In 2007, when I finished my Basic EMDR Therapy Training, I was working in a community mental health agency and focusing on treating children and adolescents in both school and day treatment settings. At that time, publications and advanced training events for these populations were scarce. I needed helpful resources. Fortuitously, through my Basic EMDR Trauma Recovery/Hap training, I was introduced to Dr. Frankie Klaff (2025 Playful EMDR Lifetime Achievement Award recipient). An expert in the field and in working with clients like mine. By developing trusting relationships with clients and practicing EMDR along with her mentoring, I was able to improve my skillset in this emerging area of practice. Specifically, we developed a partnership focused on implementing new ideas and evaluating their effect on engaging complex children and adolescent cases in EMDR Therapy. An important facet of this relationship was that she helped provide a safe space to explore new ideas while helping me stay rooted in the AIP, as I worked with these kids with complex presentations. With her guidance, I began to develop tools to help prepare my clients as well as to increase engagement in the reprocessing phases.
Helpful tools I developed and/or Integrated into my EMDR Therapy:
- Feelings memory matching to assist with developing awareness of feelings and to begin to create a shared way to communicate about feelings during EMDR Therapy.
- A variety of coloring sheets aimed to assist with increasing somatic awareness (to help with “where do you feel it in your body?”) and identifying targets for reprocessing.
- Craft activities to provide concrete and tangible safe state (formerly safe place) tokens to represent phase 2 resources.
- Having a magnetized dry erase board with a person magnet that would hold note cards that listed negative and positive cognitions and feeling faces. Kids could then move the magnet along with the Subjective Units of Disturbance (SUD) or Validity of Cognition (VOC) and use the markers to try what they were experiencing using the components of memories (or the TICES for suggestions).
- The use of mandalas to assist with closure in phase 7.
Even though I was developing useful tools, these tools were not always practical in the school setting. I often ran into trouble using these tools when I did not have a designed office, when the budget did not allow for the purchase of craft supplies or then I did not have access to a copy machine. Many school-based therapists face additional challenges and barriers, when attempting to provide evidence-based trauma treatment (EBT) while trying to balance the schedule and demands of being in a school setting.
I quickly realized it was much easier to implement a full standard EMDR protocol in the confines of my day treatment office, versus in schools. With Dr. Klaff’s support we explored alternatives. Through exploration, we found ways to move through all 8 phases and 3 prongs, while sticking to the established EMDR Continuum. It took some time to learn to balance the challenges of a school setting; school dynamics (both peers & educators), not always having an office available, the school calendar, daily student schedules, and working in multiple schools throughout the week. Here are a few steps we explored to help you implement EMDR Therapy in a school setting:
- Meet with school leadership and staff (including bus drivers, lunch, recess, and janitorial staff). Build a relationship around a shared investment in the students. Prepare a presentation on how adverse experiences and trauma impact students’ ability to learn and relate to others. Include the following:
a. ways to identify students and families who may need support (ex. mental health first aid, have an informational pamphlet about your services available in the office/on any resources tables during conferences and other planned school activities.
b. how to use the ACE Questionnaire and implement social emotional curriculum,
c. ways for school staff to support students (ex. teach them to help students down and up regulate their nervous systems, to aid in under and over stimulation-I find it best to partner with the school special educational team and occupational therapists).
Encourage relationship building versus punitive punishment. School environments that focus on control and consequences often perpetuate trauma triggers and may see increased behavioral problems in their school communities.
- Once school leadership is on board, ask for a safe and confidential office space to use while you are meeting with students. Be flexible, if your school cannot dedicate an office just for your services, find a way to create a schedule to share an office with others. One of the best purchases I made was a rolling suitcase and/or craft bag. These bags allowed me to transport a noise machine, games, art supplies, workbooks, my sensory kit, and other EMDR Therapy Aids. It’s an office on wheels.
- Understand the differences between FERPA and HIPAA. This will help you facilitate discussions between you and other school staff without violating confidentiality. Have your release of information ready. When discussing a client with others, only disclose what is necessary to help your students be successful in school and for transitioning to and from therapy and back to class.
- Pay attention to how your students transition best to school activities after therapy sessions. Some students will need to be seen before school starts. Others might need to be seen right before math class, to have numbers help bring their prefrontal cortex back online. Others will need to return to gym class or recess to have time to get the wiggles out and some might need to eat lunch with you, because this is a safe break from peer interactions. Prepare a plan and stick to it. Don’t give up when your plan is interrupted, instead stay creative and flexible and have plans B, C, & D.
- Don’t forget Resource Development and Installation and Eye Movement Desensitization (EMD). When you have limited amounts of time to work with your client. You can use EMD to desensitize and stabilize a trigger when time is short. Use RDI to help increase your student’s mastery to prepare for upcoming standardized testing, a peer interaction, or asking for help (see my other post on “What is the AIP”).
- Be prepared to respond to traumatic events that impact your school community. I recommend being trained in one or more of the EMDR Early Group Interventions. This will help you provide prevention and early intervention services to aid in jumpstarting the AIP and to help the brain and increase resiliency in your school community. Be a resource to your clients, but also to your school and your students’ families. You bring a lot to the table, use it.
For more information on how to implement EMDR Therapy in School Based and Day Treatment Settings please click the “Get in Touch” tab.