Defining New Credentialing Standards: An Update on the Work of the
EMDRIA Professional Development Subcommittee
Presented: September 2013
Wendy J. Freitag, PhD, Chair; Jocelyn Barrett, MSW, LICSW, Co-Chair, Standards &
Training Committee; Nancy Errebo, PsyD; Regina Morrow, Ed.S, LMFT, LMHC
Abstract:
This document presents the efforts, to date, of The Professional Development
Subcommittee to define standards for EMDR International Association (EMDRIA)
credentialing, as charged by the EMDRIA Standards and Training Committee. The
development of defining the standards at each credential level (Certification, Approved
Consultant, and Approved Trainer) requires a multi-stage approach. This document,
which reflects the first stage in the development process, identifies and delineates the
Core and Essential Competencies for EMDRIA Certification in EMDR. This document
will undergo review and public comment; therefore, what is presented here is subject to
revision. Further, this document does not represent the policy of EMDRIA.
Building on Freitag’s (2012) foundation, the subcommittee proposes that a competencybased system of credentialing replace EMDRIA’s current hours-based requirement
system. Competency-based training and practice of psychotherapy has emerged as a
significant movement among five mental health disciplines---psychiatry, psychology,
marital and family therapy, counseling, and social work----in response to the Institute of
Medicine’s (2003) recommendation that mental health disciplines define a set of core
competencies for clinical practice (Freitag, 2012; Sperry, 2010).
Sperry’s (2010) Core Competency Model was chosen as the template for the
subcommittee’s work because, like EMDR, Sperry’s model is integrative. Sperry’s
model identifies six core competencies espoused by all five mental health disciplines,
shows how these core competencies are inter-related, and describes the application of
these core competencies in Dynamic, Cognitive-Behavioral, and Systemic
psychotherapies.
Sperry’s Six Core Competencies of Effective Psychotherapists are:
1) Conceptual Foundation
2) Relationship Building and Maintenance
3) Intervention Planning
4) Intervention Implementation
5) Intervention Evaluation and Termination
6) Culturally and Ethically Sensitive Practice
In the current document, each of Sperry’s Six Core Competencies as well as the
Essential Competencies within each Core Competency will be delineated, first, as
defined by Sperry for clinicians of all approaches, and second, as particular to EMDR as
defined by EMDRIA (2012).
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Core and Essential Competencies for EMDRIA Certification in EMDR
I. Conceptual Foundation
The theoretical framework is one requisite clinical competency to which all other
clinical competencies are anchored. “First therapists need a theoretical
understanding of the normal process of development and functioning, which can
be called the theory of personality. Second therapists need a theory of how
functioning goes awry and becomes maladaptive, which is a theory of
psychopathology. Third, therapists need a theory of how maladaptive processes
can be changed, that is, a theory of therapeutic processes” (Sperry, 2010, p. 21).
Conceptual Foundations of the EMDR Approach to Psychotherapy
The EMDRIA Certified Clinician (ECC) demonstrates understanding of the Adaptive
Information Processing (AIP) model that is the basis of the EMDR Approach to
psychotherapy and the application of AIP in EMDR protocols. The ECC is able to
clearly and succinctly define EMDR, articulate AIP principles to clients, colleagues, and
the public, and describe the Eight Phases of EMDR and the Three-Pronged Protocol.
The ECC demonstrates the capacity to use AIP to implement EMDR effectively and
consistently with clients with conditions with which they have expertise (EMDRIA, 2012).
The ECC demonstrates the capacity to understand, articulate, elucidate and apply the
following fundamental principles of the EMDR Approach as defined by EMDRIA:
1) EMDR is an approach to psychotherapy, not a technique (EMDRIA, 2012).
2) EMDR is an integrative psychotherapy approach that evolved primarily from
clinical experience. Integrative has several meanings (International Integrative
Psychotherapy Association, 2013).
a) It draws from many views of human functioning: client centered, behavioral,
psychodynamic, cognitive, body-focused, Gestalt, and cognitive neuroscience
(Norcross & Shapiro, 2002; Shapiro, 2001, 2002a).
b) It is intended to integrate the personality, bringing unassimilated negative
information together with positive resources to empower a whole human
capable of love and service (EMDRIA, 2012; Shapiro, 2002a; Siegel, 2002).
c) It is intended to bring together the affective, cognitive, behavioral,
physiological, and spiritual systems of a person to facilitate healing of
psychological disorders (EMDRIA, 2012; Krystal, et al., 2002; van der Kolk,
2002).
3) EMDR is based on the Adaptive Information Processing (AIP) model. The
principles of AIP are as follows (EMDRIA, 2012; Shapiro, 2001)
a) Every individual has an inherent information processing system that naturally
reorganizes disturbing life events to an adaptive resolution.
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4)
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6)
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b) This information processing system is sometimes disrupted resulting in the
memory of a disturbing life event being stored in state specific form.
c) EMDR protocols, combined with Bilateral Stimulation (BLS), activate the
inherent information processing system and keep it active until an adaptive
resolution is achieved. The concept of self-healing is central to this principle.
d) EMDR reprocessing facilitates associations within and among memory
networks, ultimately achieving the integration of the disturbing memory with
the individual’s resources.
EMDR has Eight Phases, each with its own purpose and tasks (EMDRIA, 2012;
Shapiro, 2001).
In the Three-Pronged Protocol, EMDR addresses past experiences that have set
pathological trajectories, present stimuli that trigger problem emotions, body
sensations, thoughts, and behaviors, and templates for desired future behaviors
(EMDRIA, 2012; Shapiro, 2001).
EMDR occurs in the context of an empathic, collaborative therapeutic
relationship (EMDRIA, 2012; Shapiro, 2001).
EMDR protocols and procedures are embedded in a comprehensive treatment
plan guided by the client’s goals and the clinician’s expertise (EMDRIA, 2012;
Shapiro, 2001).
Theory of Personality:
The ECC demonstrates the capacity to understand, articulate and elucidate a theory of
personality based on the AIP model (EMDRIA, 2012).
The AIP model regards the personality as a constellation of characteristic patterns and
responses, each of which is considered an interaction of genetic factors and
experiences. The basis of personality development is regarded as the assimilation of
experiences into the associative memory networks and accommodation of each
experience into the person’s self-identity (Shapiro, 2001, 2002a).
Theory of Psychopathology:
The ECC demonstrates the capacity to understand, articulate, and elucidate a theory of
psychopathology based on the Adaptive Information Processing (AIP) model.
The Adaptive Information Processing (AIP) model posits that disturbing information
stored in the nervous system is the basis of psychopathology (EMDRIA, 2012; Shapiro,
2001). Singular traumatic experiences appear to disrupt the information processing
system, resulting in disturbing information being stored in state specific form in an
isolated memory network. Chronic adverse experiences appear to decrease flexibility in
the information processing system, favoring one maladaptive way to process
information (Leeds, 2009). New learning cannot link with this dysfunctionally stored
information because of the intense affect generated whenever the disturbing memory is
stimulated by present events. When the disturbing information is stimulated, the
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individual feels, thinks, and behaves in a manner similar to how he or she did at the time
of the disturbing event (EMDRIA, 2012; Leeds, 2009; Shapiro, 2001, 2002a).
Theory of Psychotherapeutic Process:
EMDR is an integrative psychotherapy with principles, procedures, and protocols that
are embedded in a comprehensive treatment plan. EMDR Treatment proceeds in eight
distinct phases. EMDR addresses past experiences, current challenges, and desired
future behaviors. In the reprocessing phase of treatment, Bilateral Stimulation (BLS) is
employed to stimulate the inherent information processing system in its work of
transmuting disturbing memories to an adaptive resolution. The client’s own brain is
doing the healing, so the clinician is a guide, rather than a director, of the process.
Thus, during this phase, the clinician refrains from offering interpretations or engaging in
dialogue. As long as spontaneous reprocessing, indicated by shifts in affect and
cognition, is taking place, the clinician gives minimal input. If reprocessing stalls, the
clinician applies brief interventions to resume effective reprocessing. Phase Eight,
Reevaluation, guides ongoing work towards the treatment goals and maintains client
stability (EMDRIA, 2012; Leeds, 2009; Shapiro, 2001).
The ECC demonstrates capacity to describe, elucidate, and apply the following:
1) Identify the Eight Phases of the standard EMDR protocol. Delineate the specific
purposes, goals, and tasks of each phase.
2) Develop a comprehensive treatment plan in Phase One that is individualized to
the client’s goals and resources.
3) Prepare client for safe, effective EMDR reprocessing of disturbing life events in
Phase Two.
4) Apply Phases Three through Seven to reprocess past experiences, current
triggers, and future templates.
5) Recognize ineffective reprocessing and implement brief interventions to stimulate
the AIP and resume effective reprocessing in Phases Four and Five.
6) Utilize Phase Eight to guide ongoing treatment.
II. Relationship Building and Maintenance
Competent therapy depends on the establishment and maintenance of an effective
therapeutic alliance. The therapeutic alliance fosters a bond of trust between client and
therapist and a mutual agreement about goals and methods of the treatment process.
This Core Competency consists of five Essential Competencies (Sperry, 2010):
1. Establish An Effective Therapeutic Alliance
2. Assess Readiness and Foster Treatment Promoting Factors
3. Recognize and Resolve Resistance and Ambivalence
4. Recognize Therapeutic Alliance Rupture
5. Recognize and Resolve Transference-Countertransference Enactment
II. 1. Establish An Effective Therapeutic Alliance
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“This competency involves the capacity to form an effective therapeutic alliance
that is sensitive to the client’s needs, expectations, and explanatory model; that
engenders trust and hope in the therapist and therapy process; and that engages
the client in the treatment process” (Sperry, 2010, p. 44).
The integrative view operationalizes the therapeutic alliance in terms of three
interdependent variables: 1) agreement on therapeutic tasks, 2) agreement on
therapeutic goals, and 3) the quality of the interpersonal bond between therapist and
client (Sperry, 2010).
EMDR Approach to Establishing an Effective Therapeutic Alliance
The ECC demonstrates capacity to achieve a therapeutic alliance during Phases One
and Two that supports the reprocessing of disturbing life events in Phases Three
through Seven (Leeds, 2009; Shapiro, 2001, 2005).
The ECC demonstrates capacity to describe the elements of establishing the
therapeutic alliance that are particular to EMDR:
1) The ECC helps the client develop trust not only in the clinician but also in the
principle of self-healing and the AIP model.
2) The ECC helps the client develop the capacity and skill to make the honest,
accurate self-report of internal, private experience that is necessary to maintain
client stability and guide reprocessing and ongoing treatment.
3) The ECC recognizes and articulates potential difficulties in EMDR treatment that
may arise from assumptions about the therapeutic alliance that are perceived to
conflict with EMDR procedures. The ECC reconciles those conflicts and
integrates EMDR and AIP into his or her preferred approach to establishing the
therapeutic alliance in a way that maintains fidelity to EMDR procedures (AdlerTapia & Settle, 2008; Korn, Zangwill, Lipke, & Smyth, 2001; Leeds, 2009).
The ECC collaborates with the client to set treatment goals and tasks that take into
account the clients expectations and wants as well as the clinician’s expertise.
II. 2. Assess Readiness and Foster Treatment Promoting Factors
“This competency involves the capacity to accurately identify the client’s
motivation and readiness for change as well as to effectively foster treatment
factors that will promote and facilitate the treatment process” (Sperry, 2010, p. 44).
EMDR Approach to Readiness and Fostering Treatment Promoting Factors
The AIP model posits that current problems are rooted in past disturbing life
experiences. Reprocessing those negative experiences, using the Three-Pronged
Protocol, in Phases Three through Seven, results in positive changes in feelings,
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thoughts, and behavior that occur naturally, organically, and without conscious effort
(EMDRIA, 2012; Shapiro, 2001).
The ECC articulates, elucidates, and applies elements of motivation and readiness that
are particular to EMDR:
1) Readiness for reprocessing of disturbing life experiences in Phases Three
through Seven comprises the following: (Leeds, 2009; Shapiro, 2001)
a) Affect tolerance
b) Ability to shift from a negative emotional state to a neutral or positive
emotional state
c) Adequate physical, social, financial, and emotional resources to sustain
ongoing treatment
d) Ability to devote adequate time and attention to the treatment without undue
interference from other commitments on the part of both client and clinician
e) The ECC is proficient in assessing readiness for reprocessing and in
interventions that remediate deficiencies and promote readiness.
2) Motivation to proceed with reprocessing may be reduced by fear and/or
secondary gain issues. The ECC is proficient in resolving those issues so that
the client is able to reprocess disturbing life experiences.
II. 3. Recognize and Resolve Resistance and Ambivalence
“This competency involves the capacity to accurately identify indicators of client
resistance and/or ambivalence in a clinical context as well as to effectively
resolve the resistance or ambivalence, which results in maintaining and
enhancing the therapeutic relationship” (Sperry, 2010, p. 64).
From the integrative perspective of the Core Competency Model, resistance or
noncompliance is understood as ambivalence, which is usually manifested as defensive
avoidance or a repetitive pattern of negative interpersonal behaviors. When this
happens in the therapeutic setting, the therapist must be mindful this is a temporary
state rather than a personality trait (Sperry, 2010).
EMDR Approach to Recognize and Resolve Resistance and Ambivalence
The ECC articulates, elucidates, and applies understanding of resistance and
ambivalence particular to AIP and EMDR (Leeds, 2009; Shapiro, 2001).
1) AIP views resistance and ambivalence as fears, phobias, or blocking beliefs
originating in disturbing life events.
2) The memories of the disturbing events can be targeted and reprocessed, thus
organically resolving ambivalence and resistance to ongoing EMDR work.
3) Resistance and ambivalence can appear in any phase of EMDR.
II. 4. Recognize and Resolve Transference-Countertransference Enactment
“This competency involves the capacity to accurately identify indicators of
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transference and countertransference, including transference enactments, as well
as to effectively resolve such enactments, which results in maintaining and
enhancing the therapeutic relationship” (Sperry, 2010, p. 64).
Transference is the client’s inaccurate transfer of thoughts, feelings, and expectations
about past interpersonal experiences onto the current relationship with the therapist.
Countertransference is the therapist’s inaccurate transfer of thoughts, feelings and
expectations from past experiences onto the current relationship with the client (Sperry,
2010).
EMDR Approach to Recognize and Resolve
Transference-Countertransference Enactment
The ECC articulates, elucidates, and applies understanding of transference and
countertransference enactment that are particular to EMDR.
1) In addition to transference and countertransference to one another, both clinician
and client may have transference to EMDR protocols and procedures
themselves.
2) The clinician responds effectively to transference material that spontaneously
emerges during Phase Four, Desensitization (Dworkin, 2005; Leeds, 2009).
3) The clinician recognizes his or her countertransference that arises from his or her
own earlier life experiences (Dworkin, 2005).
II. 5. Recognize Therapeutic Alliance Rupture
“This competency involves the capacity to accurately identify indicators of
alliance ruptures and strains as well as to effectively resolve such ruptures and
strains, which results in maintaining and enhancing the therapeutic relationship”
(Sperry, 2010, p. 64).
Alliance ruptures are tensions or breakdowns in the collaborative relationship between
client and clinician. Ruptures may occur when client and clinician disagree about the
tasks and goals of treatment or when the therapeutic bond is breached. An alliance
rupture is an interactive process between client and clinician, and must be distinguished
from clinical impasses that emphasize either client characteristics such as resistance or
negative transference, or therapist characteristics such as empathic failure or
countertransference (Sperry, 2010).
EMDR Approach to Recognizing Therapeutic Alliance Rupture
The ECC articulates, elucidates, and applies understanding of ruptures to the
therapeutic alliance and the repair of those ruptures that are particular to EMDR and
AIP.
1) The client and clinician must be able to communicate about the client’s inner
experience in a way that allows EMDR to continue safely and effectively.
2) The clinician should be able to recognize and repair ruptures to the therapeutic
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alliance as they occur in the therapeutic moment (Dworkin, 2005).
III. Intervention Planning
This Core Competency consists of five Essential Competencies (Sperry, 2010):
1. Perform A Comprehensive Assessment
2. Specify An Accurate Diagnostic Formulation
3. Develop An Effective Clinical Formulation
4. Develop an Effective Treatment Formulation
5. Draft A Clinical Case Report
III. 1. Perform A Comprehensive Assessment
“This competency involves the capacity to undertake a broad assessment of the
client and context” (p. 84) in order to develop a case conceptualization that
describes the client’s problems, explains maladaptive patterns, addresses
cultural factors, and delineates a coherent treatment strategy focused on the
client’s treatment goals (Sperry, 2010).
III. 1. EMDR Approach to Performing a Comprehensive Assessment
The ECC demonstrates capacity to understand, articulate, elucidate and apply the
principles of AIP to obtain and organize information about the client problems, goals and
resources across behavioral, affective, cognitive, and somatic domains (Leeds, 2009;
Shapiro, 2001). The Comprehensive Assessment occurs in Phase One, History-Taking.
1) Present complaints
2) Goals and Desired Outcomes
3) Type and severity of symptoms
4) Characteristic patterns of perceiving, thinking, and responding
5) Triggers or stressors that elicit negative pattern
6) Etiological events in maladaptive memory networks and adaptive memory
networks
7) Intrapersonal, interpersonal, and systemic vulnerabilities
8) Intrapersonal, interpersonal, and systemic resources
9) Possible obstacles and challenges in the therapy process, especially those
particular to each of the Eight Phases of EMDR.
10) Preparation for termination of treatment
The ECC describes the difference between performing a comprehensive assessment in
Phase One, History Taking, and Phase Three, Assessment (Shapiro, 2001).
The ECC demonstrates knowledge of standardized tools for history
taking and treatment planning (Leeds, 2009).
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III. 2. Specify An Accurate Diagnostic Formulation
“This competency involves the capacity to specify a descriptive statement about
the client’s presentation, its precipitants, its acuity and severity. It often includes
applicable DSM (or ICD) diagnoses” (Sperry, 2010, p. 104).
EMDR Approach to Diagnostic Formulation
The ECC demonstrates the capacity to specify a focused descriptive appraisal about
the nature and severity of client’s presenting symptoms and current functioning in
Phase One, History-Taking. This appraisal includes a multiaxial DSM or ICD diagnosis,
and also specifies immediate treatment considerations, problems in living, and client’s
capacity for the reprocessing phases of EMDR (Phases Three – Eight).
The ECC demonstrates knowledge of standardized diagnostic tools, especially those
that have a bearing on capacity for effective EMDR reprocessing.
III.3. Develop An Effective Clinical Formulation
“This competency involves the capacity to develop a compelling explanation for
the client’s presenting problems and maladaptive pattern” (Sperry, 2010, p. 104).
EMDR Approach to Clinical Formulation
The ECC demonstrates the capacity to understand, articulate, and elucidate a
compelling explanation for the client’s presenting problems and maladaptive pattern
derived from developmental, social, and health histories and based on the AIP Model
and the Three-Pronged Protocol of EMDR.
The ECC understands, articulates, and elucidates the influence of cultural dynamics in
the client’s behavior and functioning.
The ECC understands, articulates, and elucidates assessment of attachment status and
dissociation.
III. 4. Develop an Effective Treatment Formulation
“This competency involves the capacity to develop a coherent intervention or
treatment plan, with appropriate treatment goals and treatment focus, and which
anticipates likely obstacles and challenges to achieving these treatment goals”
(Sperry, 2010, p. 104).
EMDR Approach to Treatment Formulation
The ECC demonstrates the capacity to collaborate with the client to set treatment goals
and treatment focus.
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The ECC demonstrates the capacity to identify adaptive and maladaptive memory
networks underlying the client’s problems using direct inquiry and also bridging
techniques.
The ECC demonstrates the capacity to collaborate with the client to select and prioritize
memories to target for EMDR reprocessing.
The ECC understands, articulates, and elucidates strategies for addressing treatmentrelated fears.
The ECC understands, articulates, and elucidates the client’s internal and external
resources that will support EMDR reprocessing of target memories.
III. 5. Draft A Clinical Case Report
“This competency involves the capacity to draft a compelling and coherent
clinical report that accurately describes the client’s presentation and case
conceptualization along with treatment considerations” (Sperry, 2010, p. 104).
EMDR Approach to Drafting a Clinical Case Report
The ECC demonstrates the capacity to write a succinct, coherent case report:
1) Consistent with the client’s presenting problem and goals (i.e., Case
Conceptualization through the Comprehensive Assessment and Diagnostic
Formulation)
2) Formulated in terms of AIP principles and the Three-pronged Protocol of EMDR
(i.e., Clinical Formulation)
3) Specifies a treatment plan that identifies and prioritizes target memories for
EMDR reprocessing (i.e., Treatment Formulation)
4) Identifies obstacles and challenges to each of the Eight Phases of EMDR therapy
(i.e., Treatment Formulation)
IV. Intervention Implementation
This Core Competency consists of three essential competencies (Sperry, 2010):
1. Establishing a Treatment Focus
2. Maintaining the Treatment Focus
3. Managing Treatment-Interfering Factors
IV. 1. Establish Treatment Focus, Goals, and Strategy
“This competency involves the capacity to establish a focus for treatment based
on the case conceptualization. The treatment focus, along with the treatment
strategy, provides a map and direction for achieving specific treatment goals and
treatment targets” (Sperry, 2010, p. 117).
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Treatment Focus is the central therapeutic emphasis of a given therapeutic approach.
Treatment Goals are the outcomes mutually agreed upon by client and clinician.
Treatment Strategy is an action plan for specific intervention methods.
IV. 1. EMDR Approach to Establishing Treatment Focus, Goals, and Strategy
The ECC understands, articulates, and elucidates the following central therapeutic
emphasis of EMDR Treatment Focus in terms of the AIP Model, the Three-Pronged
Protocol, and the Eight Phases of EMDR:
Reprocess disturbing life experiences to an adaptive resolution utilizing BiLateral Stimulation, thereby integrating unassimilated negative information
together with positive information to empower a whole human capable of
love and service (EMDRIA, 2012; Shapiro, 2001, 2002a; Siegel, 2002).
The ECC understands, articulates, and elucidates the Treatment Goals in terms of the
AIP Model, the Three-Pronged Protocol, and the Eight Phases of EMDR.
The ECC understands, articulates, and elucidates the Treatment Strategy in terms of
the AIP Model, the Three-Pronged Protocol, and each of the Eight Phases of EMDR.
The ECC understands, articulates, and elucidates ways Treatment Goals and Strategy
might be modified as treatment proceeds.
IV. 2. Maintain the Treatment Focus
“This competency involves the capacity to maintain the focus for treatment. In
the process of tracking this focus, it may be necessary to reestablish it or revise
it as indicated” (Sperry, 2010, p. 118).
IV. 2. The EMDR Approach to Maintaining Treatment Focus
The ECC understands, articulates, and elucidates the maintenance of Treatment Focus
in each of the Eight Phases of EMDR, including reestablishing and revising treatment
focus in each phase, especially Phase Eight, Reevaluation.
IV. 3. Recognize and Resolve Therapy-Interfering Factors
“This competency involves the capacity to anticipate, recognize and resolve
various client, therapist, client-therapist relationship, and treatment factors that
are impediments to treatment progress” (Sperry, 2010, p. 118).
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Therapy-interfering factors cover a broad range and may be operative both within and
between therapy sessions (Sperry, 2010).
IV. 3. The EMDR Approach to Recognizing and Resolving Therapy-Interfering
Factors
The ECC understands, articulates, and elucidates the AIP viewpoint on therapyinterfering factors specific to each of the Eight Phases of EMDR and demonstrates the
capacity to anticipate, recognize and resolve them in the therapeutic moment (Shapiro,
2001).
V. Intervention Evaluation and Termination
This Core Competency consists of four Essential Competencies (Sperry, 2010):
1. Monitoring Progress and Modifying Treatment Accordingly
2. Utilizing Consultation to Monitor and Evaluate Treatment Progress
3. Maintaining Treatment Gains
4. Preparing for Termination
V. 1. Monitoring Progress and Modifying Treatment Accordingly
“This competency involves the capacity to use various methods to assess client
progress in treatment and then appropriately modify treatment focus and
direction based on that feedback” (Sperry, 2010, p. 168).
V. 1. The EMDR Approach to Monitoring Progress and
Modifying Treatment Accordingly
The ECC understands, articulates, elucidates, and demonstrates the effective use of the
SUD and VoC scales and Phase Six, Body Scan, to monitor progress and modify
EMDR treatment (Leeds, 2009; Shapiro, 2001).
The ECC demonstrates ability to select and utilize standardized treatment outcome and
process assessment scales (Sperry, 2010).
V. 2. Utilizing Supervision* to Monitor and Evaluate Treatment Progress
“This competency involves the capacity to effectively use clinical supervision to
share and receive feedback on client progress in treatment and then
appropriately modify treatment focus and direction based on that feedback”
(Sperry, 2010, p. 168). [*Note: The term “consultation” will be used by EMDRIA rather
than the term “supervision.”
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V. 2. The EMDR Approach to Utilizing Consultation to Monitor and
Evaluate Treatment Progress
The ECC demonstrates the capacity to present case material to an EMDRIA Approved
Consultant.
The ECC demonstrates the capacity to utilize feedback from an EMDRIA Approved
Consultant to modify focus and direction of EMDR treatment.
V. 3. Maintaining Treatment Gains
“This competency involves the capacity to assist clients in maintaining the
therapeutic gains they have achieved in treatment. It also involves the capacity
to assist clients in developing and implementing a relapse prevention plan”
(Sperry, 2010, p. 182).
V. 3. The EMDR Approach to Maintaining Treatment Goals
The ECC understands, articulates, and elucidates the implementation of the ThreePronged Protocol of EMDR in maintaining treatment gains (Shapiro, 2001).
1) Reprocess disturbing past experiences in sequence according to treatment plan
2) After all past experiences are reprocessed, target and reprocess remaining
current stressors.
3) Use a future template to anticipate and rehearse desired future responses
4) Throughout treatment, identify skills necessary to maintain treatment goals and
help client learn and practice them.
V.4. Preparing for Termination
“This competency involves the capacity to prepare the client for planned
termination from formal treatment” (Sperry, 2010, p. 182).
The EMDR Approach to Preparing for Termination
The ECC articulates and elucidates the process of collaborating with the client on
reviewing the treatment and bringing it to an end in an orderly and positive manner.
The ECC articulates the following indicators (Shapiro, 2001):
1) Client’s presenting problem is resolved, or symptoms are reduced or alleviated.
2) The client has developed sufficient insight to understand the problem and change
the patterns that led to treatment.
3) The client’s coping skills are sufficiently increased for dealing with life
circumstances.
4) The client has developed capacity to plan and work productively on postTermination issues.
VI. Cultural and Ethical Sensitivity
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Competent therapy requires the capacity to practice in a culturally and ethically
sensitive manner. Until recently, clinicians have received little guidance in how to
practice in that manner. Clinicians should demonstrate the capacity to develop a cultural
formulation and to plan and implement interventions consistent with that formulation.
Ethically sensitive practice requires the competence to recognize ethical issues and
dilemmas, to maintain confidentiality, to assure informed consent, and to avoid conflicts
of interest. This Core Competency consists of four essential competencies (Sperry,
2010):
1. Develop Effective Cultural Formulations
2. Plan Culturally Sensitive Interventions
3. Make Ethically Sound Decisions
4. Practice in an Ethically Sensitive Manner
VI. 1. Develop Effective Cultural Formulations
“This competency involves the capacity to develop a compelling explanation for
the client’s presenting problem and maladaptive pattern when cultural factors are
operative and indicated” (Sperry, 2010, p. 196).
Clinician performs a systematic analysis of cultural factors and dynamics (Sperry,
2010).
1) Describes the client’s cultural identity and level of acculturation.
2) Describes the impact of cultural factors on the client’s personality and
functioning.
3) Addresses cultural elements that may impact the relationship between client and
therapist.
4) Indicates necessity for cultural or culturally sensitive interventions.
VI. 1. The EMDR Approach to Developing Effective Cultural Formulations
The ECC articulates and elucidates the importance of the clinician’s cultural awareness,
knowledge, sensitivity and competence to the therapeutic relationship and positive
treatment outcomes.
The ECC demonstrates the capacity to perform an accurate, comprehensive cultural
assessment as a part of Phase One, History-Taking. The cultural assessment will
include the following:
1) Cultural Identity
2) Age
3) Ethnicity and Race
4) Gender and Sexual Orientation
5) Religion
6) Migration and Country of Origin
7) Socioeconomic Status
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8) Level of Acculturation
9) Language
10) Explanatory Model and Illness Perceptions
11) Education
The ECC demonstrates the capacity to utilize the resources of the global EMDR
community to ensure cultural competence.
1) The Francine Shapiro Library
2) Consultation
VI. 2. Plan Culturally Sensitive Interventions
“This competency involves the capacity to develop a treatment plan and
incorporate culturally sensitive treatment when cultural factors are operative and
indicated” (Sperry, 2010, p. 196).
VI. 2. The EMDR Approach to Planning Culturally Sensitive Interventions
The ECC demonstrates the capacity to adapt EMDR language and procedures in a
culturally sensitive manner while maintaining fidelity to the EMDR protocol.
The ECC demonstrates the capacity to utilize the resources of the global EMDR
community to ensure cultural competence.
1) The Francine Shapiro Library
2) Consultation
VI. 3. Make Ethically Sound Decisions
“This competency involves the capacity to engage in an intentional decisionmaking process when anticipating or encountering clinical concerns and issues
and base clinical decisions on sound professional, ethical, and legal criteria.
Making ethically sound decisions involves problem identification, information
gathering, analysis, decision-making, and implementation of the ethical decision”
(Sperry, 2010, p. 214).
VI. 3. The EMDR Approach to Making Ethically Sound Decisions
The ECC articulates and elucidates an empathic understanding of the potential impact
of each of the Eight Phases of EMDR on the individual client and the client’s social
systems.
The ECC articulates and elucidates the ethical issues of providing EMDR treatment in
terms of EMDRIA’s definition of the purpose of EMDR. That is: alleviating human
suffering and assisting individuals to fulfill their potential for development, while
minimizing risks of harm in its application.
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VI. 4. Practice in an Ethically Sensitive Manner
“This competency involves the capacity to provide professional services to
clients and others, including psychotherapy, in an ethically sensitive manner.
Ethically sensitive practice involves the ability to perform competently, to ensure
confidentiality, to ensure informed consent, and to minimize conflicts of interest”
(Sperry, 2010, p. 214).
VI 4. The EMDR Approach to Practicing in an Ethically Sensitive Manner
The ECC articulates and elucidates an understanding of EMDRIA’s Professional Code
of Conduct (EMDRIA, 2013).
The ECC stays abreast of current topics in EMDR research, theory and practice.
References
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