EMDR Assessment & Treatment Planning 3 — Questions and Answers
Question 1: When assessing dissociation prior to EMDR, a score of 30% or higher on the DES-II is significant because it suggests:
- The client is malingering trauma symptoms
- Possible pathological dissociation requiring modified or adjunctive treatment (Correct answer)
- The client is an ideal candidate for intensive EMDR processing immediately
- Dissociation at this level has no bearing on EMDR treatment planning
Correct answer: Possible pathological dissociation requiring modified or adjunctive treatment
A DES-II score ≥30% indicates elevated dissociation that may signal a dissociative disorder, warranting careful evaluation and possible modification of standard EMDR protocol.
Question 2: In the EMDR Adaptive Information Processing (AIP) model, maladaptively stored memories are characterized by:
- Complete absence of any emotional content
- Sensory, emotional, and cognitive material frozen in their original disturbing form (Correct answer)
- Highly integrated neural networks accessible during calm states
- Memories that have already resolved their associated distress naturally
Correct answer: Sensory, emotional, and cognitive material frozen in their original disturbing form
The AIP model posits that traumatic memories remain stored with their original disturbing perceptions, emotions, cognitions, and body sensations because normal processing was disrupted.
Question 3: A client wants to use EMDR to address a phobia of flying. Which target sequence is most appropriate for treatment planning?
- Target only future-anticipatory anxiety about flying
- Process past experiences that seeded the phobia, current triggers, and future coping scenarios (Correct answer)
- Begin with imaginal exposure to flying without any memory processing
- Focus exclusively on the most recent distressing flight experience
Correct answer: Process past experiences that seeded the phobia, current triggers, and future coping scenarios
The standard EMDR three-pronged approach addresses the past events that established the phobia, present triggers, and future scenarios to ensure comprehensive resolution.
Question 4: Which factor would most likely lead an EMDR clinician to extend Phase 2 (Preparation) before beginning trauma processing?
- Client has a strong dual awareness and stable support system
- Client lacks affect regulation skills and becomes easily overwhelmed (Correct answer)
- Client reports a single-incident trauma with no prior mental health history
- Client has completed prior trauma-focused CBT without benefit
Correct answer: Client lacks affect regulation skills and becomes easily overwhelmed
Clients who lack the ability to tolerate distress and regulate emotions require extended preparation to build stabilization skills before trauma memories can be safely processed.
Question 5: The EMDR Dissociative Table Technique is best described as a tool used during:
- Phase 3 to establish the negative cognition
- Phase 2 preparation to safely work with dissociative parts (Correct answer)
- Phase 5 to install the positive cognition
- Phase 8 to evaluate long-term treatment outcomes
Correct answer: Phase 2 preparation to safely work with dissociative parts
The Dissociative Table Technique is a preparation-phase resource used to help clients with dissociative presentations safely meet and communicate with internal parts before processing begins.
Question 6: A clinician is treating a combat veteran with PTSD and notes comorbid major depressive disorder. How does this comorbidity affect EMDR treatment planning?
- Depression is unrelated to trauma and should be treated entirely separately
- Depression may reflect unprocessed trauma and can improve as EMDR targets underlying traumatic memories (Correct answer)
- EMDR is contraindicated in the presence of any depressive disorder
- The clinician should address all depressive symptoms with medication before beginning EMDR
Correct answer: Depression may reflect unprocessed trauma and can improve as EMDR targets underlying traumatic memories
Research supports that depression comorbid with PTSD often stems from unprocessed traumatic experiences, and EMDR targeting those memories can lead to concurrent improvement in depressive symptoms.
Question 7: What does the 'future template' component of EMDR treatment planning address?
- A client's past adaptive experiences that serve as resources
- Anticipated future situations where adaptive responding is needed after trauma processing (Correct answer)
- The therapist's plan for the next session's targets
- A memory of a future-oriented worry that is reprocessed like a past event
Correct answer: Anticipated future situations where adaptive responding is needed after trauma processing
The future template is Phase 3 of the three-pronged approach, targeting anticipated future situations to consolidate adaptive responses and rehearse healthy behavior after past and present targets are resolved.
EMDR Assessment & Treatment Planning 3
When assessing dissociation prior to EMDR, a score of 30% or higher on the DES-II is significant because it suggests: