Sequencing Complex Trauma Targets in EMDR
After identifying multiple EMDR targets, many clinicians begin asking a different question: Where do I start? A client may have dozens of traumatic memories, several symptom clusters, attachment injuries, and multiple negative beliefs. While target selection identifies what to process, organizing those targets into a treatment plan often requires additional clinical decision-making.
Target sequencing provides a framework for organizing identified targets before reprocessing begins. Different sequencing models prioritize different aspects of a client's history, and each may be appropriate depending on the client's presenting concerns, trauma history, and treatment goals.
This article reviews several commonly used approaches to target sequencing, discusses when each model may be helpful, and explores how clinicians can organize complex trauma histories with greater clarity.
Which Target Sequencing Approach Fits This Client?
Before organizing multiple EMDR targets, consider which description best fits the client's presentation.
If the client's trauma history is primarily developmental, attachment-based, or organized around early caregiving disruptions → consider the Strategic Developmental Model.
If one symptom cluster is creating the greatest current impairment → consider the Symptom Informed Model.
If symptoms appear organized around a clear negative belief or symptom pathway → consider the Two Method Approach.
If the trauma history is relatively straightforward with identifiable incidents and a clear chronology → a traditional timeline approach may be sufficient.
These approaches are not mutually exclusive. Many clinicians naturally integrate concepts from multiple models as treatment progresses and new information becomes available.
Understanding Target Sequencing
Target selection and target sequencing are closely related, but they answer different clinical questions.
Target selection focuses on identifying the memories, experiences, or events that contribute to a client's current symptoms. Sequencing focuses on how those identified targets will be organized throughout treatment. Once multiple targets have been identified, clinicians begin deciding which memories to address first, how different targets relate to one another, and whether certain networks should be prioritized before others.
Regardless of the sequencing model used, EMDR treatment planning generally continues to follow the Three-Pronged Protocol by addressing past experiences, present triggers, and future templates. Sequencing models simply provide different ways of organizing targets within that broader framework.
Four Common Approaches to Target Sequencing
Several sequencing models have been described within the EMDR literature. Although they differ in how targets are organized, each provides a structured framework for planning treatment. Some approaches prioritize developmental experiences, while others focus on symptom clusters, negative beliefs, or chronological organization. Understanding the strengths of each model can help clinicians select a sequencing strategy that fits the client's presentation and treatment goals.
Strategic Developmental Model
The Strategic Developmental Model organizes targets according to developmental periods and attachment history. Clinicians identify potential targets across different stages of development before deciding which developmental period should be addressed first.
This approach is often helpful when developmental trauma, attachment disruptions, or early relational experiences appear central to the client's presenting concerns. Sequencing decisions may also consider factors such as dissociation, affect tolerance, memory fragmentation, ongoing stressors, and overall readiness for processing.
Symptom Informed Model
The Symptom Informed Model begins with the symptom cluster creating the greatest current impairment. Rather than organizing treatment chronologically, clinicians identify the memories connected to that symptom cluster and determine which target is most clinically appropriate to process first.
Within the selected symptom cluster, sequencing may involve the earliest event, the most disturbing event, the most recent activation, or another clinically significant target. Present triggers and future template work continue to be incorporated throughout treatment planning.
Two Method Approach
The Two Method Approach offers two different ways to organize targets. One method focuses on symptom clusters and identifies where symptoms first appeared or became significantly more severe. The second organizes treatment around core negative beliefs by identifying memories that most strongly reinforce those beliefs.
Depending on the client's presentation, clinicians may organize treatment around symptom development or around belief networks that continue influencing present-day functioning.
Timeline Approaches
For clients with relatively straightforward trauma histories, a traditional chronological approach may provide sufficient structure. When traumatic experiences are discrete, clearly identifiable, and occur within a relatively uncomplicated timeline, sequencing targets chronologically may be both practical and effective.
Some clinicians also choose representative targets within a cluster and evaluate whether processing generalizes to related memories before identifying additional targets.
At this point, many clinicians understand the different sequencing models but want a structured way to apply them during treatment planning. The EMDR Target Sequencing Clinician Handout walks clinicians through each sequencing model with guided questions, planning worksheets, and clinical considerations that support individualized treatment planning.
→ EMDR Target Sequencing Clinician Handout
Clinical Considerations When Sequencing Targets
No sequencing model answers every clinical question. Individual client factors often influence where treatment begins and how sequencing evolves over time.
For example, the earliest memory is not always the safest or most clinically appropriate starting point. The most disturbing memory may also require additional stabilization before it can be processed effectively. As treatment progresses, symptom clusters, negative beliefs, and developmental themes may become more interconnected than initially recognized.
Clinicians may also discover that processing one representative target leads to improvement across multiple related memories, while other clients require a more comprehensive approach to each target within a network. Ongoing assessment helps clinicians determine whether the original sequencing plan continues to fit the client's presentation or whether adjustments would better support treatment.
Comparing Sequencing Models
Because each sequencing approach emphasizes different aspects of a client's presentation, it can be helpful to compare them side by side during treatment planning. A visual overview often makes it easier to recognize which model best aligns with a particular case conceptualization.
The free Target Sequencing Infographic provides a clinical decision tree that summarizes four commonly used sequencing approaches and offers a quick reference for selecting an appropriate framework during treatment planning.
→ Target Sequencing Infographic (free)
Target Sequencing Is One Part of EMDR Treatment Planning
Sequencing does not occur in isolation. Effective treatment planning also includes identifying appropriate targets, evaluating client readiness, organizing symptom clusters, assessing present triggers, and planning future template work.
As treatment unfolds, clinicians often integrate concepts from multiple sequencing models while continuing to individualize care based on the client's response. Flexibility within a structured framework allows treatment planning to evolve alongside the client's progress.
If you would like a more comprehensive review of target selection, sequencing models, case conceptualization, and treatment planning, the Target Selection & Sequencing CE provides an in-depth framework for organizing complex trauma treatment.
→ Target Selection & Sequencing CE
Preparation, target selection, and target sequencing are all part of a larger treatment planning process. If you'd like additional resources on EMDR preparation, readiness, target selection, sequencing, and clinical decision-making, explore the complete EMDR Training & Treatment Hub.
→ EMDR Training & Treatment Hub
Conclusion
Complex trauma rarely presents as a single memory or a straightforward timeline. Organizing identified targets into a thoughtful sequencing plan helps clinicians approach treatment with greater conceptual clarity while remaining responsive to the client's individual needs.
Selecting a sequencing model provides a framework for organizing treatment, but clinical judgment continues throughout the course of therapy. As new information emerges and clients progress through reprocessing, sequencing decisions can be refined to support safe, individualized, and effective EMDR treatment.
Research References
de Jongh, A., ten Broeke, E., & Meijer, S. (2010). Two method approach: A case conceptualization model in the context of EMDR. Journal of EMDR Practice and Research, 4(1), 12–21. https://doi.org/10.1891/1933-3196.4.1.12
Kitchur, M. (2005). The strategic developmental model for EMDR. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 8–56). W. W. Norton & Company.
Leeds, A. M. (2016). A guide to the standard EMDR therapy protocols for clinicians, supervisors, and consultants (pp. 63–92). Springer Publishing Company.
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
