EFRS rates adherence; it does not certify competence, indication, or outcome
EMDR Fidelity Rating Scale: EFRS use, evidence, and limits
Understand EFRS Version 2.1, five-part structure, scoring context, rater requirements, licensing, validation limits, privacy, and product boundaries.
By the EMDRSuite Editorial Team
Product claims checked against the current EMDRSuite code and interface.
No independent clinical reviewer is named for this guide.
EFRS Version 2.1 is a five-part application
The EMDR Research Foundation describes EFRS Version 2.1, dated 12 January 2023, as a five-part application for rating adherence to the standard eight-phase approach and three-pronged protocol. It includes scoring forms, a manual, clinician forms, a blank workbook, and a sample workbook.
The publisher states that the scoring forms and workbooks should not be used without the manual or its relevant sections. The material is licensed CC BY-NC-ND 4.0, so open access does not permit altered or commercial republication of the instrument.
A fidelity score answers a narrow question
EFRS can support research rating, clinician review, and consultation about whether specified procedures were delivered as intended. It does not by itself establish clinical competence, formulation quality, treatment indication, cultural responsiveness, patient safety, therapeutic alliance, or benefit.
A high adherence score can coexist with poor timing or an unsuitable target; a good outcome can occur without proving protocol fidelity. Scores need the protocol named, the relevant session context, trained rating, and transparent handling of not-applicable items.
Do not merge distinct fidelity measures or validation claims
An earlier scale was developed for the 2007 van der Kolk trial and later versions evolved through user feedback. A 2019 study examined interrater reliability for a modified EMDR fidelity checklist; that finding should not be relabeled as validation of every EFRS item, workbook, subscale, language, or use.
Reliability, content coverage, treatment adherence, predictive validity, and competence assessment are different properties. Translation or local adaptation would also require permission and evidence rather than editing the official files and retaining the EFRS name.
Recording and software use add privacy boundaries
Fidelity review may involve session recordings, observation, consultation, or detailed notes. Consent, data minimization, storage, access, retention, cross-border transfer, and the patient's right to decline require separate handling under applicable professional and legal rules.
EMDRSuite does not record sessions by default, import EFRS files, score the EFRS, rate adherence, certify competence, or send patient material to a consultant. A completed clinical note is not an automated fidelity assessment.
FAQ
EMDR Fidelity Rating Scale
What does the EFRS measure?
It rates adherence to specified standard EMDR procedures across a session or treatment course; it does not directly measure competence or outcome.
What is the current EFRS version?
The publisher lists Version 2.1, completed on 12 January 2023.
Can I modify and republish the EFRS?
The official material is licensed Attribution-NonCommercial-NoDerivatives; check the current license and publisher instructions before use.
Does EMDRSuite calculate an EFRS score?
No. It does not import, reproduce, score, or interpret the EFRS.
References
EMDR Fidelity Rating Scale: EFRS use, evidence, and limits
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