EMDR Phase 1: How to Write an EMDR Treatment Plan for PTSD

You’ve got the basics of EMDR processing down, but now you’re realizing something important: you’re not totally sure how to structure an EMDR treatment plan. This is a common place to get stuck. Treatment planning in EMDR looks different from more traditional approaches, and without a clear structure, it can feel difficult to organize targets and know where to begin.

What we’re really trying to understand here is how to move from a client’s history and symptoms to a clear, clinically meaningful treatment plan. Let’s walk through how EMDR Phases 1 and 2 shape that process and how to think about treatment planning in a way that stays organized and flexible as the work unfolds.

When you’re working on an EMDR treatment plan, the next step usually depends on where you’re getting stuck:

• If you’re unsure how to move from a client’s history to specific EMDR targets → the next step is identifying patterns, themes, and experiences that are contributing to current symptoms

• If you have identified targets but aren’t sure how to organize them → the next step is grouping those targets into clusters and beginning to think about sequencing

• If you’re working with more complex presentations, such as dissociation, attachment disruptions, or pacing concerns → the next step is evaluating readiness and adjusting how you approach preparation and sequencing

Key components for writing an emdr treatment plan

Diagnoses, Goals, Objectives, Interventions

If you bill insurance — or if you give your clients Superbills so they can seek reimbursement — you’ll need to have your client’s diagnosis documented on your EMDR treatment plan. If you work at an agency, you may be required to also document the goals, objectives, and interventions specific to your client’s treatment.

Goals: These are the general outcomes your client is seeking in treatment. Goals could be learning emotion management, improving relationships, or building confidence in setting/maintaining boundaries.

If we were writing an EMDR treatment plan for Post-Traumatic Stress Disorder (PTSD), then a goal could be “client’s trauma symptoms will no longer be at a clinical level and they will have improved functioning overall.” The overarching goal is for your client’s symptoms to decrease, or even resolve completely.

Objectives: These are smaller steps that help you achieve the above-stated goal. These are meant to be measurable! Some possible objectives could be “client will be able to identify five stimuli that trigger flashbacks,” or “client will be able to implement self-soothing behaviors when triggered by a trauma stimulus.” Another could be “client’s symptoms of intrusion, avoidance, and alterations in cognition/mood/arousal/reactivity will decrease from 60 to 20 or less as measured by the PCL-5.”

Interventions: Personally, I prefer an EMDR treatment plan to be focused on interventions, because these are the actual methods used to facilitate healing. Also, when you review an EMDR treatment plan with a client, the goals/objectives are typically skipped over, because your client wants to know how you are going to help them feel better.

As EMDR has eight phases, you could conceptualize each phase as a cluster of interventions! Of note — I cluster Phases 3–8 together, as those phases are specific to each EMDR target.

When exploring a client’s history, having a structured way to identify EMDR targets helps clarify patterns, themes, and contributing experiences. Some approaches focus on timelines, while others organize experiences around core negative beliefs or use techniques such as floatback to trace current symptoms back to earlier events.

Each of these approaches produces a different clinical map. Timeline methods often highlight developmental patterns, while negative belief approaches organize experiences around a central cognition. These differences influence how targets are later grouped, prioritized, and sequenced in treatment.

The way targets are identified at this stage directly shapes how they can be organized into a treatment plan, which is why clarity during target selection makes the rest of the process more coherent and clinically meaningful.

If you’re unsure how to move from a client’s history to clearly defined EMDR targets you can actually use for treatment planning, having a structured way to elicit and organize those targets can help you decide what to do next.

The EMDR Target Selection: Clinician Guide provides a way to identify and document targets using timeline methods, negative belief approaches, and floatback techniques so you can build a clear, clinically meaningful foundation for EMDR treatment planning.

→ EMDR Target Selection: Clinician Guide

Once targets are clearly identified, the next step is organizing them into a sequence that supports effective and manageable processing.

The EMDR Target Sequencing Plan: Clinician Guide provides a structured way to group targets into symptom clusters and apply sequencing approaches such as the three-pronged model, symptom-informed sequencing, the Two Method Approach, and developmental strategies so you can determine where to begin and how to move through targets in a clear, clinically meaningful order.

→ EMDR Target Sequencing: Clinician Guide

Understanding EMDR Phase 1: History and Treatment Planning

This phase of EMDR is just like all other types of psychotherapy. When first meeting with a client, you need to understand their history and symptoms in order to help them. In EMDR, some additional legwork can really make a difference in the efficiency and effectiveness of your treatment.

Identifying your client’s attachment style can give you a lot of insight into how treatment might progress. I like to use the Relationship Questionnaire by Bartholomew & Horowitz, 1991. A client with a secure attachment style will likely need less preparation than another client with a less healthy attachment style.

It’s paramount that you evaluate the level of dissociation your client is likely to experience. There are some screeners available, such as the Dissociative Experiences Scale. I prefer to screen using the MID-60, which is a shortened version of theMultidimensional Inventory of Dissociation. If, after screening, I find I need to assess further, I like to use the Dissociative Disorders Interview Schedule, though many will also use the Multidimensional Inventory of Dissociation or the SCID-D. You’ll want to evaluate the available assessments and choose the one that best fits your needs.

Developing Your EMDR Treatment Plan

As you collect your client’s history, you’ll begin developing a generalized picture of how treatment will progress. Personally, I don’t ask for detailed descriptions of trauma memories at this stage. Instead, I focus on identifying patterns, themes, and the types of experiences that are contributing to the client’s current symptoms. More detailed information is typically gathered later, after EMDR Phase 2: Preparation, when the client has the resources in place to process those experiences safely.

As this picture becomes clearer, you can begin identifying potential EMDR targets and thinking about how they may be sequenced in treatment. This is where treatment planning in EMDR starts to take shape. Rather than selecting targets randomly, you are organizing them in a way that supports efficient and meaningful processing over time.

EMDR Phase 2: Preparation and Readiness

This phase of EMDR can vary widely from client to client! For some, you can have them ready in 1-2 sessions. Others may take months, or even years. You’ll find that for the clients with more complex PTSD, they are more likely to take months/years. If you’ve found that someone’s attachment style is highly disorganized and/or they dissociate as a primary coping tool, these are the clients who will take longer in EMDR Phase 2: Preparation.‍ ‍Knowing this early can really make a big difference in how you approach treatment with your client.

At minimum, your clients need to be educated on trauma memory storage, the Adaptive Information Processing Model, mechanics of EMDR and common reactions to EMDR. Additionally, your clients need to have skills to draw upon‍ ‍during and in between sessions. At minimum, I like to install a container and calm place. For those needing extended stabilization, additional strategies such as meditation, grounding, and resource development may be helpful. The specific approach will depend on how your client responds to each stabilization procedure.

Beginning Reprocessing and Selecting Targets

Once your client is ready for reprocessing targets, this is when you begin selecting EMDR targets and sequencing them in the most impactful order for processing. This is where treatment planning becomes especially important, because the order in which you approach targets can influence both the efficiency of treatment and how manageable the process feels for your client.

At this stage, rather than choosing targets randomly, you’re looking for patterns across the client’s history. Early experiences that shaped core beliefs, highly distressing events that continue to drive current symptoms, and situations that are easily triggered in the present all become part of the treatment plan. Thoughtful sequencing helps ensure that you are not overwhelming the client while still making meaningful progress.

Returning to the big picture, the general recommendation is to process past events to completion, then address present triggers (such as sounds, smells, or touch), and finally move on to future templates. This structure helps clients resolve the root of their symptoms, reduce current distress, and build confidence in handling similar situations moving forward.

While this framework provides a general structure, applying it consistently across different clients and presentations is often where treatment planning becomes more complex, shifting the focus to how to apply this process in a consistent and clinically meaningful way across cases.

If you’re finding that target selection and sequencing decisions vary across clients, or you’re not always sure which approach to use in different clinical presentations, having a clear framework for how to apply these models can help you make more consistent and confident treatment planning decisions while earning continuing education credit.

→ EMDR Target Selection & Sequencing CE Course

From there, having tools that help you organize and apply this process in session can make the work more consistent and easier to implement.

The Core EMDR Target Selection & Sequencing Toolkit brings together the target selection and sequencing guides, along with an additional client-facing handout, so you can organize cases more systematically and build cohesive EMDR treatment plans.

→ Core EMDR Target Selection & Sequencing Toolkit

If you want to see how EMDR treatment planning, preparation, target selection, and sequencing fit together as a cohesive system, you can find a structured overview in the EMDR Training & Treatment Hub.

→ EMDR Training & Treatment Hub

How to Document and Update Treatment Plans

It’s important to update your treatment plans regularly, especially as new information emerges and treatment begins to unfold. In EMDR, the treatment plan evolves as you gather more information about how the client responds to preparation, target selection, and early processing.

In my own practice, I document the date when each intervention is completed, along with the client’s response to that intervention. I also track progress, barriers, and the rationale for any shifts in the treatment plan. This helps create a clear record of how decisions are being made over time and supports continuity in care.

For example, if a client experiences a significant life event such as a loss, I may temporarily shift focus to grief work before returning to trauma processing. When this happens, I document both the change in focus and the clinical reasoning behind it, including how the adjustment supports stabilization and readiness for future EMDR work.

Updating the treatment plan in this way allows you to remain responsive to the client’s needs while maintaining a coherent overall direction. Rather than trying to follow a fixed sequence, you are continuously refining the plan based on what emerges in treatment.

Sample EMDR Master Treatment Plan for PTSD

I hope this walkthrough was helpful! The intention was to give you enough information to apply this to your agency or practice, as well as your own style in designing a treatment plan. Below is my generalized example of a Sample EMDR Master Treatment Plan for PTSD.