For the cases that are layered, long-standing, and need more than a standard approach.
cPTSD · Attachment Wounding · Developmental Trauma · IFS & Parts Work · Adolescents · Self-Injury · Polyvagal-Informed Care · Complex Presentations
Pre-licensed and fully licensed clinicans
Case Consultation for Licensed Therapists
Your client is counting on you.
Let's think through it together.
Case-specific consultation for licensed therapists navigating complex trauma, stuck treatment, and the cases that keep you up at night.
You're a licensed therapist. You've done the training, you know your client, and you're still not sure what's happening — or what to do next.
Sometimes the hardest part isn't the case itself. It's carrying it alone at the end of a long day.
That's not a gap in your competence. That's a complex case. And complex cases deserve consultation.
This is a focused clinical conversation, not supervision. No evaluation, no paperwork, no power differential. Just honest, experienced perspective on your most challenging cases — from a therapist who has spent her career in exactly this territory.
The Cases That Need Extra Care
Sound like one of yours?
A client with complex developmental trauma whose therapy keeps circling without moving forward
A trauma presentation that doesn't fit the textbook — and standard approaches aren't landing
A teenager who is self-harming and a family that is making everything harder
Suicidal ideation that you navigated in session but are still carrying afterward
A client who has seen multiple therapists over many years and is still stuck — and now they're hoping you'll be different
Something happened in session that you can't quite name, but you know it matters
Parts work that keeps hitting a wall — protectors who won't allow space for deep healing
Anxiety or depression with something deeper underneath that you can't quite get to
You're a newer therapist and you feel in over your head — and you're not sure who to ask
You're burnt out, running on empty, and this one case is the one you can't stop thinking about
What I Consult On
My Consultation Specialties
Complex developmental trauma, attachment, & cPTSD — early, relational trauma that lives in the body and shapes how your client sees everything; presentations that go beyond a PTSD framework
IFS & parts work — strong protector parts, clients who shut down or flood when you try to go deeper, firefighters running the show
Teenagers, self-harm & family dynamics — adolescent trauma presentations, safety planning that is actually useful, navigating parents who are part of the problem
Suicidality & risk — holding risk without rupturing the relationship; safety planning that goes beyond a form
The "nothing has worked" client — long therapy histories, multiple treatment failures, deeply entrenched patterns; figuring out what they actually need
Polyvagal-informed case conceptualization — making sense of nervous system responses that are driving what you're seeing in the room
Newly basic-trained EMDR therapists — if you've completed your basic training and feel nervous or not quite ready to use it with clients, I can help you get started with confidence (Note: I am not a certified EMDR consultant and this is not formal EMDR consultation)
About Emily
Who You're Consulting With
I'm Emily Lemke, LCSW-C. My practice is built entirely around complex trauma and attachment — clients with cPTSD, significant mental health histories, and presentations that other therapists often find challenging. I work from an IFS and EMDR framework, informed by polyvagal theory, DBT, and attachment research.
Before private practice, I worked in community mental health, residential treatment, mobile crisis, inpatient psychiatric units, and psychiatric emergency intake. I currently carry a full caseload with a consistent waitlist.
I bring all of that into consultation. My style is direct and warm — I'll tell you what I actually think, ask questions that help you see what you might be missing, and help you leave with a clearer picture of your case.
Read more about me and my experience. About Me and Therapist Mentoring and Clinical Coaching
The Basics:
Frequently Asked Questions
Clinical Questions:
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Yes. IFS is my primary lens, but I consult with therapists who use all kinds of approaches. I'll meet you and your client where you are and offer perspective you can translate into your own clinical framework.
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I use EMDR in my own practice and love it, but I am not a certified EMDR consultant, so I don't offer formal EMDR case consultation. The one exception: if you've completed your basic training and feel not quite ready to use it with clients, I'm happy to help you get started. That "bridge the gap between training and practice" conversation is one I'm glad to have. I can answer your lingering questions from basic training and offer encouragement to take the leap and start using EMDR with your clients.
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Yes — that feeling is often the most important signal. Bring it exactly like that. We'll think through it together.
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Please do. These are among the most important cases to consult on, and the ones therapists most often carry alone. We can talk through the clinical picture, how to approach this sensitive topic, what your documentation should look like so you protect yourself and your client, how to hold risk without rupturing the relationship, and how to take care of yourself when you're carrying something this heavy.
Please note: you should always seek additional consultation with your supervisor, agency, or licensing board around appropriate next steps with any client who is a safety risk.
Logistics:
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You bring a case. We dig in — what's happening, what you've tried, where you're stuck. I ask questions, share observations, and give you my honest clinical perspective. You leave with a clearer picture and a concrete next step, not just more questions.
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Sessions are 60 minutes at $50/hour, or $30 for 30 minute. — intentionally priced to be accessible for new graduates or interns. Most peer consultation runs $100–$200/hour. I set my rate at $50 because I know what it feels like to be a newer clinician carrying a hard case with limited resources, and I don't want cost to be the reason you sit with it alone. No package required, no long-term commitment — book as many or as few as you need.
Group consultation for two or more clinicians is available at $40/hour per person. If you are interested in joining a group, please complete this form.
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All case information is kept confidential. As is standard in consultation, please share only the clinical detail necessary — no identifying information is required. I follow all applicable HIPAA standards.
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Sessions are available 8am–10pm EST to accommodate full clinical schedules. Book your free 20-minute intro call and we'll find a time that works.
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Absolutely! I am always working to get a well-matched groups together. If you are interested in joining a group, please fill out this brief form so you can be contacted when there is enough interest.
In the meantime, you can schedule individual case consultation here.
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No — and that distinction matters. This is peer consultation between licensed colleagues. There is no evaluation, no documentation, and no power differential. I am not your supervisor. If you need formal licensure supervision hours, you'll need a board-approved supervisor in your state. What this offers is something different: honest clinical perspective on a specific case from an experienced trauma therapist.
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This is open to licensed mental health clinicians at any level — including graduate-level licenses such as LMSW, LGPC, and equivalents, as well as fully licensed clinicians (LCSW, LCSW-C, LMFT, LPC, LCPC, PhD, PsyD, and others). New graduates are welcome.
A few things to be clear about: these sessions are consultation, not supervision. They do not count toward licensure hours, cannot be used to fulfill supervision requirements, and I am not acting as your supervisor in any capacity. If you are a newer clinician who also needs formal supervision hours, you'll need a board-approved supervisor in your state for that piece — this is something separate and different.
If you're pre-licensed or an intern, this page isn't the right fit — but my Therapist Mentoring & Clinical Coaching page was built for exactly where you are right now.
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No. Consultation is available to licensed therapists anywhere — sessions are held virtually and there are no geographic restrictions.
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No. These are consultation sessions and do not count toward licensure hours or CEUs.
Your most complex cases deserve a second set of eyes.
Consultation isn't a sign that you don't know what you're doing. It's a sign that you take this work seriously enough to do it right.