finding opportunities for collaboration and connection with the EMDR community. Networking supports excellent EMDR therapy as it furthers the clinician’s EMDR
development in community with others.
More client referrals through recognition and credibility in the EMDR community. Good EMDR therapists are often booked several months in advance so it can be difficult in some areas to find someone who is even taking on new EMDR clients.
Evidence that the therapist invested time and finances to advance their EMDR therapy clinical skills. Since they’ve been active in the EMDR community over time, these therapists usually know others in the area for referral options if they cannot take the referral. EMDRIA’s search engine Finding a Therapist can also be used to locate an available Certified EMDR Therapist.
Some insurance companies recognize the EMDR Certified Therapist credential as an advanced professional, giving that therapist priority in referrals. (If it were only a higher rate of pay!) This seems to greatly vary by area as well as the availability of advocates who educate insurance companies about it. Given that referrals are not an issue for the EMDR clinicians I know, this ends up as possibly the least valuable reason on this list.
Next Career Step: Become an Approved Consultant
Occasionally trainees in Basic are so enthusiastic about EMDR therapy, they ask how one can become an EMDRIA Approved Consultant, like their Basic Training practice coach or facilitator, or even how to become an EMDR Trainer. Some therapists take to coaching, facilitating, or teaching naturally or have developing skills in these areas. Occasionally an expert EMDR clinician is drawn into becoming an Approved Consultant by request of their EMDR peers or colleagues.
Requirements of Approved Consultant status
The process of becoming an Approved Consultant requires completion of Certified Therapist status. After that credential is completed, the Consultant in Training process of 20 consultation of consultation hours can begin. The application to become an Approved Consultant cannot be finalized, however, until 5 years of EMDR experience after Basic training was completed.
This process of “consultation of consultation” involves 20 hours of post-certification consultation for the new Consultant in Training (CiT). CiTs present on their consultees’ growth and challenges rather than their own difficult client cases. They may discuss consultees’ challenging cases as they need resources or ideas to assist the consultees, but the Consultant in Training’s focus is on their consultee’s clinical growth in EMDR therapy. These hours may all be conducted individually, through live consultation of coaching/facilitating in Basic Training and/or in a group of Consultants in Training.
Consultants are allowed to have up to 4 consultees per group consultation hour, or 8 per two hour group consultation, in addition to offering individual consultation by request or as part of fulfilling their individual certification requirements. Check out EMDRIA’s requirements for Approved Consultant status.
The Consultation Business
Beginning the path to becoming an Approved Consultant is where your EMDR journey truly impacts your career path. EMDR consultation is an additional and separate business from one’s EMDR clinical practice, adding diversity to one’s clinical work. While consultees may call it supervision, EMDRIA purposefully calls it consultation. AC’s are not legally liable for the clinical work of consultees as supervisors are for their supervisees.
Approved Consultants may also provide Consultants-in-Training consultation about setting up the new consultation business, normalizing the ups and downs of incorporating a consultation schedule into one’s therapy practice, how to set up consultee registration and fees, and the adventures of distance consultation by phone or online.
Like any new business, establishing yourself as an Approved Consultant takes time and is an investment. Initial consultation groups might not be full and not as financially beneficial as client work. Over time, however, CiT’s consultation schedules fill up with ongoing consultees as well as new consultees requesting their services.
Consultation also makes a nice change from full-time clinical practice. Consultation and training can mediate burnout from increasingly complex and intense work with clients that expert EMDR clinicians are asked to do.
Finding Consultees
You may be fortunate enough to know a Basic Training provider who invites you to be a facilitator or coach for their Basic Training. Hours spent in coaching or facilitating all Basic training’s practice sessions and overseen by the Basic Trainer are an excellent way to build consultation skills. Trainers are able to observe, model, teach, and support the new consultant-in-training as they facilitate practice groups in training. And, it is also a built-in EMDR refresher!
If you do not have this opportunity or affiliation, you cannot provide the required 10 hours of EMDR Basic consultation to any of that Basic Training provider’s trainees. Only those AC’s whom the Basic Training provider has approved can provide the 10 required hours of Basic consultation. Any CiT or AC can provide certification consultation regardless of where the consultee got their Basic Training but the required Basic training hours must be completed by the list of Consultants that the Basic Training provider has approved for sharing with trainees.
Why? Each Training Provider wants to ensure that their trainees’ basic consultation is provided by someone who truly understands and will follow their model. Connecting with trainees in Basic training or Basic consultation is often the path EMDR clinicians take in finding the best Approved Consultant for their practice needs.
Basic trainees typically connect well with their group practice coach/facilitator, frequently choosing to continue working with that consultant for their required consultation hours.
While trainees may want to choose a consultant who has expertise in their specialty areas of practice, at this Basic level it is not required. All Consultants know the foundational skills that beginning EMDR therapists need to learn regardless of the focus of their clinical work.
As you can guess, providing Basic consultation to trainees is the most common way new CiT’s are able to build their consultation practice. Occasionally an AC, usually trained by that Provider, may request to be added to the Provider’s Approved Consultant list, and may be asked to meet additional requirements if not Basic trained by that Provider.
In-Agency EMDR Consultant
Some therapists are supported financially by their agency to be an EMDR Certified Therapist, in order to go on to become the agency’s in-house EMDR Approved Consultant. This particularly happens when agencies have paid for EMDR training and already plan to fund interested staff therapists for further consultation to achieve Certified Therapist status. Though an investment over time, it is a great way for organizations to save costs and insure availability of external consultation familiar with their client population. Potential CiT’s then have built-in consultees among their colleagues (or supervisees) in their agency.
Recommended Guidelines for In Agency Approved Consultants
For this to work effectively, CiTs need to clarify the agency’s expectations up front as well as their own requirements. The agreement between a potential In Agency CiT and the organization should clarify:
a) Any requirements for staying with the agency for a set time after becoming an AC or other expectations in repayment for the agency investment.
b) the time needed to add staff consultation, both routine and as needed, to the CiT’s schedule, and how that impacts the CiT’s available clinical hours and/or productivity requirements.
c) Clarification about the CiT’s provision of consultation to others who are outside the agency.
Consultation groups that include consultees from other organizations or in private practice truly broaden and expand the EMDR learning experience for all. Adding non-staff members to the ongoing EMDR group consultation benefits the agency and staff, not just the CiT as it enriches the experience for everyone. More consultees also allow ongoing group consultation to continue, particularly if in-agency staff do not regularly attend or there are insufficient in-house consultees to make the consultation time worthwhile to consultants. It also increases the visibility of EMDR expertise within that agency and potential leadership roles within the area’s EMDR community.
Most agencies are fine with their in-house AC offering their individual consultation services to outside consultees as long as it is done on their own time. It adds to their credibility in EMDR and trauma treatment and is not a conflict since agencies don’t typically get in the business of offering consultation for a fee as one of their services. The AC has earned this by the time and investment they’ve given in order to share their Approved Consultant expertise with others. This also adds practice wisdom and skills as a consultant and to the recognition of EMDR for the agency.
Concerns with In Agency EMDR Approved Consultant
Concerns arise with agency CiT’s when such arrangements mentioned above are not clearly understood by both parties. Difficulties arise, such as being held to the same therapy productivity standard regardless of added consultation hours, the expectation that staff can access the consultant any time regardless of the consultant’s other work. There also is disappointment, if not anger, if the Approved Consultant chooses to leave the agency after Approved Consultation status is achieved.
Other Options: Recognition of Expertise
Another option to get started is to offer free study groups to EMDR clinicians in the area, provide EMDR specialty training, do conference presentations, and in other ways get the potential Approved Consultant’s name and expertise known. This was much more successful in the past where there were few or no Approved Consultants in many areas. Now, these options are much less effective, particularly with many areas where there are already well established AC’s available. And this option is not effective unless the clinician somehow is or becomes known, respected, and sought out in the EMDR community. One’s EMDR clinical and specialty expertise as well as general reputation as a mental health professional, are all important.
Occasionally, an EMDR clinician’s expertise is noticed by the EMDR community around them, resulting in being asked to provide consultation to their colleagues. This can also happen through positive feedback from clients who were referred for EMDR therapy or when mental health colleagues hear a specialty presentation by the clinician.
How Many Consultees?
Though it is not an EMDRIA requirement, I strongly believe it is difficult to become an Approved Consultant without at least 3-4 consultees to work with. It is like trying to be certified with only a few cases. I know this because I tried it and we essentially had to wait until the person got several more staff members ready for EMDR consultation before our consultation of consultation time together was effective and useful..
Some AC’s, typically in large cities, handle the lack of consultees for their CiTs by offering CiT groups who practice consultation skills with each other. While this seems an excellent way to build consultant skills, it may also result in AC’s who have no access to consultees after investing time and money in the process.
Many expert clinicians create EMDR specialty training such as offered through EMDR & Beyond. This is an excellent way to get known and noticed, opening the door to potential consultees. Organizations like EMDR & Beyond have the ability to develop and nurture potential future EMDR presenters/Approved Consultants so you are fortunate if you have such an organization available in your area.
Of course, there are exceptions to everything I have said as we EMDR clinicians seem to be an independent group! You may find your own path or be able to access an Approved Consultant who will do it quite differently from what I’ve outlined here. I say, good for you!
Becoming an EMDR Basic Trainer
It may be disappointing to learn that there is no “official” path set by EMDRIA to becoming an EMDR Basic Trainer. Each Basic Training Provider invites those clinicians they believe have trainer potential to become trained as a trainer, under their consultation and guidance. Trainers in Training have to fulfill various requirements set by the Training Provider in order to become an EMDR Basic Trainer.
There is great variety in what Basic Training Providers ask of the Trainer in Training (TiT) in their training process. Some train new trainers by having TiT’s attend several weekend training sessions under their or an expert Trainer’s tutelage. Often, the new trainer gradually presents more of each day’s material over several training days. Then many Providers have the Trainer in Training conduct a complete Basic training under the expert Trainer’s observation. Usually expenses are covered by being a coach/facilitator for the breakout practices for that same Basic training, but occasionally it has to be paid for by the TiT.
Since there are now nearly 100 EMDRIA Approved Basic Training providers, each will have their own procedures and guidelines for becoming a Trainer for their Basic Training curriculum. As the number of approved Basic Training providers has greatly increased in recent years, EMDRIA has recently established some requirements for Trainers in Training which the Provider can communicate to their Trainers in Training.
Final Thoughts
There can be much more to learn if you choose to do so and it can significantly change your professional career path! Besides the many training and educational resources now available, the EMDR community in general is most generous with sharing information, protocols, pitfalls, and successes, just as I am attempting to do here!
EMDR colleagues usually support EMDR clinicians in any way possible along the way. The EMDR journey is fascinating, powerful, satisfying and often rewarding in unanticipated ways!
Wishing you the best in your EMDR journey,
Bonnie Mikelson LISW
Director, EMDR & Beyond