As more EMDR therapists begin offering high-quality intensive work, a common question arises: What happens when an intensive client wants to continue with ongoing therapy?
If this is something you’ve been wondering about, you’re not alone. Many clinicians find themselves navigating this territory as they transition into an intensive-forward practice structure.
In today’s episode, Dr. Carolyn Solo dives into how to thoughtfully decide when to continue working with former intensive clients, when not to, and how to structure that ongoing work so it aligns with the practice you want to build.
She also shares a composite case example that illustrates how this can unfold in real life.
Let’s break it down.
Designing Your Ideal Practice Structure
Before discussing ongoing work, Carolyn starts where she always does with her coaching clients: your ideal practice vision.
When shifting to an intensive model, most therapists are still juggling:
- A traditional 50-minute caseload
- Clients already in long-term work
- A desire for fewer hours and higher impact
- A growing interest in intensives
Because of this, Carolyn typically recommends that when you first transition into intensives, you only offer intensives to new clients.
This helps you:
- Create a clean, intentional structure
- Avoid accidentally recreating a full ongoing caseload
- Build the practice you actually want—not the one that “just happens”
Once the foundation is set, ongoing work can be an option—but only by choice, not obligation.
When Ongoing Work Isn’t the Right Fit
As Carolyn explains, many intensive clients finish their 15 hours, experience significant relief, and feel complete.
Others may want more—but that doesn’t mean the answer must be yes.
Here are reasons she might decline ongoing work:
- It doesn’t fit the structure she wants for her practice
- The client’s needs are better supported by a weekly therapist
- Continuing would compromise her flexibility or bandwidth
Importantly:
She never promises ongoing work during the consult or the intensive itself, so she is free to decide ethically and cleanly at the end.
When Ongoing Work Is Appropriate
Sometimes an intensive opens up additional material that is:
- New
- Previously inaccessible
- Emerging due to increased stability
- Ready for reprocessing
If:
- The therapeutic relationship feels solid
- The work feels meaningful
- The client expresses interest in continuing
- And the structure fits her practice model
…then Carolyn may say yes.
But this comes with clear boundaries.
How Carolyn Structures Ongoing Work
She never shifts the client into weekly therapy.
Instead, she maintains:
- Longer sessions (90 minutes or 2 hours)
- Every-other-week pacing
- A defined focus (specific memories, themes, or goals)
- A time-limited plan
This helps avoid:
- Drifting back into traditional unstructured therapy
- A bloated caseload
- Burnout
- Disrupting her intensive schedule
Boundaries protect the therapist and the client.
A Composite Case Example
Carolyn shares a blended case (intentionally de-identified) to explain how this works.
The Client’s Initial Presentation
- Came specifically seeking a 15-hour EMDR intensive
- In deep distress due to emotional infidelity in their marriage
- Was being told by their partner that their trauma was causing marital problems
- Felt immense pressure to “fix themselves”
During the intensive, a more accurate picture emerged:
- The partner had significant narcissistic and emotionally abusive patterns
- The infidelity was real
- The client’s trauma was not the problem
- The relationship was unsafe, confusing, and gaslighting
Through focused EMDR work, the client gained clarity and decided to end the marriage.
After the Intensive
With safety and distance restored, additional childhood trauma memories surfaced—memories the client had been too overwhelmed to process before.
The client reached out, asking for continued work.
Carolyn’s Decision
She said yes—because:
- The work was meaningful
- The client was motivated
- There were specific memories to target
- It aligned with her practice structure
The Structure
She offered:
- Six two-hour sessions
- Every other week
- Focused exclusively on identified target memories
At the conclusion, Carolyn initiated the termination, ensuring:
- The client returned to their ongoing therapist
- There was no abandonment
- The work stayed boundaried and intentional
Why This Matters
Continuing work with former intensive clients can be:
- Deeply fulfilling
- Clinically appropriate
- Transformational for the client
But only when it fits your practice structure.
You are allowed to decide your own boundaries.
A sustainable, high-impact EMDR practice depends on it.
Want Support Structuring Your Practice?
Carolyn now offers:
- One-on-one EMDR business coaching
- The EMDR Intensive 12-Week Group Program
- Single-session 2-hour business intensives with one month of Slack support
If you want help restructuring your practice, clarifying your boundaries, or building an intensive-forward caseload, Carolyn can support you.
Ready to transform your practice?
Book your free 30-minute consultation call here:
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