What Are the Eight Phases of Standard EMDR Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) therapy follows a structured eight-phase approach designed to help people work through distressing memories and their effects on thoughts, emotions, physical sensations, and everyday functioning.
The eight phases guide the process from understanding a person's history and preparing for treatment through memory reprocessing, session closure, and evaluating progress.
Although EMDR is often associated with side-to-side eye movements, these movements are only one component of a broader therapeutic approach.
Standard EMDR therapy also includes treatment planning, identifying specific memories, assessing distress, strengthening more helpful beliefs, and reviewing outcomes.
The eight phases do not necessarily take place in a single session. Some may require considerable time, while others may be repeated as treatment progresses.
Understanding how the phases fit together provides a clearer picture of what standard EMDR therapy involves and why its structure matters.
What Is the Standard Eight-Phase EMDR Protocol?
The standard EMDR protocol was developed by psychologist Francine Shapiro. It provides a framework for identifying and processing memories associated with current psychological difficulties.
According to the EMDR International Association (EMDRIA), standard EMDR therapy includes eight phases:
History Taking and Treatment Planning
Preparation
Assessment
Desensitization
Installation
Body Scan
Closure
Reevaluation
Each phase serves a different purpose, but the phases are interconnected rather than eight separate treatments.
The American Psychological Association also describes EMDR as a structured psychotherapy organized around these eight phases.
Phase 1: History Taking and Treatment Planning
The first phase focuses on understanding the person's experiences, current difficulties, and goals for treatment.
In standard therapist-guided EMDR, the clinician gathers relevant information about the person's history and identifies experiences that may be contributing to present symptoms.
This does not necessarily mean discussing every traumatic event in detail. Instead, the goal is to develop an understanding of which memories, situations, or patterns may be important to address.
The therapist also considers the person's strengths, available support, current circumstances, and readiness for memory processing.
How Treatment Targets Are Selected
EMDR treatment planning often considers three areas:
Past experiences: Memories that may contribute to current difficulties.
Present triggers: Situations that activate distressing reactions.
Future situations: Circumstances in which the person wants to respond differently.
For example, someone who experienced a frightening accident might continue feeling distressed while traveling in a vehicle.
Treatment planning could involve identifying the original accident memory, understanding current reactions to traffic, and considering how the person would like to respond during future journeys.
The plan is individualized and may change as new information emerges.
Phase 1 is therefore not simply an administrative introduction. It establishes the foundation for the treatment that follows.
Phase 2: Preparation
Preparation focuses on helping the person understand EMDR and become ready for memory processing.
The therapist explains what treatment involves, how bilateral stimulation is used, and what kinds of reactions may occur during sessions.
Bilateral stimulation refers to alternating stimulation from one side to the other. In EMDR, this commonly involves guided eye movements, alternating sounds, or tapping.
The preparation phase also addresses questions, expectations, and concerns about treatment.
Developing Emotional Regulation Strategies
An important part of preparation is identifying ways to manage distress.
The therapist may introduce grounding, calming, or other stabilization strategies that can be used during or between sessions.
These strategies help the person remain connected to the present while working with emotionally difficult material.
Preparation is not identical for everyone.
Some people may feel ready to begin memory processing relatively quickly. Others may benefit from additional time developing coping strategies or addressing circumstances that affect their readiness.
There is no universal number of preparation sessions required for every person.
The goal is to establish an appropriate foundation for proceeding with the next phases.
Phase 3: Assessment
In the assessment phase, the therapist and client identify a specific memory or experience to address.
This is often called the target memory.
The therapist helps the person identify several elements associated with that memory, including:
An image representing the experience.
A negative belief connected with the memory.
A preferred positive belief.
Emotions associated with the experience.
Physical sensations that arise when recalling it.
For example, a person remembering a frightening event might associate it with the belief, "I am helpless."
A preferred positive belief might be, "I can protect myself now."
These examples are illustrative. The actual beliefs depend on the person's experiences and treatment goals.
Measuring Distress and Beliefs
Standard EMDR uses two subjective rating scales during assessment.
The Subjective Units of Disturbance (SUD) scale measures how distressing the memory feels in the present moment, usually from 0 to 10.
A rating of 0 indicates no disturbance, while 10 represents the highest disturbance the person can imagine.
The Validity of Cognition (VOC) scale measures how true the preferred positive belief feels, usually from 1 to 7.
A rating of 1 means the belief feels completely false, while 7 means it feels completely true.
These ratings establish a starting point for evaluating changes during processing.
They are not the same as standardized diagnostic questionnaires used in clinical research. Instead, they help guide work with a particular target memory.
Phase 4: Desensitization
Desensitization is the phase most commonly associated with EMDR.
During this phase, the person brings the target memory to mind while engaging in bilateral stimulation.
The stimulation may involve following the therapist's fingers with the eyes, listening to alternating sounds, or experiencing alternating taps.
The therapist generally guides the person through sets of stimulation, with brief pauses to notice what arises.
What Happens During Desensitization?
As processing continues, the person may notice changes in thoughts, emotions, images, or physical sensations.
For example, a memory that initially produces intense fear may begin to feel less disturbing.
Other memories or associations may also emerge.
The therapist uses the person's responses to guide subsequent sets of processing.
The aim is not to erase the memory or force a particular emotional response.
Instead, desensitization focuses on reducing the distress associated with the target memory and allowing new associations to develop.
Researchers continue to investigate the mechanisms underlying EMDR, including the possible contribution of eye movements and demands on working memory.
The precise mechanisms are not fully established, even though EMDR has an established evidence base for treating Post-Traumatic Stress Disorder.
How Does the Therapist Know When to Continue?
The therapist periodically checks the person's distress rating and responses.
In the standard protocol, processing commonly continues until disturbance associated with the target memory reaches 0, or approximately 1 when appropriate.
However, a memory does not always reach that level during a single session.
If processing remains incomplete, the therapist can use closure procedures and return to the target in a later session.
Phase 5: Installation
Installation focuses on strengthening a preferred positive belief associated with the target memory.
During assessment, the person identifies a belief they would like to hold about themselves in relation to the experience.
After desensitization, the therapist helps the person connect that belief with the memory.
For example, someone who initially believed, "I was powerless," might come to recognize, "I have choices now."
The specific belief should be meaningful and appropriate to the person's circumstances.
What Is the Purpose of Installation?
Reducing distress is an important treatment goal, but standard EMDR also addresses how the person understands the experience and themselves.
During installation, bilateral stimulation may be used while the person focuses on the memory and preferred positive belief.
The therapist checks how true the belief feels using the Validity of Cognition scale.
The aim is to strengthen the belief until it feels fully credible, where appropriate.
This does not mean convincing someone to adopt an unrealistic statement.
The preferred belief should reflect an adaptive understanding that fits the person's actual situation.
Installation therefore extends the work beyond reducing emotional discomfort alone.
Phase 6: Body Scan
The body scan phase examines whether any residual physical disturbance remains associated with the target memory.
The person is asked to hold the original memory and preferred positive belief in mind while noticing sensations throughout the body.
These might include tension, tightness, discomfort, or other physical responses.
Why Are Physical Sensations Included?
Distressing memories can be associated with bodily reactions as well as thoughts and emotions.
Someone may report that a memory no longer feels particularly upsetting but still notice tension when recalling it.
During the body scan, the therapist checks whether these sensations are present.
If residual disturbance remains, additional processing may be used.
The goal is to identify and address remaining reactions connected with the target.
This does not mean that every physical sensation indicates unresolved trauma. Physical experiences can have many causes, and the body scan is used within the broader clinical context.
The body scan helps ensure that assessment of the target memory includes more than verbal reports of emotional distress.
Phase 7: Closure
Closure is used at the end of an EMDR treatment session.
Its purpose is to help the person shift attention away from memory processing and return to the present.
Importantly, closure occurs whether or not processing of the target memory has been completed.
What Happens if a Memory Is Not Fully Processed?
Not every memory can be completely processed during one appointment.
If the work remains unfinished, the therapist may use grounding, stabilization, or other strategies to help the person regain sufficient emotional stability before the session ends.
The therapist may also explain that thoughts, dreams, emotions, or new associations can arise between sessions.
The person can discuss these experiences during subsequent appointments.
Closure is not a declaration that treatment has been completed.
It is a structured way of ending the current session while recognizing that further work may be needed.
This distinction is important because EMDR's eight phases describe the overall treatment process, not a requirement to complete every phase in every appointment.
Phase 8: Reevaluation
Reevaluation takes place when treatment resumes after previous memory processing.
The therapist and client review how the person has responded since the last session.
They may discuss changes in distress, current symptoms, reactions to everyday situations, and the person's experience of previously processed memories.
Why Is Reevaluation Important?
A memory may feel less disturbing immediately after processing, but researchers and clinicians also want to know whether that change continues.
Reevaluation helps determine whether the target remains less distressing and whether the preferred positive belief still feels appropriate.
If disturbance remains or returns, additional processing may be considered.
If the target has been adequately addressed, treatment may move toward another memory, present-day trigger, or future situation.
Reevaluation also allows the treatment plan to be adjusted as needed.
This makes EMDR an ongoing process of assessment and review rather than a fixed sequence that must always proceed without interruption.
Do All Eight EMDR Phases Happen in One Session?
No. The eight phases describe the structure of standard EMDR treatment, not eight steps that must all be completed during one appointment.
History taking and preparation may take multiple sessions. Processing a particular memory may also require more than one session.
Closure occurs at the end of sessions involving reprocessing, while reevaluation helps guide subsequent work.
The time spent in each phase varies according to the person, treatment goals, and circumstances.
The EMDR International Association's explanation of the eight phases emphasizes that the phases guide treatment across sessions rather than functioning as a rigid schedule.
This flexibility is important because people differ in their histories, emotional responses, available resources, and treatment needs.
How Do the Eight Phases Relate to EMDR Research?
Clinical research on EMDR commonly evaluates structured treatment approaches based on the standard protocol.
The eight phases help define what EMDR treatment involves, including preparation, target selection, bilateral stimulation, and review of outcomes.
However, studies may differ in the number of sessions provided, the population being treated, and the specific adaptations used.
Researchers also use standardized assessments to measure treatment outcomes.
These may include clinician-administered PTSD interviews and self-report symptom questionnaires administered before treatment, afterward, and at follow-up.
Such measures serve a different purpose from the distress and belief ratings used during individual EMDR sessions.
The session ratings help guide processing of a particular memory, while research assessments evaluate broader symptom changes.
The strongest clinical research supporting EMDR concerns PTSD, although EMDR has also been studied for other psychological difficulties.
For a broader examination of clinical findings, see What Does the Research Say About EMDR Therapy?.
Is the Eight-Phase Structure the Same in Every EMDR Approach?
The eight phases provide the foundation of standard EMDR therapy, but the way they are implemented can vary.
Therapists may adjust pacing, preparation, and treatment planning according to individual circumstances.
Some specialized EMDR protocols modify elements of the standard approach for particular populations or treatment settings.
Online and self-guided EMDR programs may also organize exercises differently from therapist-guided treatment.
These differences matter when interpreting research.
Evidence from a clinical trial using a particular EMDR protocol should not automatically be assumed to establish the effectiveness of every other delivery method.
At the same time, differences in delivery do not by themselves determine whether an approach is helpful.
Each method should be evaluated according to its own design, research findings, and limitations.
Frequently Asked Questions
1. What are the eight phases of standard EMDR therapy?
The eight phases are history taking and treatment planning, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation. Together, they provide a structured framework for treatment.
2. Which phase involves eye movements?
Eye movements are most closely associated with Phase 4, desensitization. Bilateral stimulation may also be used during installation and the body scan. Alternating sounds or tapping can be used instead of eye movements.
3. Does every EMDR session include all eight phases?
No. The phases describe the overall treatment process. Some occur over multiple sessions, and processing of a particular memory may continue across appointments.
4. What is the difference between desensitization and installation?
Desensitization focuses on reducing distress associated with a target memory. Installation focuses on strengthening a preferred positive belief connected with that memory.
5. What happens if EMDR processing is incomplete at the end of a session?
The therapist uses closure procedures to help the person return to the present and regain emotional stability. Processing may continue during a later session.
Conclusion
The eight phases of standard EMDR therapy provide a structured approach to working with distressing memories and their psychological effects.
History taking and preparation establish the foundation for treatment. Assessment identifies the memory and associated responses.
Desensitization, installation, and the body scan address distress, beliefs, and physical sensations. Closure and reevaluation support the transition between sessions and guide further treatment.
These phases are interconnected, and the amount of time spent in each varies.
Understanding the eight-phase structure helps readers recognize that standard EMDR is more than eye movements alone. It is a comprehensive treatment process involving planning, preparation, memory processing, and ongoing evaluation.
