For Children, Adolescents and Adults
I provide two day intensive programme for children, adolescents or adults. Intensive treatments for PTSD have emerged to accommodate more rapid recovery from symptoms of PTSD. During the two day intensive EMDR therapy is implemented to a manualised, eight-phase EMDR standard (three-pronged) protocol. However, each day is tailored and flexible to the needs of the client.
Intensive EMDR Therapy Day 1
Phase 1 - History Taking
During day 1 of the intensive programme I start by assessing the main difficulties experienced by the child/adolescent. I draw upon various different models of assessment to gain a holistic view and to determine why the patient has come to therapy. In addition, I utilise the adaptive information processing model which helps me to consider the clients dysfunctional behaviour, symptoms, physical conditions, environment, and interpersonal relationships. During this phase I start to create a hypothesis about what the patient is experiencing and what was the force behind their current presentation. During this phase we construct a time line to incorporate the following:-
Past- Explore past events which might be impacting on patients currently.
Present- I analyse the current triggers and symptoms that stimulate the dysfunctional material
Future- I help the client to consider future goals/targets and explore what changes need to be made to help them have positive behaviours and attitudes in the future.
Phase 2 - Preparation Phase
During the EMDR preparation phase assessing ones ability to distress tolerance, emotionally regulate, and affect tolerate is an essential part of stabilisation. The intensive programme provides the following resources:-
Psycho -education about trauma
Establish a Safe Place-Shapiro’s (2001)
Prevent dissociation using CIPOS
Resource connection and development - building resilience
Flash technique - controlled exposure
Within the stabilisation phase of treatment, I enable children/adolescents to expand the window of tolerance over time to help the cope with levels of distress and to strengthen the child’s ability to cope with the most adverse experiences . During this part of the programme I assess the clients risk of both hyper- arousal and hypo -arousal these are often present in the therapy room when clients are going out of their window of tolerance. Prior to proceeding to phase 3, I ensure that the client is able to change their state and have positive networks reflecting on their ability to experience high and low arousal, paying particular attention to her optimum arousal zone.
Intensive EMDR Therapy Day 2
We aim to progress to Phase 3 - Assessment of Target (please note that if a client isn’t ready to re-process trauma memories then I continue to develop resilience and emotional stability with them.
During phase 3 we review the time-line created and agree on the target memory to process first. It is important to elicit a picture that represents the sensory aspect of the target memory to be reprocessed.
Phase 4 - 8
During phases 4-8 these trauma memories are re-processed. It is difficult to determine the amount of time required for processing, because this depends on how the patients brain processes, how many memories require processing and their subjective units of distress.
Throughout the intensive programme I consider the patients level of resilience and teach relaxation skills, grounding exercises, boundaries, mindfulness, safe place and resource development. Relaxation exercises, such as the light stream (Shapiro, 2001), progressive muscle relaxation and visualisation exercises are very beneficial for adolescents to develop personal growth.
As a qualified Heartmath Coach I also use the inner balance to develop stabilisation throughout the 2 day programme. The inner balance technology analyses and displays out heart rhythm, measures by heart rate variability, which indicates how emotional states are affecting our nervous system. The technology helps to train us to self - generate as highly effect physiological state called HRV coherence. This helps us increase emotional composure and clearer reasoning. Coherence practice has been known to help sleep disruption, exhaustion, anxiety, burn out and fatigue.
EMDR Therapy and the use of the flash technique with Children and Adolescents