EMDR with Teens Part II

EMDR with Teens Part II

Welcome to Part II of this blog posting. We ended off last week with History taking with our teen clients. As we move into Phase 2 we can use the great imaginations of the teens to help them create a containment mechanism, a place of retreat, and resources they may need. We have so many teens who have found a love of art and are very good at creating a visual representation of their spaces. There are many options for this. I have used wooden boxes that can be painted, building origami boxes, drawing with colored pencils, or even the use of a sand tray. Using something to allow the client to develop a representation of the container or space that is tangible can be helpful as they head into working on the memories or disruptive incidents. This time of creating also allows time to develop a therapeutic rapport and to see how your teenage client is engaging in creative thinking. This time in Phase 2 is part of assessing the readiness of the client to continue into Phase 3 and beyond. It is a time to verify environmental stability, to see how the social relationships and supports are, and to look at the client’s readiness to be open to tell you what they are experiencing. It provides the space to see what type of BLS is going to connect best with the teen. I will always provide the choice of eye movements; however, many also respond well to tappers or audio BLS. Depending on the individual situation, the teen you are working with may or may not have developed internal resources. Resource Development and Installation is helpful to develop some internal support for the teen to have as they move forward into processing. One of the horse trainers I follow named Warwick Schiller, talks about having the tool developed before needing it. This is the same principle behind the development of resources before heading into processing. If we have resources developed, these can then be brought into processing as needed rather than stopping the process to develop a new resource. 

Development of resources can also be a time to continue building rapport and understanding how your client is going to process memories and events in future sessions. It gives time to understand if the teen processes visually, somatically, emotionally, or a little bit of all of it. It also helps us as clinicians to understand the ways this teen communicates. For example, I had one teen who let me know early on that they needed a pencil or something in their hand to talk because they needed to draw in order to process. You can bet that they had paper and a writing instrument available every session. 

After we have a solid Phase 2- we know that the teen can move from an activated state to a non or less-activated state both in and out of session- we can move on to Phase 3: Assessment. When working through the Assessment Phase with a teen, I am following the same protocol as I do for an adult. I am going to ask the same questions and work for the same strong paused image, and strong, self-referencing, present-day negative and positive cognitions. We obtain the VOC, emotions, SUDs, and Body Sensations as always. I am still going to remind the client that it is their brain doing the work and that they are the ones in control of the session, they are reminded of their stop sign. I find that teens often like not having to re-tell the narrative of what has happened in their life, the use of EMDR Standard protocol provides the space for a teen to focus on one point of the incident rather than having to re-tell the entire narrative. 

Phase 4 with teens will be similar to how we work with adults. A difference may be how we attune to identify the speed and number of passes needed for the individual. Older teens may be able to manage the speed and length of sets as adults (fast, 24-36 passes), while younger teens may need to have the speed adjusted down a bit with fewer passes per set. We are going to hold the supportive neutral space for our client, allow the channel to work through until we arrive at a positive or neutral, and then complete two more sets to check for two more positives or neutrals. Teens may need to have more interweaves used to help with processing as teens have fewer years of experience than our adult clients. As we process the incident with our client, we will follow as many channels as needed with as many sets per channel as needed for the processing. We will continue to process until we run out of time with a buffer provided for the client to return to a stable state before leaving the office, or until we reach a SUD of a 0 or ecological 1. 

When we have completed the processing on a memory we will continue on with our Standard EMDR protocol into Phase 5- Installation to install the positive adaptive cognition. Then into Phase 6 with the Body Scan. I find that teens do well with these phases completed as would be standard for how we work with adults. We are going to maintain the quicker speed and longer sets used in Phase 4 into Phases 5 and 6 for continued processing. 

Teens often have many worries about the future. There may be fears and anxieties related to who they are becoming and how they are going to handle future decisions and major life events. We want to remember the use of the third prong- working in the future space to help our teenage clients create positive, adaptive neural pathways for the future. 

Important things to remember as we work with our teenage clients is that they are not aliens, they are humans who are learning how to exist in the world and how to become adults and make adult decisions. They have big ideas and at times big emotions. Teens can be a challenge as some are forced into counseling, some see others in their life as the problem, and some may be just going through the motions. I have found teens to be some of my favorite clients and ones who have taught me the most. 

0

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.

Send this to a friend