EMDR EMDR Special Populations & Adaptations 2 — Questions and Answers
Question 1: When using EMDR with older adults, therapists should consider which age-related factor that may affect treatment?
- Older adults cannot benefit from EMDR due to neurological rigidity
- Sensory limitations (vision, hearing) may require bilateral stimulation method adjustments (Correct answer)
- The EMDR protocol should be condensed to fewer phases for older adults
- Older adults require higher SUD scores to begin reprocessing
Correct answer: Sensory limitations (vision, hearing) may require bilateral stimulation method adjustments
Sensory limitations common in older adults, such as reduced vision or hearing, may necessitate switching from eye movements to tactile or auditory bilateral stimulation.
Question 2: How should EMDR therapists approach treatment with clients who have chronic pain conditions?
- Chronic pain is a contraindication for EMDR due to somatic hyperactivation risk
- Trauma memories linked to pain onset or injury can be targeted, and the body scan phase may reveal pain-trauma connections (Correct answer)
- The body scan phase should be eliminated to avoid activating pain sensations
- EMDR should only address the psychological components and avoid any focus on bodily sensations
Correct answer: Trauma memories linked to pain onset or injury can be targeted, and the body scan phase may reveal pain-trauma connections
EMDR can target trauma memories related to pain onset, accidents, or medical events, and the body scan phase is particularly useful for identifying how pain and trauma intersect somatically.
Question 3: What is the recommended adaptation for EMDR when working with clients who have significant substance use histories?
- EMDR is contraindicated for clients with any substance use history
- Establish stable sobriety and develop robust coping resources before beginning trauma reprocessing (Correct answer)
- Begin trauma reprocessing immediately as EMDR will eliminate the underlying trauma driving substance use
- Use only cognitive interweaves and omit bilateral stimulation to avoid emotional dysregulation
Correct answer: Establish stable sobriety and develop robust coping resources before beginning trauma reprocessing
Stable sobriety and adequate coping resources are needed before trauma reprocessing, as premature processing can trigger relapse by overwhelming clients who lack sober coping strategies.
Question 4: When providing EMDR via telehealth, which adaptation is most critical for maintaining treatment fidelity?
- Switching exclusively to cognitive processing and eliminating all bilateral stimulation
- Using therapist-directed tapping instructions or bilateral audio tracks as alternatives to eye movements (Correct answer)
- Telehealth EMDR is not considered evidence-based and should be avoided
- Reducing session length to 30 minutes to account for screen fatigue
Correct answer: Using therapist-directed tapping instructions or bilateral audio tracks as alternatives to eye movements
Telehealth EMDR adaptations include teaching self-tapping or using bilateral audio resources, with research supporting these as effective alternatives to in-person eye movement sets.
Question 5: For EMDR with clients who have experienced sexual assault, which therapeutic consideration is especially important during Phase 2?
- Detailed disclosure of assault is required before proceeding to Phase 3
- Establishing a strong sense of control, safety, and consent within the therapeutic relationship (Correct answer)
- Using only tapping to avoid any association between eye movements and the assault
- Completing the full 8-phase protocol within 8 sessions for optimal recovery
Correct answer: Establishing a strong sense of control, safety, and consent within the therapeutic relationship
Sexual assault survivors require special attention to establishing safety, control, and a consent-based therapeutic relationship in the preparation phase before any trauma processing occurs.
Question 6: How is EMDR adapted for use with clients who have borderline personality disorder (BPD)?
- EMDR is absolutely contraindicated for BPD due to emotional dysregulation risk
- An extended preparation phase with substantial emotion regulation skill-building is prioritized before trauma processing (Correct answer)
- The standard 8-phase protocol is applied without modification as BPD does not affect EMDR delivery
- Trauma processing should be conducted in condensed intensive formats to minimize emotional dysregulation between sessions
Correct answer: An extended preparation phase with substantial emotion regulation skill-building is prioritized before trauma processing
Clients with BPD require an extended preparation phase focused on emotion regulation skills and stabilization resources before trauma reprocessing to manage intense affect and prevent destabilization.
EMDR EMDR Special Populations & Adaptations 2
When using EMDR with older adults, therapists should consider which age-related factor that may affect treatment?