What does it take to be an EMDR trauma therapist?
As an Approved Consultant, I am in the red top section of this pyramid showing the highest level of expertise in EMDR, and the most training. Many clients (and therapists) wonder what it takes to learn EMDR, so I have provided a simple explanation below. See www.EMDRIA.org to find training opportunities and more detail.
Remember, if a therapist says they "do EMDR," but is not officially EMDRIA trained, they are NOT an EMDR therapist, and can do you great harm!!!
NOTE: EMDRIA is currently in the process of reviewing their policies and making EMDR education more rigorous. There is talk of adding written tests or oral examinations. There is a special focus on improving the rigor, quality, and education standards of Basic Training.
EMDR Basic Training
Basic Training enables a licensed mental health clinician (LPC, LMFT, LCSW, LCP, MD, etc.) to use EMDR at a low-intensity level. This means that they can treat single-event PTSD, such as a car crash or sexual assault. They should not treat clients who are emotionally unstable. They are trained to screen for complex trauma cases (where there are many traumatic events), and clients with dissociative disorders, to refer these cases to a more trained EMDR clinician. Basic Trained clinicians are not required to stay current with continuing education.
Basic Training involves two three-day weekends, in person, and about six months' worth of online or in-person training with an EMDRIA Approved Consultant. This involves a significant financial investment.
This is not in the pyramid above! But it's important. A clinician who is Basic Trained may be in the process of pursuing EMDRIA Certification (see below). This means that they review their tough cases by an EMDRIA, who often watches and critiques videos of their therapy. This level of oversight and personal dedication means that a clinician pursuing Certification offers a higher level of care, and to a limited degree can handle more complex cases, as they learn more advanced skills. Most importantly, they have a highly trained Approved Consultant at arm's reach.
See below for the Certification requirements.
An EMDRIA Certified clinician has put in a lot of effort to learn advanced techniques, and has been tested and approved by an Approved Consultant. Certified clinicians often specialize in trauma therapy, and at the very least have the strong interest, intellectual rigor, and scientific curiosity that reflects an interest in excellence. They are able to effectively handle more complex cases, in which clients may have extensive trauma across the lifespan, emotional instability, or dissociative disorders. Certified clinicians are also required to pursue regular continuing education to maintain their status and stay up-to-date on the latest techniques. Certified clinicians often decide to pursue advanced training in other disciplines that can help with the most difficult EMDR cases, for instance Ego-State Therapy and the use of hypnosis with dissociative cases.
Certification requires about two years of individual study with an EMDRIA Approved Consultant, focusing on learning advanced techniques and reviewing difficult cases. This may take longer, as the candidate must have documentation of treatment of at least 25 clients for more than 50 sessions. As with Basic Training, Certification also represents a significant financial commitment.
A CIT trains with an EMDRIA Approved Consultant who has years of experience in training EMDR therapists, in order to learn how to "teach" EMDR to individuals pursuing Basic Training or Certification. That is, a CIT is training to become a Consultant. The CIT's Approved Consultant has to have proof that a potential CIT already has a thorough grasp of advanced EMDR skills. Such an individual is certain to have extensive experience as an EMDRIA Certified clinician with the most challenging cases, and an even higher level of intellectual curiosity. Although a CIT is still simply "Certified" at a clinical level, choosing to see a CIT as a therapist likely represents a step up in quality of services. Additionally, they are accountable to their Consultant in being overseen actually leading groups or otherwise "teaching" EMDR to therapists.
To complete training as a CIT usually requires about two years of oversight by a highly experienced Approved Consultant, focusing on effectively teaching EMDR in individual and group sessions. The CIT increasingly takes a leading role in teaching, and must demonstrate not only a thorough knowledge of EMDR, but an ability to answer hard questions from experienced therapists. The Approved Consultant training a CIT puts their reputation on the line when they write a recommendation for approval upon completion of CIT training. Obviously, this represents a financial commitment also.
EMDRIA Approved Consultant
The Approved Consultant has a broad and thorough knowledge of advanced techniques, to the point that they are trusted by EMDRIA to train new EMDR therapists. To have achieved that status, they have been through the CIT process (above), and additionally must have documentation of the treatment of 85 or more individuals with EMDR, for more than 300 hours, and at least three years of experience beyond Basic Training. An AC has been Certified for quite a while, and in their practice is likely exclusively a trauma therapist seeing advanced cases and training new therapists. AC's are expected to participate in the international EMDR community. AC's are often involved in scientific research and EMDR policy-making. The AC therefore represents the highest level of proven experience and training as an EMDR therapist.
See www.EMDRIA.org for more specific information on AC's.
EMDR therapists, especially Certified therapists, often attend online or in-person weekend seminars that cover advanced or often esoteric topics, such as eating disorders, phobias, recent trauma, working with combat trauma, using EMDR with horse therapy--the list is endless. A very important advanced training is training in the Flash Technique, which might very soon become a required training.
EMDRIA Approved Consultants can pursue even more advanced training as Facilitators-In-Training, and then Facilitators, who help organize and staff the in-person weekend trainings required for Basic Training. The very most experienced Facilitators who demonstrate excellent presentation skills, and hopefully as sense of humor may become the presenter who leads the Basic Training.
EMDR-HAP, the Humanitarian Assistance Program, is a group of EMDR therapists committed to helping the world through EMDR. EMDR-HAP volunteers travel to the sites of natural disasters, refugee camps, or mass shootings, to provide EMDR therapy free of charge. EMDR-HAP Facilitators commit to helping staff at least 3-4 Basic Trainings around the country each year, without being paid to do so. As a result, training with HAP is able to be offered for half the price, and is only offered to students, workers at non-profits, or therapists in extremely high-need urban and rural areas (like me). Often, a non-profit institution will host a HAP Basic Training for their employees.
If you represent a non-profit that employs perhaps 20+ therapists who would like to learn EMDR, contact HAP for details on setting up a training.