Who should not use EMDR

EMDR is a well-established trauma psychotherapy. It is also a modality with specific contraindications, specific training requirements, and a specific scope. What follows is the honest version of what Rivet’s Workspace is and isn’t — and the categories where EMDR is not the right tool.

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Training and credentialing

Rivet’s BLS Workspace is a delivery tool for clinicians trained in EMDR therapy. It is not a substitute for EMDR training. The internationally recognized training pathways are:

• EMDR International Association (EMDRIA) — the US-based EMDR professional body. EMDRIA-approved Basic Training is the standard US credential. EMDRIA Certified Therapist and EMDRIA Approved Consultant are the higher tiers.
• EMDR Canada — the Canadian EMDR professional body. EMDR Canada Basic Training is the standard Canadian credential. EMDR Canada Certified Therapist is the higher tier.
• EMDR Europe — the European EMDR association with equivalent training pathways across European member countries.

Basic Training is typically two 3-day modules with practicum and consultation hours between. The minimum is usually around 50 hours of training plus 10 hours of consultation before independent practice. If you haven’t completed an EMDR Basic Training from one of these (or an equivalent recognized body), the BLS Workspace is not the right starting point. The protocol structure, the case conceptualization, the consent process, and the clinical judgment required to safely use BLS are taught in the training — not in this knowledge base and not in the Workspace itself.

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What Rivet’s Workspace replaces

A few specific things in your existing EMDR setup that the Workspace takes over:

• In-office BLS hardware — light bars, audio kits, handheld tappers. The Workspace runs visual + audio + (Android) haptic without any hardware on either end.
• Generic video tool + separate BLS browser tab — the Workspace lives inside the same video session as the call itself. No second window, no pivot, no awkward share-screen.
• Manual SUDS tracking — the between-sets card captures the score and the session arc renders the trajectory automatically. Copy to your chart at the end.

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What Rivet’s Workspace does not replace

• EMDR training. See above.
• Case conceptualization. Phase 1 (history-taking and treatment planning) is your clinical judgment, not a Rivet template.
• Informed consent. Your usual EMDR consent process — including the visual modality risks, the rate range, what to do if symptoms arise — is the authoritative consent layer. Rivet’s photosensitive-epilepsy warning modal is a backstop, not a substitute.
• Consultation and supervision. If you’re early in EMDR practice or working with a complex case, the consultation hours your training required don’t go away because the tooling improved.
• A clinical diagnosis. EMDR is a treatment for trauma-related conditions. The diagnosis — PTSD, complex PTSD, single-event trauma, developmental trauma — is yours to make using the standard diagnostic tools. Rivet’s PCL-5 template pairs with EMDR work for PTSD severity tracking.

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Contraindications and cautions

These are clinical categories where EMDR is not appropriate, or not appropriate without specialized adaptation. None of this is Rivet-specific — these are the standard EMDR clinical contraindications your training will have covered. The list is for orientation, not clinical authority.

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Active psychosis

EMDR is not appropriate during an active psychotic episode. The dissociative quality of reprocessing can complicate or worsen psychotic symptoms. EMDR may be appropriate after stabilization with an EMDR- trained clinician experienced with severe mental illness.

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Severe dissociative disorders without adapted protocol

Dissociative Identity Disorder, OSDD, and severe dissociative presentations require the dissociative-adapted EMDR protocol — typically more Phase 2 work, slower pacing, and specialized training in working with parts of self. The standard 8-phase protocol is not sufficient. If you’re not specifically trained in dissociative-adapted EMDR, screen for dissociation (DES-II, MID) before running reprocessing and refer to a trained colleague if dissociation scores are elevated.

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Active substance use that compromises memory

EMDR reprocessing requires the client to track the target and engage working memory. Active intoxication, withdrawal, or chronic substance use that has degraded working memory compromises both. Stabilize substance use before reprocessing.

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Acute suicide risk

EMDR can intensify affect during reprocessing. A client with acute suicidal ideation should be stabilized (safety planning, crisis support, psychiatric consultation as needed) before reprocessing begins. The PHQ-9 screening template flags Item 9 (suicidal ideation) as a manual review item — the screening is yours to act on.

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Medically unstable conditions

Active cardiac events, severe respiratory illness, uncontrolled seizure disorder, pregnancy complications — any condition that makes sustained affect arousal medically dangerous is a contraindication for EMDR in that window.

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The photosensitive seizure list

Photosensitive epilepsy, recent concussion, active migraine with aura, severe vestibular disorder, recent eye surgery — the visual modality is contraindicated. Audio + haptic remain available. See Photosensitive epilepsy safety.

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Children and adolescents

EMDR is delivered to children and adolescents, but with developmentally adapted protocols (Greenwald, Tinker & Wilson, EMDRIA’s Child & Adolescent Specialty). The standard adult 8-phase protocol is not appropriate for young children without adaptation. Rivet’s Workspace is the same tool regardless of client age — but delivering it to a child requires the developmentally adapted protocol and training in child EMDR.

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When in doubt, refer

EMDR’s reach is wide but it is not the right tool for every trauma presentation, and not every contraindication is obvious on first read. If you’re uncertain whether EMDR is appropriate for a given client — because of a complex history, an unfamiliar diagnostic picture, or a case that’s stretching your current scope of practice — refer or consult. The clinical relationships you’ve built around your practice — peer consultation, EMDR-Approved Consultants, your training organization’s member directory — are the right escalation paths. Rivet’s tooling doesn’t change that.

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What Rivet does claim

• “EMDR 2.0 and Classic EMDR modes”
• “Visual, audio, and phone-haptic bilateral stimulation”
• “Your client installs nothing”
• “Designed around the de Jongh / Matthijssen EMDR 2.0 protocol”
• “Per-practitioner preferences saved across sessions”

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What Rivet doesn’t claim

• “EMDRIA-certified.” There is no such certification for software, and Rivet doesn’t claim one.
• “Superior efficacy.” EMDR 2.0 has equivalent outcomes to Shapiro standard with fewer sets — not superior outcomes.
• “VA-approved.” That distinction belongs to specific clinical programs, not to Rivet.

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