Eye Movement Desensitization and Reprocessing (EMDR) Therapy is a psychotherapy option that is commonly used to treat symptoms associated with Post Traumatic Stress Disorder (PTSD). EMDR is a structured approach that focuses on assessing and reprocessing traumatic and other adverse memories that cause distress. This approach can help your client gain new perspectives where they once held negative beliefs, which in turn decreases the state of arousal that they experience when triggered. Keep reading to learn 50 EMDR questions you can ask clients in a therapy session.
For more valuable resources, view our EMDR Tools and Resources hub
During EMDR sessions, you will ask clients to bring their attention to traumatic or emotionally disturbing memories. At the same time, you will be asking them to focus on an external stimulus, such as hand tapping, as you guide them through the use of various eye movements. It has been theorized that when you use this process, your client can make new associations with their memories that do not provoke the same emotions.
EMDR is an evidence-based therapy that is backed by over 30 controlled studies. It has been suggested that some clients no longer meet clinical criteria for PTSD after as little as six sessions lasting 50 minutes each. An additional study indicated that over 75% of Veterans with PTSD resulting from combat experiences did not meet PTSD criteria after a dozen sessions.
As noted above, EMDR is a structured therapeutic approach with eight distinct phases. This includes:
- Phase One: Initially, your sessions will focus on taking your client’s history and assessing their readiness and appropriateness for EMDR. You will also identify specific memories and current situations that cause distress, to find your potential targets for treatment. Time is also spent talking about the specific skills and behaviors that they will need to use during the later stages of treatment.
- Phase Two: Once you are confident that your client will be able to cope with the distress they experience, you can then help them learn imagery and stress reduction techniques that they can use during therapy and in their everyday lives. We want to try and have them maintain their current level of functioning as we transition through the different stages of treatment.
- Phase Three to Six: The next three stages blend as the meat and potatoes of your treatment. Here, you will focus on the target that was identified in phase one. You will help your client identify a visual image tied to their memory, a negative belief about themselves, and other emotions and bodily sensations that arise from the target. You will guide your client through bilateral stimulation such as eye movements, taps, or tones.
- Phase Seven: During the next stage, you will ask your client to keep a log during the week that tracks experiences that arise that are related. This can help clients find opportunities in their day-to-day life where they can use self-calming activities learned in phase two.
- Phase Eight: During the final stage of treatment, you will explore the progress that has been made. This can include your clients overall experience with EMDR, current triggers that cause distress, and any future events that may need different responses to avoid distress.
Getting Ready for Your First EMDR Therapy Session with a New Client
When you’re meeting with a new client, taking time to review the information you have already can be informative. This can include self-report questionnaires, screeners, intake forms, referral paperwork, and possibly an intake assessment. Once you have an idea of what has led to your client seeking help, you can begin assessing their appropriateness for EMDR therapy.
You may find that there are situations in your clinical work, including during EMDR sessions, that you can incorporate worksheets. TherapyByPro is a leading resource for mental health professionals that offers an assortment of worksheets and other clinical forms. The following are examples of forms that may be used with EMDR therapy.
What EMDR Questions Should I Ask In Sessions?
EMDR questions can be used throughout the eight phases of treatment. We are going to focus on questions that could be asked during phase one and phase eight, as these are crucial stages for assessment and tracking progress. Examples of EMDR questions you could personalize to your client include:
- Can you tell me about what has led you to come into therapy?
- What would you say is the greatest challenge you’ve been experiencing lately?
- How has this challenge affected your everyday life?
- Can you tell me about what areas of your life are being impacted? This could include your work performance, relationships, social life, and overall emotional well-being.
- Can you think back to when this concern began?
- Is this your first time experiencing something like this?
- Can you think of any specific memories or traumas that contribute to the distress you just spoke of?
- What are some of the emotions that arise when you think of these memories?
- Have you experienced nightmares or flashbacks related to this memory?
- Can you think about negative beliefs about yourself that you can trace back to this experience?
- Can you tell me what you do to cope with distressing thoughts or emotions?
- What support do you have in your life?
- Have you tried implementing mindfulness practices into your routine?
- On a scale of 1 to 10, one being no concern at all and 10 being the most difficult rating possible, how would you rate your emotional stability at this time?
- How would you describe your sense of safety day to day?
- Do you have any medical conditions or chronic pain that could be connected to a previous trauma?
- Can you describe your sleep patterns?
- Do you have any previous mental health diagnoses, and are you taking any medications for your mental health?
- Can you tell me about your current substance use behaviors?
- What are you hoping to gain from EMDR therapy?
- What is your perception of EMDR?
- Do you have any questions for me about this therapeutic approach?
- What would healing look like for you?
- How do you feel that healing from trauma would impact your overall emotional well-being?
- Can you think of any positive beliefs that you would like to strengthen or reinforce?
- If you could erase one memory from your life, what would it be?
- Can you think of previous experiences that still affect your behaviors?
- Can you tell me about triggers that remind you of trauma or other adverse experiences?
- Can you tell me about the changes you notice in your body when you feel anxious or distressed?
- Do you have a history of panic attacks?
- Can you tell me where in your body you hold tension?
- What emotions do you feel challenge you the most?
- How would you describe your emotional experiences since our last session?
- Have there been any noticeable changes in your emotional experiences?
- Have you noticed changes in the frequency of intrusive thoughts, flashbacks, or nightmares?
- Have there been any shifts in your current depressive or anxiety symptoms?
- Does your memory bring up the same emotional experiences as it did before?
- Would you say that your memories are as distressing as they were before? What’s changed?
- Have you found a sense of closure?
- Can you think of new triggers that you’ve noticed, or that you would like to address?
- Can you tell me about situations that make you feel overwhelmed?
- Do you feel as though you have a greater sense of control over your emotions than you did before engaging in EMDR therapy?
- Can you tell me about avoidance behaviors you’ve noticed lately?
- How does this compare to their presence before EMDR therapy?
- Can you tell me about positive shifts in your beliefs or thoughts?
- Are there any new perspectives on your past that you’d like to share with me?
- Are there any shifts that you’ve noticed within your relationships?
- Do you feel as though these shifts are a positive thing?
- Are there other targets that you would like to work on in future sessions?
- How would you describe your overall experience with EMDR therapy?
Frequently Asked Clinical Questions
Below are FAQs clinicians are asking:
How does a clinician accurately differentiate between historical trauma target material and a client’s current situational crisis during phase one history-taking?
Evaluate whether their immediate emotional instability and high state of arousal are triggered purely by recent life stress or represent an affect bridge linked back to an adverse childhood memory. Current situational issues cause manageable anxiety that responds well to phase two stress reduction techniques, whereas an unprocessed touchstone target memory consistently reactivates a negative belief about the self and triggers intense somatic disturbances, nightmares, or flashbacks across multiple areas of everyday life.
What is the recommended clinical protocol if manualized bilateral stimulation triggers sudden, extreme emotional flooding or an intense abreaction during the desensitization phase?
Maintain a completely supportive environment, keep the bilateral stimulation going if processing is moving dynamically, or utilize a strategic cognitive interweave to insert safety information into the looping memory. Avoid leaving the client uncontained or letting them escape the imagery while their threat system is hyper-aroused; instead, if processing blocks completely, pause the sets and apply pre-taught resourcing templates or self-calming activities from phase two to safely restore emotional stability.
How should an EMDR therapist handle a client who accurately logs their intrusive thoughts on an EMDR progress note but remains too fearful to begin phase three memory reprocessing?
Pause the progression toward target activation and spend additional session time reinforcing phase two resource development and installation. Failing to proceed with desensitization is typically a sign of insufficient affect tolerance, meaning you must collaboratively use structured worksheets to build their internal container, practice hand tapping imagery, and monitor their readiness indicators before targeting disturbing visual images.
When is it clinically appropriate to transition a client from processing a single adverse target memory to conducting an overall review of future triggers in phase eight?
Initiate the phase eight evaluation loop only after the client achieves a Subjective Units of Distress (SUD) score of zero and completely installs a positive belief with a Validity of Cognition (VoC) rating of seven on the original target. Moving toward future template planning or tracking new avoidance behaviors before the foundational childhood trauma memory is fully reprocessed risks destabilizing their current level of functioning and causing premature treatment dropout.
Can an independent practitioner safely execute the active desensitization and installation phases of EMDR with a trauma client presenting with acute, unmanaged substance use behaviors?
No, active memory reprocessing must be carefully delayed until careful care coordination with an interprofessional team or medical provider secures a baseline of physical detoxification and emotional stability. Attempting to activate high-intensity trauma targets while a client relies on active substance use to mask intense bodily sensations and suppress flashbacks violates evidence-based guidelines and drastically elevates the risk of severe clinical destabilization or sudden relapse.
Final Thoughts On Asking the Right EMDR Questions in Sessions
Thank you for reading through this resource on EMDR questions to ask clients in counseling sessions. EMDR is a highly effective approach for clients of varying ages and populations by helping them process traumatic and other adverse experiences. Some of the key benefits that can occur with this approach include quick results, avoiding retraumatization, and reducing PTSD symptoms.
This approach can be used with children who have experienced a range of Adverse Childhood Experiences (ACEs), including abuse, neglect, natural disasters, and accidents. Children can experience reduced anxiety, school-related distress, and nightmares. This approach can be used with children who do not experience expected outcomes from traditional psychotherapy options.
EMDR is recognized by the World Health Organization (WHO) and the American Psychological Association (APA) as an effective treatment option for PTSD. If you would like to learn more about this therapeutic approach, we encourage you to explore current training and continuing education experiences. With proper training and supervision, you may be able to begin implementing this approach into your clinical work.
TherapyByPro is a trusted resource for mental health professionals worldwide. Our therapy tools are designed with one mission in mind: to save you time and help you focus on what truly matters-your clients. Every worksheet, counseling script, and therapy poster in our shop is professionally crafted to simplify your workflow, enhance your sessions, reduce stress, and most of all, help your clients.
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Resources:
- What is EMDR?. EMDR Institute. (2024, December 3). https://www.emdr.com/what-is-emdr/