Post by Amanda Martin PhD, LMFT-S, LPC
“Can I do EMDR with a client that has self-harmed recently?โ 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:
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. Itโs 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.
The factors therapists should assess before using EMDR with a client who recently self-harmed include current safety risks, emotional stability, coping skills, suicidal ideation, support systems, and readiness for trauma processing.
Stabilization is important before trauma-focused therapy because clients need sufficient emotional regulation skills and coping resources to manage distress that may arise during treatment.
EMDR can include preparation phases before trauma processing begins, allowing therapists to strengthen coping strategies, establish safety, and build emotional regulation skills.
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.
Dr. Jose Carbajal, a U.S. Army veteran, earned his bachelorโs and masterโs degrees in social work and a masterโs 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.
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.ย
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.ย
Dr. Jose Carbajal, a U.S. Army veteran, earned his bachelorโs and masterโs degrees in social work and a masterโs 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.
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.
