Dual Relationships in Couples Therapy and the Use of EMDR

The issue of dual relationships recently came up in an Advanced EMDR Workshop where I was talking about working with couples:

Is it okay for a couples therapist to do individual EMDR with their clients (meaning not conjoint sessions while doing EMDR) and still be the couple's therapist (in conjoint sessions)?

Let’s look at the DORA guidelines for Colorado:

• "Dual or multiple relationships occur when a professional assumes two or more roles at the same time or sequentially with a client or with someone who has significant relationship with the client."

• "Dual relationships may occur when a licensed, registered for certified mental health professional is or has been in a professional role with a client and:

1. at the same time is in another role with the client, or
2. at the same time is in relationship with a person closely associated with or related to the client with whom the mental health professional has a professional relationship with or,
3. enters into, or promises to enter into, another relationship in the future with the client or person associated with or related to the client."

DORA states that a dual relationship may impair the therapist from staying objective, competent and effective in treatment, and can exploit the client or cause harm to the client. This includes providing couple’s counseling and individual therapy to the same person(s) at the same time. With these guidelines in mind, therapists who want to do EMDR in couples therapy will need to do EMDR within the context of conjoint therapy. This means that the treatment needs to stay as a couple, and not do individual sessions. In order to do conjoint couple’s EMDR therapy there are some key factors that must be in place before proceeding:

• First educate the couple on what EMDR is and how it will be used in the treatment. Make sure that you get a commitment from both parties for this work before proceeding. Remember that couples tend to choose partners who evoke family of origin qualities and are needing to heal these emotional wounds.

• Begin by resourcing the couple through some exercises that will be helpful to them such as: Safe Place, Containment, times they have felt bonded, enjoyed each other, happy times, times they felt understood. This can be done using self tapping for each individual.

• Make sure there is a level of safety in the room before proceeding to EMDR. Does the couple have the necessary skills for healthy communication, empathetic listening and reflecting and has the ability to self regulate? If not, you need to help them build these skills before proceeding onto EMDR.

• Once these skills are in place then proceed to pick EMDR targets, that will be helpful to each individual, that are impacting the couple's current day relationship. Usually the issues show up by the couple triggering each other. When you take the time to work with each person's trigger, one at a time through using the floatback to find the "Touchstone" memory, each person begins to see the origin of their feelings, behaviors, thoughts and reactions to their partner. The awareness that comes from this can help a couple shift in knowing that the issue originated from each person’s family of origin and is being triggered in the present with each other. Do EMDR allowing the other person to be a witness and support in the room. This process can increase the bonding between the couple.

Note: If you feel that the issues are long term therapy for individuals or there is not enough safety for someone to do EMDR with the other person in the room, it is best to refer each individual to have their own individual therapist and you remain the couple’s therapist. Get signed released forms from the other therapists so that all therapists can work on best treatment for their clients. Working with couples can help establish healthier communication, less reactivity for the couple, easier problem solving and less drama. Make sure to always be working within the guidelines of your own state licensing board. For more information on DORA's regulations regarding dual relationship as it pertains to couples therapy, visit their website:

Department of Regulatory Agenciesr Division of Registrationsr State Board of Licensed Professional Counselor Examiners http://www.dora.state.co.us/mental-health/lpc/2012%2003%2016%20LPC%20Policies.pdf#page9

If you would like to share your thoughts on this matter, please feel free to comment on this post.