3/27/2018 Attachment-Focused EMDR for Complex Trauma Building on the Standard Protocol: an Audit of Reflective Practice Mark Brayne EMDR Europe Accred Consultant / Parnell Institute Facilitator London March 2018 Powered by Arthur Schopenhauer 1818 „Der Wahrheit ist allerzeit nur ein kurzes Siegesfest beschieden zwischen den beiden langen Zeiträumen, wo sie als Paradox verdammt und als Trivial gering geschätzt wird.“ Incorrectly if widely known as: ‘All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self- evident.’ Powered by 1
3/27/2018 The Agenda • Parnell’s AF-EMDR model has caused controversy and confusion, at times both (mis)presented and (mis)understood as a significant deviation from the 8-phase/3-prong EMDR Standard Protocol. • Collaborative case for welcoming this approach as complementary to/an enhancement of Standard- Protocol-Based/Researched/AIP-Model-Compliant EMDR Therapy. • Esp in light of ICD-11 – complex trauma. SP “insufficient”. Powered by Disclaimer 1 • Laurel Parnell Facilitator/Trainer for post-basic AF-EMDR • Therefore commercial interest – though minimal profit… Powered by 2
3/27/2018 Disclaimer 2 Powered by Powered by 3
3/27/2018 Background • Proposal for this presentation early 2017 – (3 rd go!) • Helpful Derek: “Pity no research.” Careful what you ask for… • So, three-pronged research protocol: – Qualitative interviews with 8 AF-EDMR-trained Consultants. Worcester Uni ethical approval – Survey Monkey with 87 Therapist responses. (Two collectors: own EMDRF list of 430 + JISCmail). – 49 of own clients past and present (of 164 invited). Powered by History!! Powered by 4
3/27/2018 Powered by Powered by 5
3/27/2018 It’s Serious…. • Jan 2017 Accred Cttee: “Credits will be awarded only to EMDR workshops with fidelity to Francine Shapiro’s latest definition of EMDR. In view of this we are unable to award CPD credits.” • CPD points application for Parnell workshops Jan 2017. • Jiscmail comment: “Not EMDR as we know it.” Powered by What is EMDR? Standard Procedural Steps The EMDR Therapy Protocol involves: 1. Accessing a distressing memory that generates a presently held level of disturbance: image, cognitions (beliefs), emotions and body sensations 2. Stimulating this disturbing memory bilaterally using Dual Attention 3. Moving the memory – physically, in regard to subjective disturbance, and psychologically in terms of Av.ing This is done in regard to eight distinct phases, considering the triadic elements of Past – Present – Future. All the rest is detail. D. Farrell, 2017 Powered by 6
3/27/2018 Standard Protocol/8 Phases/3 Prongs Powered by With AA – Added Attachment…. Powered by 7
3/27/2018 Parnell’s 5 Main AF-EMDR Principles 1. Foster client safety 2. Develop and nurture the therapeutic relationship to facilitate healing 3. Use client-centred approach 4. DAS (“Create reparative neuro-networks through the use of Resource Tapping”) 5. Use modified EMDR whenever client needs require Powered by Five Main AF-EMDR Themes 1. Resourcing 2. Target Selection 3. Phase Three Modified 4. BLS/DAS - Tapping 5. Interweaves/structure Powered by 8
3/27/2018 1 - Resourcing SP AF-EMDR Powered by 2 - Target Selection (Float/Affect/Bridge) Powered by 9
3/27/2018 3 – Standard vs Modified Protocol R/L • Event • Event R/L • Image R R • Image • NC L R • Emotion • PC (same domain L R etc) • Body • VoC (1-7) L • Thought/Belief • Emotion R (about self) L/R • SUDs (0-10) L • (SUDs) optional L/R • Body R Powered by BLS / DAS Powered by 10
3/27/2018 Other Forms of BLS Powered by Session Structure (bridging/“petalling..”) 3 2 4 1 5 7 6 Future Template Present Trigger First Association Touchstone+Channels Powered by 11
3/27/2018 It’s a Kind of Magic! (and very transpersonal) Powered by So, Research….. Three Prongs • Survey Monkey Therapists 1. EMDR Focus mailing list (400+, of whom ≃ 250 personally Parnelll-trained) 2. JISCMail (1000+) and Blog ( 87 returns) 3. Survey Monkey Own Clients (2007- present) • 164 BCC-ed invitation • 49 returns • Qualitative w/ Consultants – Semi-structured IVs – Uni Worcs ethics Powered by 12
3/27/2018 Prong 1 –Survey Monkey Therapist Qs • Core training in mental health? • Year completed basic EMDR training (Part 3/4) • Level of training and experience in EMDR • For what share of your client/patient work do you use EMDR? • Level of training in Dr Laurel Parnell’s approach to AF-EMDR • For what share of that EMDR work do you use AF-EMDR tools • In particular, how regularly do you tap in nurturing, protector and wise figures in Phase 2? • How regularly do you use proactive Bridging to identify attachment-related targets To what extent do you use the Modified vs the Standard Protocol • • What form of BLS do you mostly use in Phase 4? • To what extent do you use proactive, imaginal, and where useful rescue interweaves in Phase Four • What percentage of the time do you complete a session with tapping in a positive outcome • To what extent in your EMDR practice and supervision do you experience Dr Parnell’s Modified Protocol/AF-EMDR as in conflict with the Standard Protocol. • What difference has knowledge/use of Dr Parnell’s AF-EMDR/Modified Protocol approach made to your practice of EMDR? What are your views on the implications of AF-EMDR, including the Modified Protocol, for • the practice, learning and teaching of EMDR Therapy? Powered by Core training in mental health – of 87 Occupational Therapy 1 Family therapy 1 Psychiatry 3 Nursing/NHS 11 Counselling 15 Psychology 22 Psychotherapy 34 0 5 10 15 20 25 30 35 40 Powered by 13
3/27/2018 Level of training and experience in EMDR + Year completed basic training Year Finished Basic Total 2015-2018 19 At least Part 3 35 2010-2014 40 Accredited Practitioner 34 2005-2009 18 Accredited Consultant 17 2000-2005 5 Accred Trainer 1 Late 90s 3 0 10 20 30 40 50 0 10 20 30 40 Powered by Highest Level of Training in Laurel Parnell’s approach to AF-EMDR Not AF-EMDR 4 trained Books/Spvn 26 3-days 26 2-days 29 0 10 20 30 40 Powered by 14
3/27/2018 For what share of your client/patient work do you use EMDR / AF-EMDR tools? EMDR share Of which AF-EMDR share 120 % 120 100 100 80 80 Median 70% Median 68% 60 60 40 40 20 20 0 0 0 20 40 60 80 100 0 20 40 60 80 100 Powered by In particular, how regularly do you tap in nurturing, protector and wise figures in Phase 2 / Use Bridging for target identification? Resource Team Bridging 120 120 % 100 100 80 80 Median 72% Median 70% 60 60 40 40 20 20 0 0 0 20 40 60 80 100 0 20 40 60 80 100 Powered by 15
3/27/2018 Attachment /Resourcing/Interweaves • “There is real magic in using the creative interweaves and resource figures that has made huge a difference with some clients” • “Installing wise, nurturing and protective figures has been a game changer. Has enabled me to use EMDR with more complex clients” • “I offer a person, animal or magic power (or all of the above). My client today chose Solomon the owl from the Sara and Solomon books, to deal with DV witnessed as a child. Solomon immediately told her it was not her fault! I could not do effective EMDR without this resourcing.” Powered by Modified vs Standard Protocol in Phase 3 + proactive/imaginal interweaves MP vs SP Creative interweaves 120 120 100 100 80 Median 70% Median 67% 80 60 60 40 40 20 20 0 0 0 20 40 60 80 100 0 20 40 60 80 100 Powered by 16
3/27/2018 Comments 4 – Modified Protocol Assessment Phase 3 • “I am 100% fan of AF-EMDR and only use the standard protocol now if I purposefully want the client to move between right and left brain.” • “I have always struggled with NCs and PCs - always felt I was moving the client into a different part of the brain.” • “I used to spend a significant part of assessments struggling with domains and effectively diverting my clients from the experience into intellectualising and often leaving myself feeling incompetent or deskilled as a result.” • “Trying to elicit SUDs for a negative cognition and a PC/SUDs is often just too difficult for the client and can generate thoughts and feelings that they are getting it wrong, not good enough or stupid; which invariably feeds straight into their negative thoughts about themselves.” Powered by What form of BLS mostly use? Top 3 choices Tappers (buzzers held in hand or under thighs etc) 27 31% 17 20% 9 10% Eye Movements using Arm 24 28% 17 20% 12 14% Tappers/headphones together 10 11% 2 2% 8 9% Eye Movements using Light Bar or Other Equipment 9 10% 12 14% 10 11% Headphones (with tone generator or smartphone app) 6 7% 8 9% 4 5% Hand taps on side of knee 5 6% 10 11% 14 16% Other 4 5% 4 5% 2 2% Hand taps on top of knee 1 1% 8 9% 16 18% Hand taps on back of client's hands 1 1% 9 10% 12 14% Powered by 17
Recommend
More recommend
