Training Documentation & Participant Agreement Form

Participant Agreement

1. Current research is limited to the application of EMDR to trauma-related disorders. (O1/2) *

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2. All participants must be licensed to independently practice psychotherapy. You are fully licensed through your state or government credentialing board in one of the following fields and will provide the required documentation prior to acceptance into the training: 1) Licensed Psychologist, 2) Licensed Clinical Social Worker, 3) Licensed Marriage and Family Therapist, 4) Licensed Professional Counselor, 5) Licensed Psychiatrist, 6) Licensed Psychiatric Nursing, 7) Licensed Mental Health Practitioners, Licensed Psychoanalyst. (O1/2) *

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3. All participants must have a current psychotherapy caseload. This training is designed to help participants integrate Attachment-Focused EMDR therapy in their current clinical setting. This program is not intended for managers and researchers who do not carry an active psychotherapy caseload. (O1/2) *

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4a. A significant component of the training involves practicing Attachment-Focused EMDR therapy and related procedures in small groups under the supervision of the instructor or a qualified staff member/facilitator. These practice experiences are for training purposes only and not for personal therapy. All participants should be prepared to address disturbing real-life experiences as part of this training program in order to appreciate the subjective experience of Attachment-Focused EMDR as a client would and to provide valid training experiences for other participants, most notably the individual in the therapist role who is learning the new Attachment-Focused EMDR protocols and procedures. It is not unusual for a target memory to be linked to other unexpected, disturbing memories or material, which might surface during the practice sessions. You acknowledge and agree that if dreams, memories, or different feelings arise during the training, it is your responsibility to take appropriate action to deal with these occurrences, including asking the facilitator for assistance. (O1/2) *

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4b. The reprocessing of targeted incidents during practicum sessions may lead to the emergence of other disturbing memories after the practicum. It is the responsibility of the participant to seek, obtain, and pay for appropriate professional assistance if needed. Providing such assistance is not part of the training and will not be provided by the Parnell Institute training director or staff. Clinicians who elect to do personal Attachment-Focused EMDR work can find lists of EMDR trained clinicians through www.parnellemdr.com. (O1/2) *

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4c. Trauma-related case material presented didactically, in consultation sessions, or on video may be disturbing to those with unresolved personal issues. (O1/2) *

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4d. In submitting an application for training, participants affirm that they have developed appropriate self-soothing (personal Resourcing) and affect/arousal management skills to cope with exposure to this type of material and will be able to employ these skills as necessary during and following Attachment-Focused EMDR training, practice, and consultation sessions. (O1/2) *

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4e. All Participants are required to be able Resource Oneself effectively, i.e., Peaceful Place, Wise, Protector, and Nurturing Figures. (O1/2) *

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5a. Further, concerning number 4 above: Clinicians in personal therapy or treatment with a psychiatrist should inform their therapist and/or psychiatrist about all aspects of this training, including experiential components and secure their therapist’s and/or psychiatrist’s support to participate before beginning this training. (O1/2) *

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5b. Those with limiting or special medical conditions (pregnancy, a heart condition, seizures, ocular difficulties, etc.) should consult their medical professionals before participating in this training and should discuss their condition(s) with the training director in advance of submitting their application to participate in the training. (O1/2) *

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5c. Those who presently have or who have previously been diagnosed with a dissociative disorder should not participate without special arrangements being made with the training director or training coordinator as part of the application for registration. Failure to advise the training director or coordinator of such issues in advance could place you at risk, negatively impact other participants, and result in dismissal from the training without refund. (O1/2) *

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6. Although it rarely happens, the Parnell Institute may determine that a participant who is not able to participate fully, (e.g., the trainer determines that the participant is not emotionally or physically stable and safe enough to be in the client or therapist role, which undermines the educational process of others, the participant has not adequately mastered the material, or is disruptive to the training) will be dismissed at the Parnell Institute’s discretion without a refund. If this were to occur, the Parnell Institute might allow the participant to remedy the issues and return at a later date. I understand this would be done at the participant’s own expense. I understand that, in some cases, the participant may not be permitted to return to the Parnell Institute Training. You are expected to maintain a spirit of cooperation and mutual support for all in the training. You agree that the training director has the right to dismiss anyone who is disruptive from the training at any time without a refund. (O1/2) *

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7. This experiential training is intended to prepare clinicians to apply Attachment-Focused EMDR for clinical purposes only and will not qualify the participant to train others in Attachment-Focused EMDR. Attempts to train others in Attachment-Focused EMDR without meeting the standards as defined by the Parnell Institute, would represent a violation of professional ethics and standards. (O1/2) *

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8. To assure confidentiality of personal and clinical information, audio or video recording by participants is not allowed. Please inform the training coordinator if you require accommodations so that we may do our best to assist you. All participants shall maintain the highest ethical standards of confidentiality regarding all personal and clinical information shared by others in this training. Failure to maintain confidentiality shall be treated as a professional ethics issue and may result in immediate dismissal from the training program with no refund. Confidentiality shall apply to all practicum experiences: specifics may be discussed only with members of the immediate consultation or practice group, the participant's group consultant, practicum supervisor, and trainer(s). Outside the training, a participant may share his or her own emerging material with anyone. (O1/2) *

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9. Participants agree to read in their entirety and thoroughly study L. Parnell: A Therapist’s Guide to EMDR New York: W. W. Norton & Company, Inc. and L. Parnell: Attachment-Focused EMDR New York: W. W. Norton & Company, Inc. Participants must pay for the above study materials in addition to the course tuition. Participants will be provided one copy of the course manual and worksheets during the training. A fee of $35 will be charged for replacement copies of the course manual for in-person training, included in VIRTUAL TRAININGS.(O1/2) *

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10. I have been informed and understand this is an Attachment-Focused EMDR Training and is not an EMDRIA affiliated training. (O1/2) *

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11. A Certificate of Completion will be issued to all participants who satisfactorily complete the entire training Parts 1-3, including the online learning assessments, the assigned readings, and demonstrate through group discussion, practice exercises, and the required 10-hours of consultation, an understanding and application of the Attachment-Focused EMDR treatment approach. (O1/2) *

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12. Attendance Policy: Participants must attend all training days and actively participate in all supervised practice exercises and subsequent 10-hour small group consultation sessions to receive a certificate of completion for this training. Some training programs are held in person. Others are held via Zoom. Your registration form specifies how the training program is being held. Attendance is actively monitored and recorded in both formats. Those who attend this training in full and complete all the appropriate evaluation forms will receive CE credits. Those arriving more than 15 minutes after the start time or leaving more than 15 minutes before the training is completed will not receive CE credits. (O1/2) *

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13. Use of Copyrighted Training Materials: The printed course manual, PowerPoint Slides and other original materials provided by the Parnell Institute are all copyrighted by Laurel Parnell, Ph.D. Participant is granted a limited license to copy these copyrighted materials for their own study and use in their clinical practice. The participant agrees not to distribute these materials in physical or digital copies to anyone else unless they have previously received written permission from Laurel Parnell, Ph.D. Participant agrees that violating this limited license without such written authorization will subject the participant to full legal penalties for copyright infringement. (O1/2) *

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14. Waiver and Release: I know that participating in this training can result in me experiencing emotional distress, whether during or after the training. I also know that I should not participate in this training unless I am medically and psychologically able to do so. I also acknowledge that it is impossible for the Parnell Institute to determine ahead of time whether I will experience emotional distress as a result of participating in this training. I agree to abide by any decision of the Parnell Institute relative to my ability to safely participate in this training. I assume all risks associated with participating in this training, including, but not limited to, those set forth in section 4. above. Having read this waiver and knowing these facts and in consideration of the Parnell Institute accepting me into this training program, I, for myself and anyone entitled to act on my behalf, waive and release the Parnell Institute from ALL claims and liabilities of any kind arising out of my enrollment or participation in this training or my dismissal from it. (O1/2) *

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15. Mandatory Arbitration Agreement: I agree that any dispute or controversy between me and the Parnell Institute, whether based on tort, contract, or equitable relief, and that would otherwise be adjudicated in a court of law shall be submitted to and determined by binding arbitration under the California Arbitration Act (California Code of Civil Procedure §§ 1280, et seq.); provided, however, that in addition to the requirements imposed by California law, any arbitrator shall be a retired California Superior Court judge. (O1/2) *

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Accepted and agreed: (Participant Signature)(O1/2) *

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Date Signed: (O1/2) *