​We are totally getting to that point in the summer where it is vay-cay time!  
 
A sunny day, new work schedule for teens, and the family vacation or three leaves those open spots and cancellations in your week.  I mean - awesome for paperwork, side projects, and organization right? Or maybe some midday scrolling. Either or - no judgement here. 
 
And although sometimes we all need a little loosening up of our schedules, especially when the sun is shining - consistency is key for client retention and engagement. 
 
During an intake recently I asked a family why they stopped seeing a past therapist.  There was the blank stare, the “umm...well...I’m not so sure”.  It was a classic story of one week off for a dance competition, the therapist taking an extended vacation, and then the client had an annual trip out of town and...well...they just never rescheduled. 
 
It wasn’t that they weren’t in need of support.  They just weren’t able to re-engage.  There were too many barriers. And we all have those clients.  The ones that just sort of...disappear in the summer. 
 
I am definitely in favor of placing responsibility for client scheduling on the client, or well, parents if you see children.  Annnnnd at the same time one of the most vulnerable and brave things a client can do is pick up the phone to make an intake appointment, and then to keep showing up.

After a period of a couple missed sessions, sometimes the thought of re-engaging can be exhausting and they pop back into survival mode.  Therapy appointments get shuffled into the pack of other appointments, engagements, trips, and homework.  It’s not until things get pretty severe that there is a fire lit under families to make a call to re-engage.  Sometimes it is months or more than a year. 
 
Other times they might not think you as the therapist are committed to them.  And as we all know, the number one factor for therapeutic change is the relationship and connection you have with a client and their family.  
 
Why does this all matter?  Well firstly it is definitely good client care (and ethical) to do your best to engage a client in a way that is consistent. At the end of the day when they actually engage in therapy they can work towards their goals and mental wellness.  To simplify - meeting goals allows them to live life as the best version of themselves.  
 
So where does this leave us?  You definitely aren’t going to re-schedule that vacation you have been dreaming about forever and that dance competition is still going to be there.  So what now?
 
Well...this might mean that you consider vacation time that doesn't consistently cancel the same clients over and over OR you offer them alternative spots within the week before or after to keep consistency.  
 
One of my favorite strategies is the recurring appointment where they have their same time/day spot weekly or every other week.  That way they know you will be there for them after business gets back to usual.  If they don’t have an appointment scheduled or have cancelled a couple in a row an engagement call can help to show clients that you are committed to continuing their therapeutic work.   
 
Lastly, acknowledging the elephant in the room goes a long way.  Letting your client know that you are sorry that you are cancelling knowing that you missed a couple of other appointments.  This could even mean creating a support plan for when you are out of the office, which might include crisis resources, therapy activities, or other family bonding activities to engage in during the “off time”.  
 
All of this can go a long way to help clients engage in the hard work of therapy and foster the relationship and connection while at the same time juggling life! 
 
And if you are looking for more support around scheduling check out this course HERE designed specifically for therapists working with children! 
 
What about you?  What are your best engagement strategies for the summer lull?  Drop a comment below! 

Trauma is complex.  The treatment of trauma is complex. 
 
And, the treatment of trauma is definitely something you do not become competent in by taking one day long course or reading one text book, although that is a fantastic start!  

Most often the key ingredients to ethically providing trauma treatment, especially with young people, is extensive training, supervision/consultation, and practice. 
 
And after sitting down and doing the hard work to get trained...well...sometimes it takes a while for all this knowledge to digest and integrate into your practice.  Sometimes you can get out of an intensive training and although you have the binder and know the steps it can feel pretty overwhelming. Sometimes you feel paralyzed and don’t know how to exactly put it all into action. 
 
More often than not it takes learning the theory, modality, or technique from several different people in several different ways for us to really develop a deeper understanding.
 
This can be the way you hear it from your trainer, how it is talked about in a consultation group, or reading an article, text, or book about the topic.  It can also be hearing the information on a podcast, taking in a blog, or watching a YouTube video - all with vetted sources of course! 
 
Each of these pieces gives us a clearer and more comprehensive picture about what are the most effective ways to treat trauma, the neuroscience behind it all, and how to handle all the stumbling points and road blocks along the way. 
 
I am a huge fan of making sure you are taking in quality training for trauma and at the same time supplementing that with continued learning in other ways! Eye Movement Desensitization and Reprocessing (EMDR) is one of my most favorite ways to treat trauma, usually in combination with Child Centered Play Therapy and Cognitive Behavioral Play Therapy! 
 
I wanted to help you take some of the load off and drop my 9 favorite free resources that I love that have to do with all things EMDR and trauma! So, if you have a free moment between clients, in your car, at the gym...or wherever don’t wait to dive into these excellent resources!
 
Ana Gomez 
Ana M Gomez, MC, LPC is an amazing EMDR consultant, trainer, Play Therapist, and author specializing in working with kids with complex trauma and dissociation. She is also the founder of the Agate Institute. She has a wealth of free resources HERE and HERE including free story downloads and multiple VoC / SUDS scaling sheets! 
 
Dr. Jamie Marich 
Dr. Marich Ph.D., LPCC-S, LICDC-CS, REAT, RYT-500, RMT is an EMDR consultant and trainer for EMDRIA, author, and owner of the Institute for Creative Mindfulness. Her depth of knowledge and expertise is amazing and  HERE and HERE she has a ton of generous free resources such as EMDR demonstration videos, resources for dissociation and addiction, mindful living coping skills and so much more. You can also check out her blog HERE and YouTube channel HERE! 
 
Jackie Flynn 
Jackie Flynn MPA, EdS, LMHC, RPT is a EMDR consultant and trainer as well as a Play Therapist! She has so many invaluable resources on her website including free downloads for the 8 phases of EMDR HERE and she has a ton of amazing videos for EMDR and Play Therapy on her YouTube channel HERE! 
 
Kambria Evans 
Kambria Evans, LMFT and EMDR Consultant has an amazing YouTube channel called Zero Disturbance HERE that takes you through a review and amplification of many of the important topics in EMDR like how to explain EMDR to clients, how to treatment plan, and how to pick the right target.  She also has additional free resources HERE! 
 
Global Childhood EMDR Alliance 
The Global Childhood EMDR Alliance was formed in the midst of the COVID-19 pandemic to help support children with trauma globally. Check out the founding members HERE. They have many blogs and videos as well as resources for children  and adolescents. 
 
Notice That Podcast 
Jennifer Savage, LPC and Melissa Sundwall, LPC - both EMDR consultants and trainers along with Bridger Falkentien, PLPC teamed up to create an AMAZING podcast on EMDR and trauma called Notice That.   It is seriously like a refresher of basic training - it confirms the things you have learned along with deep dives into special topics.  And they break it down in a way that is digestible and relatable! They have even developed a separate podcast designed just for EMDR clients! 
 
Robyn Gobble 
Robyn Gobble, LMSW is a trauma therapist who specializes in helping support parents parenting children with trauma. She is EMDR certified and a Play Therapist!  Although not EMDR specific, her blog is FULL of amazing resources and insight on trauma, parenting, and attachment - check it out HERE! She also has a fantastic free video series on Trauma, Memories, and Behaviors and Regulation, Connection, and Felt Safety. She also has a ton of other free resources HERE!   These are excellent resources for you as a therapist as well as parents! And last but certainly not least she has a wonderful podcast called Parenting After Trauma.  
 
Justin Sunseri
Justin Sunseri, LMFT is a master in all things polyvagal theory.  This is one of my favorite ways to conceptualize and think about trauma. Justin has a podcast called Stuck Not Broken that does a deep dive into polyvagal theory! You can check out his blog HERE, free polyvagal theory worksheets and handouts HERE, and get a crash course in polyvagal theory HERE.
 
Irene Lyon 
Irene Lyon MSc is a nervous system specialist and somatic neuroplasticity expert. She is a wealth of information about the nervous system, trauma, and polyvagal theory!  You can check out her blog HERE and Youtube channel HERE! She also has a free resource center HERE! 
 
Facebook Groups 
 
Here are some Facebook groups that you might consider joining! 

• Play Therapy and EMDR Conversations 
• EMDR With Kids 
• Playful EMDR 
• Global Child EMDR Alliance 
• New Wave: Offering Online EMDR in a Safe and Ethical Way 
• EMDR Therapist Resources 

 
What about you?  What are your favorite free trauma resources? Share the love and drop a link below! 

Looking for something a little more? Check out my training on Playing Through Phase 2: Combining Bibliotherapy and Play Therapy for Phase 2 of EMDR. 

​Do you ever have a gloomy thought that just won’t seem to go away? The more you try to ignore it the bigger it gets. Just sitting there, hanging around, making you feel all yucky. 
 
It’s the uninvited guest that won’t leave. 
 
Those are the worst.  Cognitive Behavioral Theory would call these maladaptive or distorted thoughts.  Eye Movement Desensitization and Reprocessing (EMDR) would call these Negative Cognitions. 
 
Either way these thoughts are uncomfortable at best and deeply painful at the worst. 
 
In the book Catching Thoughts, Bonnie Clark uses the beautiful imagery of a black balloon to show just what it is like having these thoughts hang around. We go on a journey of all the ways that one might try to get rid of these thoughts like ignoring, running away, and getting mad and yelling at them. 
 
We find that when we can notice the thought and hold it at a distance we can then become aware of new thoughts, beautiful thoughts, and thoughts that are true and excellent. We learn that you can choose what thoughts to catch and can fill your life with beautiful color. 
 
This is truly a must have book for your bibliotherapy collection, especially if you do EMDR or Cognitive Behavioral Play Therapy (CBPT).  
 
One of the ways that I like to use this book is my free downloadable “What Thought Do You Choose” worksheet HERE!  The cool news is that you can use it as a companion to the book OR completely on its own. 
 
Here we have young people identify what thoughts are in their black balloon.  These are the thoughts they acknowledge mindfully as something that is going through their head, notice it, and then….let it go! 
 
In the colorful balloons they write the thoughts they would like to have about themselves OR the really good, beautiful, true, and excellent thoughts that they are having about themselves already that they want to really hold on to and sink deeper into. 
 
From here you can engage in a visualization of the black balloon drifting away and notice the thoughts, feelings, and sensations of holding the colorful balloons.  If you are trained in EMDR you can add bilateral stimulation to install this image as a resource.  
 
You can also get really creative and get some black balloons where you can put inside pieces of paper with the thoughts that you want to go away, blow it up, and have the child release the balloon.  You can then choose some colorful balloons and have the child write on the balloon the positive good thoughts.  They can notice how they feel in their bodies as they hold on to and say the positive words. 

So what about you?  Will you be catching thoughts in your practice?  If so, grab the FREE What Thought Do I Choose printable!
 
Is this a book you use in your practice?  If so drop a comment about the creative ways you play!

And...want to know more about trauma, EMDR, and children?  Check out my training on Playing Through Phase 2: Combining Bibliotherapy and Play Therapy for Phase 2 of EMDR. 

​You love EMDR and learned so much in your basic training! But...there was a lot packed into those intensive training days.  You probably have a binder or a manual, tons of handouts, and some practice under your belt. 
 
Maybe you are struggling to pull it all together and get a hang of the basic protocol whether it was two weeks or two years since your basic training.  Maybe you are even struggling to start with your first client. Or mayyyybe you are a pro at it and can do all 8 phases with your eyes closed...metaphorically of course! 
 
Either way, for a lot of clinicians, even ones who are really confident in carrying out the protocol with adults, doing this work with children seems overwhelming and maybe a bit scary. Or terrifying. 
 
I meet many clinicians who have an apprehension for diving into this work with children, even if they have been doing it consistently with adults.  AND it is so great to name that and acknowledge it, because if you are going into the session anxious, nervous, and not quite sure what to do - your clients will feel that.  It will be a neuroception of danger and they will be on high alert too. 

Not so great for trauma work. If they know you feel anxious, children might have a harder time staying in their window of tolerance. Bottom line - if you're not quite sure about it, they won’t be either. 
 
SO because of this and knowing how transformational EMDR can be for children, one of my most favorite things to do is to support clinicians in getting confident and prepared to engage in EMDR with children.  Getting a clear idea of just how to adapt the protocol to be developmentally friendly for children, so you can be confident to rock an excellent EMDR session!
 
If you're looking for resources to get you started I talk HERE about what you need to know about children and trauma work.  If you are wondering if young people are really ready for trauma work you can read more about that HERE! You can dive deeper into how to incorporate books and play into EMDR HERE.
 
But, if we start at the very beginning one of the first things we are doing with young people in Phase 2 is giving psychoeducation about EMDR.  There are definitely a lot of ways to do this and I find it is a balance between overwhelming clients with neuroscience vs. providing them enough information about how their body and brain stores trauma.  
 
I find that when young people can fully understand just what is happening in their bodies they are more likely to have a stronger buy-in for the EMDR process. BUT you don’t want to send them into an all out snooze fest where their eyes are glazing over.
 
The solution? Super fun metaphors and some video clips!  I like to talk about EMDR using the movie Inside Out.  This is a movie that is ripe with scenes that we can watch and apply to how our brain processes trauma and what we are setting out to do with EMDR. 

You want in? Swipe my script HERE for how I talk to young people about EMDR in an interactive way using the movie Inside Out! 

And...if you want to know more about trauma, EMDR, and children check out my training on Playing Through Phase 2: Combining Bibliotherapy and Play Therapy for Phase 2 of EMDR. 

EMDR is a type of trauma therapy developed by Francine Shapiro that has 8 phases, where a therapist trained through an EMDRIA approved basic training works through the model with clients to help with trauma memories that are disturbing, distressing, and impact functioning. Learn more about EMDR therapy and kids HERE! 
 
Phase 2 is the Preparation Phase.  This phase includes establishing a relationship of trust, giving an explanation that is age appropriate of EMDR, learning relaxation and state change activities, developing resources, and increasing the window of tolerance to allow for dual awareness. 
 
EMDRIA states that most clients will need 1-4 sessions of preparation, however for chronic and complex trauma this number can significantly increase. I talked HERE about how to know if young people are ready, really ready, for trauma work. I also talk HERE about the essential ingredients for doing EMDR with young people. 
 
I find that the majority of children that I see are not children who have a single incident trauma. Young people also aren’t voluntarily seeking out a therapist to work on their trauma, the majority of the time.  There are also a lot of factors in a child’s life that may lead to instability that they have no control over.   
 
For these reasons here are the top 10 reasons why children and teens may need a longer Phase 2 for EMDR Therapy: 

• May require more psychoeducation about trauma in general 
• Need a longer amount of time to develop a trusting relationship 
• Have a small window of tolerance that prevents dual awareness or leads to flooding 
• Are unable to engage in state change within session or outside of session 
• Have life situations that are destabilizing and chaotic 
• Absence of adaptive information in neural networks 
• Have low levels of emotional literacy 
• Are not able to understand or identify feelings or body sensations 
• Are unfamiliar with scaling such as SUDS and VOC 
• Need to develop resources 

 
Your training, clinical judgement, and consultation around EMDR cases will always help you understand how to pace your EMDR work with young people.  Hopefully some of the examples above help you understand if a client may need a longer phase 2! 
 
What about you? What are your top signals that a client may need an extended phase 2?  Drop a comment below! 

Want to know more about trauma, EMDR, and children?  Check out my training on Playing Through Phase 2: Combining Bibliotherapy and Play Therapy for Phase 2 of EMDR. ​

​EMDR and Play Therapy is a brilliant combination for healing trauma. 
 
Children and young people lack the abstract reasoning and verbal processing skills to engage in therapy that is primarily talk based. They also need therapy that is engaging and accesses all portals of learning: visual, auditory, and tactile and kinesthetic. 
 
And this last portal?  Well... it happens to be the primary portal of learning for children under 11, so it’s pretty dang important to incorporate touch, movement, and activities into EMDR.
 
So taking all of this into account having a child sit still and “notice that” isn’t going to get you that far. It will likely either lead to underaccessing, boredom, or flooding outside of the window of tolerance. Which is not a winning combination for trauma work.
 
Young people are already distressed knowing they are going to begin some form of trauma work.  They are smart.  Young people know that eventually they will get to the tough stuff.  
 
All of this can leave therapists trained in EMDR a little apprehensive to begin to do this work with children.  And I get it!  Most EMDR basic trainings have so much to fit in that training comprehensively to modify the EMDR approach for children isn’t something that is achievable. 
 
So it is understandable how many professionals exit the basic training and feel a bit overwhelmed by thinking about starting this work with young people. You can learn more about EMDR therapy and kids HERE and HERE! 

AND I always recommended extra training and consultation before starting. You can also check out these three books HERE, HERE, and HERE which are always on my list of recommendations for professionals starting EMDR work with children.  
 
Now when you get down to it and are ready to do this work with young people, my three favorite things to help with engagement and help young people access all three portals of learning are play, books, and games! 
 
Play
Play is an excellent way to help young people keep within their window of tolerance.  It also allows young people to communicate in a different way about their struggles, symptoms, and trauma and show you their world. 
 
Engaging in a type of play such as Child Centered Play Therapy can help gain insight into specific Negative and Positive cognitions a child may have relating to their trauma.  You might also get insight into specific resources that may be helpful or places there may be blocking beliefs.  
 
Ann Beckley-Forest and Annie Monoaco have a fantastic text on the integration of Play Therapy and EMDR that is a must read!  
 
Play also helps you gain rapport and trust with a young person.  Unlike adults, most young people don’t present themselves for therapy with high levels of engagement and motivation to work through trauma.  For this reason I believe children and teens may need a longer period of rapport building to increase trust before going into the depths of their trauma. This is especially true for complex trauma as opposed to a single incident trauma. 
 
Play therapy activities such as sand tray, drawing, or other creative activities are also essential for phases 3-8!  
 
Books 
I absolutely LOVE books.  Books can be used in phase 2 to help with tasks like increasing emotional literacy, emotional regulation, state change, adding adaptive information into appropriate neural networks, and normalizing an experience. 
 
The experience of watching a child as they are able to connect and identify with a book, see themselves in the characters, and the look of relief as they realize they are not the only one to have experienced something is truly amazing. Books are also externalizing and directive so they can be a safer activity to begin trauma work.  
 
Check out these resources HERE, HERE and HERE to help with emotional literacy and emotional regulation! This book HERE is also an excellent resource to help young people identify Negative Cognitions, Positive Cognitions, develop resources and to explain EMDR and trauma processing! It also happens to be one of my most favorite Bibliotherapy books! 
 
Games
Games are another essential to help engage in a strong phase 2, which sets you up for an excellent desensitization and reprocessing of trauma memories. It allows the young person to come in being an expert in identifying thoughts (to help with NCs and PCs), feelings and body sensations.  When you ask all the questions for phase 3 they will be ready!  
 
There are tons of Play Therapy games to help increase emotional literacy, identify cognitions, identify areas of resilience and strength, increase window of tolerance (especially practicing losing!), and practice scaling like you will need with the VoC and SUDS. 
 
Check out this article HERE on 3 ways that games with bubbles can help you provide psychoeducation about feelings, engage in state change, and identify thoughts. This game HERE of Strengths and Struggles can help young people identify strengths that are great for resourcing and identify struggles that may be incorporated into Negative Cognitions. 
 
These are my three ingredients that are essential for modifying the EMDR protocol for use with young people!  What about you?  What are your favorite activities? Comment below! 

Want to know more about trauma, EMDR, and children?  Check out my training on Playing Through Phase 2: Combining Bibliotherapy and Play Therapy for Phase 2 of EMDR. ​

Is he really ready for the trauma work? What if it gets worse? I don’t know if she can handle it. Is this the right time?
 
These are real fears that come up for us as therapists who work with trauma, especially when we consider the ethical principle of nonmaleficence or do no harm.

AND as trauma therapists we need to have some objectivity and identify whether the fear is due to the child actually not being ready or if the fear is our own. To piece this apart I wanted to share what goes into my decision making about child readiness for EMDR.
 
If we ground ourselves in the 8 phase model of Eye Movement Desensitization and Reprocessing (EMDR) the answers to the questions above will become clearer.  Specifically asking ourselves “Are the activities that we are doing with young people in Phase 2 Preparation Phase sufficient enough and is the environment stable enough to warrant moving on into working with trauma memories?”
 
To answer that question we need to look at the work of Dr. Francine Shapiro, the originator and developer of EMDR who gives clear identifications of the factors for readiness for EMDR.  Kathleen M. Martin LICSW also developed an amazing Readiness Checklist for Phase 4 of EMDR that I use as an invaluable resource.* 
 
So, first we are looking for a strong therapeutic alliance where young people feel safe enough to be honest and truthful about the EMDR process. For young people who are typically not voluntarily signing up to do trauma work (as adults are) and are brought in by a parent, it may take a longer period of time to build the therapeutic alliance. 
 
Next we consider if we as therapists have a thorough enough history of the presenting problem, negative cognitions, and themes.  We need to have a clear understanding of the order of progression through the trauma targets and also identify if there are any secondary gains that need to be identified and addressed. 
 
As Play Therapists we can gather rich information and data from non directive forms of Play Therapy such as Child Centered Play Therapy.  By understanding themes in the play we can develop hypotheses about how these themes relate to their Negative Cognitions for EMDR work. 
 
Next we look at stability, which is so essential to consider for young people. Young people may be going back into a significantly chaotic, traumatic, or abusive home environment which may not be supportive of trauma work.

Or there may be other environmental factors that would indicate putting a pause on trauma desensitization and reprocessing work such as a teen just breaking up with a partner, a child losing a family member, parents announcing a divorce, a large test coming up, or any other sort of destabilization or stressful events that would be negatively impacted if the child were dysregulated from trauma reprocessing. 
 
Also consider other timing issues such as therapist or client vacation or extended periods of absence.  We want to make sure that we are available to our clients during Phase 4 of EMDR and there are not going to be any extended periods where a client does not have access to their therapist. Another issue to consider is if a  client has difficulty with consistent attendance.  This is one of my big factors for beginning trauma work with children, because if they are missing 1-2 or more sessions per month our trauma processing will not be consistent.
 
We also want to screen for dissociation unless you are specifically trained and have received consultation in working with EMDR and dissociation.  My go to screenings are the Adolescent Dissociative Experiences Scale-II and the Child Dissociative Checklist - Version 3, which is a parent report for younger children. 
 
So if all of those factors are met then we look at the activities we are doing with clients in sessions.  First we need to make sure that young people have an age appropriate idea of what EMDR is.  We also need to make sure that young people have all their questions answered about what EMDR might be like. 

Oftentimes parents get the longer more in depth explanation and younger people can have a shorter and simpler explanation or a metaphor.  We also want to make sure parents have a clear understanding of what symptoms may be like after reprocessing and how to support their child after a trauma session. 
 
There also needs to be some familiarity with the materials and types of scaling questions that will be used in Phases 3-6.  For example we don’t want the first time a child uses the sand tray to be the first time they enter Phase 4.  This new type of material or activity can actually create a neuroception of danger which is contraindicated for starting Phase 4.  We also want young people to have ample time to experiment with different kinds of Bilateral Stimulation (BLS) to get used to what type feels best for them. 
 
During the preparation phase we also want to make sure we are playing games and engaging in activities that label feelings, increase emotional literacy, use scaling, and help identify body sensations. If young people are not able to stay within their window of tolerance, have dual awareness of the past and present, or cannot engage in state change from dysregulated to regulated (both in and out of session) then more preparation phase work is needed. 
 
We need to make sure that young people have access to feelings (not over accessing or repressing), can label them, can identify the level of feeling, and can connect to their body sensations before moving forward. 
 
Again, if you are nodding and all of this looks good and seems right then it is likely that a child is ready to enter Phases 3-8 of EMDR. You know your client best and ensuring factors for readiness are met, reliance on your training, and using your clinical judgement is key to make the official decision. 
 
If you are still unsure then you can start with an easier or “softer” target to see how young people handle the BLS and reprocessing.  This may be a milder trauma target or a present day trigger.      

Want to know more about trauma, EMDR, and children?  Check out my training on Playing Through Phase 2: Combining Bibliotherapy and Play Therapy for Phase 2 of EMDR. ​

What else do you look for as a "green light" for trauma work?  Drop a comment below! 


*If you google this description you can easily find the Readiness Checklist for Phase 4 of EMDR sheet Kathleen M. Martin LICSW also developed.  It is not hosted on a website and clicking on the link lets you automatically download the word document. 

​Combining Eye Movement Desensitization and Reprocessing (EMDR) and Play Therapy is one of my most favorite ways to work with young people! 
 
If you don’t know about EMDR, it is an 8 phase model of therapy for the treatment of trauma developed by Dr. Francine Shapiro.  As an EMDRIA Approved Consultant I love to talk with other therapists about how engage children in trauma work combining EMDR and Play Therapy techniques to make EMDR for children developmentally appropriate. 
 
I wanted to share the top 5 things you need to know about working with children, trauma and EMDR if you are thinking about getting trained in EMDR, or are already trained but aren’t quite sure where to start. 
 
EMDR Treats Trauma 
​
EMDR is based on the theory of Adaptive Information Processing (AIP) which asserts that psychopathology is due to memory processes of maladaptive encoding and/or incomplete processing of life experiences that are traumatic, disturbing, or adverse.

This freezes the trauma in a state-specific form (with all the sights, sounds, tastes, smells, physiological reactions, and body sensations) in its own neural network, which makes it unable to connect with other memory networks that hold adaptive information.
 
So, for example, when someone who is the victim of a dog bite comes into contact with a dog (a very lovely safe dog), they are not able to have an understanding (linking to adaptive information) that they have met a TON of safe and loveable dogs and only one dangerous one. 

Instead the frozen, maladaptively encoded, and incompletely processed neural network of the trauma is activated by the trigger of seeing a dog in the here and now and now all dogs seem extremely dangerous and the body begins to have a trauma response. 
 
When someone is triggered, the past (frozen neural network) becomes present. This maladaptive encoding and/or incomplete processing impacts one's ability to integrate the experiences in an adaptive manner. The very real threat of the dog in the past feels and experienced the exact same way in the present. 
 
Through the 8 phase model of EMDR a three pronged approach is used to target the past, present, and future.
 
EMDR facilitates the resumption of normal information processing and integration by desensitizing the trauma and reprocessing the trauma memory to link up the frozen neural networks to networks that hold adaptive information. 
 
SO COOL. If you are curious about EMDR you can learn more it HERE! 
 
EMDR treats “small t traumas” 
 
When I was a bitty baby therapist and first started out in the field I heard the notion that most kids that present for therapy have some form of trauma, annnnd I couldn’t quite wrap my head around it.  
 
The majority of my intakes weren’t endorsing events like major car crashes, domestic violence, traumatic weather events, or physical or sexual abuse.  At the same time I want to take great care to express that there are many things that clients don’t disclose, for many reasons, at intake that are happening in their lives or have happened. 
 
And in my practice today? It is very rare that someone comes into my office that doesn’t have some form of trauma.  
 
Wait…. Did I get a whole new caseload? Start working at a wildly different practice?
 
Nope!
 
My definition of trauma changed as I learned more about the neuroscience of trauma and theories such as Adaptive Information Processing. As I have used the powers of Play Therapy and EMDR to treat a wide range of traumatic events I have seen the transformational change reprocessing and integrating stuck and unprocessed memories has on functioning and level of symptoms. 
 
When we can stop chasing behavior and get to the root of the difficulties (ie a likely memory stuck and frozen in the neural network getting triggered by something in the present, causing the past to be present) the behaviors are no longer necessary. 

This is because the trauma doesn’t feel like it is happening in the here and now when a child is faced with a trauma trigger. When we think about current behaviors as adaptive given how the body is remembering and experiencing the trauma when triggered - the behaviors make sense. 

And it makes even more sense knowing that some trauma memories can trigger implicit memories (ie a "felt sense", somatic, or emotion memory) not just explicit (ie the things we consciously remember - pictures, sounds, tastes, etc.).   This means that young people may FEEL a certain way (triggered, scared, unsafe, angry, sad, etc.) but aren't able to consciously connect it to a past trauma or trauma trigger.  
 
Trauma comes in all forms, and Dr. Shapiro differentiates big “T” trauma from small “t” trauma.  She notes that Big “T” Trauma includes events that caused actual or threatened injury or sexual violation.  Shapiro states that Small “t” Trauma are events that are emotionally distressing. 

She states that both Big “T” and Small “t” Trauma can both have comparable long lasting negative effects and can become the basis of current dysfunctional reactions or mental health difficulties. 
 
So, through training and experience I have witnessed the painful long term effects of events such as bullying, becoming ill when separated from a parent, parents minimizing, yelling, or name calling.  
 
And, I see the transformation that can happen once these memories are linked with the neural networks that hold adaptive information. So given this information - if you see kids there are definitely a wide variety of young people that will walk in your door with both big “T” trauma and small “t” trauma that can benefit greatly from this approach! 
 
EMDR needs to be done by a therapist fully trained in EMDR 

Hopefully this one is  given but I wanted to detail out what the process is for being fully trained in EMDR. EMDR International Association (EMDRIA) has outlined the criteria for someone to be fully trained in EMDR.  Usually this training is 40 hours long as well as 10 consultation hours on your use of EMDR with clients. 
 
There are some programs out there that will do an introduction EMDR program in a day, books that you can get, or other ways that you can become familiar with EMDR.  However, I truly believe that being trained fully by an EMDRIA accredited program is not only a good idea but also ethical and necessary! 
 
So you are either one of two people - you know all about EMDR and are fully trained and totally are picking up what I am putting down OR you know a little bit about EMDR or maybe nothing at all.  If the latter is you, you can check out how and where to take this amazing training HERE! 
 
Annnd if children are a large part of the population you see there are trainers that specialize more in working with children, so seeking out someone with this expertise for your initial training could be something to consider!
 
Children benefit from EMDR 

I can’t tell you how many professionals I run into that were fully trained in EMDR with little to no training on how to adapt the protocol to use in their work with children.  And I get it, there is SO much information to cover about trauma, AIP, and the EMDR protocol that when you put in some demonstrations, time for practice, and trying to highlight special topics there is not much time left for anything else. 
 
BUT  because of this some draw the conclusion that it can’t really be done with children. OR it feels really cumbersome and complicated to translate the 8 phases into something that doesn’t feel too scary, overwhelming, or inappropriate developmentally for a young person. 
 
So here is why I think it is absolutely necessary to do EMDR work with children (who are a good fit of course)- first looking at the neuroscience of trauma! 

Neural circuits that are used over and over are strengthened.  The saying “neurons that fire together wire together” by Donald Hebb is absolutely true.  It is also a “use it or lose it” kind of thing.  So - neural circuits that are not used are dropped or pruned.  
 
There are two waves of branching and connecting that are followed by a reduction and pruning - ages birth through three and ages 11/12 years old. So what this means is trauma that occurs in childhood can actually hardwire in a fight/flight/freeze trauma response rather than wiring for prosocial connection and engagement. 
 
If we can heal trauma before these crucial periods of neural cropping it sets children's brains up for success in their later teens and adult life. 

AND because children have less dense neural networks (ie less memories, experiences, connections) they actually process faster than adults! 
 
Furthermore research has found that EMDR can be used effectively with children four years old and up to treat trauma symptoms. And apart from the pages in a research journal I have seen this firsthand, and it is AMAZING!  
 
Kids can get it, they can engage, and they can do this hard work! 
 
EMDR must be adapted to use with children 
 
Most children need minor to significant adaptations to the standard protocol to be able to work through the 8 phases of the protocol.  And typically the younger the child the more adaptations may be needed. And, to be honest if you ask a 5 year old to focus on any one thing while just sitting still you are not likely to be successful, especially with trauma work.
 
EMDR and trauma work with children can be fun, engaging, and done with cooperation and willingness.  Usually this means games, sand tray, combining with Play Therapy, bibliotherapy, or any number of different interactive activities.  
 
EMDR with children also means shifting how we administer Bilateral Simulation (BLS) to make it fun and engaging and being more visual with how to scale SUDS and VoC.  It also means having a longer Phase 2 Preparation to get young people used to the materials they will be using and tasks they need to engage in during the desensitization and reprocessing phases. 
 
Now, your question might be - what next?  How do I get started?  I always suggest getting extra training from an EMDRIA CE provider who works with children as well as seeking out consultation with someone who specializes in working with kids. 
 
I also wanted to share my three favorite books to help you start to begin to put it all together!  The first is from Ana Gomez - EMDR Therapy and Adjunct Approaches with Children: Complex Trauma, Attachment, and Dissociation. Ana takes you through step by step with the specific activities, games, and techniques she uses within the 8 phase model.
 
Next is the book EMDR With Children in the Playroom: An Integrated Approach by Ann Beckley-Forest and Annie Monaco. This book does an excellent job of how to integrate EMDR with a prescriptive Play Therapy approach and use bilateral stimulation within Play Therapy.  
 
Lastly is Small Wonders: Healing Childhood Trauma with EMDR by Dr. Joan Lovett. Dr. Lovett applies a storytelling modeling of EMDR for work with younger children.  

Want to know more about trauma, EMDR, and children?  Check out my training on Playing Through Phase 2: Combining Bibliotherapy and Play Therapy for Phase 2 of EMDR. 

 
Now what about you?  If you are EMDR trained and work with children what do YOU want therapists to know? If you are thinking about getting trained in EMDR what questions do you have?  Leave a comment below! 

Have you ever had a client walk into session, SO EXCITED, holding one of their prized possessions from home?  They have been thinking about your session for DAYS and even put their toy right by the door so they wouldn’t forget it before they left! 
 
Well...if that has never happened to you in office it has most definitely happened to you while doing Tele-Play!  I mean, for most kids (even if they have a Play Therapy Kit) they definitely want to use their toys too during play.
 
So...um...how do we approach this? Does using toys from home in Play Therapy matter either way? 
 
Well...the answer to this, as with most things, is - it depends! 
 
Let’s start with theory.  Depending on what theory you are working from might hold a lot of clues to how to approach this.  If your theory states that the therapist will be selecting all the toys and deciding how they will be played with then there might be some more rules or restrictions. OR if theory only restricts to certain specific toys and activities then let theory lead the way! 
 
If we look at Child Centered Play Therapy, Dr. Garry Landreth’s text Play Therapy and the Art of the Relationship has one general rule, which is only allowing items in the playroom that you would normally select for the playroom. 
 
Not so sure what that means?  This article HERE from the University of North Texas does an excellent job of spelling out criteria for selecting toys and materials, highlighting the three categories of toys, and giving a sample list of a fully equipped playroom. 
 
So long story short - the dinosaur, baby doll, race car, or lego ship are totally invited in to play.  The Xbox or DS? Not so much. 
 
My take on this is that if children think about, in advance, their time with you and are planning out what they specifically want to do, whatever they bring has special meaning, purpose, and intention. AND could it be that that they have a special theme they want to express that they aren’t sure you have a toy that would exactly cover it?  
 
Because of this rarely do I not allow a child to bring into the Playroom and engage with a toy they have brought from home.
 
I usually say something like “I see you brought something special from home”.  Then they usually tell me what it is and what they would like to do with it.  
 
From there I set some structure and say something along the lines of “Well I want you to know that what you bring in with you must leave with you today! Your dinosaur would be pretty lonely if he had to hang out with me for the rest of the week until I see you next!”  
 
This statement can be especially important if a client brings in a toy that is similar to yours (ie a lego character or miniature) to really make sure that they are leaving with all of their belongings.  I have also had young people bring in the EXACT same miniature of something I have!  It gets a little trickier from there - but OH what a treasure trove of potential themes! 
 
Now one of the things I appreciate about toys from home when doing in office therapy is the space that is naturally created and distance from the play theme as the client leaves the office.  They stop playing, gather their things, head to the waiting room, take the elevator down to the parking area (at least in my office!) and have a car ride home before the toy can be really played with again.
 
This creates some distance and safety from the play themes they have been working through in your office.  The danger with toys from home in Tele-Play Therapy is that the camera will shut off, the client will continue playing out the play theme without the support and containment of the therapy process AND someone will walk in. 
 
Maybe it’s a brother that completely takes over the storyline of the play.  Or maybe a sister teases and makes fun of the toys or story.   Maybe it is a parent who is frustrated if there is a mess, they didn’t do their homework, or the way they are playing with the toys.  
 
Here lies the danger that these dynamics are going to come in and affect a play theme and the processing that has just been done.  SO because of this I am a HUGE fan of creating a bin of toys that the client only plays with during Play Therapy sessions and then returns to the bin together at the end of the session creating containment (either the client or parent). 
 
However, there are some young people that can’t afford or do not agree to having a separate toy bin.  For these clients I also think there is some benefit from creating an intentional clean up time and space from the toys for at least a little bit.  Maybe to get a snack, maybe play outside for a bit, or play with some other toys before coming back to the toys used during therapy. 
 
What about you? What does your theory say about toys from home?  Drop a comment below!

Everyone needs a rainbow! Even on a cloudy or gloomy day we can always cultivate a rainbow from within.  

The metaphor of a rainbow is so powerful – the bright beautiful colors after the storm. Hope, healing, acceptance. Sometimes it can be a symbol of better things to come.  You know, somewhere over the rainbow! Oh, and don’t most rainbows have a pot of gold at the end?

So considering all of this pairing rainbows, breathing, and mindfulness seems like a winning combination!

I want to share three ways to use rainbows for mindfulness and deep breaths!  The awesome thing about these activities is that they all have printables that you can use for directive play therapy in office OR email to clients if you are doing Tele-Play!

 Rainbow Bubble Breathing
This breathing exercise is fantastic for smaller children or those new to deep breathing.  One large bubble is used to symbolize a deep breath in and two smaller to symbolize slower smaller breaths…for all the colors of the rainbow! Grab the free download from the Branch Habitat Blog!

Rainbow Meditation
Dawn Selander shares her printable for her rainbow meditation for kids!  She has a characteristic that goes with each color (red = physical, orange = emotional, yellow = personal, etc.) and provides a meditation script that goes through the entire rainbow.  The concepts and language are great from preschoolers up to teens!

Rainbow Breath
This printable from Monkinya has children trace and breathe in a color and breathe out worry for all colors of the rainbow.  This is an excellent activity for Cognitive Behavioral Play Therapy where you are shifting cognitions, putting the difficult thoughts out of your mind, and being intentional about what thoughts occupy your brain! 

So there you have it! Three ways to use rainbow breathing in your therapy practice!

What about you?  Do you have any rainbow techniques that you like to use in your practice with children? Drop a link or comment below! 

Looking for more resources for regulation? Check out my training on Keep Calm and Regulate On: Play Therapy and the Neuroscience of Emotional Regulation! ​