EMDR Assessment & Treatment Planning 2 — Questions and Answers
Question 1: Which instrument is most commonly used to assess PTSD symptom severity before initiating EMDR treatment?
- Beck Depression Inventory (BDI)
- PTSD Checklist for DSM-5 (PCL-5) (Correct answer)
- Hamilton Anxiety Rating Scale (HAM-A)
- Dissociative Experiences Scale (DES)
Correct answer: PTSD Checklist for DSM-5 (PCL-5)
The PCL-5 is a widely validated 20-item self-report measure aligned with DSM-5 PTSD criteria used to gauge symptom severity before and during EMDR treatment.
Question 2: When a client presents with complex trauma and multiple traumatic memories, what is the recommended sequencing approach in EMDR treatment planning?
- Address the most recent trauma first
- Process memories in chronological order from earliest to latest
- Target the touchstone memory or earliest representative memory first (Correct answer)
- Begin with the least disturbing memory to build confidence
Correct answer: Target the touchstone memory or earliest representative memory first
Standard EMDR protocol recommends identifying and processing the touchstone event—the earliest or most representative memory linked to the current presenting problem—to address root-level learning.
Question 3: A clinician is assessing a potential EMDR client who reports hearing voices and has a history of psychosis. What is the most appropriate next step?
- Proceed immediately with EMDR to reduce trauma driving the psychosis
- Rule out active psychosis and stabilize before considering EMDR (Correct answer)
- Skip the history-taking phase and move directly to resource installation
- Administer the DES and proceed if dissociation is below clinical threshold
Correct answer: Rule out active psychosis and stabilize before considering EMDR
Active psychosis is a contraindication for standard EMDR; the clinician must ensure psychiatric stability before beginning trauma processing.
Question 4: In EMDR treatment planning, what does the term 'float-back technique' help clinicians identify?
- The degree of bilateral stimulation needed for processing
- Earlier memories linked to a current negative cognition or body sensation (Correct answer)
- The client's window of tolerance boundaries
- The appropriate length of each EMDR session
Correct answer: Earlier memories linked to a current negative cognition or body sensation
The float-back (or affect bridge) technique guides clients from a current disturbing emotion or body sensation back to earlier memories that share the same template, aiding case conceptualization.
Question 5: Which of the following best describes 'informed consent' in the context of EMDR treatment planning?
- Explaining only the bilateral stimulation component to avoid alarming clients
- Providing a full explanation of EMDR procedures, risks, benefits, and alternatives (Correct answer)
- Obtaining written consent only if the client is a minor
- Describing the treatment after the first processing session
Correct answer: Providing a full explanation of EMDR procedures, risks, benefits, and alternatives
Ethical practice requires that clients receive comprehensive information about EMDR—its procedures, potential risks (e.g., abreaction), benefits, and alternatives—before treatment begins.
Question 6: A client scores 37 on the PCL-5 during intake. What does this score indicate regarding treatment planning?
- The client is below the clinical threshold and does not require EMDR
- The score indicates a provisional PTSD diagnosis, warranting trauma-focused treatment (Correct answer)
- The client requires hospitalization before outpatient EMDR can begin
- The score is too high to safely use bilateral stimulation
Correct answer: The score indicates a provisional PTSD diagnosis, warranting trauma-focused treatment
A PCL-5 score of 33 or above is considered the provisional cut-point for PTSD, indicating significant symptomatology that supports the need for trauma-focused intervention like EMDR.
Question 7: What is the primary purpose of conducting a thorough history-taking phase (Phase 1) before EMDR processing?
- To teach the client relaxation techniques before trauma exposure
- To identify target memories, current triggers, and future adaptive behaviors for the treatment plan (Correct answer)
- To administer bilateral stimulation and assess client response
- To develop the negative cognition that will be used in Phase 3
Correct answer: To identify target memories, current triggers, and future adaptive behaviors for the treatment plan
Phase 1 history-taking maps past traumatic events, present triggers, and desired future states, forming the three-pronged framework that guides the entire EMDR treatment plan.
EMDR Assessment & Treatment Planning 2
Which instrument is most commonly used to assess PTSD symptom severity before initiating EMDR treatment?