Group T SAFE EMDR Basic Training Consultation Form
Please do not give any identifying information about the client.  Only identify by Case #1, #2 or #3.

Notes about consultation:  Each participant is required to present at least 1 case they have been working with between days 1-3 and days 4-6 of the training.  You will be meeting in small groups for consultation for a total of 10 hours in the 2nd 3 days of the training. It is very important that you fill this out for at least 1 and up to 3 cases.  

We will be inviting and demonstrating nonviolence and the use of our SAFE model practices for the consultation.  

Instructions for the group:  Each participant can present their case.  The group is invited to be mindful about the present moment experience as they hear the clinician present the case.  We are encouraging right brain, present moment experience more than problem solving and analyzing.  

1.  The person presents the case and the group is invited to notice in silence their present moment experience, what body sensations, images, metaphor, images or movements come up.  

2.  The group is invited to write down their experience.  

3.  If time permits other members of the group may share the images, metaphor

4.  Presenter then asks clarifying questions.  

5.  Presenter reflects on the feedback, noticing the new perspective.  

6.  Presenter may say how they see the path moving forward with the client.  

7.  Expression of appreciation and gratitude for the group.  

These 7 steps were informed by and adapted from Wayne Scott, LCSW, Trauma Informed Case Consultation Format.

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Your Full Name
Please do not give any identifying information about the client or diagnosis, it is not necessary.  You may fill out this form for up to 3 cases, you may identify the case by number 1-3.   (please take note of which case is which number when you are presenting)
Clear selection
Which of the 8 phases have you completed with this case?
How do you conceptualize this case using the AIP?  How are the client's past experiences influencing the present?  
What is the client's "Answer", what does the client do well?
How will you know if therapy is successful?  What will be different in the client's life?  What will you or the client see?  
How are you feeling stuck with this client?  
How do you see your answer surfacing with this client?
When you think about working with this client, what do you notice right now in your body?   Does that feel familiar?  
What are you curious about as you bring up this case?  
What specific areas of concern or confusion do you have?
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