Assessing for Dissociation
You also have to make sure that the client has been that you've screened the client for Dissociative Disorder because EMDR can work very effectively with Dissociative symptoms, but you need to know what the actual diagnosis is because DD is a specialty area, and there are certain upfront work that needs to get done. So you need to make sure that you've done the appropriate screening. There are screening tools. We gave you the DES, the Dissociative Experience Scale. But just in terms of your screening, you're also doing a mental status exam, certain red flags, years of unsuccessful therapy, multiple hospitalizations, depersonalization or derealization, memory lapses, flashbacks and intrusive thoughts, which is not a contraindication because it can simply be PTSD.
But what you're looking at is a full context and continuum here. Schneiderian symptoms, voices in their head, thoughts coming out of the blue, thoughts and feelings they can't have a place anywhere, somatic symptoms. All of these things you need to go through and simply know who your client is because you can't really treat the client until you have a real good map of who you're dealing with. So dissociative disorders, regardless of the form of psychotherapy you're using, should be something that you're screening for.