The eight phases of EMDR therapy provide a framework to understand the treatment process. They act as a map for the EMDR therapist to follow. All eight phases contribute to the overall effectiveness of EMDR therapy, however, not all phases may be used in one EMDR therapy session.
EMDR’s 8 phases
Phase 1: History and Treatment Planning
This first phase includes a discussion between the therapist and client regarding what brings the client into therapy and whether EMDR therapy may benefit that client. The therapist and client begin to build a secure working relationship. This phase generally takes one or two sessions at the beginning of treatment and continues throughout therapy, especially as new issues or “stuck points” arise.
The therapist takes a thorough client history and discusses with the client the impact of a specific problem(s), including behaviors and symptoms stemming from that problem. With this information, the therapist will develop a treatment plan that defines the specific “targets” on which to use EMDR. The therapist also assesses the client’s internal and external resources.
Phase 2: Preparation
Most clients spend about 1-4 sessions in the Preparation phase. For those with complex traumas, more severe trauma histories, or certain diagnoses, a longer time may be necessary. In this phase, the therapist helps the client learn specific techniques in order to tolerate any emotional disturbance that may arise during treatment. This may include learning a variety of relaxation or grounding techniques.
By the end of this phase, the therapist will have explained the theory of EMDR, how it’s implemented, and what the client can expect during and after treatment.
Phase 3: Assessment
In the Assessment phase, the therapist works with the client to “set up” the first target. This includes identifying the target event, along with images, beliefs, feelings, and sensations about the event. The therapist assesses initial baseline measures using the Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale. The goal of the following phases, is for SUD scores of disturbance to decrease while the VOC scores of positive belief increase.
Phase 4: Desensitization
This Desensitization phase focuses on the client’s disturbing emotions and sensations as measured by the SUD rating. This phase focuses on the client’s responses (ie. other memories, insights and associations that may arise) as the targeted event changes and its disturbing elements resolve.
The therapist leads the person through sets of BLS with appropriate shifts and changes of focus until the SUD levels reduce to zero.
Phase 5: Installation
During the Desensitization phase, the client will have decreased the disturbance intensity of the negative belief. Phase 5 strengthens and “installs” the positive cognition with the goal of helping the client accept the full truth of the positive self-statement at a VOC level of 7 (completely true). It’s important to remember that EMDR cannot make a client believe anything positive that is not appropriate for that client.
Phase 6: Body Scan
After the therapist guides the client through strengthening and installing the positive cognition, the therapist will ask the client to bring the original target event to mind to assess whether the client notices any residual tension in the body. If so, these physical sensations are then targeted for further reprocessing.
An EMDR session is not considered successful until the client can bring up the original target without feeling any body tension. Positive self-beliefs are important, but the client has to believe them on more than an intellectual level.
Phase 7: Closure
Phase 7 occurs at the end of every individual treatment session. If the client does not completely process the traumatic target event in a single session, the therapist will assist the client in using a variety of self-calming techniques in order to regain a sense of equilibrium. The client remains in control during the EMDR session, and it’s important that the client continue to feel in control outside the therapist’s office.
The therapist also briefs the client on what to expect between sessions. For examples, processing may continue and some new material may arise. Clients may journal or record these experiences and use calming techniques to self-soothe in life outside the therapy session.
Phase 8: Reevaluation
The Reevaluation phase reopens at the beginning of every new session. This phase guides the therapist through the client’s treatment plan in order to determine the success of treatment over time.
Although clients may feel relief almost immediately with EMDR, it’s important to complete all eight phases of treatment to maintain the modality’s effectiveness. EMDR therapy is not complete until attention has been brought to the past memories that are contributing to the problem, the present situations that are disturbing, and what skills the client may need for the future.
Our services
Our bodies have a natural ability to heal, even through trauma and PTSD. We offer individual EMDR therapy and EMDR Intensives for our clients, all conducted by clinicians who have completed an EMDRIA-approved training. There is no shame in seeking the treatment you need. Contact us at hello@sustainablewellnessny.com to begin your healing journey.
EMDR Resources
Examples of EMDR sessions and a complete transcript of a three-session EMDR treatment can be found in F. Shapiro & M.S. Forrest (2004) EMDR. New York: BasicBooks. http://www.perseusbooksgroup.com/perseus-cgi-bin/display/0-465-04301-1.
You may also download EMDRIA’s Eight Phases of EMDR Therapy infographic in English or Spanish.
Excerpts above from: F. Shapiro & M.S. Forrest (2004) EMDR: The Breakthrough Therapy for Anxiety, Stress and Trauma. New York: BasicBooks. http://www.perseusbooksgroup.com/perseus-cgi-bin/display/0-465-04301-1