EMDR SUD Scale Worksheet: Tracking Emotional Distress Across Sessions

In Eye Movement Desensitization and Reprocessing (EMDR), the Subjective Units of Disturbance (SUD) Scale is the primary psychometric tool used to measure the emotional and physiological “charge” of a traumatic memory. Utilized during Phase 3 (Assessment), Phase 4 (Desensitization), and Phase 8 (Reevaluation), this scale allows for the objective tracking of a memory’s decline in intensity. This worksheet provides a structured, multi-page longitudinal tracker designed to document SUD ratings from the “Beginning of Session” to the “End of Session.” By requiring a 0–10 rating, where 0 represents no disturbance and 10 represents the worst possible distress, the tool provides empirical evidence of the Adaptive Information Processing (AIP) system at work.

The structured layout is designed to facilitate the forensic deconstruction of the four memory components: image, cognition, affect, and body sensation. Research in EMDR suggests that while a client may intellectually process a trauma, the SUD rating provides the vital “neurological check” to ensure physiological habituation has actually occurred. By utilizing this tracker across multiple dates, clinicians can visualize the “desensitization curve,” identifying when a target memory has reached a stable SUD of 0 (or ecologically valid 1). This data-driven approach is essential for professional case formulation, as it helps practitioners determine when to close a target prong and move forward in the trauma hierarchy.

This clinical resource draws significant inspiration from the foundational protocols established by Francine Shapiro and the standardized monitoring frameworks refined by Marilyn Luber. By operationalizing the tracking of distress into a clean, professional format, the worksheet assists practitioners in maintaining high-fidelity records of clinical breakthroughs. This process is foundational for a comprehensive treatment arc, ensuring that the therapeutic journey leads to a permanent reduction in trauma-related arousal and a reclaimed sense of internal peace.

How This Worksheet Can Be Used

Desensitization Monitoring (Phase 4):
Therapists use the tracker to record the decline of distress during active reprocessing. It serves as a visual guide to ensure that the session does not end while a client is in high arousal, facilitating the transition to Phase 7 (Closure).

Treatment Reevaluation (Phase 8):
This tool is highly effective for checking “maintenance” at the start of a new session. The clinician records the SUD at the beginning of the hour to ensure the memory has remained desensitized since the previous encounter.

Addressing Somatic “Stuck Points”:
Clinicians use the “Notes” section to document specific physical sensations that maintain high SUD scores. This allows for targeted somatic interweaves or a shift in focus to a different “feeder” memory within the network.

Benefits of the EMDR SUD Scale Worksheet

• Quantifies emotional intensity using the standardized 0–10 Subjective Units of Disturbance scale.
• Supports the AIP model by providing empirical proof of neurological habituation.
• Tracks progress across 3 full pages to allow for longitudinal treatment monitoring.
• Facilitates high-fidelity documentation of the “Beginning” and “End” states of each session.
• Identifies the effectiveness of desensitization interventions in real-time.
• Includes dedicated space for session dates and clinical notes for professional case management.

References

• Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.
• Wolpe, J. (1969). The Practice of Behavior Therapy. Pergamon Press. (Origin of the SUD scale).
• Luber, M. (2009). Eye Movement Desensitization and Reprocessing (EMDR) Therapy Scripted Protocols. Springer Publishing Company.
• Leeds, A. M. (2016). A Guide to the Standard EMDR Therapy Protocols for Clinicians, Supervisors, and Consultants. Springer Publishing Company.