An exploration of how integrative therapists working with clients presenting with complex trauma use EMDR as part of their practice: a grounded theory study

Eye Movement Desensitisation and Reprocessing (EMDR) is widely used for treating complex trauma. Although there is a large evidence base around the efficacy of EMDR, there is little practice-based research into how EMDR therapists work with clients. EMDR therapists come from a range of professional backgrounds and basic EMDR training provides limited guidance on how to integrate it into a therapist’s existing practice. This research therefore aimed to explore how Counselling Psychologists and Psychotherapists, who define their practice as ‘integrative’, use EMDR as part of their practice when working with clients presenting with complex trauma.

Two rounds of semi-structured interviews were conducted with nine integratively orientated EMDR therapists who work with clients presenting with complex trauma. Constructivist grounded theory was used to explore how these therapists work with their clients. A theory was constructed from the data, demonstrating the unique and individual nature of the way each therapist works with different clients, but with significant commonalities. Five main categories resulted: ‘Relational Stance’, ‘Working with Developmental History’, ‘Parts Work’, ‘Structure and Process’ and Right-Brain Processes’. The interactions and relationships between the categories demonstrate the fluid, dynamic, co-created and highly individual nature of this way of working and led to the development of the core category ‘Integration – Uniqueness with Commonalities’.

EMDR is a relatively new therapy and the ways in which it is researched, trained and practiced continue to evolve. This research has relevance for clinicians working with complex trauma who want to use EMDR as part of their practice. The resulting theory has been developed to support clinicians to work at an appropriate level of complexity when using EMDR with clients presenting with complex trauma as part of an integrative practice. It could also serve to inform training, practice and further research, particularly given the diverse clinical backgrounds of EMDR therapists.