Research-Driven Strategies for EMDR Target Sequencing

EMDR Target Selection and EMDR Target Sequencing are cornerstones of EMDR Phase 1: History Taking and Treatment Planning. But how do we know the best way to select and order trauma targets? Beyond clinical experience, research has a lot to teach us about how to build an effective EMDR Master Treatment Plan.

This post reviews recent studies and theoretical models that shed light on EMDR treatment planning, offering clinicians evidence-based guidance for writing clear, impactful plans.

Why Research Matters for Treatment Planning

EMDR has been established as an evidence-based treatment for PTSD across dozens of randomized controlled trials. Yet, within clinical practice, many therapists still struggle with how to identify feeder memories, organize clusters, and choose the best starting point. That’s where research becomes an invaluable guide.

By weaving together findings from meta-analyses, systematic reviews, and protocol development studies, clinicians can build EMDR Treatment Plans that are not just individualized, but also grounded in evidence.

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Evidence for EMDR Phase 1 Planning

• Shapiro (2018) noted that fewer than two dozen targets are usually required for significant relief of PTSD symptoms. She emphasized that the key is identifying the most disturbing memories and sequencing them strategically.

• De Jongh, de Roos, and El-Leithy (2024) provided a state-of-the-science review showing that EMDR remains one of the few first-line trauma treatments endorsed by major international guidelines. Their review highlights the role of sequencing in maximizing treatment efficiency.

• Rasines-Laudes and Serrano-Pintado (2023) conducted a systematic review and meta-analysis, concluding that EMDR significantly reduces PTSD symptoms compared to control conditions. They noted that treatment length and target organization influence overall outcomes.

• Leeds (2016) documented empirical support for symptom-informed sequencing, in which clinicians address the earliest, worst, and most recent memories within a symptom cluster before moving on to present triggers and future templates.

• Yunitri et al. (2023), in a network meta-analysis, ranked EMDR among the most effective trauma-focused therapies and pointed to structured sequencing as a key factor supporting its effectiveness.

Cultural and Developmental Considerations

Research also reminds us that EMDR treatment planning cannot be “one size fits all.” Bannink et al. (2021) reviewed cultural adaptations of EMDR in five African countries, showing that target wording, resourcing, and sequencing often require tailoring to cultural and spiritual contexts.

Similarly, Kitchur’s Strategic Developmental Model (2005) emphasizes sequencing by developmental stage — beginning with middle childhood, then preverbal, then adolescent and adult targets. This aligns with findings that developmental trauma often serves as feeder material for later disturbances.

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Bringing Research into Daily Practice

So how do we translate all this into action?

• Use timelines, float back techniques, and cluster mapping to organize targets systematically.

• Anchor your sequencing in research-backed models (symptom-informed, developmental, or cognition-focused).

• Consider cultural context when identifying resources and target language.

• Reassess regularly — research supports ongoing updates to the EMDR Master Treatment Plan as symptoms shift.

Conclusion

Research confirms what many clinicians experience in practice: EMDR Target Selection and Sequencing are not just preparatory steps but essential drivers of treatment success. By grounding EMDR Phase 1 planning in evidence — from international reviews to cultural adaptation studies — clinicians can design EMDR Master Treatment Plans that are efficient, flexible, and profoundly healing.

To learn more, Enroll now in EMDR Treatment Planning: Target Selection and Sequencing

References

1. Bannink, F., Mbazzi, K., Dewailly, A., Admasu, K., Duagani, Y., Wamala, K., Vera, A., Bwesigye, D., & Roth, G. (2021). Cultural adaptations of the standard EMDR protocol in five African countries. Journal of EMDR Practice and Research, 15(1), 29–43. https://doi.org/10.1891/EMDR-D-20-00028

2. de Jongh, A., de Roos, C., & El-Leithy, S. (2024). State of the science: Eye movement desensitization and reprocessing (EMDR) therapy. Journal of Traumatic Stress. https://doi.org/10.1002/jts.23012

3. Kitchur, M. (2005). The strategic developmental model for EMDR. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 8–56). Norton.

4. Leeds, A. (2016). A guide to the standard EMDR therapy protocols for clinicians, supervisors, and consultants (pp. 63–92). Springer Publishing.

5. Rasines-Laudes, P., & Serrano-Pintado, I. (2023). Efficacy of EMDR in post-traumatic stress disorder: A systematic review and meta-analysis of randomized clinical trials. Psicothema, 35(4), 385–396. https://doi.org/10.7334/psicothema2022.309

6. Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols and procedures (3rd ed.). Guilford Press.

7. Yunitri, N., Chu, H., Kang, X. L., Wiratama, B. S., Lee, T.-Y., Chang, L.-F., Liu, D., Kustanti, C. Y., Chiang, K.-J., Chen, R., Tseng, P., & Chou, K.-R. (2023). Comparative effectiveness of psychotherapies in adults with posttraumatic stress disorder: A network meta-analysis of randomized controlled trials. Psychological Medicine, 53(13), 6376–6388. https://doi.org/10.1017/S0033291722003737