SAN DIEGO EMDR REGIONAL BASIC TRAINING PARTICIPANT'S AGREEMENT

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The undersigned participant acknowledges that they have thoroughly and carefully read, understand, and agrees to the following.
EMDR Therapy is widely recognized as an empirically supported treatment for PTSD and Acute Stress Disorder. While there are published studies of its application to a range of clinical presentations there is not yet enough published controlled clinical trials to be evidenced based for other disorders. The latest research can be found at www.EMDRIA.org.

Email *

1. Participants must be licensed to independently practice psychotherapy in a Mental Health discipline recognized by EMDRIA. An exception will be made if the participant: A) is not licensed, but is enrolled in an accredited graduate program in a mental health or related discipline recognized by EMDRIA and is in their final internship; or B) has completed Master's level coursework and is currently in a licensing track. In either case the participant must be supervised by a licensed clinician with a signed Clinical Supervisor Agreement submitted at the time of registration. The Agreement from the licensed, supervising clinician indicates the participant: A) has clinical privileges to practice psychotherapy under supervision, B) has been endorsed to participate in EMDR therapy training, and C) when appropriate, can use the knowledge and skills acquired at the training. (Participants must meet EMDRIA clinician requirements. https://www.emdria.org/emdr-training/emdr-training-old/eligibility-requirements-for-emdr-training/) *

Yes, I am a licensed Mental Health Professional

I am currently completing requirements towards my mental health license and will include a supervisor agreement to verify that my supervisor is aware and in agreement with my participation in this training with the expectation that I will begin to practice some of the EMDR therapy skills, as appropriate, in clinical practice.

I am currently in my last year of a graduate degree in the mental health field in a track towards licensure in mental health and in an internship or practicum where i can practice what I learn in this EMDR training. I will include a clinical supervisor agreement to verify that my supervisor is aware and in agreement with my participation in this training with the expectation that I will begin to practice some of the EMDR therapy skills, as appropriate, in clinical practice

Required

2. All participants should have a current active psychotherapy caseload where they can begin to apply the principles of EMDR therapy. This training is designed to help participants integrate the use of EMDR in their clinical practice during the course of the training. The time between training days and consultation meetings is designed for implementation EMDR skills as clinically relevant for your setting. *

Yes, I have an active caseload where I can practice what I learn from this EMDR training.

Required

3. A significant component of the training involves clinicians practicing EMDR related procedures in small groups with some guidance from training staff. Participants should be prepared to address real life experiences that have some level of disturbance as part of this training program to appreciate the subjective experience of EMDR as a client would and to provide valid training experiences for other participants. These practice experiences are for educational purposes, using the real life material of participants but without a full intake assessment. It is up to the participant to alert the training staff of concerns, and to discern if this is the right time to participante in this type of training. While many participants report adaptive therapeutic outcomes it is not unusual for a target memory to be linked to other, unexpected, disturbing material or memories that might surface during or after the practice sessions. Additionally, case material presented didactically, on video and/or consultation sessions may be disturbing or triggering. It is expected that the participant has developed self-soothing and affect/arousal management skills and will be able to employ these skills as necessary during and following EMDR training, practice and consultation sessions. If this training brings up disturbance that needs further attention it is up to the individual to seek out treatment. A) Participants who are engaged in personal therapy and/or psychiatric treatment should inform your therapist and/or psychiatrist about all aspects of this training including the experiential component and secure your therapist’s and/or psychiatrist’s support to participate before beginning this training. B) Participants with limiting or special medical conditions (high-risk pregnancy, seizure disorder, heart condition, eye problems, etc.), should consult their medical professional(s) before participating in this training and should discuss the condition(s) with this instructor in advance of registering for the training. C) Participants with a dissociative disorder, acute or severe PTSD, GAD, panic disorder, substance use disorder, personality disorder, or affective disorder, should not participate without special arrangements made at the time of registration and discuss this with this instructor prior to registering. Such issues could place you at risk, negatively impact other participants, and possibly result in dismissal from the training without refund. *EMDRIA and the EMDR Institute have EMDR trained clinicians listed for those who would like to pursue EMDR therapy. This is not included in the cost of this training. https://www.emdria.org/find-an-emdr-therapist/ *

Yes, I am prepared to use my own personal material in practicum and (if applicable have discussed this with my therapist). I am aware that it is my responsibility to seek and obtain appropriate professional assistance if needed. I am aware that providing such assistance is not an extension of the training and will not be provided by the instructor. I will make the trainer and facilitator aware of any special circumstances or diagnosis that might affect the practicum experience.

Required

4. Participants are expected to maintain a spirit of cooperation and mutual support for all in the training. Splitting and conflict-generating behavior will not be tolerated. Participants who are disruptive to the training will be dismissed without refund. *

I agree that the instructor has the right to dismiss me from the training at any time without refund if they determine that I am negatively impacting the training experience of others.

Required

5. In order to assure confidentiality of personal and clinical information, audio/video recording by participants is not allowed. All participants are expected to maintain the highest ethical standards of confidentiality regarding all personal and clinical information shared by others in this training. Failure to maintain confidentiality shall be treated as a professional ethics issue, may be reported to a licensing board, and likely will result in immediate dismissal from the training program with no refund. Confidentiality applies to practicum and consultation meetings: specifics may be discussed with members of the immediate practice and consultation group and instructor. You may share your own emerging material as you choose. Please avoid using identifying information when discussing cases in training or practicum. *

I will maintain confidentiality of personal and clinical information. I will not record any portion of the training and will not distribute training materials without written permission.

Required

6. The required consultation sessions provide the opportunity for continued learning about EMDR therapy theory and practice. Consultation provides an opportunity for clarification and feedback in the application of the procedural steps: use of EMDR therapy within a structured treatment plan, case conceptualization, client readiness, target selection, specific application of skills, and the integration of EMDR into clinical practice. *

I understand that EMDR Consultation is not clinical supervision and that neither Alicia Avila as the Instructor and consultant, nor other facilitators, therapists/participants shall be construed as providing supervision on any specific case. While clinical possibilities will be discussed and ideas shared in relation to the clinical situations presented, each therapist is solely responsible for the clinical management of the client/patient and is expected to exercise their best judgment in all relevant clinical matters.I understand that whatever information is presented in these sessions is to be kept confidential among the participants both during and after participation in the group.

Required

7. Required reading not covered in your tuition fee: A). Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing, Basic Principles, Protocols and Procedures (3rd ed.). New York: The Guilford Press B) Shapiro, F. (2012). Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy. New York: Rodale. *

I will read these as part of my training.

Required

8. Additional required reading available through training links: A) Go With That Magazine Fall 2020, Volume 25, Issue 3 [EMDR & Racial Trauma] https://mk0emdrias99osg9utnb.kinstacdn.com/wp-content/uploads/2021/05/GWT.2020.Vol_.25.Issue_.3.RacialTrauma.ALL_.pdf B) Guidelines for Virtual EMDR Therapy (Spring 2020) https://mk0emdrias99osg9utnb.kinstacdn.com/wp-content/uploads/2020/04/virtual_tg_report_for_member.pdf C) Required videos to watch before day 1 of training: Tips on doing EMDR therapy online: https://youtu.be/mE1iBALWDNU C) Video presentation on the Basics of Traumatology (Link will be shared after confirmed enrollment) D) Video Presentation of the Research Basis for EMDR Therapy (Link will be shared after confirmed enrollment) *

I will read these 2 articles and watch the 3 videos. I will make sure I watch the 3 videos before the first day of training.

Required

9. Full attendance is required in all 6 days of training plus the 10 hours of group consultation. Those arriving more than 5 minutes after the start time or leaving more than 5 minutes before the workshop will not receive credit for the course. A Certificate of Completion will be issued only to those who satisfactorily complete the entire training (including ten hours of consultation), complete the assigned readings, videos, and demonstrate in group discussion, practice exercises and consultation, an understanding of the EMDR treatment approach. Participants are expected to participate actively and to work diligently. Failure to attend part or all of a training day will handicap a participant in this learning process and can have a negative impact on the small group process. Missing portions of the training is likely to result in dismissal from the training program and forfeiture of all tuition paid. There will be no refunds, under any circumstances, for withdrawals after the beginning of the training program. It is up to you to make your instructor aware of any extenuating circumstances that might prevent you from completing the course. Any individual time necessary to make up missed material is subject to a $190/hr cost and dependent on the instructor’s limited availability. If you do not complete the training program as scheduled, please be aware that EMDRIA requires that participants who begin the EMDR therapy training must complete the entire training within 12 months from their initial start date. Due to the group process and how concepts build on one another it is likely that missing any portion of the training will preclude you from completing the training. *

I understand that full attendance is required for all 6 days of trainings as scheduled as well as the 5 scheduled consultation meetings.

Required

10. If you withdraw or request to reschedule your training with 60 days or more notice you can obtain a refund less $75 administrative fee. If you cancel or request to reschedule with less than 60 days of the first day of training you can get a 50% refund of the full training fee. There is no refund for cancelling or rescheduling on or after the first day of training. *

I agree

Required

11. This experiential workshop is for clinical purposes only and will not qualify the participant to train others in EMDR. Attempts to train others in EMDR without meeting the standards as defined by the EMDR International Association would represent a professional ethics violation. *

I agree.

Required

12. If this is scheduled as a virtual training. Please stay logged into Zoom (or Google Meet) all day on training days. Turn your camera off during breaks, lunch, and if you need to move to another room. Leave your mic on mute unless you are called on or you need urgent assistance. You can raise your hand or send questions on the chat function. Plan to use a laptop or desktop, in a private, quiet area. It is recommended that you limit other’s use of your WiFi during the training. Check your internet bandwidth on www.speedtest.com (600kbps and 1.5Mbps recommended). Connect your computer to power to avoid losing the connection. If you have an ethernet port on your computer you can connect directly to your WiFi or buy an adaptor to connect directly for a more reliable connection. Have a backup device and your cell phone fully charged in case it’s necessary. Disable alerts on your device during the training hours. Headphones or Earbuds are preferred for the afternoon practicum. Have your cell phone nearby and fully charged for additional communication in case it is needed.

For online trainings, your camera must be on and you must be present (not multitasking) for the duration of the training. EMDRIA requires that the training staff can visually monitor your facial expressions and other visual cues of your response to the training material.

I agree and plan to use a laptop or desktop, in a private, quiet area and to have my camera on for the duration of the training.

Required

13. For the bilateral, dual attention stimulation it will help if you can have two objects handy that can be used as focal points to your right or left, two lamps, or picture frames, or coffee mugs, or post it notes will work. It's also helpful if you have a "line to follow" using a window, curtain rod, or piece or furniture that has a top "line" you could follow to lead your own eye movements. This is explained in a 20 min video mentioned above: Tips on doing EMDR therapy online: https://youtu.be/mE1iBALWDNU *

I will review this video and gather supplies to prepare before the 1st day of training.

Required

14. You will receive a training manual to use during the training. You will use the manual to follow the lecture, and to take notes. In the afternoon you will read from your manual practicum scripts and you will be asked to write on the practicum pages of the manual each day of training. Clinical worksheets to use in your practice will be provided on a separate link. Have tissues and pen or pencil handy. Consider having snacks available. You are welcome to eat during lecture as you would in an in person training. *

I will be ready to read from and write in the practicum pages of the manual during the training.

Required

15. If this is a virtual training: Those not registered for the training should not be within earshot of your computer for confidentiality and to protect others from possible activation/vicarious trauma. Pets can be of comfort as long as they are not distracting especially during practicum. *

I will make sure I have a private space to attend to the training.

Required

Option 1

Name *

Today's Date *

YYYY

Email address: *

Cell phone number: *

Texts will be used in addition to the "chat" function to keep open lines of communication especially in the afternoon practicum of the training dates. Please let the trainer know if you have concerns about using texts for additional communication as needed. *

I agree to receive and send texts as needed.

I am unable to receive or send texts and will make special arrangements with the trainer for communication options

Required

Landline for where you'll be during the training. *

Address where I'll be for the training *

Emergency contact name and phone number *

Any concerns, questions, or special requests *

Grievance process: If you have a grievance please contact me 858-344-9440. I am open to your feedback and want this to be a positive experience. It's important to learn of things that do not work for some participants and to have the opportunity to grow as an instructor or to consider policies. If for some reason you do not feel comfortable contacting me directly, please contact one of my training assistants. *

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