Therapist's Gde To Emdr Cl

Practice essentials from a leading EMDR trainer and practitioner. With an emphasis on clinical usefulness rather than research, this book provides practitioners of eye movement desensitization and reprocessesing (EMDR) with a hands-on guide to this essential therapy. Reviewing basic concepts (such as interviewing and case formulation) as well as providing advanced strategies (such as closing incomplete sessions), this is a book for all EMDR clinicians.

Acknowledgments

xiii

Preface

xv

Introduction

3

What EMDR Does and How it Works

3

Neurobiology of Trauma and Recent Brain Research

14

The Discovery of EMDR and its Development

18

Organization of Book

22

Conventions Used Throughout the Book

23

PART I: EMDR THEORETICAL OVERVIEW

1. EMDR Refresher

27

Review of Basic EMDR Protocol and Procedure

27

Rationale and Application of Interweaves

33

EMDR Resource Development and Installation (RDI)

34

Three-Phase Trauma Therapy Model

34

EMDR as a Stand-Alone Therapy vs. EMDR as a Therapeutic Method That Is Integrated into a Treatment

35

2. Essential EMDR Protocol

36

Modifications of the Standard Procedural Steps

36

How to Modify the Standard Procedural Steps

39

When to Modify the Standard Procedural Steps

42

Modifying the Procedural Steps for Clients with Complex Trauma

43

PART II: USING EMDR WITH CLIENTS

3. Evaluation and Preparation for EMDR

47

Take a History of the Presenting Problems

47

Assessing Readiness for EMDR

57

Integrating EMDR into Clinical Treatment: How to Introduce EMDR to Clients

65

Explanation of Theories

66

Informed Consent for EMDR

67

Set Up Signals for "Stop" and "Keep Going"

68

Types of BLS

68

Establishing a Metaphor to Use

70

Treatment Issues

71

4. Tools and Techniques for Ego Strengthening

79

Identification, Development, and Installation of Inner and Outer Resources

80

Other Coping Skills

110

Techniques for Creating Distance and/or Containment

116

5. Case Formulation

119

Using the Standard Protocol for Current Anxiety and Behavior

121

How to Determine a Target from a Current Issue or Problem

123

Longer-Term Therapy with Multiple Complex Issues

135

6. Reevaluating the Therapy

140

Functioning

143

Check the Log or Journal

143

Symptoms

145

Behavioral Shifts

145

Dreams

146

Insights

146

New Memories

146

System Changes

146

The Target

147

7. Target Development

148

Targeting Single-Incident Traumas

148

Targeting for Clients with Multiple Traumas

149

Tips for Target Development

151

Targeting Triggers and Flashbacks

153

The Bridging Technique for Target Development

154

Using Art for Targets

184

Dreams as Targets

187

PART III: THE EMDR SESSION

8. The Procedural Steps

193

Installing or Evoking Resources

193

Identifying the Presenting Issue or Memory

193

Creating an Image

193

NC (Negative Cognition)

197

PC (Positive Cognition)

198

VoC (Validity of Cognition) Scale

200

Emotions/Feelings

201

SUDS

201

Location of Body Sensations

202

Desensitization

203

Installation of the PC

211

Body Scan

211

Close and Debrief the Session

212

Suggestions for Helping Clients Manage Between Sessions

222

9. Tools and Techniques for Processing Difficulties

224

Working with Abreactions

224

Dissociation During EMDR Processing

229

Client Sleepiness

231

Client Numbness

233

Clients with Body Memories without Visual Memories

233

Memory Chaining

235

Using Interweaves and Other Strategies to Release Blocked Processing

236

Implementing Non interweave Strategies

248

Implementing Interweave Strategies

251

PART IV: CLINICAL APPLICATIONS

10. Working with Phobias

293

11. Recent Traumas and Critical Incidents

309

Protocol for Recent Traumatic Events

309

Modified Protocol for Recent Traumatic Events

314

Using the Recent Traumatic Events Protocol with Critical Incidents

317

12. Care for the Caregiver

320

Suggestions for Therapist Self-Care

320

How to Be the Best EMDR Therapist

323

Appendix 1: EMDR Procedures and Checklists

325

EMDR Procedural Steps Checklist

325

Sample Vignette of the Procedural Steps

326

Modified EMDR Procedural Steps Checklist

328

Sample Vignette of the Moded Procedural Steps

329

Clinical Signs of Dissociative Disorders

330

Quick Assessment for EMDR Readiness in an Outpatient Setting

332

Summary of Resources, Coping Skills, and Techniques for Creating Distance and/or Containment

333

Protocol for Development of the Positive, Conflict free Image

334

List of Negative and Positive Cognitions

335

Summary of What to Do If the Processing Is Looping or Stuck

336

Summary of Noninterweave Strategies

336

Important Concepts for Adaptive Information Processing

337

Summary of Interweave Categories and Subcategories

337

Appendix 2: Trauma Exposure and Crisis Intervention with CIPBS

339

References

345

Index

353

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Therapist's Gde To Emdr Cl

Summary

Table of Contents

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