Assessment

The therapist and client identify a specific memory or experience to process and gather key information about how that memory is currently stored.

The client identifies:
1. The event or image being processed.
2. A distressing belief connected to the memory.
3. A healthier belief the client would like to develop. 
4. The client identifies: current emotional distress, physical sensations connected to the memory.

Desensitization

This is the phase most people associate with EMDR.

The client focuses briefly on the distressing memory while engaging in bilateral stimulation, such as: guided eye movements, alternating tapping, alternating sounds.

Importantly, the goal is not to erase the memory, but to help the brain store it in a less disturbing way.

Installation

Once distress related to the memory decreases, the therapist strengthens the client's preferred positive belief.

Bilateral stimulation may continue while the positive belief is reinforced.

The goal is to increase feelings of confidence, safety, and self-worth.

Body Scan

The client is asked to notice any remaining physical sensations connected to the memory.  The therapist helps process any lingering tension, discomfort, or emotional activation until the body feels calm and neutral.

The goal is to clear remaining physiological distress associated with the memory.

Closure and Reevaluation

The therapist ensures the client returns to a regulated emotional state before ending the session.  This may involve: grounding exercises, breathing techniques, relaxation strategies, and reviewing coping skills.

The therapist also prepares the client for possible continued processing between sessions.

At the beginning of the next session, the therapist assesses: changes in distress levels, new insights or memories that emerged, remaining symptoms, whether additional processing is needed.

Clinical and cost‐effectiveness of eye movement desensitization and reprocessing for treatment and prevention of post‐traumatic stress disorder in adults: A systematic review and meta‐analysis

A Clinician's Guide to the Efficacy of EMDR Therapy