EMDR Phase 3 Assessment Worksheet: Target Image, Cognitions & Distress Ratings

This clinical worksheet operationalizes Phase 3 (Assessment) of the Eye Movement Desensitization and Reprocessing (EMDR) 8-phase protocol. The layout provides a structured framework for identifying the primary components of a traumatic memory network before active reprocessing begins. A critical clinical component of this tool is the forensic identification of the Target Image, representing the “worst part” of the memory, and the pairing of that image with the Negative Cognition (NC)—the maladaptive self-belief currently held by the client. By documenting these elements alongside the Positive Cognition (PC), the worksheet ensures that the therapeutic target is clearly defined, preventing “wandering” during bilateral stimulation.

The structured layout is designed to facilitate the baseline measurement of the Adaptive Information Processing (AIP) system. By utilizing the 1–7 Validity of Cognition (VoC) scale and the 0–10 Subjective Units of Distress (SUD) scale, clinicians can quantify the baseline intensity of the disturbance and the current believability of an adaptive alternative. This worksheet further emphasizes the somatic component of trauma by requiring the mapping of physical Sensations and their specific locations in the body. This multi-modal assessment—incorporating visual, cognitive, emotional, and somatic data—is essential for creating a “baseline bridge” that allows for the objective tracking of desensitization progress in Phase 4.

This clinical resource draws significant inspiration from the standard 8-phase protocol developed by Francine Shapiro and the standardized assessment procedures refined by Marilyn Luber. By operationalizing the assessment phase into a manageable, two-page format, the worksheet assists practitioners in ensuring all “Targeting Sequence” requirements are met. This process is foundational for a safe and effective treatment arc, providing the clinical scaffolding necessary to move from stabilization to the deep neurological retraining of the desensitization and installation phases.

How This Worksheet Can Be Used

Defining the Processing Target:
Therapists use the worksheet to anchor the transition from Phase 2 to Phase 3. It serves as the “script” for helping clients narrow down a complex traumatic event into a single, workable “worst” image and a corresponding core belief.

Quantitative Benchmarking:
The tool is utilized to record the initial SUDs and VoC ratings. These numbers serve as the clinical benchmark; clinicians refer back to these ratings in Phase 8 (Reevaluation) to prove the empirical effectiveness of the processing work.

Identifying Somatic Triggers:
By documenting the “Sensations” and their locations, the clinician can help the client maintain “Dual Awareness” during BLS. If the client becomes stuck, the therapist can refer back to the body location listed to re-access the processing flow.

Benefits of the EMDR Phase 3 Assessment Worksheet

• Ensures high-fidelity adherence to Phase 3 of the standard EMDR protocol.
• Identifies the critical link between the Target Image and the Negative Cognition.
• Utilizes the 1-7 VoC and 0-10 SUD scales for precise clinical monitoring.
• Facilitates a multi-modal assessment of visual, cognitive, and somatic distress.
• Supports the AIP model by establishing a clear baseline for adaptive integration.
• Reduces clinical “noise” by focusing the client on the most disturbing parts of the memory.

References

• Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.
• Luber, M. (2009). Eye Movement Desensitization and Reprocessing (EMDR) Therapy Scripted Protocols: Basics and Special Situations. Springer Publishing Company.
• Leeds, A. M. (2016). A Guide to the Standard EMDR Therapy Protocols for Clinicians. Springer Publishing Company.
• Hase, M., et al. (2017). The Adaptive Information Processing Model: Support from the internal world of trauma. Frontiers in Psychology.