EMDR (standard, group and recent-event protocols)

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Francine Shapiro

What it is

Eye Movement Desensitization and Reprocessing (EMDR) is a structured psychotherapy for symptoms that arise from disturbing life experiences. The client briefly holds a disturbing memory in mind while attending to a bilateral stimulus (eye movements, alternating taps or tones). The therapist then…

Format

• Session count and format: individual sessions, typically 50–90 minutes. Shapiro reports 3–6 sessions for single-incident trauma (for example, three 90-minute sessions or about six 50-minute sessions) and 8 sessions in several RCTs. She notes that repeated childhood abuse generally needs longer.…
• Phases: (I) History, gathered as far as circumstances allow, including from others; screen for complex PTSD; IES-R if possible; discourage detailed retelling. (II) Preparation and stabilisation (safe/calm place, resource connection and/or the 4 Elements exercise) plus a distancing metaphor.…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• a VoC stuck at 5–6 (look for a blocking belief).
• the resource memory linking to loss or trauma (switch resource).
• clients who leave activated. Do not let time pressure skip closure.
• realistic danger, which needs problem-solving, not desensitization.
• gains that were not integrated into daily functioning or relationships.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.