Comprehensive EMDR Protocol PDF Guide
EMDR therapy is such an innovative method, breaking traditional boundaries in psychological treatment. With origins dating back to the late 1980s, EMDR, or Eye Movement Desensitization and Reprocessing, has evolved into a well-recognized psychotherapeutic technique. Its efficacy backed by years of research and clinical practice has revolutionized therapy for trauma and PTSD. You can find the link to download the EMDR protocol PDF at the bottom of this blog post!
EMDR therapy unfolds in eight distinct phases, each designed to tackle various facets of a client’s emotional wellbeing. From delving into personal history to the actual reprocessing of traumatic memories, EMDR’s structured framework fosters profound changes. By moving through phases like Desensitization, Installation, and Body Scan, clients experience the transformative power of this method.
Embark on this comprehensive journey through the intricacies of the EMDR protocol. Accessible as a PDF guide, it offers a deep dive into everything from the theoretical foundations to EMDR’s clinical applications and research validations. Whether you’re a mental health professional or simply someone intrigued by this therapeutic breakthrough, prepare to explore the key components that make EMDR a trusted pillar in trauma therapy.
What is EMDR therapy?
EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories. By engaging the brain’s natural adaptive information processing mechanisms, EMDR therapy facilitates the healing of psychological trauma and provides relief from PTSD, anxiety, and various other mental health disorders. Unlike traditional talk therapies, EMDR focuses directly on the memory, and is intended to change the way that the memory is stored within the brain, thus reducing and potentially eliminating the problematic symptoms.
Definition of EMDR therapy
The core of EMDR therapy revolves around eight distinct phases – each serving a specific purpose within the larger treatment plan. This structured approach involves the client focusing simultaneously on spontaneous associations of traumatic images, thoughts, emotions, and body sensations, along with bilateral stimulation that is most commonly in the form of eye movements. The bilateral stimulation in EMDR therapy is believed to be akin to the psychological state that occurs naturally during dreaming or REM (rapid eye movement) sleep. Through this method, clients can reprocess the traumatic memory in a way that leads to psychological healing.
History and development of EMDR therapy
EMDR therapy was developed by Dr. Francine Shapiro in 1987 after she made the chance observation that eye movements can reduce the intensity of disturbing thoughts under certain conditions. Shapiro’s findings were corroborated by rigorous research, and EMDR was quickly recognized as an effective form of treatment for trauma and other disturbing experiences. Since its inception, this therapy has evolved and has been influenced by various other theories and practices. It is now a comprehensive protocol that integrates elements from many different psychological orientations and is widely endorsed by more and more mental health professionals and organizations worldwide. Its use has also been generalized to a variety of psychological conditions beyond PTSD.
The Phases of EMDR Therapy
Eye Movement Desensitization and Reprocessing (EMDR) therapy operates on a unique eight-phase protocol, serving as a roadmap for therapists and clients navigating through treatment. This structured approach, developed by Dr. Francine Shapiro, provides a comprehensive method to treat trauma and other psychological stress. Each phase builds upon the previous, facilitating the client’s journey from distress to recovery.
Phase 1: Client History and Treatment Planning
In Phase 1, the therapist meticulously gathers the client’s history to inform the treatment process. This foundation stage encompasses understanding the current situation the client is in and exploring past events that could be contributing to their current emotional distress or problematic behaviors. This knowledge allows the therapist to craft a tailored treatment plan which addresses client goals comprehensively, incorporating the client’s needs into the larger treatment plan.
Phase 2: Preparation
Preparation is key to ensuring clients are well-equipped for the journey ahead. During Phase 2, the therapist builds a rapport with the client and explains the EMDR process, including its potential effects and what to expect in subsequent sessions. Clients are equipped with stress-reduction techniques to utilize between sessions, laying the groundwork for successfully navigating future emotional disturbances.
Phase 3: Assessment
In the assessment phase, the therapist and client collaborate to identify a target memory for the session, including the associated image, beliefs, feelings, and body sensations. This phase sets the stage for processing as the client selects a negative belief to be replaced and identifies a positive belief to aim for, establishing a baseline for measuring progress across the EMDR journey.
Phase 4: Desensitization and Reprocessing
Desensitization is at the heart of EMDR therapy. In Phase 4, the therapist facilitates the client’s focus on the target memory while simultaneously inducing bilateral stimulation (often through guided eye movements). The goal here is to reduce the emotional charge associated with the memory. It’s common to experience shifts in emotions, thoughts, or body sensations, which are carefully monitored by the therapist.
Phase 5: Installation
With reduced emotional distress, the focus shifts in Phase 5 to strengthening the positive belief identified earlier in Phase 3. The client holds on to the positive belief while engaging in bilateral stimulation, helping to integrate this healthier perspective into their cognition more strongly.
Phase 6: Body Scan
Phase 6 involves a body scan to detect any residual physical tension or somatic distress linked to the target memory. If the client reports any body tension, the identified tension is specifically targeted with further processing to achieve full desensitization.
Phase 7: Closure
Given the intense nature of EMDR processing, Phase 7 ensures the client leaves each session feeling better than when they arrived. If processing is not completed, the therapist provides guidance to return the client to equilibrium. This may include the use of the techniques learned in Phase 2.
Phase 8: Reevaluation
At the beginning of subsequent meetings, Phase 8 entails looking back at previous sessions to ensure that progress has been maintained, and to verify the generalization of treatment effects to other areas of the client’s life. It’s a time to reassess and recalibrate the treatment plan, ensuring the client continues to move forward in their healing journey.
Following the EMDR protocol is crucial in providing structured and effective treatment. Professionals often rely on resources from reputable sources such as EMDR Consulting and Guilford Press for protocol guides and templates tailored to their clients’ needs. These resources ensure that the therapy is administered in line with the established best practices, allowing for the best possible outcomes.
Key Components of the EMDR Protocol
The EMDR Protocol is a structured form of psychotherapy that helps individuals process and integrate traumatic memories, negative beliefs, and physical sensations associated with distressing experiences. The protocol involves eight distinct phases:
- Phase 1: History Taking – This is where the therapist and client explore the client’s history to identify potential traumatic events for processing and to establish client goals for therapy.
- Phase 2: Preparation – The therapist explains the EMDR process to the client, establishes trust, and teaches the client self-calming techniques.
- Phase 3: Assessment – In this phase, the therapist helps the client select a target memory for processing and identifies the negative cognition associated with it, along with a positive cognition to replace it later.
- Phase 4: Desensitization – The therapist guides the client through sets of bilateral stimulation, typically eye movements, while the client focuses on the traumatic memory until the distress is reduced.
- Phase 5: Installation – Here, the positive cognition identified in Phase 3 is strengthened and associated with the target memory.
- Phase 6: Body Scan – After desensitization and installation, the client is asked to scan their body for any residual tension, which is then targeted for further processing.
- Phase 7: Closure – The session is brought to an end in a way that ensures the client feels better than at the beginning, regardless of what has been brought up during the session.
- Phase 8: Reevaluation – In subsequent sessions, the client’s progress from this and previous processing sessions are reviewed, and the treatment plan is adjusted as necessary.
These phases work collectively within the EMDR protocol to help individuals achieve therapeutic goals and integrate traumatic experiences into their larger life narrative.
Past Memory Worksheet Script
A Past Memory Worksheet in the context of EMDR assists clients and therapists in identifying and documenting specific details about targeted memories before advancing through the processing phases. This worksheet typically would ask for:
- Brief description of the targeted memory
- The negative cognition currently held about oneself in relation to the memory
- The positive cognition the client would like to believe instead
- The emotions and body sensations associated with the memory
- The Subjective Units of Disturbance (SUD) level
- Any other related memories
Therapists guide clients through this worksheet to anchor the processing work in specific, measurable terms and to create a clear roadmap for the session.
Focusing on Negative and Positive Cognitions
EMDR centers on the shift from negative to positive cognitions—the negative self-beliefs formed as a result of the distressing experience versus the positive beliefs that the client aspires to hold. During the Assessment phase (Phase 3), the client pinpoints the negative cognition (“I am powerless,” for example) and contrasts it with a positive cognition (“I am in control”). The processing in subsequent phases aims to weaken the hold of the negative belief and bolster the credibility of the positive one.
Subjective Units of Disturbance (SUD)
Subjective Units of Disturbance (SUD) scale measures the intensity of disturbance or distress the client feels when thinking about a particular memory or incident. The scale ranges from 0 (no disturbance) to 10 (highest disturbance). SUD levels are evaluated before and after processing a memory to gauge the effectiveness of the intervention and to determine when to move on to the next target.
Present Trigger Worksheet
The Present Trigger Worksheet helps to identify current situations that provoke the distress connected to the traumatic memory. This worksheet would ask for:
- Description of the situation causing distress
- The thoughts, emotions, and body sensations triggered
- Any negative cognitions activated by the present situation
- The SUD level associated with the current trigger
By delineating current triggers, therapists can address ongoing issues that are pertinent to the client’s day-to-day emotional well-being.
Future Template Worksheet
The Future Template Worksheet focuses on desired outcomes and the application of positive cognitions to upcoming situations. It often includes:
- Description of a future scenario that the client wishes to handle more adaptively
- The positive cognition that the client wants to apply
- Visual imagery of the scenario unfolding with the positive cognition in place
- Anticipated emotions and body sensations
This worksheet is part of EMDR’s unique contribution to enhancing future emotional functioning and resilience by preparing the client to face upcoming challenges with a new mindset.
Validity of Cognition
The concept of the Validity of Cognition (VoC) is a critical element in EMDR (Eye Movement Desensitization and Reprocessing) therapy, playing a pivotal role in the assessment and treatment planning stages. VoC is meant to gauge the client’s belief in the truthfulness of a positive cognition in relation to the targeted memory or issue. During EMDR therapy, clients are urged to rate the VoC on a scale typically ranging from 1 to 7, where 1 suggests complete disbelief in the positive cognition, and 7 indicates full belief that the positive cognition is true.
- Importance:
- Measures client’s belief in positive self-cognitions.
- Facilitates the identification of cognitive shifts during the reprocessing stages.
- Helps in assessing the progress and efficacy of the treatment.
- Implementation:
- Introduced typically in EMDR Phase 3 as part of developing the client’s target memory.
- Reassessed during Phases 4 to 7 at strategic points to note any changes.
- Outcome:
- A higher VoC post-treatment suggests a successful alteration in the cognitive-emotional association with the troubling memory.
- Lower VoC scores may indicate a need for further processing or reevaluation in Phase 8.
When the VoC score increases, it often reflects the client’s improved belief in their own positive self-statements, signifying progression in therapy.
Subjective Units of Disturbance
Subjective Units of Disturbance Scale (SUDS) is a self-assessment tool that allows individuals to rate their emotional distress on a scale, typically ranging from 0 to 10. Zero represents a state of complete calm, while 10 signifies extreme emotional turmoil. It’s used widely in various therapeutic settings but features prominently in Eye Movement Desensitization and Reprocessing (EMDR) therapy during the assessment phase, known as Phase 1.
During an EMDR session, the therapist will ask the client to evaluate their level of disturbance related to a specific target memory before commencing the processing phases (Phase 4 onwards). This baseline SUDS level helps to gauge the intensity of the client’s emotional reaction at the start and track changes throughout the therapy. It informs the therapist about the client’s current situation and helps to tailor the treatment planning to be most effective. After processing sessions, the SUDS score is reassessed to evaluate changes in emotional distress, providing insight into the generalization of treatment effects and informing any necessary adjustments to the larger treatment plan.
Short, concise paragraphs make SUDS information digestible, and a rating scale table could provide readers with a clear visual representation of how distress levels are categorized:
- 0: No distress
- 1-3: Mild distress
- 4-6: Moderate distress
- 7-9: High distress
- 10: Extreme distress
Remember, SUDS is subjective—it varies from person to person, providing a personalized metric to understand individual emotional experiences during therapy.
EMDR Research and Validation
Eye Movement Desensitization and Reprocessing (EMDR) has become a widely recognized psychotherapeutic approach, notable for its effectiveness in treating various trauma-related conditions. Numerous studies have been conducted to research and validate its efficacy, providing empirical support for its application in therapeutic settings. EMDR research spans several areas, including its impact on post-traumatic stress disorder (PTSD), anxiety disorders, and other conditions linked to distressing life experiences.
Researchers have consistently observed significant reductions in the symptoms of PTSD among clients who have undergone EMDR therapy. Its validation is further enhanced by its endorsement from numerous international organizations as an effective treatment for trauma. EMDR is not only measured by symptom reduction but also by changes in client behaviors, achievement of client goals, and the comprehensive protocol’s consonance with the larger treatment plan. If therapists need any additional support, a great option is to look into EMDR Consulting and find a consultant you trust to help with any questions and support you may need.
Overview of Shapiro’s work in 2006
In 2006, Francine Shapiro, the originator of EMDR, continued to contribute to the body of research supporting the therapy’s effectiveness. By refining and testing the standard EMDR protocol, Shapiro focused on optimizing the therapeutic outcomes across a range of conditions and populations. Through a systematic approach, incorporating phases 1 through 8, including client history-taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation phase, the 2006 work reinforced the clinical and research-based foundation of EMDR.
Critical to this work was the emphasis on the Three-Prong Protocol which addresses past memories, current situation client distress, and future potential challenges. Shapiro’s 2006 publications often discussed the generalization of treatment effects, where the benefits of processing traumatic memories extended into clients’ day-to-day experiences and future outlook.
Overview of Shapiro’s work in 2018
By 2018, Shapiro’s efforts were geared towards further expanding the application of EMDR within the psychological landscape. Her work continued to evolve, with publications and research examining the neurological mechanisms behind EMDR’s success and exploring its potential beyond trauma to treat conditions like depression, anxiety, and even somatic disorders. The research delved deeper into the importance of the comprehensive protocol, and its integration in treatment planning and the larger treatment plan.
Publications in 2018 frequently referenced the adaptive information processing model as a theoretical grounding for EMDR, proposing that EMDR facilitates the accessing and processing of traumatic memories and adverse life experiences, leading to an adaptive resolution. Also highlighted were the closure phases and the reevaluation phase, pointing to the importance of assessing the progress and ensuring the stabilization of treatment gains in subsequent processing sessions.
The consistency of the body of work by Shapiro has played a pivotal role in the development, dissemination, and refinement of EMDR, ultimately contributing to its position as a recommended treatment for trauma-related psychopathology in clinical guidelines worldwide.
