Ann, thanks for your questions! I saw them yesterday but wanted to wait to respond until I could spend the time to answer them more thoroughly. I'll answer to the best of my ability, however I am not an expert on this. Also, I am Level 2 trained.
[1] Hire qualified Therapist who belongs to? trained by? certified by few? many? different Places? few? many? diff Persons OR only EMDRIA?
The therapist needs to be at least Level 1 Trained to used EMDR with clients (20 hours of training including a practicum - practical experience portion). Therapists who have been trained, paid a membership fee, and agreed to the code of conduct, will be members of EMDRIA, but membership is not required to use EMDR. It does include them on the organization's list. EMDRIA sets the standards and gives approval to individuals/organizations to provide the training in EMDR therapy, so there are different training places approved by EMDRIA. I would suggest only using a therapist who has been trained by an EMDRIA-approved organization or person. Certification is something I will get into in the next question. (Also,
PESI & The Bodymind Institute are NOT EMDRIA approved.)
[2] Is there some List of emdr "trained" therapists? "certified" therapists? specifying Level of training? How many levels are there?
On the EMDRIA website there is a list of members who are trained (Under "Find a Therapist") and are members of EMDRIA and another list can be found on the EMDR website ("Find a Clinician"). The levels are Level 1, Level 2 (Advanced), Certified, Approved Consultant. Level 1 is the minimum requirement for using EMDR in one's practice. Certification is something often confused with this treatment, with only about 5% of people ever being certified. The process itself does not necessarily make the therapist more effective, but gives them status because they have gone through a more rigorous process to be assessed by an approved consultant.
[3] How many Hours of training did you have before you felt ready to treat a patient?
Because I was trained directly through EMDRIA, and had previous training on trauma, I felt ready to use EMDR after Level 1 training (while consulting with a therapist who has more experience with EMDR). I began with my longer-term clients, rather than beginning with new clients, because the safety had already been established with them, which is significant in using this intervention.
[4] You said emdr is an 8-Step Process. Is there a Youtube site OR Website that gives an overview of the whole process?
I looked for quite a while to find a video, but couldn't find one I completely agreed with. I found a PDF which comes directly from the creator of EMDR, which gives a pretty good explanation of the 8 steps (I can't post links, but if you google search ""THE EIGHT PHASES OF EMDR THERAPY ACCORDING TO FRANCINE SHAPIRO", the top PDF by pamsweeneymft should be the one).
[4] Before step 4 a lot of talking must happen? To get full history? To teach Internal "safe place" {visualization, grounding, container} Skills?
In this case, history means the history of the issue, not necessarily the client's whole history. It does not need to be fully described or detailed. The clinician will want to identify the "target memory" meaning either the first ("touchstone" memory), the worst, or the most recent, depending on the situation. It can be several sessions before step 4, depending on the type of trauma, and how complex it is.
[5] Do you target memories/traumas in chronological order? OR focus on lesser traumas then move to biggest?
Generally, it's best to start with the youngest connected memory, because that is when our emotions, thoughts about ourselves, and body sensations were first attached to the memory, and therefore to our current lives. This is not always the case, as sometimes a more severe or more recent one is more in the forefront of our minds. But think of targeting earliest memories like cutting a tree down by its roots.
[6] Does successful emdr Tx eliminate need for RXs?
I can't answer this, because research hasn't tested this directly, but depending on what the medication is for, I can see at least a possible reduction in need for medication. It would depend on what the psychiatrist recommended, but if the symptoms are significantly lower, I would think the psychiatrist wouldn't see a need for it anymore.
[7] You recommend at least 1 support person, a driver, a safe place. What should support people know/understand?
They should be told specifically what YOU want and need from them, and that it may be different at times. They can start by asking what you need today, and letting you know they're available. You might want to talk about a session or something that came up during the week, or you might want to talk about something completely different, to keep your mind away from it. You might want to explain to them a little about what to expect from you, possibly being quiet or a little "spaced out," or feeling various things you may or may not want to talk about. They should mostly know to let you lead, even if that means you tell them you need them to check on you, etc.
[8] You recommend TICES journaling. Is this something you read/review?
At the beginning of each session I assess what the client has noticed or experienced since the last session, so if they did the journaling, it's a good source for that. I don't require it because it might be added stress.
[9] Once Step 4 starts, how often are sessions? 1, 2, 3 times per week?
I meet weekly with most of my clients, but some people do best with multiple times a week.
[10] Do you make yourself available to those who might "freak" post Tx?
Yes! I'm definitely available between sessions, and I don't let clients leave the session if they're too dysregulated. I make sure to leave enough time at the end of session to calm down and feel stable. Different clients require different lengths of time to return to a regulated state.
I hope these answers are sufficient, and please feel free to ask follow-up questions!
