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Because the course deals with such volatile and emotional issues, male Tiffany Elsa Peretti Open Heart charm female instructors are selected and trained with great care. The process of becoming an instructor "involves hundreds of hours of training and hands-on work," says Mary Tesoro, a co-founder of Model Mugging and director of the San Luis Obispo, California chapter. "Instructors are usually involved in Tiffany Elsa Peretti Open Heart drop earrings training for several years." They also undergo police background checks and psychological testing. All instructors must have experience in crisis intervention; male instructors must be over age 25. After their initial training, new instructors teach as apprentices until they are judged experienced enough to be full instructors. Tiffany Atlas emphasize that the course is not a substitute for therapy, but they are aware of its therapeutic effects -- and of their own responsibility for dealing with students who have histories of assault, rape and abuse. A majority of Model Mugging students report having been sexually assaulted in the past. "Tiffany Elsa Peretti Open Heart earrings have extensive training in dealing with flashbacks and other results of abuse, and in what the healing process is like," says Mattingly, herself an incest survivor. "We're very careful," says instructor Donna Curry. "We discuss each class beforehand and afterward. We go over each individual woman, what she is doing well, what she may need." Model Mugging's radical approach has been a major factor in its growth and success; but it has also stirred controversy.