After completing this form please click SUBMIT and allow the information to process. This may take up to 30 seconds. When complete you will be directed to your CIT contract.

Be sure to check your inbox for a confirmation email once you have submitted your form. If you did not receive a confirmation, your form was not received by Shrink, Inc.

  • hours toward becoming a Certified in EMDR.  This contract is for 2 years as of the date of the signature below. Each consultee needs to have a clinical caseload in order to be in the certification track, have malpractice insurance and maintain proper licensure and supervision according to your professional state board.

    Payment: It will be agreed that a fee of $150.00 per hour will be charged and paid at the scheduled consultation hour.  If the consultee cancels 24 hours before the scheduled meeting the fee will not be charged. For group consultation, the fee will be split between the attendees.  The group can decide if absent person’s portion will be paid by the rest of the group or the absent member.

    Susan Thompson LSCSW will evaluate the consultee in various areas listed on the Addendum that the consultee will demonstrate EMDR Basic Training Skills in order to be certified. Shrink Inc./Susan Thompson has no legal, ethical or clinical responsibility for the consultee or their clients.  This is not supervision.   

    The goal is for the consultee to know all aspects of the protocols and application of EMDR as the EMDR Institute and EMDRIA recommends. An Addendum will be attached to this document.

    The consultee will do the following:

                1. Read EMDR Basic Principles, Protocols, and Procedures by Francine Shapiro and be familiar with the basic AIP model, the 8 phase protocol and other protocols.

                2. Exercise good clinical judgment and reasoning when utilizing EMDR.

                3. Accept feedback in a professional manner from Susan Thompson LSCSW.

                4. Will be prepared with real life examples for consultation meetings in an organized manner to utilize time well.

                5. Will conduct 2 live demonstrations of an EMDR session with another person from the group using the 8-step protocol and all safety measures as outlined in the training to demonstrate fidelity of the EMDR model.


    Susan Thompson LSCSW will do the following:

                1. Give feedback on fidelity to the EMDR model with consultees.

                2. Enhance the consultee’s growth.

                3. Will present each phase for clarification and review.       

                4. Will convey any new information from EMDRIA and EMDR Institute.

                5. Evaluate consultee and make recommendations for further study or knowledge.

                6. Support consultee in problems as they arise and assist them in problem solving as problems arise.

                7. Help consultee know ethical and legal issues guidelines and teach these to consultees as needed.

                8. The hours accrued will be good for the duration of this contract.

  • MM slash DD slash YYYY