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EMDR therapy techniques: An overview for mental health providers
Need fresh EMDR therapy techniques? Get practical ideas, tips, and condition-specific adjustments — plus implementation help from Headway.
Eye movement desensitization and reprocessing therapy (EMDR) is a trauma-focused therapy developed by Dr. Francine Shapiro, Ph.D., in 1987. Put simply, EMDR therapy helps clients work through traumatic memories and the emotional distress that can accompany them.
EMDR therapy began with eye-movements and other forms of “bilateral stimulation,” which help clients work through a traumatic memory by making it less emotionally overwhelming. This evidence-based therapeutic method can help clients recover from post-traumatic stress disorder (PTSD), as well as symptoms of trauma, including flashbacks, intrusive thoughts, and hypervigilance.
Read on to learn more about EMDR. Whether you’re interested in learning about new EMDR techniques or refreshing your current knowledge, you’ll learn how to incorporate EMDR tools into your client’s treatment plan.
Key insights
1
EMDR is a structured, trauma-focused therapy that uses bilateral stimulation to help clients work through trauma.
2
EMDR can also be used to treat depression, chronic pain, and anxiety.
3
There are eight stages of EMDR: history-taking, preparing the client, assessing the target memory, desensitization, installation, body scan, closure, and evaluating treatment results.
What is EMDR?
EMDR was developed in the late 1980s. Unlike cognitive-behavioral therapy, EMDR doesn’t solely focus on altering the client’s thoughts, feelings, and behaviors. Rather, it’s a structured, trauma-focused therapy that’s used to help clients process trauma, as well as other distressing experiences like chronic pain and depression.
EMDR therapists use bilateral stimulation techniques, such as body tapping, eye tracking, and sounds to help their clients reprocess traumatic events and memories. These techniques stimulate the right and left hemispheres of the brain, which helps calm down the nervous system. Bilateral stimulation helps the client process the trauma to reduce emotional charge and triggers from traumatic memories.
What are the stages of EMDR?
There are eight phases of EMDR, each one is designed to help clients recover and heal. Read on to learn more about the eight phases of treatment.
1. History
During history-taking, the therapist and client work together to identify the client’s goals for EMDR. This includes taking a personal history, asking about emotional triggers, and inquiring about your client’s past experiences with therapy. In this initial phase, the therapist works to gain a better understanding of the client’s psychological resources and readiness for treatment.
2. Preparing the client
In phase two of EMDR, the therapist educates the client about the EMDR process, letting them know what they can expect. Relaxation exercises, such as grounding and deep breathing, are introduced. These exercises can help establish a sense of safety as clients begin therapy, which also helps reduce anxiety.
3. Assessing the target memory
During this phase, the therapist asks the client specific questions to activate the traumatic memory, bringing it into the client’s awareness. The therapist helps the client identify how they experience the memory, which is a critical phase of EMDR therapy.
4. Desensitization
In phase four, the therapist uses bilateral stimulation techniques such as side-to-side eye movements, tapping on opposite sides of the body, or eye-tracking left and right to help the client reprocess the traumatic memory. Bilateral stimulation helps reduce the emotional distress of the memory.
5. Installation
When stage four is complete, the therapist uses bilateral stimulation to help the client stall their beliefs about the trauma. The reframed beliefs can include “I am safe now,” or “I’m worthy.” Clients are asked to rate how much they believe these statements, and bilateral stimulation is used until the new belief is fully ingrained as the truth.
6. Body scan
With the body scan, the client is directed to scan, or pay attention to, the body from head to toe. They’re then asked if any negative sensations arise. The therapist continues to use bilateral stimulation until any negative sensations subside, which may happen over the course of several sessions.
7. Closure
In this stage, the therapist helps the client return to a state of calm, ensuring that they feel safe enough to head back out into the world. The therapist may use visualization or a container exercise — a guided visualization to help individuals temporarily "store" overwhelming emotions, distressing memories, or intrusive thoughts — to close out the session.
8. Evaluating treatment results
Each session of EMDR concludes with evaluating treatment results. The client is invited to talk about the traumatic memory and how their symptoms are changing. When distress around a specific memory has subsided, the client is encouraged to move on to the next memory. The client is also encouraged to share feedback with the therapist.
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EMDR techniques for specific conditions
While EMDR was developed as a structured, trauma-focused therapy, it’s been proven to successfully treat post-traumatic stress disorder (PTSD), as well as depression. There are many different EMDR techniques to choose from, depending on your client’s diagnosis and presenting concern.
EMDR techniques for trauma and PTSD
- Visual stimulation: Following the therapist’s finger or light back and forth for bilateral stimulation
- Imagining a safe space: Coming up with an image of a safe, serene space to instill a sense of grounding and reduce anxiety
- The movie technique: Imagining the traumatic memory as a scene in a movie, to create emotional distance
- Containment: Picturing storing the traumatic memories in a locked box until the next therapy session, which helps reduce feelings of overwhelm
- Tapping on the body: Tapping on the body or using buzzers for bilateral stimulation, which helps process trauma
EMDR techniques for depression
- Butterfly hug: A self-soothing technique that can help calm down the nervous system when your client is feeling sad, overwhelmed, or hopeless
- Installation: Strengthening positive beliefs, which help replace negative ones
- Deep breathing: Using deep breathing to help your client regulate
Example EMDR treatment plan
An EMDR treatment plan should include a comprehensive assessment, which documents your client’s presenting symptoms, trauma timeline, and current functioning. You’ll also want to document a diagnosis, which will guide your EMDR treatment plan. It’s also needed to bill insurance payers. As with any treatment plan, it’s important to include your client’s goals for therapy, and how EMDR can help your client reach those benchmarks.
In addition, you’ll want to outline the way that your client’s past trauma is affecting their daily functioning, plus any current or past trauma triggers. Using the eight phases of EMDR, map out what each phase of therapy will address.
Here’s a fictitious sample EMDR treatment plan to guide you:
Client Name: John Public
DOB: 1/1/1991
Age: 32
Date: 1/11/2023
Exact start time and end time: 1:03 pm–1:55 pm: 52 mins
Session location: Serenity Behavioral Health Center, 123 Serenity Street, Hopeville, TX 56789
Diagnosis: (F41.1) Generalized anxiety disorder
Treatment goals
Goal 1: Reduce rumination or somatic responses related to anxiety triggers
- Objective 1.1: Client will identify and describe 2–3 target memories with current symptoms
- Objective 1.2: Client will reduce SUDS from ≥8 to ≤2 for each target memory
- Objective 1.3: Client will report decreased frequency/intensity of intrusive thoughts
Goal 2: Strengthen adaptive beliefs and self-concept
- Objective 2.1: Client will identify negative cognitions (e.g., “I am not safe”)
- Objective 2.2: Client will install positive cognitions (e.g., “I am in control now”)
Goal 3: Improve emotional regulation and present-day functioning
- Objective 3.1: Client will demonstrate at least 3 coping strategies (e.g., grounding, safe place visualization)
- Objective 3.2: Client will report reduced avoidance behaviors
- Objective 3.3: Client will tolerate distress without dissociation
Interventions (EMDR phases)
Phase 1: History Taking & Treatment Planning
- Identify target memories using past–present–future framework
- Assess readiness and stability
- Develop case conceptualization
Phase 2: Preparation
- Teach grounding and resourcing skills
- Develop “safe place” imagery
- Explain EMDR process and set expectations
Phase 3: Assessment
- Identify:
- Target image
- Negative cognition (NC)
- Positive cognition (PC)
- Emotions and body sensations
- Establish baseline SUDS
Phase 4: Desensitization
- Use bilateral stimulation (eye movements, tapping, or tones)
- Process memory until SUDS decreases to 0–2
- Allow free association and reprocessing
Phase 5: Installation
- Strengthen positive cognition
Phase 6: Body Scan
- Identify and process residual somatic distress
Phase 7: Closure
- Ensure client returns to emotional stability
- Reinforce coping strategies
- Provide between-session guidance
Phase 8: Reevaluation
- Review previous targets
- Assess symptom changes
- Identify new targets as needed
Frequency & Duration
- Sessions: 50–60 minutes
- Frequency: 1x/week (adjust as needed)
- Estimated duration: 8–20 sessions depending on complexity
Expected Outcomes
- Decreased distress related to traumatic memories
- Improved emotional regulation
- Increased adaptive beliefs and self-efficacy
- Reduction in GAD symptoms
Tips for implementing EMDR techniques in your practice
EMDR can be used as a stand-alone therapy, or combined with other therapeutic modalities such as cognitive behavioral therapy and dialectical behavior therapy. Having a roadmap can help you integrate EMDR techniques into your clinical practice.
Session structure and planning
Setting up and planning sessions that incorporate EMDR techniques begins with the intake session. Knowing what symptoms your clients are struggling with, as well as how this distress impacts their life, can guide treatment planning.
Here’s how to get started:
- Identify your client’s symptoms.
- Identify how these symptoms are affecting their daily life.
- Identify their goals for treatment.
- Using the eight phases of EMDR, identify techniques that may help your client manage their symptoms.
- Introduce these techniques to your client.
- Provide a framework on how to incorporate each technique with practical examples.
- Check in on your client’s progress and invite them to share feedback with you.
Documentation and compliance considerations
It’s important to document your client’s symptoms, diagnosis, and goals for treatment, as well as any EMDR techniques that you’ve included in their treatment plan. Documentation and a diagnosis are also needed to bill insurers. Here’s how to get started:
- Document your client’s symptoms.
- Document their goals for treatment.
- Document their diagnosis(es).
- Document the EMDR techniques that you’re incorporating into their treatment plan.
- Document your clinical rationale for choosing these tools.
- Document any measurable outcomes, such as reduced PTSD symptoms, improved mood, or improved sleep.
At Headway, we provide structured templates so that you can focus on your clients’ care.
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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
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