Acknowledgement – Simpson, C., McGlanaghy, E., McAuslan, L. 

Introduction

EMDR is a therapeutic approach designed to support individuals who have experienced traumatic or distressing events. It can help alleviate symptoms such as flashbacks, intrusive thoughts or images, mood disturbances and anxiety (Shapiro, 1989). The National Institute for Health and Care Excellence (NICE) recommends EMDR as an effective treatment for PTSD (NICE, 2018).

The EMDR Association UK (2019) recommends a minimum of one hour per month of individual supervision or two hours per month of group supervision (in a group of no more than six supervisees). An ‘SOS’ facility is also encouraged, whereby the supervisor can be contacted between supervision sessions for brief consultation. This supervision should be carried out by an EMDR consultant. Currently, within Forth Valley Health Board, these recommendations are unable to be fully met. There is only one EMDR consultant within the service who is responsible for the supervision of two accredited practitioners and consultants in training, several qualified therapists working toward accreditation and a number in practice who are not currently working towards accreditation.

EMDR in the context of an NHS health board adult psychological therapy service

A substantial and growing demand for psychological therapy, particularly among individuals presenting with PTSD and complex PTSD, has been observed within the service. Additionally, therapists trained in EMDR frequently prefer to use EMDR to treat complex PTSD, despite trauma-focused cognitive behavioural therapy also being an evidence-based treatment option for this population (NICE, 2018). Findings from a recent focus group conducted within the service revealed that most dual trained (EMDR/CBT) therapists expressed a strong preference for EMDR in their clinical practice.

The constraint of having one EMDR consultant across the health board limits EMDR supervision capacity and poses challenges to maintaining therapist competency and fidelity to the modal. These findings demonstrate a clear need to support and scaffold EMDR supervision provision to support therapist competency and service capacity, thereby improving timely access to effective trauma treatment for patients and improved outcomes.

Introduction to the EMDR PODS programme

A mixed-methods systematic review by Hammond et al. (2023) found that many therapists experience challenges when integrating EMDR into their practice. These challenges include a lack of confidence in their EMDR skills and anxiety about practising the therapy safely and effectively. The study emphasises the importance of organisational support and effective supervision in facilitating the adoption of EMDR by clinicians. Hammond et al. (2023) found that despite completing training, many reported feeling uncertain about applying the methodology in real-world settings. This lack of confidence can hinder clinicians’ ability to deliver effective therapy and fully integrate EMDR into their practice.

Challenges faced by newly trained EMDR therapists

Newly trained EMDR practitioners often encounter several clinical implementation issues. Many clinicians who train in EMDR experience difficulties in real world translation. Bernard (2023) emphasises the value of a staged and process-oriented approach to delivering and learning EMDR. However, EMDR training often focuses on client populations that differ significantly from those typically seen in NHS clinical settings. One UK mixed-methods study found that approximately 40% of therapists, particularly those from analytic or humanistic orientations, reported significant challenges in integrating EMDR into their practice (Dunne & Farrell, 2011). The structured phases, specialised terminology and technical procedures of EMDR can also lead to cognitive overload for new therapists.

The interval between initial EMDR training and attaining proficiency underscores the necessity for structured and supportive avenues for skill development. Without adequate supervision focusing on content and skills, newly trained practitioners may experience decreased retention rates. Effective supervision has been linked to increased job satisfaction and retention among therapists (Rothwell et al., 2021). In the context of EMDR therapy, adherence to the Standard Protocol is crucial, and supervision plays a vital role in ensuring this fidelity. Studies have indicated that EMDR therapists who have achieved accreditation, often through comprehensive supervision, report better treatment outcomes compared with those without accreditation (Logie, 2022). Clinicians who continue to use EMDR reported that they did so because of its effectiveness and the continuing consultation they received (Grimmett & Galvin, 2015).

A common constraint for practitioners where group supervision is offered is the limited time available in supervision sessions. Supervision often focuses on basic process or client-related concerns, leaving limited opportunity for deeper skill development in EMDR case conceptualisation and model application. Practitioners frequently bring repeated questions to supervision, suggesting the need for consistent, targeted support. While these questions demonstrate a desire to deepen understanding, they can take up time in the group when only one EMDR consultant is available to address the needs of multiple practitioners in the health board or trust.

To close the gap between novice and mastery, the EMDR consultant secured management and leadership approval to engage three highly experienced practitioners in exploring effective strategies to build confidence and competence in EMDR skills. This led to the development of a structured support mechanism, the EMDR Practice Observation and Development of Skills (PODS) programme, a collaborative and efficient approach to skills building. This model addresses key practitioner concerns, optimises supervision time and fosters learning and growth, ensuring that newly qualified practitioners feel confident in integrating EMDR and delivering better patient outcomes.

The EMDR Association UK commits itself to regulating and reviewing the EMDR accreditation process, supporting the clinical development of practitioners and upholding the highest standards of practice, which will in turn benefit EMDR therapy for the public. The cornerstone to achieving this is strengthening members’ knowledge, skills and professionalism through learning opportunities, access to resources and active participation in specialist groups and professional development forums. The implementation of the PODS post-basic training initiative would serve as a valuable tool in advancing the EMDR Association’s objectives by offering structured support, continuing education and a platform for practitioners to refine their expertise and maintain best practices in the field.

Methods

PODS sessions were held every six weeks over a 12-month period. Having group skills training every six weeks allows therapists extended time to apply learning in practice, reflect on group facilitation experiences and return with meaningful questions and case examples, thus enhancing integration of theory with real-world application (Powell, 2019). Furthermore, spacing learning over time can reduce cognitive overload and enhance deeper processing, retention, and transfer of learning (Carpenter et al., 2022; Wang et al.,2014) . It may also increase accessibility for participants managing busy clinical workloads or personal commitments, while supporting CPD (Lopez et al., 2022).  Allowing time between training sessions enables therapists to apply newly acquired skills in practice, reflect on their experiences, and return with clinical examples for discussion. Such cycles of application, reflection, feedback, and refinement are consistent with contemporary models of clinical supervision and deliberate practice that emphasise active learner engagement and responsibility for ongoing professional development (Rosén, 2025; Sacks, 2025).

Two of the PODS programmes were held online via Microsoft Teams. Online group training offers increased accessibility, flexibility and cost-effectiveness, allowing participants to attend sessions regardless of geographical barriers (Inchausti et al., 2020). In this case, participants were able to join from different NHS sites. Online platforms can enhance opportunities for observing diverse facilitation styles across sites, fostering exposure to various group dynamics (Lopez et al., 2022). Studies indicate that online training can maintain comparable satisfaction and perceived learning outcomes as face-to-face training, particularly when using interactive methods such as role play (Feijt et al., 2020). Additionally, online settings may reduce participant anxiety during practice-based activities, creating a psychologically safe environment conducive to skill acquisition (Reilly et al., 2021).

Despite its accessibility, online group training can limit the richness of non-verbal communication, making it harder for participants to observe and respond to subtle group processes and emotional cues (Humer et al., 2020). The lack of shared physical space may hinder the development of group cohesion among participants, potentially impacting the effectiveness of training in managing group dynamics and complex interpersonal interactions (Békés & Aafjes-van Doorn, 2020). One of the PODS groups was held in person and onsite. In-person training offers direct engagement with group processes, allowing participants to develop sensitivity to non-verbal cues, in-the-moment emotional shifts and the group energy essential for effective group facilitation (Powell, 2019). The physical environment can influence the development of group cohesion by creating a sense of safety, comfort, and interpersonal connection. A supportive group setting may facilitate greater participation, trust, and interpersonal learning, thereby enhancing relational learning among group members (Yalom & Leszcz, 2020)In-person roleplays and live supervision provide immediate, embodied feedback, facilitating reflective practice and skills generalisation in a context closely resembling real-world settings (Räuchle J., et al 2025).

 However, in person training may be less accessible for participants with geographical, financial or caregiving constraints, limiting the diversity of participants, (Inchausti et al., 2020). It typically requires higher logistical investment from both participants and the service, including travel, venue and accommodation (Feijt et al., 2020). In-person settings may also increase performance anxiety during experiential exercises, potentially hindering learning for some participants who require a psychologically safer distance to practice new skills (Reilly et al., 2021).

Three highly experienced EMDR nurse practitioners within the service were chosen to facilitate the first cohort of PODS groups while being supervised by the EMDR consultant on a six-weekly basis. All PODS leads were experienced supervisors, having undertaken the NHS Education Scotland Generic Supervision Certificate in Psychological Therapies and Intervention. They were all trained by a long-established approved training provider within a short period of each other, giving the advantage of consistent information being offered to participants. They had over 10 years’ experience in EMDR delivery and attending consultant-led supervision. EMDR was highly integrated within their regular practice, across a diverse and complex clinical caseload. The PODS leads met frequently to discuss progress.

Eleven participants were invited to attend the PODS programme, based on their being newly qualified to EMDR or having not used EMDR frequently in their practice and so needing to refresh their knowledge. Participants were from the wider psychological therapy service and included psychologists, nurse psychotherapists and psychological therapists. Criteria for inclusion/exclusion are listed in Table 1. Ten participants completed the PODS programme. Written consent was obtained from all participants to use their data.

Table 1: Criteria for inclusion/exclusion

Inclusion	Exclusion
Has undertaken EMDR Europe accredited training in EMDR	Has not undertaken EMDR Europe accredited training in EMDR
Is using EMDR currently	Is not working in the NHS health board where project is taking place
Has previously used EMDR but not for some time
Staff of NHS health board where project is taking place

Measures and aims

The self-reported evaluation form (Appendix 1) and structure of the groups were aligned with the core competencies for EMDR, ensuring that the content focused on the practical and clinical skills required for effective delivery. Participants were asked to complete the evaluation form at the beginning of their PODS journey to establish a self-reported baseline, and at the end. This allowed us to measure changes in their competence and confidence in delivering EMDR. As the primary aim of the group was to increase therapist competence and confidence in using EMDR and achieve optimal patient outcomes, it was deemed appropriate to evaluate progress specifically against the eight-phase protocol framework. This approach allowed for targeted identification of development areas while ensuring alignment with best practice standards in EMDR delivery.

The PODS programme was primarily set up for recently trained EMDR therapists; however, we recognised that therapists’ who had not used EMDR in their practice for a period would also benefit. The importance of supervision and skills training when returning to using psychological therapy, especially after a break, is significant for several reasons. These practices are essential for maintaining ethical, effective and evidence-based therapy. Supervision and training help clinicians to refresh and update their knowledge and skills. Returning therapists may experience self-doubt or anxiety about their competence. Skills training and supervision provide reassurance and structured support. Returning to psychological therapy without updated training and supervision is a risk to both practitioner and patient. Supervision and skills training ensure that therapists are safe, confident, ethical and effective in their work, which benefits client care and therapist wellbeing, (Lohani & Sharma, 2022; Rothwell et al., 2021). These studies collectively affirm that supervision and skills training are vital for therapists re-entering practice, ensuring that they provide competent, ethical and effective care.

Several academic studies from the past decade highlight the benefits of using evaluation forms and competency measures in psychological therapy training and supervision. These tools are instrumental in assessing therapist development, ensuring effective practice and enhancing client outcomes (Liness et al., 2019; Gonsalvez & Crowe, 2014; Barlow & Brown, 2020).

The self-reported evaluation forms were administered during both the first and last session to assess any changes in skill competency levels over the course of the PODS programme engagement. This approach allowed for a comparative analysis of participants’ self-reported abilities at the outset and conclusion of the groups, providing a measurable indication of skill development and the effectiveness of the intervention in enhancing EMDR skills. Each competency was measured on a scale of 1–5 (Table 2) and totals for each phase of the protocol are different, depending on how many competencies are included (Table 3). Participants were asked to assess themselves using the statement that fitted them best for each competency.

Table 2: Self-reported evaluation form scale

Strongly disagree	1
Disagree	2
Neither agree nor disagree	3
Agree	4
Strongly agree	5

For the purposes of quantitative analysis, a 70% threshold was selected to indicate improvement, reflecting common practice in medical and psychological training where moderate cutoffs are used to denote basic competence. In this context, a 70% performance benchmark for EMDR competency assessment should be understood as a pragmatic standard aligned with broader clinical competency frameworks (Saigí Rubió et al., 2024; McCrossan et al., 2022), rather than one derived from any specific EMDR-based theoretical rationale.

Competency-based clinical guidelines, such as those issued by the American Psychological Association (2025) emphasise the importance of setting clear minimum competence criteria to ensure safe and ethical trauma related practice, reflecting how mid-range thresholds commonly function in regulating practitioner readiness. Within EMDR specifically, a 70% threshold aligns with the structured, developmental nature of training that emphasises progressive acquisition of protocol fidelity and attunement skills. EMDR’s foundation in the adaptive information processing model requires clinicians to demonstrate consistent application of core procedures but early career practitioners are not expected to reach full mastery before being judged minimally competent. A 70% standard appropriately acknowledges the steep learning curve involved while encouraging the continued professional growth necessary to achieve mastery over time (Wright et al., 2024).

Participants completed a structured feedback survey to obtain qualitative information on the effectiveness, usability and overall experience of the PODS programme. Ethical approval was not required as this was a service evaluation project. It was registered with the health board’s quality improvement department.

Table 3: Participants scores (and percentage) for each phase

Completed pre- and post-data were available for 7 of the 11 participants in the PODS programme. One additional participant left during the programme, while three failed to complete the post-group evaluation.

Table 3 presents participants’ scores and corresponding percentages for each competency across the phases. With the competency threshold set at 70%, four participants had already met or exceeded this benchmark before they undertook the PODS training, while three participants scored below the threshold before PODS engagement. Variability within the results may be attributed to factors such as the timing of participants’ training, the companies with whom they trained and the extent to which the training had been implemented between course completion and entry into a PODS group. Participant 1 scored marginally above the threshold in seven phases pre-PODS training; however, following participation, the scores increased across all phases, ranging from 82% to 100%. Participant 2 exceeded the threshold in all eight phases at baseline, with post-PODS programme scores increasing further to above 80% in every phase. Participant 3 met the threshold in five of the eight competencies; post-programme scores remained unchanged for the closure phase and decreased by 1 point in the evaluation phase, which perhaps may be indicative of an inflated competence phenomenon (Probst et al., 2022). Participant 4 exceeded the threshold in only three phases before participation yet achieved scores above the threshold in all phases post-PODS training, which represented the greatest overall improvement. Participant 5 scored just above the threshold in all eight phases pre-PODS training, with post-PODS scores increasing substantially to 89–100%. Similarly, participant 6 scored marginally above the threshold across all phases prior to PODS programme engagement, with post-programme improvements evident, including two phases reaching 100%. Participant 7 demonstrated the highest pre-PODS programme performance, achieving 100% in four phases; following programme participation, the remaining four phases also increased to 100%.

These scores show that while participants entering the PODS programme were mostly at the threshold for success in using EMDR, the training was effective in increasing their scores, implying that the PODS programme consolidated training, and encouraged confidence and competence within the eight phases

There are currently no published figures that directly measure the retention rates of newly qualified EMDR therapists in the UK, but some related evidence provides insight into how many continue to use EMDR in practice. One survey of EMDR therapists in the UK and Ireland found that only around 10–12% of those who complete a basic EMDR training go on to become accredited practitioners (Maxfield et al., 2019). This does not necessarily equate to therapists abandoning EMDR altogether, but it does suggest that many do not pursue further formal development or recognition.

Qualitative results

A follow-up feedback form was distributed to nine participants who remained employed within the health board area. This form was designed to collect qualitative data, in contrast to the evaluation form, which gathered quantitative data. Six completed feedback forms were returned, representing two responses per facilitator. Of these, four responses were from participants who engaged in online PODS support and two were from participants who took part in face-to-face PODS sessions. Full results are presented in Table 4.

Table 4: Qualitative results

Question	Participant response
What did you find most helpful?	Revisiting and exploring protocol.
	Clarifying the protocol and asking silly questions.
	Sharing knowledge and application.
	Learn with colleagues and gain their breadth of knowledge.
	Tune up.
	Tips and handy hints.
	Examples and role play.
	Aligned with EMDR accreditation criteria.
	Develop your own intuition whilst maintaining fidelity to the model.
What did you find least helpful?	Being online.
	Range of experience in group.
	Conflicting advice/so much input.
	Not being able to use cases.
	Not knowing role or purpose.
	Inconsistent attendance.
Has the PODS had an impact on your practice?	Yes confidence.
	Massive difference to my learning. More confident.
	More confident.
	Benefitted from PODS facilitators knowledge.
	Yes confidence.
Would you recommend a PODS to your colleague?	100% of participants recommended it.
Would you suggest any changes?	In person and more practice.
	Decide what skills need improvement first rather than just go through everything.
	Deliberate practice.

Discussion

What have you learned from the research, and how does this contribute to your knowledge, practice and ideas for further research?

In the UK and Ireland, Farrell & Keenan (2013) reported that EMDR-accredited clinicians were more likely to have supervision arrangements and that these supervisors were more likely to be EMDR trained. Importantly, supervision by an EMDR-accredited consultant was statistically related to better outcomes. A 2023 mixed-methods systematic review by Hammond (2023) also emphasised that available supervision and organisational support are key facilitators for clinicians’ continued implementation of EMDR in practice. There remains, however, little direct experimental or longitudinal research testing how different forms, frequencies or qualities of continuing training and supervision affect EMDR competence, fidelity or client outcomes. Dyson (2024) echoed Hammond’s (2023) findings, highlighting that ‘of the therapists who do EMDR training, only 10–12% progress and add it to their therapeutic repertoire by becoming accredited in EMDR’. This figure indicates a relatively low level of progression from initial training to accreditation, which can be taken as one indicator of retention.

Several barriers to retention and long-term use of EMDR have been identified. These include difficulties integrating EMDR into existing service models, supervision structures and caseload demands (Maxfield et al., 2019). Cost and time commitments required for accreditation and supervision may also discourage therapists from continuing beyond the initial training (Woolliscroft, 2025). Institutional support, clinical pathways and workplace recognition of EMDR practice appear to be important factors influencing whether therapists retain and apply EMDR skills over time. Of the 11 participants in the PODS programme, 2 left their roles within the health board, where they will no longer be practicing EMDR, a retention rate of 82%. There did not seem to be any score differences within professional roles or between practitioners who attended in person compared with those attending an online forum.

The PODS programme provided several important insights. Overall, the findings suggest that structured follow-up support might be beneficial. The initiative demonstrated value in supporting both newly trained therapists and those seeking to refresh their skills to further develop their clinical practice.

Participation in the PODS programme enabled therapists to address fears and concerns, become less risk-averse and build confidence, particularly when working with complex clients. This highlights the role of structured support in facilitating the translation of training into proficient practice. The importance of managerial support was also evident. Staff release was crucial to participation and, without this support, engagement would probably have been constrained by service capacity and competing demands.

At initial survey, PODS participants described poor retention of knowledge and low confidence to commence EMDR in practice post EMDR training. This gap can contribute to insecurity and risk-averse decision making. Engagement in the PODS process helped to counter these challenges by providing a sense of scaffolding and support, which participants described as relieving and containing.

Finally, the shared structure of the PODS programme created a safe space for staff to come together to reflect, discuss experiences and share learning from a common starting point, further enhancing professional development and peer support.

Limitations

The participant sample is small, with 7 of 11 eligible participants taking part in self-reported evaluations. These small numbers limit the strength and generalisability of findings. The self-reported scores from the evaluation form could have been influenced by inflated competency (Probst et al., 2022). Using the competencies as an evaluation questionnaire involved an unvalidated measure, raising concerns about the reliability and accuracy of the findings. Without formal validation, the tool may not consistently assess the constructs it targets, potentially leading to misleading conclusions or under- or overestimation of participants’ skills (Probst et al., 2022). This study does not differentiate between competence in skill use and confidence in applying those skills. That distinction warrants future investigation, particularly as the self-report measure includes items assessing both understanding and confidence.

A further limitation was the high demand for places. There is currently a waiting list for PODS support via future cohorts, highlighting its perceived value but also underscoring the need for additional capacity. As this is a novel approach, no formal training for conducting such an initiative is available. Initial lack of clarity required several focused conversations and guidance with the PODS leads and EMDR supervisor to achieve consistency and confidence in the process. As this is not a structured training course, the absence of guidance led to some uncertainty about how best to facilitate the PODS groups and regular review and monitoring led to iterative changes. Alignment to the core competencies of EMDR in both the accreditation process and EFRS (Korn et al., 2018), provided helpful parameters. Offering orientation or light-touch training for leaders may help to increase consistency and confidence in delivery.

Summary and recommendations

The EMDR consultant supervisor reported that all participants who completed the PODS programme are now regularly presenting cases and contributing to group supervision with an increased level of competence and confidence. All practitioners who participated in the programme self-reported improvements in confidence and competence, which was highlighted in the pre- and post-evaluations. All participants reported that the PODS training added value to their existing knowledge and skills and self-reported feedback was unwaveringly positive.

This model demonstrates how targeted post-training support can optimise patient choice, contributing to improved delivery of evidence-based trauma therapies within NHS services, while also reducing supervision burden on the small pool of accredited consultants.

Current estimates indicate that only 10–12% of trained therapists pursue accreditation and consistently integrate EMDR into their practice (Farrell & Keenan, 2013; Dyson, 2024). Against this backdrop, the PODS model demonstrates a significant improvement: 82% of participants completed the programme and continued using EMDR clinically. This marks a notable departure from previous trends, with100% of participants who completed a PODS group reporting enhanced confidence and competence in EMDR delivery. This outcome underscores the potential effectiveness of structured, continuing skill-based support in bridging the gap between initial training and sustained clinical application.

The PODS programme demonstrates a practical solution to strengthen EMDR delivery, improve therapist confidence and maintain fidelity to the model. It supplements formal supervision, addresses systemic challenges and promotes sustainability within the NHS health board. Early findings suggest improved retention, enhanced competence and potential benefits for therapist wellbeing and service efficiency. This mental health nurse-led innovation offers a replicable model for other health boards/trusts.

This project has demonstrated that accredited and experienced EMDR practitioners are ideally positioned to lead PODS programmes, creating a safe, structured environment for professional growth. The process of evaluating PODS training not only ensures the quality and consistency of the groups but also generates valuable feedback that can be used to strengthen practice and identify areas for growth. The evaluations received have justified the continuation of this initiative with a new cohort, incorporating previous insights to deliver meaningful enhancements.

Engaging in PODS support offers multiple benefits across the wider EMDR framework. An unexpected benefit for PODS leads is the creation of a pathway towards consultancy and accreditation by offering hands-on leadership experience, opportunities for reflective practice and structured peer evaluation. For organisations, it supports succession planning by building a pipeline of skilled leaders who are confident in guiding others through safe EMDR practice. This ensures long-term sustainability and growth of expertise within the community.

The evaluations highlighted the importance of attendance and participation in the groups. This prompted the introduction of a participation agreement, designed to clarify expectations and secure commitment to the group learning programme. It is perceived that this agreement will reinforce the need for attendance and participation, reduce the need for repetition and allow participants to have a better understanding of the purpose and structure of the PODS groups.

The success of the first cohort of PODS participants highlighted the question of whether the benefits of attending would encourage or prepare practitioners to work towards accreditation. To address this issue, the question was added to the feedback form distributed at the end of the PODS programme. This will then enable the evaluation of whether the PODS programme will have any impact on practitioners’ desires to work toward accreditation.

Appendices: Extra Data

Appendix 1: Self-reported evaluation form

EMDR PODs evaluation/impact monitoring

For each of the statements below, circle the response that best fits how you feel about the statement:

Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
1	2	3	4	5

1. HISTORY TAKING
I feel able to take an appropriate general history from the client.
I feel confident in obtaining a history of the origins of the disorder informed by the AIP model, including dysfunctional behaviour and symptoms.
I feel confident in assessing whether the client is appropriate for EMDR.
I feel confident in identifying ‘red flags.’
I feel confident in screening for dissociative disorders.
I feel able to identify appropriate safety factors, e.g. risks, support structures, life constraints.
I feel confident in my ability to conceptualise the case using the AIP model.
I feel confident in identifying that the client is able to deal effectively with high levels of physical and emotional disturbance.
I feel confident in determining appropriate target selection and target sequencing in relation to past, present and future.
Within the three-pronged protocol, I understand the first/worst/most recent approach.
I feel able to prioritise or cluster in cases of multiple targets.
I feel confident in identifying a ‘touchstone’ event that relates to the client’s issue.
I feel confident in identifying ‘less heat/distress’ memories to titrate into EMDR.
I have a good understanding of EMD/EMDr/EMDR and when to use this.
I understand when Flash forward is appropriate to use.
2. PREPARATION
I feel able to establish an effective therapeutic relationship in conformance with national or professional standards and code of conduct.
I feel confident in my ability to discuss factors which will optimise or impede processing.
I feel confident in my ability to test bilateral stimulation (BLS) with clients.
I feel skilled in my ability to teach and check a client’s ability to self-regulate including use of safe/secure place and resource installation.
I feel confident in my ability to address client concerns, fears, queries, or anxieties.
I feel confident in using effective metaphors.
I can describe the importance of dual attention and explain what bilateral stimulation is.
I feel confident establishing a STOP signal and in determining position / speed/ method(s) of bilateral stimulation.
3. ASSESSMENT
I feel confident in selecting the correct target image and worst aspect.
I feel confident in identifying the negative and positive cognitions.
I feel able to establish negative cognitions that reflect a currently held, negative self-referencing belief that is irrational, generalisable and has affect resonance and that accurately focuses upon the target issue.
I feel able to ensure cognitions are within the same domain/matched category.
I feel confident in recognising when it is appropriate to help the client to identify pertinent negative and positive cognitions.
I feel confident in using the Validity of Cognition (VOC) scale at an emotional level, and in direct relation to the target.
I feel confident in identifying emotions generated from the target issue or event.
I feel confident in applying consistent use of the Subjective Units of Disturbance (SUDs) scale to evaluate the total disturbance.
I feel confident in helping the client identify body sensations and location.
I feel confident of how to restart an incomplete session.
4. DESENSITISATION
During the ‘desensitisation phase’ I feel confident in processing the dysfunctional material stored in all channels associated with the target event and any ancillary channels.
I feel confident in my ability to remind clients to ‘just notice’ whatever comes up during processing, while encouraging client not to disregard any information that might be generated.
I feel I am consistently able to explain that changes during processing can relate to images, sounds, cognitions, emotions, and physical sensations.
I feel competent in the use of bilateral stimulation (BLS), emphasising the importance of eye movements including speed/ direction/ length of sets
I feel confident in knowing when to add other forms of BLS or change method of BLS and have a good rationale for this.
I feel competent in using appropriate post-set interventions, and I am able to ‘stay out of the way’ as much as possible.
I am able to reassure the client verbally and non-verbally during each set.
I feel confident in maintaining momentum throughout the desensitisation stage with minimal intervention where possible.
I recognise when it is appropriate to returns to target.
I feel confident in my ability to recognise feeder memories, loops and blocks.
I feel confident in my ability to know when it is appropriate to use a cognitive interweave.
I understand the difference between a content and a process interweave.
I feel confident in effectively managing heightened levels of client affect, including recognising an abreaction, using both accelerating and deaccelerating interventions.
I can recognise when I have come to the end of a ‘channel.’
I fully understand the importance of seeking a SUDs of 0/10 in most cases.
I feel confident in recognising where a SUDs score above 0/10 is ecologically valid.
I feel confident in my ability to close an incomplete session safely, where the client is grounded and the traumatic material is well contained.
5. INSTALLATION
During the ‘installation phase’ I feel able to concentrate primarily upon the full integration of a positive self-assessment with the targeted information.
I feel confident in checking the positive cognition for both applicability and current validity, ensuring the positive cognition chosen is the most meaningful to the client (I understand why it is important to check the resonance of the original positive cognition obtained at phase 3 and does this still ‘fit’.)
I feel confident in using the VoC scale to evaluate the positive cognition.
I feel competent in enhancing the positive cognition linked specifically with the target issue or event.
I feel confident in addressing any blocks during the Installation phase.
If new material emerges, I feel confident in effectively returning to the most appropriate phase of the EMDR protocol or use the ‘incomplete session.’
6. BODY SCAN
During the ‘body scan phase’ I feel able to consider the link between the client’s original memory/event and the discernible physical resonance that this may generate.
I feel confident in enabling clients to hold both the memory/event and the positive cognition in mind while mentally scanning their entire body to identify any lingering tension, tightness, or unusual sensation, and apply bilateral stimulation.
I feel I am competently prepared for if further material surfaces and to respond accordingly. a) What to do if disturbance is noted. b) What to do if positive sensation is noted.
	7. CLOSURE
	I feel competent when closing a session and what are important elements of this phase.
	I am able to confidently debrief the client.
	I am able to effectively use the ‘incomplete session.’
	I am able to use appropriate containment exercises and safety assessment.
	I always encourage clients to maintain a log between sessions.
	I feel confident in agreeing good self-care practices with clients at end of session.
8. RE-EVALUATION OF PREVIOUS SESSION
During the ‘re-evaluation phase’ I consistently assess how well the previously targeted material has been resolved and determine if new processing is necessary.
I feel confident to return to previous targets.
I am able to identify evidence of client readjustment.
I am able to determine whether the individual target has been resolved.
I feel confident in identifying any other material that has been activated and needs addressed.
I feel I am able to ensure that all necessary targets have been processed in relation to the past, present and future.
I feel confident in using when necessary a ‘future/positive template.’
I feel confident in effectively ending client’s therapy.
I feel confident in demonstrating an understanding of PTSD and traumatology.
I feel confident in demonstrating an understanding of the use of EMDR either as part of a comprehensive therapy intervention or as a means of symptom reduction.
I feel confident in applying the standard EMDR protocol and procedures to special situations and clinical problems, including recent events, phobias, excessive grief, and somatic disorders.

Appendix 2: Follow up feedback form

EMDR POD evaluation (Microsoft Teams form) – anonymous completion

This is to help us develop the PODs and improve in any areas which may further enhance skills acquisition in EMDR. Please do fill in this short survey.

When you submit this form, it will not automatically collect your details like name and email address unless you provide it yourself.

Required

1.Who was your POD lead?

2.Was your POD in person or online?

3.What did you find most helpful?

4.What did you find least helpful?

5.Has the POD had any impact on your EMDR practice?

6.Would you recommend a POD to a colleague recently trained in EMDR?

7.Would you suggest any changes to the current format?

8.Any other comments?