Practitioner Certification Assessment Templates
Supporting Assessment Templates
These templates are a controlled companion document to the Practitioner Certification Standards. They support reviewed session assessment, certification portfolio decisions, renewal review, and event participation records.
They are public for transparency, but they do not replace the standards. Where a template and the standards diverge, the standards prevail.
Practitioner Certification Standards Certification Overview
Deep Emotional Work Academy
Issued by: Emotion Coaching gUG (haftungsbeschraenkt) Version: v2026-07-05-draft Status: Internal adoption draft, companion to the Practitioner Certification Standards Effective date: To be set upon adoption Controlling document: Practitioner Certification Standards v2026-07-05-draft. Where a template and the standards diverge, the standards prevail.
Purpose and Use
This document contains the controlled evaluation sheets used to assess certification candidates and practitioners under the Practitioner Certification Standards. It is maintained separately from the standards so that layout and usability can improve without changing certification requirements.
Use rules:
- One Session Assessment Sheet (Template A) is completed per reviewed session submission.
- One Certification Portfolio Review and Decision Sheet (Template B) is completed per certification decision.
- One Renewal Review Sheet (Template C) is completed per renewal decision.
- One Event Participation Record (Template D) is completed per on-site or live event certificate.
- Each criterion is rated Met or Not Met. Criteria that do not apply to a session are marked N/A and are excluded from the assessed-criteria counts, per Section 5.4 of the standards.
- Any Not Met rating in Client Safety and Boundaries triggers the safety flag procedure in the standards, regardless of overall scores.
- Completed sheets are candidate records and are handled under Section 5.6 of the standards (access limits, secure storage, data protection, retention).
Template A: Session Assessment Sheet
A.1 Session Identification
| Field | Entry |
|---|---|
| Candidate name / ID | |
| Certification level pursued | DES / DEP |
| Session ID and date | |
| Submission date | |
| Session type | client / practice participant / peer practice |
| Techniques applied | |
| Processing techniques used in this session | yes / no |
| Processing clearance on file (required if yes) | yes / no / n.a. |
| Reviewer name and role | |
| Review context | instructor review / supervision / audit |
A.2 Submission Completeness
| Check | Yes / No |
|---|---|
| Consent and confidentiality record present | |
| Anonymization maintained throughout | |
| Pre-session assessment complete | |
| Session documentation complete (recording where required, protocol notes) | |
| Post-session reflection complete |
An incomplete submission is returned for completion and is not scored.
A.3 Domain 1: Client Safety and Boundaries
| Criterion | Met / Not Met / N/A | Notes |
|---|---|---|
| Readiness assessment documented before technique application | ||
| Stabilization established before processing | ||
| Signs of overwhelm, dissociation, or destabilization recognized and addressed if present | ||
| Session closed with explicit grounding or containment | ||
| No escalation beyond demonstrated client or participant capacity | ||
| Referral, consultation, or supervision considered where appropriate | ||
| Confidentiality and anonymization maintained |
Safety flag: Any Not Met above -> mandatory review under Section 4.1 of the standards. Flag raised: yes / no. Date and route: ______
A.4 Domain 2: Technique Execution
Stabilization technique group (all candidates):
| Criterion | Met / Not Met / N/A | Notes |
|---|---|---|
| Technique selected is appropriate for the current phase | ||
| Initiation or induction protocol followed correctly | ||
| Pacing adapted to observable client or participant state | ||
| Containment or grounding provided before, during, or after the technique as needed | ||
| Clean exit from the technique with no unresolved activation left open |
Processing technique group (Processing Level sessions only; otherwise N/A):
| Criterion | Met / Not Met / N/A | Notes |
|---|---|---|
| Readiness for processing assessed before initiation | ||
| Processing protocol executed correctly | ||
| Activation or abreaction managed safely | ||
| Processing work integrated with stabilization rather than treated as an isolated protocol | ||
| Transition into and out of processing managed, including any decision not to proceed |
A.5 Domain 3: Process Awareness
| Criterion | Met / Not Met / N/A | Notes |
|---|---|---|
| Rationale for technique selection is coherent | ||
| Phase identification is correct | ||
| Contraindications considered and documented | ||
| Deviations from plan explained with sound reasoning | ||
| Post-session reflection identifies genuine learning points | ||
| Candidate integrates prior feedback into later practice |
A.6 Domain 4: Ethical Conduct and Professional Integration
| Criterion | Met / Not Met / N/A | Notes |
|---|---|---|
| Consent documented where recording or assessment submission is involved | ||
| Qualifications and role represented accurately | ||
| Scope and supervision requirements respected | ||
| Documentation is precise, descriptive, and reconstructible | ||
| Communication is respectful and professionally appropriate |
A.7 Session Score Summary
| Field | Entry |
|---|---|
| Criteria assessed (excluding N/A) | |
| Criteria met | |
| Session percentage met | |
| Session below 60% | yes / no |
| Safety flag raised | yes / no |
A.8 Written Feedback
- Strengths observed:
- Development areas:
- Required actions before next submission, if any:
- Feedback delivered to candidate on (date, form):
Reviewer signature and date: ______
Template B: Certification Portfolio Review and Decision Sheet
B.1 Candidate and Level
| Field | Entry |
|---|---|
| Candidate name / ID | |
| Certification level pursued | DES / DEP |
| Prior DES certification, if pursuing DEP | number / date / n.a. |
| Decision-maker name and authority | |
| Conflict of interest declared per Section 7.1 | none / declared and handled (attach note) |
B.2 Minimum Volume Checklist (Section 5.3)
| Requirement | Required | Documented | Met |
|---|---|---|---|
| Documented client or practice sessions total | 25 | ||
| Distinct clients or practice participants | 10 | ||
| Sessions with direct instructor review | 10 | ||
| Sessions including processing techniques (DEP only) | 8 | ||
| Structured peer practice sessions | 10 | ||
| Peer practice sessions in practitioner role with processing techniques (DEP only) | 4 | ||
| Self-experience with Academy techniques | 10 hours | ||
| Supervision hours total | 18 | ||
| Of which individual supervision | 6 |
B.3 Portfolio Score Summary
| Field | Entry |
|---|---|
| Reviewed sessions in portfolio | |
| Cumulative percentage of assessed criteria met | |
| Sessions below 60% | |
| Open safety flags | |
| Unresolved conduct, confidentiality, or scope issues |
B.4 Domain Summary
| Domain | Standard met (yes / no) | Basis |
|---|---|---|
| 1. Client Safety and Boundaries | ||
| 2. Technique Execution (technique groups for the level) | ||
| 3. Process Awareness | ||
| 4. Ethical Conduct and Professional Integration |
B.5 Decision (Section 7.2)
Select one:
- Certified at the level pursued
- Certified at Stabilization Level with Processing Level deferred (DEP candidates only; development plan attached)
- Certification deferred with development plan (development plan attached)
- Not yet certified (written feedback attached; reassessment interval stated)
- Certification declined (written statement attached)
| Field | Entry |
|---|---|
| Certificate number issued, if any | |
| Certification level issued | DES / DEP / none |
| Scope statement on certificate | |
| Applicable supervision requirement | |
| Valid until | |
| Appeal rights communicated (Section 7.3) | yes / n.a. |
Decision-maker signature and date: ______
Template C: Renewal Review Sheet
C.1 Practitioner and Certificate
| Field | Entry |
|---|---|
| Practitioner name / certificate number | |
| Certification level | DES / DEP |
| Certificate valid until | |
| Renewal application received on | |
| Grace period / temporary authorization status | n.a. / details |
C.2 Renewal Requirements (Section 8)
| Requirement | Required | Documented | Met |
|---|---|---|---|
| DEW-relevant sessions in the three-year period | 30 | ||
| Supervision or consultation hours | 12 | ||
| Continuing professional development hours | 24 | ||
| Processing-related practice and supervision reflected (DEP, where required) | per Academy | ||
| Accurate representation of the credential confirmed | confirmation | ||
| No unresolved complaints, conduct, confidentiality, or scope issues | check |
C.3 Decision
Select one:
- Renewed at current level (new valid-until date: ______)
- Renewal deferred pending completion of stated items (attached)
- Not renewed; certificate lapses per Section 8
Decision-maker signature and date: ______
Template D: Event Participation Record
| Field | Entry |
|---|---|
| Participant name | |
| Event name | |
| Dates and location or delivery format | |
| Total contact hours | |
| Technique or topic areas covered | |
| Perspective | self-experience / guided peer practice / observation |
| Attendance requirement met | yes / no |
| Active engagement confirmed by lead instructor | yes / no |
| Conduct, confidentiality, and safety record clear | yes / no |
| Certificate of Event Participation issued | yes / no |
| Hours creditable toward (if any) | training phase / self-experience / CPD / none |
| Crediting recorded in candidate or practitioner record | yes / n.a. |
Lead instructor signature and date: ______
Boundary Statement
Deep Emotional Work Academy materials are non-clinical professional education by default. They are not medical or psychological advice, diagnosis, treatment, psychotherapy, cure, or a guaranteed mental-health outcome. Assessment under these templates evaluates competence in non-clinical educational techniques within the boundaries of the Practitioner Certification Standards. Matthias Behrends is not a licensed therapist or psychologist.
Deep Emotional Work Academy Emotion Coaching gUG (haftungsbeschraenkt), Mannheim, Germany www.deepemotionalwork.academy
Copyright Emotion Coaching gUG. All rights reserved. Internal controlled document; not for external distribution before adoption.