EMDR Target Sequence Plan (Clinician)

About this resource

EMDR treatment planning rests on the Adaptive Information Processing model: current symptoms are understood as the product of unprocessed memories, and treatment targets those memories in a deliberate order. Shapiro's standard three-pronged protocol structures this as past, present and future. Past targets are the experiences that laid down the dysfunctional material, typically organised around a negative cognition (for example 'I am not safe', 'I am worthless') and often traced to a touchstone memory, the earliest experience that carries the belief. Present targets are the current situations that trigger distress. Future targets are templates for handling anticipated situations adaptively once the past and present material has been processed.

Selecting and sequencing targets is where much of the clinical skill in EMDR lies. Processing the touchstone memory first often generalises to later memories in the same cluster; conversely, starting with a recent, manageable target can build confidence in clients who need early evidence that processing is tolerable. Techniques such as the float-back and affect bridge identify earlier memories linked to a present trigger by shared belief or feeling. Sequencing must also take account of readiness: stabilisation skills, current risk, dissociation, and the client's capacity to remain dually aware during processing.

This template gives the clinician a working document for the plan: presenting problems and the negative cognitions behind them, memory clusters and touchstones, present triggers, future templates, readiness indicators and the agreed processing order with room for revision. It follows the structure taught in standard EMDR training and in Leeds's guide to the protocols, and is intended to be updated at each re-evaluation phase. The professional version notes when a symptom-focused or recent-event approach is preferable to a chronological one, and cautions against overloading the plan with targets that may resolve through generalisation.

How to use it

1. Complete the first draft during phase 1 (history taking), usually across one to three sessions. Begin with the presenting problems and the negative cognitions the client endorses, then work backwards to the memories that carry each belief.
2. Group memories into clusters by theme or negative cognition. For each cluster, identify the touchstone (earliest or most formative) and the worst or most representative memory. Use float-back from a current trigger when the client cannot readily identify origins.
3. List present triggers concretely: situations, people, sensations or reminders that currently produce distress. Note which cluster each appears to belong to.
4. Assess readiness before scheduling phase 4. Confirm stabilisation skills are in place and have been tested, review current risk and dissociation, and confirm the client understands the process and consents. Record the outcome.
5. Agree the processing order with the client. The default is past (touchstone first, then other cluster members), then present triggers that remain active, then future templates. Deviate deliberately and record why, for example beginning with a recent, contained event.
6. Revise the plan at each phase 8 re-evaluation: note which targets are resolved (distress 0 or ecologically valid, positive cognition 7, clear body scan), which generalised, and what remains.

References

• Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.
• Leeds, A. M. (2016). A Guide to the Standard EMDR Therapy Protocols for Clinicians, Supervisors, and Consultants (2nd ed.). Springer.
• de Jongh, A., ten Broeke, E., & Meijer, S. (2010). Two method approach: A case conceptualization model in the context of EMDR. Journal of EMDR Practice and Research, 4(1), 12-21.