EMDR A-TIP Worksheet: Targeted Incident Processing Protocol

The Targeted Incident Processing Protocol (A-TIP) is a specialized clinical intervention within the Eye Movement Desensitization and Reprocessing (EMDR) framework, designed specifically for rapid stabilization and the processing of acute, recent traumatic events. This comprehensive 7-page worksheet operationalizes the A-TIP protocol, providing a structured sequence that moves from informed consent and grounding to active desensitization and installation. By utilizing a simplified version of the standard 8-phase protocol, A-TIP allows clinicians to address “recent events” or specific concerns before they become deeply consolidated into maladaptive memory networks. A critical clinical component of this tool is its focus on the Affect Bridge and the immediate reduction of vividness in traumatic imagery through short bursts of Bilateral Stimulation (BLS).

The structured layout is designed to support the Adaptive Information Processing (AIP) model by facilitating “early intervention” trauma care. The worksheet guides the clinician through the identification of the Irrational Belief (Negative Cognition) and the Adaptive Belief (Positive Cognition), utilizing the 0–10 Subjective Units of Distress (SUD) and 1–7 Validity of Cognition (VoC) scales to track physiological and cognitive shifts in real-time. By requiring documentation across five rounds of desensitization and five rounds of installation, the tool ensures that reprocessing is systematic and that “Dual Awareness” is maintained. This process is essential for preventing the development of chronic PTSD symptoms following an acute stressor.

This clinical resource draws significant inspiration from the Acute Trauma Incident Protocol (A-TIP) developed by Francine Shapiro and the simplified “Recent Events” protocols refined by Elan Shapiro and Brurit Laub (R-TEP). By operationalizing these crisis-intervention strategies into a manageable, step-by-step format, the worksheet assists practitioners in providing immediate psychological first aid. This process is foundational for a trauma-informed treatment arc, ensuring that acute distress is contained and reprocessed before it can fragment the client’s sense of self or destabilize their daily functioning.

How This Worksheet Can Be Used

Acute Crisis Intervention:
Therapists use the worksheet when a client presents with a very recent traumatic event (e.g., an accident or assault). It serves as a focused “surgical strike” on that specific incident to lower arousal and prevent memory crystallization.

Phase 2 Stability Testing:
This tool can be used during the Preparation phase to test a client’s ability to process a “small” disturbance. Success with the A-TIP worksheet provides the clinician and client with the clinical self-efficacy needed for deep processing of long-term trauma.

Session Summary & Documentation:
The “A-TIP Treatment Summary” on the final page serves as a formal clinical record. It documents the longitudinal shift from “Starting SUD” to “Ending SUD,” providing essential data for case conceptualization and reevaluation sessions.

Benefits of the EMDR A-TIP Worksheet

• Facilitates rapid desensitization of acute, recent traumatic incidents.
• Supports the AIP model through structured cognitive and physiological monitoring.
• Integrates essential grounding exercises (circular, eye-roll, four-square) for maximum safety.
• Provides 5-round tracking for both the Desensitization and Installation phases.
• Identifies “Stop Signals” and body sensations to prevent dissociative flooding.
• Includes a comprehensive Treatment Summary for professional clinical documentation.

References

• Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.
• Shapiro, E., & Laub, B. (2008). The Recent Traumatic Episode Protocol (R-TEP). Journal of EMDR Practice and Research. (Context on acute incident processing).
• Luber, M. (2009). Eye Movement Desensitization and Reprocessing (EMDR) Therapy Scripted Protocols: Special Situations. Springer Publishing Company.
• Leeds, A. M. (2016). A Guide to the Standard EMDR Therapy Protocols for Clinicians. Springer Publishing Company.