EMDR TICES Worksheet: Tracking Distress, Cognitions, & Body Sensation

The TICES grid is a foundational clinical tool utilized primarily during Phase 1 (History Taking) and Phase 2 (Preparation) of the Eye Movement Desensitization and Reprocessing (EMDR) protocol. This worksheet operationalizes the TICES acronym (Trigger, Image, Cognition, Emotion, Sensation), providing a structured framework for clients to log distressing incidents in real-time. By requiring the forensic documentation of the environmental trigger alongside the resulting internal imagery and negative self-talk, the tool facilitates “Metacognitive Awareness.” This process is essential for helping clients move from being “fused” with their trauma responses to becoming objective observers of their own nervous system, which is a prerequisite for successful reprocessing.

The structured layout is designed to support the Adaptive Information Processing (AIP) model by identifying the specific components of a maladaptive memory network. A critical clinical component of this tool is the integration of “Before and After” Subjective Units of Distress (SUD) monitoring paired with the documentation of Coping Skills. By requiring clients to rate their distress on a 0–10 scale before and after utilizing interventions like the Calm Place or Lightstream, the worksheet provides empirical evidence of the client’s growing “Window of Tolerance.” This data-driven approach allows clinicians to evaluate the efficacy of current stabilization techniques and identify the most high-priority targets for upcoming Phase 4 (Desensitization) sessions.

This clinical resource draws significant inspiration from the foundational memory-mapping protocols established by Francine Shapiro and the standardized TICES logging procedures refined by Marilyn Luber. By operationalizing the tracking of somatic and cognitive distress into a manageable format, the worksheet assists practitioners in developing a precise case formulation. This process is foundational for a trauma-informed treatment arc, ensuring that the client possesses the necessary “Dual Awareness” to remain grounded in the present while identifying the historical feeder memories that drive their current symptoms.

How This Worksheet Can Be Used

Baseline Symptom Monitoring:
Therapists use the worksheet during the early stages of treatment to identify the frequency and intensity of a client’s triggers. It serves as a diagnostic map to see which trauma themes (e.g., safety, responsibility, or worth) are most prevalent in the client’s daily life.

Testing Stabilization Efficacy:
This tool is highly effective for auditing Phase 2 resources. By reviewing the “SUD after intervention” column, the clinician can identify which specific coping skills (e.g., mindfulness vs. exercise) are most effective for a client’s unique autonomic system.

Target Identification (Phase 3):
The “Image” and “Cognition” fields provide the “raw data” needed to select targets for processing. The clinician can scan multiple TICES entries to find recurring “Touchstone” images that anchor a larger trauma network.

Benefits of the EMDR TICES Worksheet

• Provides a structured 5-point framework (Trigger, Image, Cognition, Emotion, Sensation) for trauma logging.
• Supports the AIP model by identifying the constituent parts of distressing memory nodes.
• Utilizes 0–10 SUD scales to provide empirical evidence of emotional habituation and regulation.
• Encourages “Resource Usage” by prompting the documentation of specific coping skills.
• Reduces “Recall Bias” by requiring documentation in the client’s natural environment.
• Facilitates a proactive approach to managing hyperarousal and hypoarousal states.

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.