Eye Movement Desensitization and Reprocessing Therapy, commonly referred to as EDMR, was founded by Francine Shapiro with the intention of helping individuals who were struggling with traumatic memories. Since its creation, EMDR has successfully helped individuals living with a variety of mental health concerns.
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For many, seeking help for a mental health concern can be overwhelming. Those who experience significant impairment from their mental health concerns are often worried about the time it takes to see the benefits of counseling. Eye Movement Desensitization and Reprocessing Therapy can be an effective tool to improve the quality of life for some clients in a timely manner.
EMDR is designed to help counselors access and process traumatic memories or events so that they can work with their Client’s to reach a new resolution (EMDR, n.d.). This can help decrease negative symptoms including psychological arousal and distress, and assist in reformulating core beliefs (EMDR, n.d.). Overall, having a positive impact on the Client’s quality of life. Keep reading to learn 10 EMDR Therapy Exercises and Activities you can do with your clients.
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EMDR 8 Step Approach
Eye Movement Desensitization and Reprocessing Therapy follows an eight-phase approach. The eight phases are outlined as the following, by the EMDR Institute, Inc.:
Step 1: Information Gathering
Initially, it is important to focus on information gathering, which should include the client’s history and relevant experiences. At this time, the client’s treatment plan will be developed during this phase.
Step 2: Preparing to Cope with Emotional Distress
The Clinician then begins to focus on preparing the client to cope with the emotional distress that the Client will experience in later phases.
Steps 3 – 6: Identify and Process Painful Events
3-6. The target memory or event is identified and processed using EDMR procedures. During this phase, the client will work to identify a vivid visual of the event, any negative beliefs they have of themselves, and identify related emotions and body sensations. Clients are also asked to identify positive self-beliefs they have. The Clinician will guide and support the client through these phases.
Step 7: Logging Experiences
The Client is asked to keep track of their experience for one week in a written log. This log is designed to show the client’s use of what they have learned in session, including self-calming activities.
Step 8: Review Experience
The final phase examines the Client’s experience with EMDR therapy. This can include exploring what they have achieved and identifying future goals.
Mental Health Concerns That Can Benefit from EMDR Exercises
Research has found that EDMR can effectively reduce symptoms associated with Posttraumatic Stress Disorder, Panic Disorder, and some phobias (Cahill, S.P., Carrigan, M.H., & Frueh, B.C., 1999).
The EMDR Institute, Inc. reported that 84-90% of individuals who experienced a single traumatic event found that they no longer struggled with their Post Traumatic Stress Disorder symptoms after three 1.5 hour EMDR sessions. Additionally, promising results have been found for individuals who have multiple traumas and combat veterans with as few as 12 EMDR sessions (EMDR,n.d.). These results are encouraging for Clients who may be hesitant or concerned about the length of time that would be needed to see the positive effects of EMDR Therapy.
Eye Movement Desensitization and Reprocessing therapy is supported by the American Psychological Association, the World Health Organization, and the U.S. Department of Defense.
Eye Movement Desensitization and Reprocessing Activities
Eye Movement Desensitization and Reprocessing exercises can be used to enhance the client’s experience in session. EMDR exercises can reinforce information discussed in the session, and help Clients utilize the skills they learn in their sessions. Here is an example list of EMDR activities that can be used during EMDR sessions:
- Teaching your client about the Subjective Unit of Disturbance, or SUD, can help clients rate the amount of distress they experience regarding challenging memories. Providing clients with a SUD worksheet, like the one available at TherapyByPro, can help them track their level of distress over time. Clients can use this worksheet to track their experience outside of the session and use it as a tool to reflect on their progress. Tracking their SUD can also provide them with an opportunity to reflect on the progress they have made in therapy.
- Introduce your client to the Butterfly Hug method to self-soothe. Take time to demonstrate this skill and answer any questions that they may have. Talk your client through the steps of a Butterfly Hug and follow up by asking about how they felt after practicing this skill. Encourage your client to use this self-soothing skill outside of the session, and follow up about their ability to do so.
- The Challenging Cognitions Worksheet offered by TherapyByPro can help clients develop positive cognitions to replace negative cognitions. Experiencing negative cognitions is a common experience after experiencing a challenging or negative event. Clients can use the worksheet to track negative thoughts that they were able to challenge and replace outside of therapy sessions, which can help them see their progress.
- Introduce your client to grounding skills. Grounding skills can be used to keep our minds in the present moment, rather than being wrapped up in the past or the future. You can discuss the use of our five senses in grounding skills, and encourage them to practice various grounding skills that they can utilize outside of sessions in moments of distress.
- Introduce your client to the concept of the Window of Tolerance. Understanding physical symptoms associated with hyperarousal, optimal arousal, and hypoarousal can help your client recognize when they fall into a hyperarousal or hypoarousal state so that they can use skills to work towards feeling calm and safe within the optimal arousal state. TherapyByPro offers a Window of Tolerance Worksheet that can be used to track their experience outside of therapy sessions.
- Introduce your client to the practice of deep breathing. Explain the process of breathing in through their nose and expanding their diaphragm rather than their chest. Some may benefit from visually seeing a demonstration where the Clinician breathes int through their nose, to their belly, and exhales through their mouth. Encourage your client to take several deep breaths in a row, and explore how they feel after this exercise compared to before the practice. Encourage your client to utilize deep breathing as a self-soothing skill.
- Another relaxation technique that clients can benefit from is using a Safe Place or a Calm Place. This can include thinking of a place that makes them feel calm and safe, how they feel when they think about this place, and using their senses within their safe place. They can then identify a word that represents their safe place for them so that when they think of that word, they can think of the positive associations they have with their safe place. TherapyByPro EDMR Safe Place Worksheet can be completed in a session and kept by the client to serve as a reminder of their safe place.
- A helpful EMDR exercise for sessions would be to practice the eye movements that the client will be using during their EMDR Therapy sessions. This can help your client feel confident in their ability to engage in their therapy sessions and provide the Clinician with an opportunity to address any concerns that the client may have.
- Clients who find themselves struggling to manage their distressing symptoms can benefit from using an EMDR Container Worksheet. The Container exercise can help Clients visualize a strong container that can carry their distressing feelings. The container should allow for the client to take out a single concern at a time, and they would have control regarding how much of a concern they take out at a time. During this exercise, clients are asked to describe the jar and explore how they would feel if they could put some of their concerns in their container. TherapyByPro offers an EMDR Container Worksheet that can serve as a template for an in-session EMDR activity.
- Clients will likely experience distress outside of the session. An EMDR TICES worksheet can help clients track the triggers, images, cognitions, emotions, and sensations they experience when they feel distressed. Encourage your client to notice the trigger, and take a snapshot of it that they can record on the worksheet and bring to the session. Once clients have completed the worksheet, they can put it in a safe place until their session when they can revisit the worksheet in session.
Final Thoughts on EMDR Therapy Exercises and Activities for your Clients
Thanks for reading this resource on EMDR Therapy Exercises and Activities you can do with your clients. Eye Movement Desensitization and Reprocessing Therapy is a great tool for Clinicians who are working with clients who are struggling with Post Traumatic Stress Disorder and other mental health concerns. Research has supported the reliability that EDMR can help various populations who are significantly impacted by their mental health concerns. EDMR can provide relief for clients sooner than other forms of psychotherapy, including talk therapy.
Clinicians who work with clients who struggle with traumatic memories could benefit from learning more about the uses of Eye Movement Desensitization and Reprocessing Therapy. This can be done through specialized training sessions, courses, or continuing education opportunities. Your supervisor can be a valuable resource if you are looking to expand your knowledge of EMDR.
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- Cahill, S. P., Carrigan, M. H., & Frueh, B. C. (1999). Does EMDR work? And if so, why?: a critical review of controlled outcome and dismantling research. Journal of anxiety disorders, 13(1-2), 5–33. https://doi.org/10.1016/s0887-6185(98)00039-5
- EMDR Institute, Inc. (n.d.). What is EMDR? EMDR. Retrieved March 2, 2023, from https://www.emdr.com/what-is-emdr/