Strategies for Making the Most of 55 Minute EMDR Sessions

For many clients, 45-55 minutes is enough of time to reprocess many targets.  For others, you will wish for an additional 20 minutes (which you probably will not have).  The following strategies seem to be effective at making the most of EMDR reprocessing sessions inside a standard clinical hour:

• When starting with a new client, do as much resourcing as you can in the sessions prior to the first reprocessing session. Before starting reprocessing, check in with the resources installed in the prior session to make sure that they are accessible to the client.  It takes very little time to have the client “touch” the resources that have already been installed.  I rarely work to install new resources and start reprocessing with a new client in a single session.
• Encourage timeliness in yourself and your clients. I go out of my way to start my sessions on time.  I let my clients know this.  They know if they arrive on time, they are likely to come straight back to my office within moments of arriving.  If they are early and I’m available, I try to take them back early (when possible).  Those extra few moments help.  They also know that my sessions end on time and that part of my job during reprocessing is to monitor the clock and to make sure that the session ends with as much safety and grounding as possible.
• Work with clients in prior sessions to provide education about reprocessing. Part of this is that we need as much time as possible to reprocess.  In a session that we plan to do reprocessing, I do a quick check-in related to how the client has been doing since last session.  Unless the client reports something that needs to be addressed in language, I’m quick to ask (usually in the first 2-4 minutes): “So, what would you like to work on today?”  They usually respond that they are ready to work on the identified target.
• We spend very little time identifying the target memory, gathering the negative cognition, positive cognition, VOC, emotions, and SUDS.  There are ways to do this quickly that do not feel rushed as you practice it.  If a client struggles with the positive cognition, I will suggest several and the client can pick the one that best fits (protocol allows it to change, anyway).  We usually go from “what would you like to work on today” to “notice that” in less than 3-4 minutes.  So, if my client’s session is scheduled to start at 2:00, she is usually several sets in by 2:08.  This leaves most of an hour for us to really slow down during reprocessing and it leaves plenty of time for closure.  If you consistently start reprocessing 15-25 minutes into a 55 minute session, many of your sessions are likely to end with a SUDS in the 3-5 range (but may be a 0 or 1 if you had started 15 minutes sooner).
• Once reprocessing starts, minimize your talking. Stay out of the client’s way, unless the client requests your assistance, is encountering a block, or reprocessing doesn’t seem to be progressing for some reason.  Otherwise, your communication should be limited to very short phrases directing the client to notice (or an occasional word or two that reassures the client in some way, “Good, notice that.”).  Everything else can probably wait until the end of the session.
• An ounce of prevention will bring buckets of expedited healing. Having a client adequately resourced and adequately informed for the journey will help make the most of reprocessing sessions.  I review the therapist and the client “roles” in EMDR well before we start reprocessing.  Clients who understand the process are more likely to be focused on their core role of noticing what is coming up and are less concerned about expressing verbally or having a communication about what is coming up.