Ep 50: Shared Decision Making in Trauma-informed Therapy

Anyone else feeling irritated by how clinicians love to tell each other what is right or wrong? Ever notice how scripts often don’t thoroughly address client preferences or the process of client engagement? Where is the role of autonomy for the client?

To remedy our irritation, today we zoom out and get curious about how we make clinical choices, and how we engage with our clients about making those clinical choices.

For EMDR clinicians, this can be tricky. Questions may already be coming up for you like: How do we make a shared decision with our clients when we have a protocol, step-by-step process, and/or script that we are to follow to do it right and be effective?

Herein lies the balancing act between positive health outcomes and patient autonomy. How and when do we make clinical choices with our clients? How do we follow the script or protocol, and stay client-centered? What’s important to the client? How do we triage what is clinically relevant? The questions are important, and the answers feel challenging.

Good news: physicians have been researching this for decades. And it’s time for us to catch up with the rest of the healthcare literature. Today, as we talk about shared decision making, we realize that we cannot say we are trauma-informed if we are not client-centered. I said what I said.

You deserve to have richer conversations with your clients, in consultation, and even in Facebook groups. As we dive into models of shared decision making, get clarity on which shared decision making model you’re using when you make clinical choices. By identifying your orientation along the shared decision making spectrum, you'll get to have more productive conversations with your colleagues and clients.

And you can finally understand how to make EMDR a client-centered therapy. Perhaps you were also clinically trained in a paternalistic model of shared decision making. I was, and boy did it mess me up. The paternalistic model tells us the rules about EMDR, like talking during Phase 4, what target to start from, and what form of BLS to use.

Let’s get curious about how to translate the gold of EMDR into the deliberative model of shared decision making so we can serve more clients effectively. What does EMDR in the deliberative model look like? Listen in to find out!


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With a Masters in Education from Vanderbilt, Kambria has been creating trainings and teaching adult learners for 20 years. As Director of Education and Quality Improvement at Stanford Medical School, her job was to decomplicate and consolidate complex systems and topics, thereby giving medical trainees successful learning experiences. Now, as a busy mom of fraternal twins, dedicated business owner of Zero Disturbance, and EMDRIA Approved Consultant, Kambria knows what it means to do things efficiently, effectively, and in a learner-centered way.