Why Clinicians Stop Using EMDR (And How EMDR Consultation Helps)
Therapists that complete EMDR Basic Training and their first 10 hours of EMDR Consultation expect to integrate it into their clinical work right away. Yet, within a short time they find themselves using EMDR less often, sessions begin to feel unclear or confusing, and they start to revert back to other therapies they are more familiar with.
This does not mean EMDR therapy doesn’t work or is ineffective. Instead, it reflects a gap between learning the EMDR protocol and applying it in clinical practice.
Understanding this gap is important for clinicians seeking to complete EMDRIA consultation hours and build confidence using EMDR with their clients. Many clinicians at this stage begin searching for EMDR consultation to overcome stuck points in their clinical work.
The Gap Between EMDR Training and Clinical Practice
EMDR training introduces clinicians to the eight-phase protocol and the adaptive information processing (AIP) model. However, real clinical work often presents challenges that are not fully addressed during training. Many trainings will go as far as to point out that the learning takes place in an artificial setting–you’re not working with real clients when you practice with colleagues.
In training, cases are contained, the script and structure are reinforced, and guidance is immediately available. In clinical practice, therapists are on their own and therapists can immediately feel unprepared. Therapists are working within time constraints, managing multiple treatment demands, and responding to clients whose presentations are often more complex than those encountered in training settings.
The result is not a loss of knowledge, but a change in context. What felt clear in training can begin to feel less structured or incomplete in practice, particularly when cases involve multiple trauma experiences, dissociation, or competing treatment priorities. This is when, many clinicians begin to recognize that knowing the protocol and applying it effectively are not the same skill.
Why EMDR Sessions Start to Feel Unclear
When EMDR is first introduced, it often feels structured and contained. The model seems to make sense intuitively. Over time, however, clinicians may begin to experience sessions as less predictable.
Uncertainty often emerges around case conceptualization, target selection, and how to respond when sessions do not progress as expected. Clinicians may begin to question whether reprocessing is working, whether they are choosing the right targets, or whether they are applying the protocol correctly.
This does not reflect a failure of the model. It reflects the increasing complexity of real clinical work. Without a framework for navigating that complexity, EMDR can begin to feel less reliable, even when the underlying model remains sound.
The Challenge of Target Selection in EMDR
In practice, clients rarely present with a single, clearly defined traumatic memory. More often, clinicians are working with networks of experiences that include multiple events, associated beliefs, and patterns of emotional response.
As these complicated networks become more apparent, the question of prioritization becomes less straightforward. Clinicians sometimes find themselves moving between targets without a clear sense of progression or resolution. Over time, this can create a sense that sessions are active but not necessarily moving toward a defined outcome.
This is often the point at which clinicians begin to feel “stuck.” Not because EMDR is ineffective, but because the structure that supported them in training is no longer sufficient for the complexity of the cases they are encountering.
Why EMDR-Trained Clinicians Stop Using EMDR
When sessions begin to feel unclear, EMDR may be used less frequently, reserved for specific cases, or replaced by approaches that feel more predictable. Soon, EMDR may be abandoned altogether.
This change is typically driven by increasing uncertainty rather than a conscious decision to abandon the model. Clinicians may continue to value EMDR but feel less confident in their ability to apply it effectively, particularly with complex trauma.
Over time, this creates a gap between training and practice. EMDR remains part of the clinician’s skillset, but it is no longer integrated into their day-to-day clinical work.
The Role of EMDR Consultation
EMDR consultation is designed to address this gap. For clinicians pursuing certification, it also fulfills requirements for EMDRIA consultation hours. During EMDR Basic Training, clinicians complete a required 10 hours of consultation focused on understanding and applying the protocol. While this provides an essential foundation, it is not intended to ensure confident use of EMDR in complex clinical work.
Consultation that occurs on an as-needed basis also serves a purpose, particularly when clinicians encounter specific challenges in a case. However, this type of consultation is typically focused on resolving immediate questions rather than developing a broader framework for clinical decision-making. As a result, it may not provide the structure needed to fully integrate EMDR into ongoing practice.
More importantly, ongoing, structured EMDR consultation provides a consistent space to examine how the model is being applied in real cases.
Effective consultation extends beyond case review. It supports clinicians in understanding how to think within the EMDR framework, particularly when sessions do not follow a predictable course. It offers guidance on target selection, sequencing, and clinical decision-making, all within the context of the clinician’s actual work.
When consultation is consistent and structured, it begins to restore a sense of competence. Sessions become more intentional, decision-making becomes more grounded, and EMDR starts to feel effective again under real-world conditions.
How Consultation Builds Confidence in EMDR
Confidence in EMDR does not develop through repetition alone. It develops through supported application, where clinicians can test their understanding, receive feedback, and refine their approach over time.
As this process unfolds, EMDR begins to shift. What once felt uncertain becomes more structured. Clinical decisions become clearer, and sessions begin to move more predictably and smoothly.
This is often the point at which EMDR becomes integrated into practice, not as a specialized intervention, but as a reliable part of ongoing clinical work. Many therapists start to consider themselves “EMDR therapists” considering the AIP model as a regular part of their daily clinical work.
Completing EMDRIA Consultation Hours
For clinicians working toward certification, completing EMDRIA consultation hours is an important milestone. However, the value of consultation extends beyond meeting a requirement.
Structured consultation creates the conditions for EMDR to become usable in a consistent and effective way. It supports both the development of clinical confidence and the ability to apply the model across different types of cases.
In this sense, consultation is not simply a step toward certification. It is often the point at which EMDR becomes a practical and sustainable part of a clinician’s work.
Conclusion
Many clinicians stop using EMDR after training not because the model is ineffective, but because applying it in real clinical settings introduces a level of complexity that is not well addressed in initial training.
Without structured support, that complexity can lead to uncertainty. Over time, this uncertainty can reduce the use of EMDR, even among clinicians who believe in it.
EMDR consultation provides a way to bridge this gap. It supports both the completion of EMDRIA consultation requirements and the development of confidence in real clinical work
Apply This to Your Practice
If you have completed EMDR Basic Training but find that EMDR feels unclear or difficult to use, this is a common stage in the transition from training to practice.
A structured EMDR consultation program provides a way to complete EMDRIA consultation hours while developing confidence in how to apply the model in clinical work—particularly in cases where sessions have begun to feel unclear.
Works Cited
Shapiro, Francine. Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures. 3rd ed., Guilford Press, 2018.
