You’re a newer clinician to EMDR and you’ve been focusing on how to process EMDR targets . . . but now that you’ve got that down you realize you’re not sure how to write an EMDR treatment plan! You’ve got some ideas, but would like to see an example of how to write an EMDR treatment plan. I can help with that! I’ve got a sample EMDR treatment plan for PTSD right here for you.

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.

Objective: 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 5 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.

EMDR Phase 1: History & 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 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 the Multidimensional Inventory of Dissociation. If, after screening my client and 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 an choose the one that best fits your needs.

emdr treatment planning

As you have been collecting your client’s history, you’ll begin developing a generalized picture of how treatment will progress. Personally, I don’t ask specific details about client’s trauma history at this time. I typically gather more specific information after EMDR Phase 2: Preparation. Though you can create a rough treatment plan that covers each of the 8 phases of EMDR.

EMDR Phase 2: Preparation

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 client’s need to be educated on trauma memory storage, the Adaptive Information Processing Model, mechanics of EMDR and common reactions to EMDR. You need to ensure your clients are fully informed about this process so they can consent to EMDR treatment.

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 my clients that need extended stabilization and preparation, other tools such as meditation, grounding and resource development are among the many tools available. This will all depend on how your client responds to each different stabilization procedure.

EMDR Reprocessing

Once your client is ready for reprocessing targets, this is when I recommend you select EMDR targets and sequence them in the most impactful order for processing. This is a nuanced procedure which is out of the scope of this blog, but you can find a detailed walk through here.

Returning to the big picture, the general recommendation is to process past events to completion. Then process present triggers (such as sounds, smells, touch, etc). Finally you move on to Future Templates.

General treatment updates

It is really important to update your treatment plans regularly. I prefer to document the date when each intervention was completed. Additionally, I’ll document general progress along with any barriers I’ve encountered in treatment. I document the rationale for pivoting from one type of intervention/to another. For example, if someone has a death in the family, we’ll pivot to grief counseling until it’s appropriate to return to the EMDR treatment plan. I’ll document this in their regular progress notes as well as their EMDR treatment plan under the “treatment update” section.

sample emdr master treatment plan for ptsd

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

If you’d like additional consultation for EMDR treatment planning, click here to book a free 15 minute video consultation to discuss how we can move forward.