8 Stages of EMDR
By John Soderlund
1. Client history and treatment planning
The therapist develops a treatment plan and assesses the client's suitability for EMDR, helping the client to identify treatment goals and potential problem areas where the client might benefit from particular skills, eg. relaxation techniques.
2. Preparation for EMDR
The therapist prepares the client by educating him or her about the process and teaching self-control techniques and affect management skills. The client may be given self-study materials to better understand the process.
3. Assessment of the target
The client targets a specific memory and the most distressing visual image associated with it. The therapist encourages the client to outline the thoughts and feelings that are elicited by the visual image and to identify a current negative cognition about him or herself which is related to the target memory. By contrast, the therapist also gets the client to choose a positive cognition to juxtapose alongside the negative image. This positive image expresses a desired cognitive picture of the client. The client then rates the accuracy of this positive belief on the Validity of Cognition Scale (VoC), where 1 represents "completely false" and 7 represents a "completely true" statement. The client also identifies the emotions that are elicited when the visual image is combined with the negative belief. The attendant level of distress elicited by the memory of the disturbing event or negative cognition is rated from one to 10 on the Subjective Unit of Disturbance (SUD) scale, where 0 is calm and 10 is the most crippling distress.
4. Desensitisation & reprogramming
The client focuses on the visual image, the negative belief flowing from it and attendant emotions and bodily sensations while being exposed to bilateral stimulation in repeated, dosed exposures. In each of these bilateral stimulation episodes, the client holds all these elements in mind while simultaneously moving his eyes from side to side for 15 or more seconds, following the therapist's fingers or an alternate object as it is moved across the client's visual field. As alternatives to finger movements, hand-tapping or aural stimulation have been used. After each set of bilateral stimulation, the client is asked what material arose during the stimulation. This material is focused upon for the ensuing set of eye movements. This cycle of alternating focused exposure and client feedback, is repeated several times as the therapist looks for shifts in affect, physiological states, and cognitive insights.
If processing stalls, specialised interventions may facilitate processing. Processing can become stuck, for example, where cognitive distortions exist, and the client cannot identify the distortion without outside help. In an approach which Shapiro calls the "cognitive interweave", the therapist attempts to elucidate the cognitive distortion to the client. The therapist may ask a direct question about the distortion in a manner which allows the client a new perspective on it. The SUD level is reassessed once emotional, physical, and cognitive resolution becomes apparent. A SUD score of 0 or 1 indicates the end of this phase.
5. Cognitive installation of the positive self-statement
The client is instructed to pair the previously identified or an alternative positive self-statement with the original traumatic image at the same time as further bilateral stimulation takes place. The efficacy of this phase is measured by the client's self-reported VOC. An attempt is made to increase the VOC to a score of 6 or 7.
6. Body scan
The client scans his or her bodily sensations while thinking of the image and the positive cognition, with a view to identifying any tension or unusual sensations which may be apparent. Based on the understanding that emotional distress is often experienced physiologically, processing is not considered complete until the client can bring the traumatic memory into consciousness without feeling any body tension. Any sensations found in the process are targeted with further bilateral stimulation until the tension is no longer evident.
7. Closure
Once the therapist is comfortable that the physiological, cognitive and affective markers of the memory have been reduced to a functional level, closure can begin with a view to re-evaluating at the forthcoming treatment session.
8. Re-evaluation
This takes place at the beginning of every subsequent session, and involves the therapist in checking that the client's treatment gains have been maintained. The SUD, VOC and body self-report measures offer more objective gauges.
|
|||||
 |
|||||
Francine Shapiro, ... Best Price $5.64 or Buy New $12.21 |
|||||
 |
|||||
|
|||||
 |
|
|
|
|
|
Copyright © New Therapist
|
|||||
 |
|||||
Eye Movement Desensitization and Reprocessing Best Price $41.99 or Buy New $48.00 |
|||||
|
|||||
|
|
|
|
|
|