Example EMDR Case Presentation Form – 8 Phases

This form is a structured template designed to help EMDR therapists organize and present client cases during consultation. It guides consultees through documenting clinical background, treatment planning, and observations across all eight phases of the EMDR Therapy protocol.

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Example EMDR Case Presentation Form – 8 Phases

Last updated: 02/26/2026

The purpose of this EMDR Case Presentation Form is for the consultee to use this form to summarize the EMDR case they are bringing for discussion during the consultation process. Case presentation details can be outlined and summarized by the consultee so the consultant can provide guidance and feedback on their use of EMDR with this client. Both consultants and consultees are welcome to use the form as is, make modifications, or use other resources for the consultation process.

Describe the focus area or question for this consultation session and the behavioral sample that you are including (video (preferably, if it is possible), near verbatim case transcript, or any other material):

Relevant Consultee Areas:

• Describe therapist relationship with client (sensitivity to client differences?):
• EMDR appropriateness for client assessed:
• Adequate preparation for EMDR therapy (explanation issues, hesitations from consultee or client?):
• Informed consent for EMDR therapy:

Phase 1: Client History
(be mindful of client confidentiality/HIPAA requirements)

• Why did the client seek treatment?
• Relevant historical, cultural, family, medical, emotional, social support, or attachment information:
• Relevant dissociative assessment (ie. DES, MID) and/or other assessment information:
• Relevant current life stressors and resources:
• Relevant trauma history and target possibilities:
• Past memories, present triggers, future goals? Complex trauma?
• Case conceptualization using AIP:
• Identify memory networks for presenting problem:
• Relevant clinical themes (responsibility, self-worth, safety, control, choices):
• EMDR Treatment Plan (indicate reasoning):
• Stabilization/resource development sufficient prior to reprocessing?
• Symptom reduction or comprehensive treatment?
• Three prongs addressed? Future goals? Observations?
• Target sequencing plan and why? (ie. Problem Driven, Present Trigger first, Timeline, Single Event, Other)
• Questions about this phase?

Phase 2: Preparation

• Logistical preparations such as distance, BLS speed, stop signal:
• Safe/Calm Place
• Are additional stabilizing resources needed (Resource Development Installation (RDI), Container, skills to stay present, etc):
• Questions about this phase?

Phase 3: Assessment

• Target selected (Past memory or present trigger?):
• Picture/image/worst part:
• NC, PC
• VOC:
• Emotions:
• SUD:
• Body Location:
• Questions about this phase?

Phase 4: Desensitization

• Describe relevant parts of the desensitization process. How did it go? Observations?
• BLS type and why (BLS changes?):
• SUD 0 or ecological?
• Stuck points, insights, shifts?
• Feeder memories, following new material:
• Interweaves needed:
• Questions about this phase?

Phase 5: Installation

• Describe the installation process. How did it go? Observations?
• PC same or change:
• VOC to 7?
• Blocks? Feeder memories?
• Questions about this phase?

Phase 6: Body Scan

• Describe the body scan process. How did it go? Observations?
• Clear:
• Unclear:
• Blocks? Feeder memories?
• Questions about this phase?

Phase 7: Closure

• Describe the process. Was the target reprocessing incomplete/complete?
• If incomplete, where was the client getting stuck? How was client stabilized?
• What was client experience?
• Questions about this phase?

Phase 8: Reevaluation

• Describe client self-report during follow-up at their next session. How did it go? Observations
• Questions about this phase?

Present Triggers

• Were all present triggers processed? How did it go? Observations?
• What was client experience?
• Blocks? Feeder memories?

Future Triggers

• Describe setting this up after present triggers are resolved. How did it go? Observations?
• What was client experience?
• Blocks? Feeder memories?

Additional Relevant Notes of Questions: __