The EMDR Therapist Weekly aims to provide a weekly dose of insights, tools, and opportunities for EMDR therapists; designed to support your growth, sharpen your practice, and connect you with what's next. To achieve this, we like to invite subject matter experts as guest writers. This week I'm honored to introduce our next guest writer: Carol Miles, LCSW.

Having served a term as President of EMDRIA, Carol remains an EMDRIA certified Therapist, Consultant, and Basic and Advanced Trainer. Owner of Three Rivers Training Center, she also leads other EMDRIA Approved Trainers in supporting the next generation of EMDR clinicians. Her contributions to the field of EMDR have been recognized through the Outstanding Contribution Award in 2023.

In addition to her professional endeavors, Carol's passion for education led her to serve as an adjunct professor at the Tulane School of Social Work for two decades, nurturing future generations of mental health professionals. As a retiring co-chair of the South Louisiana EMDR Network and a former member of the EMDRIA Board of Directors, Carol's legacy continues to inspire and shape the landscape of mental health care.

Carol writes:

Why EMDR Training Doesn’t Always Turn Into Practice: What Clinicians Should Know

For more than 30 years, thousands of clinicians around the world have been trained in Eye Movement Desensitization and Reprocessing (EMDR). It’s one of the most effective treatments we have for trauma. But here’s the problem: a lot of clinicians finish their training and then struggle to actually use EMDR in their day-to-day work. Understanding why this happens can help us close the gap between training and practice.

Confidence and Skills

A big barrier is confidence. EMDR isn’t just a technique you pick up in a weekend—it’s a structured process that requires practice. You need to prepare clients well, follow specific steps, and manage what comes up in the moment. EMDRIA builds in 10 hours of consultation during basic training to help with this, but that doesn’t always feel like enough. Without ongoing mentorship and practice, many clinicians hesitate to dive in because they’re worried about making mistakes or doing harm.

Time and Workload Pressures

EMDR sessions can be longer or more intense than standard talk therapy, especially in the reprocessing phases. If you’re working in a busy agency, with back-to-back clients, squeezing in a 90-minute EMDR session may not feel realistic. On top of that, planning and paperwork take more time, and many workplaces don’t adjust caseloads or scheduling to make room for trauma- focused care.

Organizational Roadblocks

Even if a clinician is excited to use EMDR, their workplace might not be on board. Agencies that don’t value trauma-informed care may not support training, supervision, or flexible scheduling. Supervisors without EMDR training can’t offer much guidance, and administrators may not see the point in investing time and money into something new. Without organizational buy-in, EMDR often gets pushed aside.

Cultural and Ethical Concerns

Social work values remind us that healing isn’t one-size-fits-all. EMDR is powerful, but it isn’t culturally neutral. Research shows that many clinicians—often white and middle-class—assume EMDR can be applied universally without adapting for culture or context. That’s a problem. Trauma is deeply connected to identity, history, and systemic oppression. Clinicians who don’t feel confident bringing cultural humility and anti-oppressive frameworks into EMDR may avoid using it altogether.

Keeping Skills Fresh

Like any clinical skill, EMDR gets rusty if you don’t use it regularly. If a clinician doesn’t see many clients with trauma, or doesn’t feel supported to practice, their skills can fade. Peer groups, refresher trainings, and ongoing consultation are key to keeping EMDR sharp and usable.

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How We Can Close the Gap

So, what helps clinicians move from training to confident practice? A few strategies stand out:

• Stay connected: Ongoing consultation or peer groups build confidence.
• Bring in culture and ethics: Adapt EMDR with cultural humility and anti-oppressive practices.
• Create systems: Agencies that build EMDR into workflow and protocols make it easier for clinicians to use it consistently.
• Make time: Agencies need to support longer sessions and flexible scheduling.

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Wrapping Up

EMDR is one of the most effective tools we have for trauma, but training alone isn’t enough. Clinicians need confidence, organizational support, and a strong grounding in ethics and cultural humility to make EMDR work in the real world. By tackling these barriers head-on, we can make sure clients actually benefit from this powerful approach—while staying true to the core values of our profession.

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Carol Miles, LCSW

EMDRIA Certified Therapist, Approved Consultant, and Basic and Advanced Trainer

Connect with Carol here.

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