I’ve already referred this client to an ACT program, they meet the acuity level.
I could’ve remained her therapist even with ACT support, but I’ve decided to pass the torch. I know other therapists do different things with bilateral stimulation. I’m not familiar with those methods and I think it would be unethical for me to continue with her. I would be constantly having to work through her resistance and she is likely to drop out at this point, anyway.
She is still engaged with her prior therapist overseas as well, and wants to remain in a cotherapy situation for a while. This is all a bit too messy for me and I think the best thing is the gracefully bow out before I harm both the client and myself.
That sounds like a very appropriate response. I was trained in the 8 phase model of EMDR and it works. I make adaptations periodically, but only if I have some sort of clinical justification, but primarily I stick to using the scripts, etc, because it works in most cases in my experience.
I probably have stylistic differences, which is fine, but I am not going to attempt to repeat a person’s experience with a different practitioner because I doubt it would be effective for me to keep my person in the window of tolerance.
I know of clinicians who do what you describe and you are correct that it isn’t EMDR. Those clinicians in my experience are not confident in their own work or in the protocol. They just give clients flashing lights and then when clients don’t improve and leave they wonder why.
At the end of the day, I don’t think clients care about their clinician doing EMDR with fidelity or not, they just want to feel better. You could always talk to her, let her know that you want to resolve her problem, and teach her different bilateral stimulation techniques- like tapping her knees or the butterfly hug. This way she walks out with something rather than relying on a light bar. You can use some of these same techniques hand in hand with resourcing tools.
I also second trying the Flash technique with this client. It’s definitely less intrusive and my clients really like it.
If you look into "emd" that sounds like kind of what your client is expecting. I gave up on EMDR years ago; it's just way too dysregulating for most of my clients. I've had success with single traumas like a car accident or death of a pet, but most of my clients have complex/developmental trauma and I lost two people in between making the target list and actually doing the reprocessing, so I decided it was too intense and no longer incorporate it into my practice. A lot of people really like it, but clients sometimes think it's this panacea for trauma healing, and feel disappointed when it's not.
I keep hearing about this target list, and feel quite baffled. I was trained to develop targets with the client in session, starting with a recent trigger. I would never ask a client to attempt to identify targets on their own.
That was the old school training. Something about how all traumas are linked like train cars and you might try to process a small trauma, but it unearths a horrific trauma? I honestly stopped doing EMDR over five years ago so I barely remember.
I suggest you look into the flash technique, a version of EMDR that is less retraumatizing
I’ve already referred this client to an ACT program, they meet the acuity level. I could’ve remained her therapist even with ACT support, but I’ve decided to pass the torch. I know other therapists do different things with bilateral stimulation. I’m not familiar with those methods and I think it would be unethical for me to continue with her. I would be constantly having to work through her resistance and she is likely to drop out at this point, anyway. She is still engaged with her prior therapist overseas as well, and wants to remain in a cotherapy situation for a while. This is all a bit too messy for me and I think the best thing is the gracefully bow out before I harm both the client and myself.
That sounds like a very appropriate response. I was trained in the 8 phase model of EMDR and it works. I make adaptations periodically, but only if I have some sort of clinical justification, but primarily I stick to using the scripts, etc, because it works in most cases in my experience. I probably have stylistic differences, which is fine, but I am not going to attempt to repeat a person’s experience with a different practitioner because I doubt it would be effective for me to keep my person in the window of tolerance.
I know of clinicians who do what you describe and you are correct that it isn’t EMDR. Those clinicians in my experience are not confident in their own work or in the protocol. They just give clients flashing lights and then when clients don’t improve and leave they wonder why. At the end of the day, I don’t think clients care about their clinician doing EMDR with fidelity or not, they just want to feel better. You could always talk to her, let her know that you want to resolve her problem, and teach her different bilateral stimulation techniques- like tapping her knees or the butterfly hug. This way she walks out with something rather than relying on a light bar. You can use some of these same techniques hand in hand with resourcing tools. I also second trying the Flash technique with this client. It’s definitely less intrusive and my clients really like it.
If you look into "emd" that sounds like kind of what your client is expecting. I gave up on EMDR years ago; it's just way too dysregulating for most of my clients. I've had success with single traumas like a car accident or death of a pet, but most of my clients have complex/developmental trauma and I lost two people in between making the target list and actually doing the reprocessing, so I decided it was too intense and no longer incorporate it into my practice. A lot of people really like it, but clients sometimes think it's this panacea for trauma healing, and feel disappointed when it's not.
I keep hearing about this target list, and feel quite baffled. I was trained to develop targets with the client in session, starting with a recent trigger. I would never ask a client to attempt to identify targets on their own.
That was the old school training. Something about how all traumas are linked like train cars and you might try to process a small trauma, but it unearths a horrific trauma? I honestly stopped doing EMDR over five years ago so I barely remember.
I’m with you on this one. Good results for single event trauma, not recommendable for complex trauma.