Questions to ask your EMDR therapist

Potential EMDR clients regularly ask what they should know before starting EMDR therapy. The range of answers can go in many directions, including knowledge about the process of EMDR itself, including the eight phases, the effectiveness of EMDR, how it aids our body’s natural healing process, and how to ask about the training or credentials of the EMDR therapist. To help bring more light to this topic and provide more public awareness,  we polled the EMDRIA membership. We received SO MANY great responses that we were able to create two blog posts.

  • Part 1 features EMDRIA members’ responses regarding “What should clients ask an EMDR therapist before beginning EMDR therapy?”
  • This post features EMDRIA members’ responses regarding “What should clients know before starting EMDR therapy?”

We grouped the most popular responses and found several main focal questions to feature in the infographic.

Thanks to all the EMDRIA members who contributed, and view their responses below.

If you are looking for an EMDR therapist, our Find an EMDR Therapist Search is a great resource.

“What should clients know before starting EMDR therapy?”

Before starting EMDR, it would be good to learn how to self-soothe. Practice things that help reduce your nervous system activation, such as getting in touch with the five senses; make your bedroom or a space in your home comfortable with calming sounds, smells, textures, lighting, etc.  *** Rachel Agrario, LCADC

Clients have the right to ask any question regarding EMDR therapy. First, information about EMDR therapy and how it works. Second, the therapist’s qualifications, competency, and years of experience. Plus, where did they get their training? Third, costs and number of sessions required. Finally, “What if it didn’t work?” might be a common question so that they will question the risks of EMDR. They are anxious and curious about a new experience involving disturbed, painful memories.  *** Hind Alrustamani

It’s not a magic bullet or 12 steps to feeling no distress. It teaches the brain not to flood into being overwhelmed with stored past trauma and allows us to be responsive at the moment to whatever is activating or numbing our nervous systems. It teaches our brain/nervous system ways to respond to distress, move through it and recover into responsiveness and grounding. *** Helen Butlin, RP, PhD

When [someone] comes to see me for an EMDR consultation, I always encourage them to ask me questions. Some prospective clients have just heard a little about EMDR, others have done some research, and others are curious. When they don’t ask any questions, I help them by asking the following questions: (Client) “Do I need to have previous experience with therapy? What other treatments will be beneficial to do at the same time as doing EMDR?  Is this treatment appropriate for any age, gender, culture, social class, or religion? Do I need to be able to dream, visualize, imagine? What type of thinker am I? Is it appropriate for me to do it in person? Online? Both? If I don’t like to talk in therapy, can I be silent while working on it? Do I need to read anything before I start my therapy? Do I need any special equipment?” (Therapist) Should I ask for a certified clinician and the provider’s credentials? How many years of experience does the provider need to apply the treatment? Where and how the provider was trained? Is it better to have a provider that speaks my language, belongs to my same culture, and shares my beliefs?” *** Jacqueline Diaz Maldonado, LMHC

Therapists need to assess EMDR readiness before starting work with EMDR. Clients can also determine if a therapist is the right fit by asking questions. While asking about training and knowledge is helpful, the more important question is whether the therapist has experienced EMDR as a client. This one question can help a client connect with the therapist in a transformative way through the therapist’s ability to see both sides of the EMDR healing journey. *** Laurie Eldred, LMSW-C

It is important to determine whether the therapist has utilized EMDR therapy for the client’s particular issue they are coming to counseling. What other types of problems do they use EMDR for? How long have they been trained in EMDR Therapy, and how much of their practice do they use it? Also, how will I know if EMDR therapy is a good treatment for my problem? *** Sara Gilman, PsyD, LMFT

I am an EMDR therapist who was also a client, which has allowed me to experience both chairs in the therapy room. As a client, I wanted to know the mechanism of action of EMDR therapy and bilateral stimulation, the therapist’s experience providing the treatment and their unique approach to it, the suitability of the modality for my needs, the length of treatment and how we measure progress, what to expect before, during, and after a session, the risks, benefits, and side effects of the therapy, and explaining how to stay safe while accessing the worst moments of my life. *** Grant Goehler, LCSW

Clients should ask if their therapist is trained vs. certified and what the difference is. They should also be able to know how long we have done EMDR and what our specialty is, and the length of the treatment. These are general questions but are very important. When I go to any specialist, I like to know their level of experience in treating my condition. I also want to know about their experience working with BIPOC folks and their commitment to diversity and social justice causes.*** Elizabeth Gonzalez-Jaskulak, LCSW

I work with children, so I often have to find the simplest way to explain a complex process. Potential clients sometimes ask, “Will it hurt?” My answer is both yes and no. It’s hard to think that something that has stuck with us for so long will be easy to get rid of, so in reality, sometimes healing hurts. But the feeling after and the awareness of how your life has changed once you have healed makes the journey worth it. So EMDR is a beautiful process that stings for a little bit but lasts a lifetime. *** Lisa Ibekwe, LICSW

Before starting EMDR therapy, clients should know a few critical points. First, EMDR therapy is a specialized approach to addressing trauma and related mental health issues. It involves recalling distressing memories while engaging in bilateral stimulation, such as eye movements, audio sounds, or tapping. Second, clients should understand that EMDR therapy may bring up intense emotions and memories during the process, but a skilled therapist will guide them through this process safely. Third, it is crucial to work with a licensed therapist experienced in EMDR therapy to ensure proper treatment delivery. Finally, clients should have realistic expectations and be committed to the therapy process, which requires active participation and collaboration. *** Arielle Jordan, LCPC

Clients should know that EMDR can impact how you make your life choices afterward. For instance, if you have always been confined by negative thoughts like “I’m not good enough” or “I’m trapped,” those thoughts likely informed your decision-making. Once the experiences that taught you these ideas have been processed, you will likely make different decisions. This is a good thing, but it may bring unexpected changes. Examples would be getting out of a relationship you have felt trapped in or leaving a job that doesn’t value you and your skills. *** Amanda Kimbrell, LPC-MHSP

When you have an EMDR therapist in mind (hopefully certified), I’d recommend asking them:

  • If they can clearly and succinctly explain their training (and hopefully show you their training completion certificates if they’re not EMDRIA-certified; in that case, you can at least check to see if their training program was EMDRIA-approved), broader background calmly and non-defensively, and how they’d use EMDR therapy to help you with your presenting issue.
  • Ensuring, if possible, their training is from an EMDRIA-approved training program (you can check on EMDRIA.org).
  • Requesting a free 10-20 minute phone consultation to see if the therapist feels like the right fit for you. EMDR works best when you feel safe, connected with, listened to, and supported by your EMDR therapist.
  • Asking about their training and comfort with dissociation (even if you don’t know precisely what it means, all good trauma therapists should know how to answer clearly), especially if you were diagnosed with a dissociative disorder. Finding a certified therapist with specialized training in dissociative disorders is ideal if that’s the case.
  • Check to see if they engage in ongoing consultation to keep their skills sharp, get support with cases they experience as challenging, and stay current with the latest developments in the field. *** Jason Linder, PsyD

Selecting the right EMDR therapist is crucial. Consider their experience and qualifications: “How many years of EMDR experience do you have?” Experience matters in effectively handling complex trauma and dissociation. “Are you specifically trained in treating clients with complex trauma?” Specialized training is vital for nuanced support. “What certifications or credentials do you hold as an EMDR therapist?” Reputable certifications indicate proper training and practice standards. “Have you successfully treated clients with similar issues?” A proven track record instills confidence in their abilities. Focus on understanding the therapist’s EMDR approach and how it aligns with your needs. Choose wisely for a transformative healing journey. *** Melissa McManis, LCSW

When choosing a therapist, it is essential to make sure you are a good fit in personality, just as much (if not more) as clinical skill. You pay attention to how you feel in your body and your emotional response to this person. I would first ask: “How are you going to handle it if I emotionally break in our first session?” I would like to know how long they have been utilizing EMDR. Finally, I would ask them to tell me what the process is like and if they can explain why EMDR works. *** Luna Medina-Wolf, LMHC

Before beginning EMDR therapy, it is important for clients to understand that they might feel worse before they feel better, mainly if we are working on a target memory that cannot be fully processed in one session. It is usual for symptoms to increase due to accessing and activating the memory initially. If they are willing to trust the process and ride out the discomfort of elevated symptoms both during and in between processing sessions, they will very likely achieve lasting symptom relief! *** Sara Thane Milam, LCSW

I get this question asked often. “Will we start EMDR [reprocessing] in the first session? Or how soon will EMDR [reprocessing] begin?” Like any other doctor or therapy appointment, we want to know you first. So initially, we’ll focus a bit on history taking, and get to know your interests, goals, and what’s been helpful to you during difficult times. As EMDR clinicians, we also want to have a good sense of your ability to tolerate stress and understand your coping skills. This is where we would practice skill building, grounding techniques, and in some cases – as I do with my clients—focus on some somatic-based exercises. Exploring healthy habits, hobbies, or means of relaxation would also be focused on for a few sessions. This is to ensure that when we start processing, you have more knowledge and education on how to maintain yourself in the present moment and what helps your body and mind regulate during the week between sessions.  After these pieces are established, and a good foundation is built, we use EMDR [reprocessing]. *** Ashley Morolla, LPC

It is important for the client to feel comfortable with the EMDR process, so they should have the freedom to ask questions. People often seek EMDR therapy for something that happened to them that was out of their control, so knowing they have some control over the EMDR process can be helpful. Also, ask, “Can I stop if I am too uncomfortable?” another thought would be to ask, “If I have an important meeting or job interview later in the same day as my session, can we postpone EMDR that day?” *** Amy Orlovich, LCPC

One important question that I recommend clients ask before beginning EMDR therapy is whether or not the EMDR therapist has had their own EMDR therapy. I believe we, as therapists, can only guide clients to places where we know how to go ourselves. Our ability to know ourselves is an important part of engaging in effective and meaningful therapeutic relationships. Also, experiencing EMDR therapy helped me learn about my preferences for conducting the mechanics of EMDR, thereby improving my practice with my clients. *** Christie Pearl, LMHC, LPC

I don’t know if clients should be expected to ask anything about EMDR as most clients are new to EMDR. I feel that it is our responsibility to be transparent with them as most clients obtain information about EMDR online or from other therapists that are not EMDR trained. But, if I could ideally hope that a client would be more curious about EMDR, below would be some of the questions that I think could be helpful for the client to ask, and to avoid client frustration due to misinformation and misunderstanding of how EMDR works, especially with trauma and CPTSD.  “1. Is EMDR a quick treatment? 2. Can I stay with my current talk therapist? 3. Will I become dysregulated? 4. Can I manage my emotions when I am not in therapy? 5. How will you know if I can start EMDR therapy? 6. Can I choose what I want to work on, and can you guarantee that we will only work on what I want to work on/deal with? 7. Will EMDR make me stop _____________ (fill in), i.e., drinking, feeling insecure, smoking? etc.” *** Serena Pesch, LCSW

Clients can interview their EMDR therapist to ensure it’s a good fit before working together. Ask how long they’ve been using EMDR, how frequently they use EMDR in their practice, and if they’ve had success using EMDR for the specific types of trauma or symptoms, you want to work on (ex: birth trauma, nightmares after a car accident, chronic pain, anxiety, etc.). I always like to ask my EMDR therapists what recent training they’ve taken to stay fresh on their EMDR skills and up-to-date with the latest research.  *** Erin Pritchard, LPCC-S

To decide whether a trauma therapist is right for you, start with this: 1. Finding the right therapist can be challenging. While credentials and experience have their place, the most important thing is fit. Go with your gut. Do a phone consult. Did they listen? Did you feel heard? Speak with more than one therapist. It’s worth doing this due diligence. (Fifty percent of therapists graduated in the bottom fifty percent of their class.) 2. Ask, “What is EMDR?” This is a test of how well they explain things. EMDR and trauma are complicated, and how well they simplify and explain it over the phone proves how well they will explain things throughout your treatment. 3. Ask, “How long does EMDR treatment take?” This is a trick question because no one can predict how long an individual’s treatment will take. Life often intrudes, or you discover other issues to work on. What you want to avoid is someone over-selling EMDR with a simple answer like, “Three to five sessions, max!” *** Peter Pruyn, LMHC

Client: “How does EMDR therapy work?” Therapist: “EMDR is an eight-phased approach in psychotherapy for distressing memories providing a jump-start to the brain to resume normal function of processing trauma or distress using bi-lateral stimulation.” Client: “What is EMDR used to treat?” Therapist: “Post-traumatic stress disorder, anxiety, depression, and substance/chemical dependency, to name a few.” Client: “Are there any risks with using EMDR? How is progress measured? How do I know when is the right time for scheduling?” Therapist: “Risks and distressful memories are addressed before desensitization phase 4. For example, if there is a complex trauma, dissociation may be present, and stabilizing parts may be necessary before desensitization distress memories. Progress is measured through symptom reduction and disturbance scores. EMDR can be exhausting, and the day and time of day are important, especially once phase 4 begins.” ***Janelle Reid, LACP

Many clients ask what it is because they don’t know anything about it, so I explain it. Approximately 20 percent of clients report they have tried EMDR with another therapist (that was not certified), and they did not have a good experience. This is pretty common to hear from certified EMDR clinicians. Most clients have no idea the difference between a clinician who has been Basic Trained, has advanced training, or is certified in EMDR. This is concerning as one of our first rules is not to harm, and we should inform clients of the training level. ***  Tara Sorenson, LCPC

A question always arises in EMDR is, “Am I doing it right?” I tell my clients: “You can’t do it wrong!  Your only job is to notice what’s happening.  That could include thoughts, emotions, images, or physical sensations.  That tells us your brain is processing. It’s my job to shift things if none are happening. Just know that you can’t do it wrong.” ***  Frances Spillane, LMHC

Before beginning EMDR therapy, I invite my clients to be curious about what, why, when, where, and how? In my experience, confusion creates activation, so the more the client understands, the more stabilized they feel.

  • What is EMDR? When explaining EMDR to my clients, I aim to personalize the experience using less jargon and more analogies, stories, and metaphors.
  • Why do you think EMDR will be helpful for me specifically? It’s important for a future EMDR client to understand why their therapist is recommending EMDR.
  • When can we start the process? I love informing my clients of the 8 phases of EMDR and letting them know what phase we are in and why. This allows them to understand the treatment plan and helps them feel included in the process.
  • Where will I need to be located to engage in sessions? Telehealth and in-person sessions are available for my clients. Some therapists prefer in-person sessions for EMDR clients. Having this conversation before getting started can be helpful so that if a client needs any specific tools for processing, they can prepare.
  • How they can prepare for EMDR therapy sessions. This may mean having a conversation about expectations. Reminding that EMDR has a protocol, but it is an individualized process. This process will look different for everyone. I ask clients to remain open about their feelings and experiences from start to finish.

One of my favorite quotes is, “If it’s coming up, it needs to come out, ” ensuring my client knows there is no wrong way or wrong answer. We heal when we learn to accept and embrace all parts of us and our experiences. EMDR is a beautiful approach to facilitating that process. ***  Yunetta Spring Smith, LPC, MHSP

Many therapists offer no-cost consultations that will allow you both to talk and find out if you both feel you can work together effectively. It can be helpful to interview therapists before starting any outpatient therapy services. Before beginning EMDR therapy, clients should ask about the therapist’s: *training in EMDR and general scope of practice, *availability (and be upfront about yours), *cost of services, *how sessions are structured, *how the therapist facilitates bilateral stimulation, *how the therapist determines whether or not they believe EMDR is appropriate, *how the therapist gauges a client’s readiness to move into desensitization, *any other questions you have about EMDR and where to find more information about it. ***  Dana Strickland, LPC

Before beginning EMDR therapy, clients should first seek an understanding of why the clinician feels EMDR would be helpful for them.  Clients should ask about the practitioner’s experience with EMDR reprocessing, including their personal experience receiving EMDR and their experience delivering to clients. They should also ask about the practitioner’s approach and goals with EMDR because they vary with different clinicians. ***  Matthew Swartz, LMSW

Before starting Eye Movement Desensitization and Reprocessing (EMDR), it’s important to ask your therapist key questions. Understand their EMDR training, certification, and practical experience. Ask about their successes with similar cases, considering EMDR’s established efficacy for PTSD and anxiety disorders. Query your therapist’s strategies for managing potential distress, which is essential for a safe therapy environment. Discuss how EMDR will dovetail with your treatment plan, ensuring a coherent therapeutic approach. Lastly, ascertain the methods for assessing therapy effectiveness. Knowing how and when progress will be measured is crucial for managing expectations. This pre-therapy discussion ensures a safe, integrated, and effective therapeutic journey. *** Tania Welikala, LCSW

 

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Additional Resources

If you are a therapist interested in the EMDR training, visit our EMDR Training & Education tab:

If you are EMDR trained:

If you are an EMDRIA Member:

 

 

Date
August 11, 2023

Series
EMDRIA Members Respond

Audience
EMDR Therapists, General/Public

Language
English

Content Type
Blog/Blog Post

Original Source
Focal Point Blog

Access Type
Open Access

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