Clinical Application & Case Management Flashcards

A client with complex PTSD has difficulty tolerating the distress involved in EMDR reprocessing. Which modification is most appropriate?

Answer: Extend the preparation phase and strengthen affect regulation skills before processing

Clients with complex PTSD often require extended preparation, including robust affect regulation and stabilization skills, before trauma reprocessing begins.

During the installation phase, the client's Validity of Cognition (VOC) remains at 5 despite multiple sets of BLS. What should the clinician do?

Answer: Check for blocking beliefs or ecological validity concerns that may be limiting the VOC

A VOC that does not reach 6-7 may indicate a blocking belief or an ecologically invalid positive cognition that needs to be addressed.

A veteran client reports flashbacks occurring daily despite completing several EMDR sessions. The most likely explanation is:

Answer: Insufficient number of trauma targets have been identified and processed

Ongoing symptoms after some sessions often indicate that additional trauma targets, touchstone memories, or earlier contributing events still need reprocessing.

Which client presentation would most warrant postponing EMDR reprocessing and returning to stabilization work?

Answer: A client who is currently experiencing a domestic violence situation with ongoing threat

Active ongoing threat is a contraindication for trauma reprocessing; safety must be established before processing past trauma.

A client's SUD rises from 4 to 7 mid-session after new traumatic material emerges. The best response is to:

Answer: Continue BLS and allow the new material to process within the same session

Increased distress when new material emerges is a normal part of processing; continuing BLS allows associated memories to be reprocessed.

In EMDR case conceptualization, which element forms the foundation of the three-pronged protocol?

Answer: Past events, current triggers, and future templates

The three-pronged protocol addresses past events that underlie the problem, present triggers that activate it, and future templates for adaptive behavior.

A dissociative client unexpectedly switches to an alter personality mid-EMDR session. The clinician should first:

Answer: Calmly orient the system, ensure safety, and stop reprocessing for the session

When dissociation occurs during reprocessing, the priority is to stabilize and orient the client system before any further processing.