This is an example contract which means you can tailor this form and modify the language to suit your specific consultation practice and needs. You are not required to use this example contract, but we do expect the consultant and consultee to enter into some type of written contractual agreement for consultation services.

The purpose of this agreement is to establish a clear understanding of the expectations of consultation. There are several different reasons a consultee seeks consultation. Which reason is of primary importance to you now?

_____To complete the 10 hours of consultation to meet EMDR basic training requirements
_____To gain knowledge regarding complex trauma, build confidence using EMDR, but not EMDRIA credential purposes
_____To achieve the EMDRIA Certification credential
_____To achieve the EMDRIA Approved Consultant credential
_____Other _____________________________________________________

Your reason for entering consultation directs the type of consultation activities. As you develop, you may choose to change the focus of consultation. As soon as you decide to make changes in your focus, please let me know and we will discuss the change in activities or requirements at that time.

The following clarifies expectations, the general structure of consultation, what consultees can expect of me and what is expected of you when seeking to complete 10 hours of consultation for EMDR basic training, or to become EMDRIA Certified in EMDR. I am an EMDRIA Approved Consultant. This means that if you have completed the Basic Training in EMDR and wish to become an EMDRIA Certified Therapist, I am approved to provide consultation toward that end, or consultation-of-consultation to become an EMDRIA Approved Consultant.

Please visit EMDRIA at www.emdria.org for further information on these requirements.

What the Consultee can expect of Consultant
1. EMDRIA currently requires a minimum of 20 hours of consultation (at least 10 hours must be individual consultation) to apply for EMDRIA Certification. I require work samples of all 8 Phases and 3 Prongs of the standard EMDR therapy, and evidence of correcting any concerns prior to writing a recommendation letter for EMDRIA Certification. If you use more than one Approved Consultant in your journey toward EMDRIA Certification, I require a minimum of __ hours of individual consultation prior to writing a recommendation letter for you to submit for EMDRIA Certification.
2. I encourage you to seek consultation from other consultants if they have a specialty area which fits your needs. Please notify me if additional consultants are utilized for hours towards EMDRIA Certification. The guidance provided to you will be enhanced if you grant both consultants permission to speak to each other.
3. I will document and track our time spent in consultation. I will retain documentation of our consultation together for a five year period from the date our work together concludes. I will write a letter of recommendation or written verification if you have acquired the skills and knowledge base to be Certified and demonstrate this. If the skills and knowledge have not been demonstrated, I can provide written documentation of the time spent in consultation, the skills and knowledge acquired and the areas still needing improvement. We will discuss issues as they arise especially if you are having difficulty.
4. I will keep abreast of current trends and changes happening with EMDR and trauma treatment. I will provide consultees with new information and accommodate your needs as long as it stays within the scope of my knowledge. I will refer to other consultants if your needs are beyond my scope.
5. We will schedule our individual appointments as schedules permit. Suggested frequency is __ hours per month.
6. I will make efforts to provide a safe and supportive learning environment. Any concerns about this, when shared with me, will be addressed with you in private.

What is expected of Consultee
1. You are expected to come prepared to present case material, complete with notes on that case.
2. Do not include any information that will identify the case you are presenting on materials you share with me.
3. You are expected to practice within the ethical guidelines of both your license and professional associations. EMDRIA states that if there is no professional association, then the APA’s code of ethics will be the standard for all EMDRIA members. It is your responsibility to stay current on both the laws and ethics applicable to them.

For EMDRIA Certification
• Examples of your clinical work are essential to the consultation process. You will need to come prepared with near verbatim transcripts or (if you prefer) video or audio recordings of your client sessions. You will need to obtain the necessary releases from clients. The verbatim/video/audio must include your words and interventions.
• You will need to demonstrate proficiency and fidelity to the standard EMDR therapy and also an awareness of situations in which modifications to standard EMDR therapy are necessary in order to safely and effectively treat the client. This may include reading and training outside of consultation.

For Consultants in Training
• You are expected to work with at least five different consultees, three of whom have already completed the EMDR basic training.
• Consultation-of-consultation will involve developing your forms and skills as a consultant and reviewing examples of your clinical and consultation work.
• I will expect the following in addition to consultation-of-consultation: auditing an EMDR basic training, shadowing the practicum facilitator role at an EMDR basic training, shadowing and/or co-facilitating group consultation, offering and forming a consultation group for the duration of your CIT status.

Consultation vs Supervision
Consultation is not supervision. Consultation focuses on mastery of standard EMDR therapy and integrating EMDR into your practice. You are responsible for the therapeutic relationship with your clients and competency in the modalities you offer. As a consultant, I do not hold liability for how you practice.

If you are seeking consultation toward EMDRIA Certification, I will be evaluating your proficiency and fidelity to the standard EMDR therapy and your awareness of situations in which modifications to standard EMDR therapy are necessary in order to safely and effectively treat the client.
If you are seeking consultation-of-consultation toward becoming an EMDRIA Approved Consultant, I will be evaluating your skills and progress in both knowledge of EMDR therapy terms and protocols, and your abilities as a consultant.

Consultation does not substitute for foundational psychotherapy skills. Should concerns in this area become evident, I may require that these concerns be remedied prior to writing a recommendation for Certification.

Consultee Information
Full Name and degree:__________________________________________________________________________
License type and number: _______________________________________________________________________
Preferred mailing address: _______________________________________________________________________
_____________________________________________________________________________________________
Work Phone:_____________________ Cell Phone: ___________________________
Email: ________________________________
Please provide the dates of your EMDR basic training and trainer’s name:
__________________________________________________________________________________
*Consultee will provide certificate of completion*

Name of work setting: ________________________________________________________________
Address of work setting:_______________________________________________________________
Number of clients you see a week: ________________
What are your goals for consultation?
1) __________________________________________________________________________________________
2) ___________________________________________________________________________________________
3) ___________________________________________________________________________________________

Based on the goals for consultation you have chosen, please be prepared to provide the following:

10 hours required for EMDR basic training completion
_____ Signed agreement (initial meeting)
_____ Provide the Targeting Sequence Plan/ EMDR Treatment Plan for each case (bring to each consultation)
_____ Provide the Basic Protocol Worksheet from each case (bring to each consultation)
4)

EMDRIA Certification
_____ Signed agreement (initial meeting)
_____ Informed consent process including EMDR therapy utilized at your place of practice (initial meeting)
_____ Case presentation material for discussion (bring to each consultation)
5)

Consultant in Training
_____ Signed agreement (initial meeting)
_____ Completion of the CIT declaration process (this is done online through the EMDRIA website)
By the ___ consultation-of-consultation meeting date you should have the following:
_____ Your own agreement designed to fit your consultation practice
_____ Your own case presentation format to fit your consultation practice
_____ Your own learning objectives or evaluation measure to fit your consultation practice

Fees:
My fee for individual consultation is $X/hour. Payment is expected at time of service. Check, cash, charge, or Paypal. If you prearrange a discounted fee for paying in advance for 5 or more hours of consultation, that full payment is due at the first session.
Notes/how paid: _____________________________________________________

I have read and understand and agree to the above conditions and expectations.

__________________________________________________________________________________________________
Consultee Name (print) Signature Date

__________________________________________________________________________________________________
Consultant Name (print) Signature Date