EMDR Therapy San Francisco Bay Area
Eight Phases of Treatment
Elese Lorentzen, LCSW 126095 provides EMDR therapy to those who reside in California. Her office is a 20-minute walk from the Walnut Creek BART station, making it a commuter-friendly location. Free parking is available.
What is EMDR Therapy
EMDR is a comprehensive, evidence-based therapeutic approach that has been thoroughly researched. Studies show EMDR is effective at treating depression, trauma, anxiety, OCD, chronic pain, and addictions. EMDR was found to be more effective in treating PTSD than Prozac in one study. Several organizations endorse EMDR such as the International Society for Traumatic Stress Studies, American Psychiatric Association, US Department of Veterans Affairs, US Department of Defense, and The World Health Organization (WHO).
EMDR addresses dysfunctional memory networks and the way in which the networks affect a client’s experiences (Shaprio, 2018). In session, clients engage in bilateral stimulation while connecting to distressing content in short consecutive periods. Bilateral stimulation (BLS) occurs via auditory activation, hand tapping, or lateral eye movements, and activate both hemispheres of the brain. Research suggests that BLS induces the orienting reflex and taxes working memory (Shapiro, 2018). BLS can result produce better executive functioning, increased relaxation, and reduced physiological and emotional distress.
1) Client History and Treatment Planning
During this phase, the therapist gathers bio-psychosocial information from the client such as the client’s symptoms, goals, and ability to tolerate emotional disturbance that could arise from therapy. Therapist will assess client readiness using a checklist to ensure client’s safety. The therapist and client develop a treatment plan (Shapiro, 2018).
2) Preparation and Stabilization
The therapist explains EMDR protocols and other important information to the client. The client will learn how to engage in bilateral stimulation via eye movements, hand-tapping, and auditory techniques. The therapist guides client through multiple imagery and stress reduction techniques to increase client’s relaxation and stabilization skills. Therapist answers any questions client may have before entering the next phase.
3) Target Assessment
The assessment phase helps establish the baseline response to a specific target. Targets include current triggers, past memories, or future goals. The therapist asks the client to: A) select an image that best represents the memory; B) identify a negative cognition that represents the memory; C) select a positive cognition in which to later replace the negative cognition; D) determine how true the positive cognition is for the client right now on a 7-point VOC scale. [VOC stands for Validity of Cognition, or how true the positive cognition currently feels to the client]; E) share what emotion(s) arise when the client holds the image and the negative cognition in their mind; F) determine the level of disturbance that the image and negative cognition cause the client on a 10-point SUDS scale. [SUD stands for Subjective Units of Disturbance, or how disturbing the negative cognitions currently feel to the client]; G) identify location of physical sensations that are currently associated with the image and negative cognition.
4) Desensitization
With the therapist’s guidance, the client begins conducting sets of visual, auditory, or tactile BLS until the client reports a 0 or ecologically appropriate number on the 10-points SUDS scale.
5) Installation
This phase focuses on strengthening the relationship between the memory and the positive cognition until the client reports a VOC of 7 or an ecologically appropriate number.
6) Body Scan
During phase 6, the client is asked to hold the memory and the positive cognition in their mind. The therapist asks the client to scan their body to identify any remaining sign of disturbance. The client exits this phase once the body scan is clear or an ecologically appropriate response is given.
7) Closure
Towards the end of each session, the therapist will help the client distance themselves from the target and become more oriented to the present. The therapist reminds the client that they may experience dreams or emotional disturbances before their next session, and to utilize the relaxation and stabilization practices that they had practiced during phase 2.
8) Reevaluation
The therapist and client review what has happened since the previous session. Did the client experience any changes to their symptoms or have develop new insights? When the client thinks about the memory from the previous session, what comes up for them now?