Can I Do EMDR with a Client that Has Recently Self Harmed?

Can I Do EMDR with a Client that Has Recently Self Harmed?

Post by Amanda Martin PhD, LMFT-S, LPC

“Can I do EMDR with a client that has self-harmed recently?” This is a common question in training and the key is the clinical assessment. When assessing if a client with self-harming behaviors is appropriate and ready to start EMDR, I recommend considering the following:

  • Is the client motivated and willing to do EMDR? It’s important for the client to have voice and choice in treatment.
  • How serious is the self-harming behavior (requires emergency medical attention or superficial)?
  • How frequent is self-harm? Are they able to go extended periods of time without self-harm (2 weeks or more)?
  • Is the client able to identify the triggers for the self-harm behaviors?
  • Does the client respond well to the state change exercises and other self-regulation tools? Are they able to use them when triggered to provide some self-soothing?

If the client is motivated to do EMDR, the self-harm is not life threatening or requires medical attention, is able to identify the triggers for self-harm behavior, and is able to implement state change exercises or self-regulation tools to assist with self-soothing; then I proceed with EMDR treatment. I do spend some time (several sessions) on preparation practicing state change exercises; and create a self-care plan that includes aspects of daily self-care and psychological first aid to use when triggered. If the client is able to progress with these interventions and improve self-awareness to implement the psychological first aid with self-regulation tools outside of session (abstain from self-harm for 2 weeks or more); then I proceed to EMDR phase 3-8 processing the identified targets. It’s important to continue to check in on how the client is doing with the processing and if regression occurs, we return to preparation to stabilize before returning to processing.

 

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Dr. Amber Quaranta-Leech, LPC-S

Amber holds a PhD in Counselor Education and Supervision from Regent University. She is a Licensed Professional Counselor in both Texas and Oklahoma and holds Supervisor credential for Texas. Amber is an EMDRIA consultant and trainer. She has over a decade of experience in the trauma field in work with uniformed services, domestic violence, childhood trauma and abuse, and recent mass trauma events. Amber provides consultation for EMDRIA certification, for consultants-in-training, and supervision for LPC-Associates. Amber continues to research the benefits of EMDR therapy with a variety of populations. Her goal is to help build strong clinicians who are well versed in trauma interventions to better support their clients. Amber sees a limited number of clients with a focus on trauma work, she is also a Certified Career Counselor and Certified through EAGALA to provide equine-assisted therapy. 

Dr. Jose Carbajal, LCSW

Dr. Jose Carbajal, a U.S. Army veteran, earned his bachelor’s and master’s degrees in social work and a master’s in theological studies from Baylor University, and a Ph.D. in Social Work from the University of Texas at Arlington. With over 15 years of clinical experience and extensive teaching experience, Jose specializes in trauma, sexual abuse recovery, domestic violence, and substance abuse. His research focuses on trauma interventions, neuroscience, and faith. He is EMDR Certified, an Approved Consultant, and an EMDRIA Approved Trainer, with numerous publications and professional presentations to his name.

Dr. Amanda Martin, LMFT-S, LPC, BCN

Amanda Martin holds a PhD in Family Therapy and is a Licensed Professional Counselor, Licensed Marriage and Family Therapist Supervisor, and EMDRIA Approved Consultant. With over 14 years of experience, she specializes in trauma therapy for individuals and families in residential and outpatient settings. Amanda also provides supervision for EMDR certification, EMDR consultants-in-training, and LMFT-Associates. Her mission is to help people find a healthy, joyful, and fulfilling path in life. Her warm, supportive, and interactive counseling style incorporates Symbolic Experiential Therapy, Trauma-Focused Cognitive Behavioral Therapy, EMDR, HeartMath, Animal-Assisted Therapy, Neurofeedback, and Collaborative Problem Solving.

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