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Spreading the Wealth: More and
Better EMDR Training
Sidran Traumatic Stress Institute, Baltimore, MD, USA. September 2002 Note: This paper reflects the personal views of the author only. Correspondence may be addressed to rg@childtrauma.com. Models of EMDR training have proliferated, and demand for training is outpacing availability in many locations. Those of us listed as credentialed trainers regularly receive requests for training in other areas. The purpose of this paper is to briefly review the current status of EMDR training, and to make specific suggestions intended to further improve both quality and availability of EMDR training offerings. With the publication of yet another positive review of EMDR in a prestigious publication (Chemtob, Tolin, van der Kolk, & Tolin, 2000), as well as increasing acceptance of, and even requests for, EMDR by health care companies, therapist interest in obtaining EMDR training continues to snowball. With the recognition that EMDR is a complex approach and not merely a simple procedure (Shapiro, 1991a), quality and thoroughness of training have been identified as critical issues (Shapiro, 1991b). The standards regarding EMDR training have continued to evolve, perhaps because what was once regarded as adequate training did not consistently prove sufficient for therapists to achieve treatment fidelity (Greenwald, 1996). The EMDR International Association’s (EMDRIA) Certification credential now requires additional supervised practical experience as well as continuing education as components of training considered essential for proficiency (EMDRIA, 1999). Along with increased interest in EMDR and rising standards for training, there has been a proliferation of training models. These mainly fall into two broad categories: the weekend workshop model pioneered by the EMDR Institute, and the locally based model featuring ongoing contact over time, such as is commonly taught within universities (e.g., Rounzoin, Kaplan, Lombana, & Barker, 2000). I have previously (Greenwald, 1997) made the case for the superiority of the latter approach, because the opportunity for repeated contact over time is optimal for mastery of this complex therapeutic method. This point is widely acknowledged, and even trainers using the weekend workshop model generally encourage their trainees to obtain regular consultation as they begin to use EMDR. I also argued for complete training packages because it is not desirable to have a proliferation of “half-trained” (e.g., Level 1 only) therapists using EMDR. However, in my call for senior EMDR practitioners to become locally based EMDR trainers, I failed to address two critical issues, which are in fact strengths of the weekend workshop model: quality and availability. The EMDR Institute - the exemplar of the weekend workshop model - has a comprehensive training program for its trainers and facilitators, and is known for the excellence of its workshops. The Institute is also able to offer trainings in a variety of locations because, within their model, such training only requires a single trip (two trips for the full training) to a given location. Until high quality EMDR training is available from local providers in a lot more places, the weekend workshop model will remain an important source of training. I will now make specific suggestions which should allow proponents of each training model to incorporate, at least to some extent, the strengths of the other model. First of all, there is no longer adequate justification for offering a partial training option, even though this has been the custom. Now that EMDR is validated and becoming more widely recognized, therapists can reasonably be expected to make a commitment to the complete training before they start. This point applies to either model of training, at least within the USA (I am not sufficiently knowledgeable about circumstances in other parts of the world to extend this assertion). Weekend workshop providers such as the Institute could offer their training as a package, including Levels 1 and 2 plus a component of guidance/support over time. This could be implemented by opening one or more locally based training sites which continue to offer the weekend workshops (in current or modified format) within a more complete package including group and individual supervision. Alternately, the workshop provider could affiliate (or contract) with a qualified locally-based clinician at each workshop location, who would offer the supervision over time in conjunction with the weekend trainings. This type of approach would allow the trainers to maintain their current levels of expertise and mobility, while maximizing the proportion of trainees who become competent in EMDR. In so doing, the Institute in particular would be in a position to continue providing leadership in EMDR training, which has been a significant contribution in the past. The community of independent and university-affiliated trainers can also support the quality and wider availability of locally-based trainings, by mentoring senior EMDR clinicians who wish to become trainers in their own localities. The “apprentice” trainer would typically already have attained Consultant status, or at minimum be working towards that status and meet all requirements except for the “consultation of consultation.” An apprenticeship arrangement can allow for supervision and mentorship of consultation and teaching, while also making the locally-based teaching model viable for an independent trainer to provide from a modest distance. The specifics of this arrangement can vary and may require negotiation to account for the unique distribution of responsibilities and expenses. For example, when a senior EMDR clinician asked me to provide training in her city (several hours drive) I suggested that she work with me, with an eye to doing subsequent trainings herself. This clinician will produce the training (publicity, registration, site selection, etc.), prepare and lead selected components of the course under my supervision, and provide some in-class small-group supervision as well as between-class individual telephone consultation (part of my training model; see Greenwald, 1997). Also, my training model includes a series of monthly “post-training” supervision meetings which can appropriately be led by the apprentice trainer (with my consultation support). My collaborator’s ability to take care of local logistics and supervision relieves me of the need for additional travel and makes my participation more feasible. On another occasion, I have contracted to provide training for a private agency some distance from home, for a group of 25 clinicians. Rather than merely hiring Consultants for assistance with small-group practicum supervision, I have chosen to invite individuals interested in apprenticing along the lines described above. Although financial arrangements may be negotiated, the basic principle is that the apprentices work in exchange for mentorship and consultation hours (for which they would normally have paid), whereas the instructor receives the income from class participants in exchange for providing the training, mentorship, and consultation. I discuss logistics and finances here because these are actually critical to decision-making regarding when, where, and how training may be offered. Weekend workshop trainers can incorporate the strengths of the locally based model with relative ease, by offering a full training package in conjunction with local centers and/or consultants. Experienced independent and university-based trainers can incorporate the strengths of the weekend workshop model by mentoring locally-based trainers within a modest distance. These approaches will allow high-quality EMDR training to be offered in the more desirable locally-based training model in more and more locations. References
Chemtob, C. M., Tolin, D. F., van der Kolk, B. A.,
& Pitman, R. K. (2000). Eye movement desensitization and reprocessing. In
E. B. Foa, T. M. Keane, & M. J. Friedman (Eds.), Effective treatments
for PTSD: Practice guidelines from the International Society for Traumatic Stress
Studies, pp. 139-154. New York: Guilford.
EMDRIA. (1999). Criteria for Certification. Available Internet: http://www.emdria.org. Greenwald, R. (1996). The information gap in the EMDR controversy. Professional Psychology: Research and Practice, 27, 67-72. Greenwald, R. (1997). A better approach to training: Why you should teach EMDR in your home town. Eye-2-Eye. Available Internet: http://www.emdr-practitioner.net. Rounzoin, C., Kaplan, S., Lombana, J. & Barker, S. (2000). Teaching EMDR in graduate school settings and agency sites. Workshop presented at the annual meeting of the EMDR International Association, Toronto. Shapiro, F. (1991a). Eye movement desensitization and reprocessing procedure: From EMD to EMD/R - A new treatment model for anxiety and related traumata. The Behavior Therapist, 14, 133-135, 128. Shapiro, F. (1991b). Eye movement desensitization and reprocessing: A cautionary note. The Behavior Therapist, 14, 188.
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