What Should Clients Track Between EMDR Sessions?
Clients may notice a range of experiences after an EMDR session, including dreams, emotions, memories, body sensations, fatigue, or new insights. By the next appointment, however, the details may be difficult to reconstruct. A client may remember that the week felt intense without remembering when the reaction began, how long it lasted, whether it gradually decreased, or what helped.
Brief tracking between EMDR sessions can give clinicians a clearer picture of what occurred after the client left the therapy room. The goal is to preserve useful observations that can inform the next session without asking clients to continually monitor themselves, interpret every reaction, or actively process trauma material on their own.
What Should Clients Track Between EMDR Sessions?
The information that is useful to record depends on what the client notices after the session:
If dreams, memories, or new associations emerge → Briefly note what stood out and whether it appeared connected with therapy themes or the material being processed.
If emotions or body sensations increase → Notice the experience, approximate intensity, how long it lasted, and whether it decreased.
If the client feels unusually fatigued, emotionally sensitive, or reactive → Notice how long the change continues and whether it interferes with ordinary functioning.
If distress increases → Notice whether previously established regulation resources remain accessible and whether distress decreases, remains steady, or increases.
If the client becomes increasingly overwhelmed, disconnected, or unable to function as expected → Follow the established plan for contacting the therapist instead of waiting for the next scheduled appointment.
Clients do not need to determine what each experience means. Their observations give the clinician information that can be reviewed alongside what occurred during the EMDR session and the broader treatment plan.
Keep Between-Session Tracking Brief
Tracking can become less useful when clients feel responsible for documenting every thought, emotion, dream, or physical sensation. For some clients, extensive monitoring may also increase attention to symptoms or encourage them to spend additional time with traumatic material outside therapy.
A brief note is usually enough to preserve an experience for discussion. A client might write that they had a vivid dream related to the target, felt unusually irritable the following afternoon, remembered another part of an event, or noticed a familiar body sensation. They can then return their attention to daily activities and use any regulation strategies that have already been established in treatment.
Clients should also understand the difference between noticing an experience and deliberately continuing trauma processing outside the session. Between-session tracking is intended to help the client remember what occurred so it can be discussed with the therapist. It is not an invitation to intentionally activate the target, search for additional memories, or work through traumatic material independently.
Track the Pattern & the Distress Rating
A distress rating can be useful, especially when the client notices a significant increase in activation. The number becomes more informative when the clinician also knows what happened around it.
Consider a client who reports an emotional wave that reached 8 out of 10, lasted approximately 15 minutes, and gradually settled after the client used a previously established grounding resource. Another client may report distress at 6 out of 10 that continued for several days, interfered with sleep, became increasingly difficult to regulate, and remained elevated at the next appointment.
Those experiences give the clinician different information even though the second client reported a lower peak distress rating. Duration, course over time, manageability, resource access, recovery, and changes in functioning help place the intensity rating in clinical context.
This is also why a single question such as “How was the week after EMDR?” may not capture enough information. Clients may need more specific prompts to remember how their reactions developed and changed between appointments.
Dreams, Memories, and New Associations Between EMDR Sessions
Clients may notice dreams related to therapy themes, additional memories, reminders of the material being processed, or new connections between experiences. Cognitive shifts or insights may also emerge after a session. When these experiences occur, clients can briefly record enough information to remember them. A few words describing the dream, memory, association, or insight may be sufficient. The clinician can then explore the experience during the next appointment and consider how it relates to the material already being addressed.
This type of observation can be especially useful when a client reports that “something came up” during the week but has difficulty recalling the details once the next session begins. Clinicians who want a broader discussion of the reactions clients may experience after EMDR can review Managing Reactions Between EMDR Sessions. That article focuses on understanding and responding to between-session reactions, while the focus here is the information that is useful to bring back into treatment.
Emotional and Body Reactions Can Be Tracked Over Time
Emotional changes may include sadness, anger, grief, anxiety, relief, increased sensitivity, or feeling more reactive to ordinary stressors. Clients may also notice body sensations associated with the material being processed, fatigue, or reduced emotional bandwidth.
When these experiences stand out, the clinician benefits from knowing when they occurred and what happened afterward. A reaction that gradually decreases may lead to a different clinical discussion than one that persists, increases, repeatedly interrupts sleep, or interferes with work, relationships, or daily responsibilities.
Clients do not need to create a detailed record of every fluctuation. A brief description of the reaction, its approximate intensity or duration, and whether it improved gives the clinician a starting point for reviewing the experience.
Notice What Happens When the Client Uses Established Resources
Between-session experiences can also show whether preparation resources remain accessible outside the therapy session. If activation occurs, the clinician may want to know whether the client could use grounding, orientation, Calm Place, Container, or another resource that had already been introduced and practiced in therapy.
The client's response provides useful information. A resource may be easy to access during a regulated session and considerably harder to retrieve after a trauma reminder, vivid dream, or unexpected emotional wave. Another client may use the resource independently and notice that activation gradually decreases.
The next session can include a review of which resources the client attempted, whether they could access them, and what happened afterward. Repeated difficulty using established resources may indicate that the resource needs additional practice or adaptation in session.
A Simple Way for Clients to Track Between Sessions
Clients often need enough structure to remember what occurred without turning reflection into an extensive assignment. A short check-in can capture the experiences most useful for later clinical discussion.
The Client Reflection Sheet for Experiences Between EMDR Sessions gives clients an optional place to record their overall emotional state, highest distress level, dreams, emotional waves, memories or insights, body sensations, fatigue, sensitivity or reactivity, and reminders of the material being processed. It also provides space for a brief reflection and anything the client wants to discuss with the therapist.
The sheet can be introduced before reprocessing so clients understand how it will be used. Clinicians can explain that the client does not need to complete every section or analyze the experiences they record. The purpose is simply to preserve observations that may be useful when treatment resumes.
→ Client Reflection Sheet for Experiences Between EMDR Sessions
How Between-Session Tracking Can Inform the Next EMDR Session
Reviewing between-session experiences gives the clinician an opportunity to look at the pattern that developed after the previous appointment. The discussion can include what emerged, how activation changed, whether the client remained able to function, which resources were accessible, and whether the client returned toward their usual level of regulation.
New memories or associations may become relevant to treatment planning. Difficulty accessing resources may indicate a need to reinforce preparation. Repeated disconnection may warrant additional assessment of dissociation or present orientation. Persistent activation may lead the clinician to reconsider pacing before continuing with the next target or returning to reprocessing.
Between-session information is most useful when it is considered alongside the client's presentation in session, current stressors, treatment history, and response to previous EMDR work. The clinician is looking for patterns that help determine what the client needs next.
When Between-Session Reactions Need a Clinical Response
Some experiences can be recorded and discussed at the next scheduled appointment. Other changes may warrant communication sooner, depending on the client's presentation and the treatment and safety plans already established.
Clinicians can give clients individualized guidance about when to make contact between sessions. Increasing emotional overwhelm, persistent sleep disruption or nightmares, worsening dissociation or detachment from reality, distress that continues without improvement, or thoughts of self-harm may require earlier communication and clinical assessment. Instructions for routine between-session contact, urgent concerns, and emergency or crisis procedures should be established before clients need to use them.
When a client reaches out, the information they have tracked may help clarify how the reaction developed. The clinician can review when it began, whether it has increased or decreased, how it is affecting functioning, and whether previously established resources remain accessible. Those observations can help determine the appropriate clinical response.
Managing Reactions That Continue Between Sessions
When tracking identifies recurring or difficult reactions, clinicians may need to decide what to address before continuing reprocessing. The response may include reviewing grounding and orientation, strengthening an established Container or Calm Place, addressing somatic activation, evaluating dual attention or dissociation, or reconsidering treatment pacing.
The Managing EMDR Reactions Between Sessions clinician guide organizes these decisions in one resource. It includes normalization language, between-session strategies that have already been introduced and practiced with the client, indications for contacting the therapist, and preparation skills clinicians can review when reactions continue. The guide also emphasizes that clients should not be expected to learn new stabilization techniques independently between appointments.
→ Managing EMDR Reactions Between Sessions
When Between-Session Patterns Suggest Additional Preparation
Repeated patterns across several sessions may provide information about the client's current preparation needs. Difficulty returning toward baseline, reduced access to established resources, increasing dissociation, or recurrent difficulty managing activation outside the therapy room may lead the clinician to reconsider the amount or type of preparation currently in place.
Returning to Phase 2 remains available after reprocessing has begun. The clinician can reinforce resources, address newly identified barriers, reassess regulation or dual-attention capacity, and reconsider pacing before deciding when to continue trauma processing.
Between-session tracking can make these decisions easier to ground in observed patterns. Instead of relying only on how the client presents at the beginning of the next appointment, the clinician has additional information about how the client functioned during the days between sessions.
Continuing Education for EMDR Phase 2 Preparation
Clinicians who want additional training in preparation, stabilization, and readiness can take EMDR Phase 2: Preparation, Stabilization, and Readiness for Trauma Processing. The 4-hour continuing education course provides instruction on emotional regulation, dissociation, dual attention, stabilization resources, readiness assessment, and clinical decisions about when additional preparation may be indicated.
The course is designed as supplemental education for licensed mental health professionals who have completed or are completing formal EMDR training. It offers 4 EMDRIA Credits and continuing education credit through an APA-approved sponsor.
→ EMDR Phase 2: Preparation, Stabilization, and Readiness for Trauma Processing
EMDR Preparation and Stabilization Resources
Between-session functioning is one part of the broader clinical picture clinicians consider when evaluating preparation and readiness for trauma processing. Questions about dissociation, regulation, dual attention, resource access, treatment pacing, and readiness often intersect as treatment progresses.
The EMDR Preparation & Stabilization Hub brings together clinician education, assessment tools, client resources, and continuing education related to these areas. Clinicians can use the hub to find additional resources as new preparation questions emerge during treatment.
→ EMDR Preparation & Stabilization Hub
Conclusion
Between-session tracking gives clinicians information about what happened after the client left the therapy room. Dreams, emerging memories, emotional and body reactions, changes in functioning, resource accessibility, and the client's ability to recover from activation can all contribute to the discussion at the next appointment.
The most useful tracking is brief and clinically focused. Clients can notice experiences that stand out, record enough information to remember them, and bring those observations back to therapy. The clinician can then place the experiences in context and decide whether the next step involves continuing as planned, adjusting pacing, strengthening preparation, or completing additional assessment.
Research References
Hoppen, T. H., Lindemann, A. S., & Morina, N. (2022). Safety of psychological interventions for adult post-traumatic stress disorder: Meta-analysis on the incidence and relative risk of deterioration, adverse events and serious adverse events. The British Journal of Psychiatry, 221(5), 658–667. https://doi.org/10.1192/bjp.2022.111
Leeds, A. (2016). A guide to the standard EMDR therapy protocols for clinicians, supervisors, and consultants. Springer Publishing.
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
